Among 1,108 college students, those who simultaneously used nonmedical prescription stimulants with alcohol or marijuana showed the heaviest drinking, most marijuana use, most consequences, and used marijuana to alter the effects of other substances.
College health professionals, campus prevention coordinators, substance use counselors
51% of recent prescription stimulant users combined them with alcohol simultaneously
What the researchers found
32.8% reported lifetime nonmedical prescription stimulant use; 12.5% used in the past 3 months. Of recent users, 51.1% simultaneously combined stimulants with alcohol and 40.2% with marijuana. The simultaneous use group had the heaviest drinking and marijuana use, the most consequences, and specifically used marijuana to alter effects of other substances.
Why it matters
Simultaneous use of multiple substances creates compounded health risks. Identifying that simultaneous prescription stimulant-cannabis-alcohol users represent a distinct high-risk group enables more targeted campus prevention.
The numbers in context
1,108 students from 3 universities; 32.8% lifetime NPS use; 12.5% past-3-month use; 51.1% of recent users combined with alcohol; 40.2% combined with marijuana; simultaneous users had heaviest substance use and most consequences
How the study worked
Cross-sectional survey of 1,108 college students from three universities who reported past-year marijuana and alcohol use. Compared three groups: no nonmedical prescription stimulant history, nonmedical use without simultaneous combination, and simultaneous use with alcohol and/or marijuana.
What this study cannot tell us
Cross-sectional survey cannot determine causal ordering. Three universities may not represent all campuses. Self-reported data. Only students reporting past-year alcohol and marijuana use were included, excluding abstainers.
How to read the evidence
Multi-site cross-sectional survey with adequate sample size, though limited by self-report and cross-sectional design.
When this study was published
Published in 2021.
The bigger picture
The finding that marijuana was used specifically to alter the effects of other substances suggests intentional polydrug management among college students, a pattern that existing single-substance prevention programs may not adequately address.
Questions still open
- Are students using marijuana to "come down" from stimulant effects or to enhance them? Would polydrug-specific prevention messaging be more effective than single-substance approaches?
Common questions
How common is mixing prescription stimulants with cannabis?
Why do students combine these substances?
Read the original research
Patterns, Consequences, and Motives in Simultaneous Use of Prescription Stimulant Medication with Alcohol and Marijuana.
Substance use & misuse, 56(13), 1972-1981
Citation
Fossos-Wong, Nicole; Kilmer, Jason R; W Sokolovsky, Alexander; Lee, Ha-Yoon; Jackson, Kristina M; White, Helene R. (2021). Patterns, Consequences, and Motives in Simultaneous Use of Prescription Stimulant Medication with Alcohol and Marijuana.. Substance use & misuse, 56(13), 1972-1981. https://doi.org/10.1080/10826084.2021.1963983
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