Using Cannabis and Alcohol Together Was Linked to Depression in Both Male and Female College Students
Monthly simultaneous cannabis and alcohol use predicted depression in both male and female college students, with possible sex differences for anxiety and stress that need larger studies to confirm.
Quick Facts
What This Study Found
Among 367 college students, monthly simultaneous cannabis and alcohol (SCA) use significantly predicted depression in both males (beta=0.322) and females (beta=0.296). SCA use also predicted anxiety (beta=0.323) and stress (beta=0.369) among males but not females, though these sex differences were not statistically significant. The depression finding held after controlling for age, most recent cannabis use, and typical alcohol frequency.
Key Numbers
367 college students; monthly SCA predicted depression in males (beta=0.322) and females (beta=0.296); anxiety in males only (beta=0.323); stress in males only (beta=0.369); sex differences not statistically significant
How They Did This
Cross-sectional survey of 367 college students. Multigroup path analysis compared male and female students on relationships between monthly SCA use (vs less than monthly) and depression, anxiety, and stress, controlling for age, recent cannabis use, and alcohol frequency.
Why This Research Matters
Simultaneous use of cannabis and alcohol is common among college students but understudied. The finding that combined use predicts depression independent of individual substance frequency highlights the importance of assessing polysubstance patterns rather than each substance in isolation.
The Bigger Picture
College mental health services often assess alcohol and cannabis use separately. This study suggests the simultaneous use pattern carries unique risks for depression that may be missed by screening for each substance individually.
What This Study Doesn't Tell Us
Cross-sectional design cannot establish causation. Relatively small sample, particularly for sex-stratified analyses. Self-report measures. Monte Carlo simulation confirmed the study was underpowered for detecting sex differences. Cannot distinguish effects of SCA from general heavier substance use patterns.
Questions This Raises
- ?Would interventions targeting SCA specifically reduce depression risk more than targeting either substance alone?
- ?Do the suggested sex differences in anxiety/stress hold in larger samples?
Trust & Context
- Key Stat:
- Evidence Grade:
- Preliminary: cross-sectional design, moderate sample size, underpowered for sex-stratified analyses.
- Study Age:
- 2025 publication
- Original Title:
- Monthly simultaneous cannabis and alcohol use: effects on depression, anxiety, and stress in male and female college students.
- Published In:
- Journal of cannabis research, 7(1), 87 (2025)
- Authors:
- Hetelekides, Eleftherios M, McMichael, Tabitha, Tyskiewicz, Alexander J(2), Prince, Mark A, Emery, Noah N, Conner, Bradley T, Karoly, Hollis C
- Database ID:
- RTHC-06661
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-06661APA
Hetelekides, Eleftherios M; McMichael, Tabitha; Tyskiewicz, Alexander J; Prince, Mark A; Emery, Noah N; Conner, Bradley T; Karoly, Hollis C. (2025). Monthly simultaneous cannabis and alcohol use: effects on depression, anxiety, and stress in male and female college students.. Journal of cannabis research, 7(1), 87. https://doi.org/10.1186/s42238-025-00347-y
MLA
Hetelekides, Eleftherios M, et al. "Monthly simultaneous cannabis and alcohol use: effects on depression, anxiety, and stress in male and female college students.." Journal of cannabis research, 2025. https://doi.org/10.1186/s42238-025-00347-y
RethinkTHC
RethinkTHC Research Database. "Monthly simultaneous cannabis and alcohol use: effects on de..." RTHC-06661. Retrieved from https://rethinkthc.com/research/hetelekides-2025-monthly-simultaneous-cannabis-and
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.