Simultaneous Cannabis and Alcohol Use From Nationally Representative Data.

Han B.; Hobin J.; Compton W. · JAMA network open · 2026

**Background & Methods** This cross-sectional study analyzed nationally representative data to examine the prevalence and characteristics of past-month simultaneous cannabis and alcohol use among US adults. The research compared individuals engaging in concurrent use with those using alcohol only or cannabis only, utilizing population-based survey data to identify demographic patterns and usage correlations. **Key Findings** • Simultaneous cannabis and alcohol use represents a distinct usage pattern among US adults, with identifiable demographic and behavioral characteristics that differentiate it from single-substance use patterns. • Individuals engaging in concurrent use demonstrated different prevalence rates and risk profiles compared to alcohol-only or cannabis-only users, suggesting distinct populations with unique substance use behaviors. • The study identified demographic subgroups with elevated rates of simultaneous use, providing epidemiological data on the distribution of this combined usage pattern across the US adult population. **Dosage & Administration** Not reported. **Safety & Adverse Effects** Not reported. The abstract does not provide information regarding adverse effects, health outcomes, or safety concerns associated with simultaneous cannabis and alcohol use. **Evidence Quality** This cross-sectional study design provides descriptive epidemiological evidence classified as Level 3 evidence, appropriate for prevalence estimation but limited for causal inference. Key limitations include the inability to establish temporal relationships or causality between simultaneous use and health outcomes, reliance on self-reported substance use data which may be subject to recall bias and social desirability bias, and the snapshot nature of cross-sectional analysis which cannot determine progression or consequences of concurrent use patterns. The use of nationally representative data strengthens external validity and generalizability to the US adult population. However, the study's observational nature prevents definitive conclusions about mechanisms of concurrent use or specific health impacts. Additional longitudinal research would be needed to evaluate consequences of simultaneous cannabis and alcohol use and identify causal pathways. The findings serve primarily to characterize the epidemiology and prevalence of this usage pattern rather than establish clinical safety or efficacy data.

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