Nuanced Relations Between Simultaneous Alcohol and Cannabis Use Motives and Negative Consequences Among College Students: The Role of Multiple Product Use

Public Significance Statement This study suggests that college students who consume both alcohol and cannabis for social reasons may be at unique risk for negative consequences. Young adults who use alcohol and cannabis simultaneously to enhance intoxication, for social reasons, or because it was offered may benefit from recommendations to limit the number of alcohol products used on a given day to reduce the occurrence of physiological consequences. Simultaneous alcohol and marijuana (SAM) use is common, but it exacerbates negative consequences. Individuals use alcohol and cannabis products in different ways and have distinct reasons for use. The present study examines day-level effects of motives on consequences on SAM-use days, accounting for consumption, and tests whether using multiple alcohol (e.g., beer + liquor) and/or cannabis (e.g., concentrate + leaf) products on the same day mediates these relations. College students engaging in SAM use at least once in the past month (N = 281; M (age) = 20.17) completed two bursts of 28 consecutive days of data collection. We examined within-person effects of motives (effect-enhancement, social, offered [it was offered], coping) on number of negative consequences and on experiencing hangover, nausea, or blackout; and indirect effects via two concurrent mediators: using multiple alcohol products and multiple cannabis products. Total effect models showed effect-enhancement motives were related to nausea, social motives to number of total consequences and hangover, and coping motives to blackout. Effect-enhancement, social, and offered motives evinced significant indirect effects on consequence outcomes via multiple alcohol, but not cannabis, product use. Coping motives did not exhibit significant indirect effects, and were related to multiple cannabis, but not alcohol, product use, although all other motives were related to both mediators. Findings support recent work demonstrating within-person relations between social motives and negative consequences on SAM-use days. Limiting the number of alcohol products consumed on SAM-use days may be beneficial, particularly for young adults using to enhance intoxication or for social reasons.