A Surprising Consequence of Cannabis Legalization: Higher Alcohol Consumption

Alcohol Drinking with Friends Celebration Concept

Cannabis and alcohol are psychoactive substances that can have short and long-term effects on the body and mind. Cannabis, also known as marijuana, is usually smoked or vaporized and can produce a range of effects, including relaxation and altered perception. Alcohol is commonly consumed in beverages and can produce effects such as relaxation and impaired judgment. Both cannabis and alcohol can have negative effects when consumed in excess, including increased risk of accidents and injuries, impaired memory and cognitive function, and addiction.

According to new research from the University of Pittsburgh School of Public Health, states that have legalized recreational cannabis have seen a slight increase in alcohol consumption, particularly among young adults and men.

This increase in alcohol use, which was recently reported in JAMA Health Forum, suggests that states considering recreational cannabis legalization should also consider targeted public health messaging and policy interventions to mitigate problem drinking.

“Recreational cannabis laws have made cannabis legally accessible to nearly half of U.S. adults, but it has been unclear how this affects the use of other substances, such as alcohol,” said senior author Coleman Drake, Ph.D., assistant professor in the Department of Health Policy and Management at Pitt Public Health. “It appears that cannabis use increases the probability that people drink, at least in the three years after legalization.”

Drake and his team obtained data on alcohol use by more than 4.2 million adults through the Centers for Disease Control and Prevention’s annual Behavioral Risk Factor Surveillance System surveys administered from 2010 through 2019 – at which point 11 states had legalized recreational cannabis.

The survey inquired about any alcohol use, binge drinking, and heavy drinking within the last month, and the researchers looked at differences in responses before and after recreational cannabis legalization.

Any drinking – measured as having “at least one drink of any alcoholic beverage” in the past month – increased by 1.2 percentage points in the first year after recreational cannabis was legalized, but diminished in the following two years. There was no change in binge or heavy drinking in the overall population.

When the team dove into the data, they found that the increase was driven by adults ages 18 to 24 who had a 3.7 percentage point increase in any drinking. None of the other age groups had a statistically significant increase in any drinking after cannabis legalization.

Demographically, the increase was also associated with men, non-Hispanic whites, and people without some college education.

While recreational cannabis legalization was linked to a small increase in alcohol consumption, the team did not find any evidence of sustained effects on binge or heavy drinking. However, Drake noted that cannabis use has nearly doubled over the past decade, and a prior study estimated that, between 2011 and 2015, excessive alcohol use resulted in the death of over 93,000 Americans per year.

“So, it will be important to monitor whether recreational cannabis laws cause increases in drinking over longer periods of time, particularly among younger adults and men,” he said.

By zeroing in on the groups of people who may be most likely to increase risky behaviors, such as drinking more while using cannabis, states can proactively engage those communities and look for ways to mitigate risk – such as through public health campaigns or alcohol tax strategies – before recreational cannabis laws go into effect, Drake explained.

“In prior work, I found that recreational cannabis laws temporarily reduced opioid-related emergency department visits,” Drake said. “So, I would resist characterizations of cannabis legalization as categorically good or bad. We need to learn more about how cannabis legalization affects all substance use, health, and non-health outcomes, such as drug-related arrest rates, work-related injuries, and labor market outcomes. Policymakers should try to think through all these costs and benefits as they consider passing recreational cannabis laws.”

Reference: “Association of Recreational Cannabis Legalization With Alcohol Use Among Adults in the US, 2010 to 2019” by Vandana Macha, Rahi Abouk, Ph.D. and Coleman Drake, Ph.D., 18 November 2022, JAMA Health Forum.
DOI: 10.1001/jamahealthforum.2022.4069

The study was funded by the National Institute on Drug Abuse.

2 Comments on "A Surprising Consequence of Cannabis Legalization: Higher Alcohol Consumption"

  1. Cannabis consumers deserve and demand equal rights and protections under our laws that are currently afforded to the drinkers of far more dangerous and deadly, yet perfectly legal, widely accepted, endlessly advertised and even glorified as an All-American pastime, alcohol.

    Plain and simple!

    Legalize Nationwide Federally Now!

    Prohibitionists always use terms like “INVOLVED” , “RELATED” or “LINKED” when they tout these negative sounding statistics and claims. Because they can’t ever prove cannabis consumption directly and alone to be the actual “CAUSE” of anything seriously detrimental.

    Fear of Cannabis Legalization Nationwide is unfounded. Not based on any science or fact whatsoever. So please prohibitionists, we beg you to give your scare tactics, “Conspiracy Theories” and “Doomsday Scenarios” over the inevitable Legalization of Cannabis Nationwide a rest. Nobody is buying them anymore these days. Okay?

    Furthermore, if all prohibitionists get when they look into that nice, big and shiny crystal ball of theirs, while wondering about the future of cannabis legalization, is horror, doom, and despair, well then I suggest they return that thing as quickly as possible and reclaim the money they shelled out for it, since it’s obviously defective.

    There is absolutely no doubt now that the majority of Americans want to completely legalize cannabis nationwide. Our numbers grow on a daily basis.

    The prohibitionist view on cannabis is the viewpoint of a minority and rapidly shrinking percentage of Americans. It is based upon decades of lies and propaganda.

    Each and every tired old lie they have propagated has been thoroughly proven false by both science and society.

    Their tired old rhetoric no longer holds any validity. The vast majority of Americans have seen through the sham of cannabis prohibition in this day and age. The number of prohibitionists left shrinks on a daily basis.

    With their credibility shattered, and their not so hidden agendas visible to a much wiser public, what’s left for a cannabis prohibitionist to do?

    Maybe, just come to terms with the fact that Cannabis Legalization Nationwide is an inevitable reality that’s approaching much sooner than prohibitionists think, and there is nothing they can do to stop it!

    Legalize Nationwide!…and Support All Cannabis Legalization Efforts!

  2. A couple of shots of spirits or a couple of cans of beer is fun, anything more than that can take a toll on me, I think adding THC to them and lower the alcohol content would be awesome.

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