Study links legal adult-use cannabis to increased alcohol consumption

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A new study co-authored by a William Paterson University (WPU) professor found that states in the U.S. that have legalized recreational cannabis saw a slight uptick in alcohol consumption, particularly among young adults.

Published Nov. 18 in the Journal of the American Medical Association, the study was conducted by WPU economic professor Rahi Abouk, University of Pittsburgh School of Public Health professor Coleman Drake and University of Pittsburgh economic professor Vandana Macha.

Specifically, they examined the relationship between recreational cannabis laws and alcohol use by more than 4.2 million Americans in states that have decriminalized adult-use cannabis.

As part of their research, the team reviewed data provided through the U.S. Centers for Disease Control and Prevention’s (CDC) national behavioral risk survey, an annual questionnaire that gathers information on alcohol use, binge drinking and heavy drinking.

Between 2010 and 2019, alcohol use jumped 6% for young adults ages 18 to 24 in 10 states (Colorado, Washington, Alaska, Oregon, California, Maine, Massachusetts, Nevada, Vermont and Michigan), as well as the District of Columbia. For the adult population, overall, the increase was lower, at 1.5% and mainly driven by the aforementioned younger demographic, according to the research.

Although recreational cannabis legalization was linked to a small increase in alcohol consumption, researchers did not find any evidence of sustained effects on binge or heavy drinking.

“Cannabis use also poses its own health risks, yet its legalization has been associated with decreases in opioid prescribing, temporary reductions in opioid-related emergency department visits, and does not appear to increase the use of other substances,” the authors wrote.

They noted that future studies would be needed to continue “to examine the relationship between alcohol and cannabis use, both over longer periods of time and in terms of other health outcomes.”

And, as more states consider legalizing recreational cannabis, Abouk, who serves as director of WPU’s Cannabis Research Institute, believes policy makers should “consider the unintended consequences” of adult-use cannabis.

“Cannabis legalization may come with a series of direct costs, such as costs due to the treatment of cannabis use disorders, and our study suggests that indirect costs – associated with an increase in alcohol use, for one – should probably be added to this analysis when policy makers decide about cannabis legalization,” Abouk said.

As of August 2022, 38 states had implemented medical cannabis laws, 19 of which also legalized recreational cannabis for adult use. It is also legal in the District of Columbia.

Altogether, the laws have made cannabis accessible to approximately half of adults in the U.S. and resulted in a 25% increase in cannabis use, the study said.