"Double Trouble?" Sociodemographic Correlates of Simultaneous Alcohol and Cannabis Use in a Multisite Sample of U.S. College Students.

Berry K.; Newins A.; Van Hedger K.; Zamboanga B.; Randazza M.; Looby A.; Ham L.; Blumenthal H.; Perrotte J.; Kim S. et al. · Journal of psychoactive drugs · 2026

**Background & Methods** This multisite cross-sectional study examined sociodemographic correlates of simultaneous alcohol and cannabis (SAM) use among 3,655 U.S. college students (69.7% women, 51% White). Researchers analyzed associations between multiple sociodemographic variables and past-year SAM use patterns, stratifying analyses by frequency of use. **Key Findings** • Residency status was the most consistent sociodemographic predictor of SAM use: students living off-campus were significantly more likely to report past-year SAM use and frequent SAM use compared to those living on-campus or with parents/relatives, suggesting environmental and autonomy factors influence simultaneous substance use patterns. • Demographics associated with frequent SAM use included older age, male gender, White race/ethnicity, and fraternity/sorority membership, indicating that certain student subgroups engaged in more regular simultaneous use despite similar overall prevalence rates across most demographic categories. • Most sociodemographic factors showed no significant differences in past-year SAM use endorsement overall, suggesting that while certain groups use SAM more frequently, the behavior itself is relatively broadly distributed across the college population studied. **Dosage & Administration** Not reported. **Safety & Adverse Effects** The abstract notes that SAM use is "linked to greater negative consequences than using alcohol or cannabis alone or using both substances concurrently," but specific adverse effects or consequences are not detailed in the provided abstract. **Evidence Quality** This study provides low-to-moderate evidence quality due to several limitations. The cross-sectional design precludes causal inference regarding sociodemographic factors and SAM use. The sample, while large and ethnically diverse, was limited to college students, restricting generalizability to other populations. The abstract does not specify measurement methods for substance use (self-report vs. biomarkers) or detail potential confounding variables. The finding that most sociodemographic factors showed no significant associations suggests SAM use may be driven by factors beyond demographics. The authors acknowledge existing knowledge gaps regarding SAM-specific risk factors, indicating this represents preliminary epidemiological characterization rather than mechanistic understanding. Results support the need for prospective studies and qualitative research to elucidate causal mechanisms underlying differential SAM use patterns.

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