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PITTSBURGH — Does hitting a bong lead to picking up the bottle? Researchers from the University of Pittsburgh report U.S. states that recently legalized recreational cannabis experienced a slight yet notable increase in alcohol use. Importantly, study authors add this pattern was largely driven by young adults and men.
In light of these findings, the research team believes states that legalize recreational marijuana moving forward should invest in targeted public health messaging espousing the dangers associated with alcohol, as well as additional policy interventions aimed at mitigating 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,” says senior study author Coleman Drake, Ph.D., assistant professor in the Department of Health Policy and Management at Pitt Public Health, in a university release. “It appears that cannabis use increases the probability that people drink, at least in the three years after legalization.”
Who is drinking more in states where cannabis is legal?
This project used data on alcohol usage pertaining to over 4.2 million adults originally collected by the Centers for Disease Control and Prevention’s annual Behavioral Risk Factor Surveillance System surveys administered between 2010 and 2019. During that time period, a total of 11 states legalized recreational cannabis.
The surveys asked respondents about their typical alcohol habits, as well as any binge drinking or heavy drinking within the last month. Study authors placed particular focus on response differences before and after local recreational cannabis legalization.
Any drinking, defined as consuming “at least one drink of any alcoholic beverage” over the prior month, increased by 1.2 percentage points over the first year following recreational cannabis legalization, but actually dropped during the next two years. The team did not note any changes in either binge or heavy drinking across the overall population.
When the research team analyzed all that data, they discovered these alcohol consumption increases center around adults between ages 18 and 24. This cohort displayed a 3.7 percentage point increase in drinking. Meanwhile, no other age groups showed a statistically significant increase in any level of drinking after marijuana became legal locally.
Demographically, this increase displayed a strong link to men, non-Hispanic whites, and people without any college education.
Marijuana use has skyrocketed in recent years
So, while recreational cannabis legalization had a link to a minor jump up in alcohol use, researchers note they did not find any evidence of a sustained effect on binge or heavy drinking. However, Prof. Drake does add that cannabis use in general has roughly doubled over the past decade. Additionally, a prior study estimates that excessive alcohol use resulted in the death of over 93,000 Americans annually between 2011 and 2015.
“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,” Drake explains.
By focusing specifically on groups that are more likely to engage in increased risky behaviors, like drinking more alcohol while using cannabis, U.S. states can take a proactive approach to mitigating potential health risks. Examples of actions states can take prior to recreational cannabis laws going into effect include public health campaigns or alcohol tax strategies, Prof. Drake says.
“In prior work, I found that recreational cannabis laws temporarily reduced opioid-related emergency department visits,” Prof. Drake concludes. “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.”
The study is published in JAMA.
