College students reported more pleasure on days they used both alcohol and cannabis, but alcohol may be the main driver

In a 21-day diary study of 237 college students, co-using alcohol and cannabis was associated with more frequent and higher pleasure than cannabis alone, but not more than alcohol alone, suggesting alcohol drives the pleasure of co-use.

Linden-Carmichael, Ashley N et al.·Addictive behaviors·2024·Moderate EvidenceObservational
RTHC-05478ObservationalModerate Evidence2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Observational
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

On co-use days, odds of substance-related pleasure were higher than on single-substance days. However, level of pleasure was higher on co-use days only compared to cannabis-only days, not alcohol-only days. This suggests the perceived pleasure of co-use is largely driven by alcohol.

Key Numbers

237 college students; 21-day diary; 2,086 daily surveys with substance use; higher odds of any pleasure on co-use days; level of pleasure higher on co-use vs cannabis-only but not vs alcohol-only days

How They Did This

Twenty-one-day daily diary study of 237 college students (65% female, ages 18-24) who reported at least one alcohol-cannabis co-use occasion. Daily surveys assessed substance use and pleasure experiences, yielding 2,086 use-day surveys analyzed with multilevel models.

Why This Research Matters

Understanding why people co-use alcohol and cannabis together is important for prevention. If pleasure drives co-use but is mainly attributable to alcohol, interventions targeting alcohol-related pleasure expectations may reduce co-use.

The Bigger Picture

Co-use of alcohol and cannabis is associated with greater risks than either substance alone. If the pleasure incentive is mainly alcohol-driven, breaking the co-use pattern may be achievable through alcohol-focused interventions.

What This Study Doesn't Tell Us

Self-selected co-using students; subjective pleasure reports; 21-day window may not capture variation over longer periods; cannot determine if pleasure causes continued co-use or if other factors drive both; no biological measures of intoxication

Questions This Raises

  • ?Would reducing alcohol-related pleasure expectations (through expectancy challenges) reduce co-use?
  • ?Is the relationship between co-use and pleasure different for daily versus occasional users?

Trust & Context

Key Stat:
2,086 daily substance use surveys from 237 students
Evidence Grade:
Daily diary design with multilevel modeling captures real-time experiences, though limited to self-selected co-users and subjective pleasure reports.
Study Age:
2024 study
Original Title:
Alcohol and cannabis use in daily lives of college-attending young adults: Does co-use correspond to greater reported pleasure?
Published In:
Addictive behaviors, 159, 108130 (2024)
Database ID:
RTHC-05478

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Watches what happens naturally without intervening.

What do these levels mean? →

Frequently Asked Questions

Is co-using alcohol and cannabis more pleasurable?

Students reported more frequent pleasure on co-use days compared to single-substance days. However, the intensity of pleasure was higher than cannabis-only days but not higher than alcohol-only days, suggesting alcohol is the primary source of the pleasurable experience.

Why does this matter for prevention?

If people co-use alcohol and cannabis because they believe the combination is more pleasurable, but the pleasure is mainly from alcohol, then interventions targeting alcohol use expectations could potentially reduce co-use. Pleasure as a reinforcing factor is a viable intervention target.

Read More on RethinkTHC

Cite This Study

RTHC-05478·https://rethinkthc.com/research/RTHC-05478

APA

Linden-Carmichael, Ashley N; Stull, Samuel W; Lanza, Stephanie T. (2024). Alcohol and cannabis use in daily lives of college-attending young adults: Does co-use correspond to greater reported pleasure?. Addictive behaviors, 159, 108130. https://doi.org/10.1016/j.addbeh.2024.108130

MLA

Linden-Carmichael, Ashley N, et al. "Alcohol and cannabis use in daily lives of college-attending young adults: Does co-use correspond to greater reported pleasure?." Addictive behaviors, 2024. https://doi.org/10.1016/j.addbeh.2024.108130

RethinkTHC

RethinkTHC Research Database. "Alcohol and cannabis use in daily lives of college-attending..." RTHC-05478. Retrieved from https://rethinkthc.com/research/linden-carmichael-2024-alcohol-and-cannabis-use

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.