Effects and Prevalence of Simultaneous Use of Alcohol and Cannabis: A Narrative Review
Main Article Content
Abstract
Introduction: the use of cannabis has increased significantly over the last few decades. However, knowledge surrounding the simultaneous use of this substance and alcohol is scarce.
Objective: to explore the prevalence, effects and risky situations related to the simultaneous use of cannabis and alcohol, with a focus on Mexico.
Method: for this narrative review, a search was carried out in the PubMed database using the terms “alcohol”, “cannabis”, “marihuana”, “co-use” and “simultaneous use”. The relevant literature was selected and notable references were reviewed, focusing on alcohol and cannabis use disorders, consumption during pregnancy and before driving.
Results: the prevalence of simultaneous alcohol and cannabis use has increased over the past few years, particularly among adolescents and young adults. This consumption pattern results in increased cognitive impairment, a higher number of negative consequences, a greater impact on embryonic development and a higher probability of risky driving compared to single-substance use.
Discussion and conclusions: understanding this consumption pattern is essential for developing prevention and harm reduction strategies for vulnerable populations and risky situations. It is necessary to standardize the terms and methodologies used and carry out more studies focused on the prevalence, pharmacological and long-term effects of simultaneous alcohol and cannabis use with larger and more diverse samples, including the Mexican population.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
Bedillion, M. F., Blaine, S. K., Claus, E. D., & Ansell, E. B. (2021). The Effects of Alcohol and Cannabis Co-Use on Neurocognitive Function, Brain Structure, and Brain Function. Current Behavioral Neuroscience Reports, 8(4), 134-149. https://doi.org/10.1007/s40473-021-00243-8
Bedillion, M. F., Claus, E. D., Wemm, S. E., Fox, H. C., & Ansell, E. B. (2024). The effects of simultaneous alcohol and cannabis use on subjective drug effects: A narrative review across methodologies. Alcohol, Clinical & Experimental Research, 48(6), 988-999. https://doi.org/10.1111/acer.15322
Comisión Nacional contra las Adicciones. (2021). Informe sobre la Situación de la Salud Mental y el Consumo de Sustancias Psicoactivas en México. Recuperado de https://www.gob.mx/cms/uploads/attachment/file/648021/INFORME_PAIS_2021.pdf
Connor, J. P., Stjepanović, D., Le Foll, B., Hoch, E., Budney, A. J., & Hall, W. D. (2021). Cannabis use and cannabis use disorder. Nature Reviews: Disease Primers, 7(1), 16. https://doi.org/10.1038/s41572-021-00247-4
Consroe, P., Carlini, E. A., Zwicker, A. P., & Lacerda, L. A. (1979). Interaction of cannabidiol and alcohol in humans. Psychopharmacology, 66(1), 45-50. https://doi.org/10.1007/BF00431988
Cooper, Z. D., Abrams, D. I., Gust, S., Salicrup, A., & Throckmorton, D. C. (2021). Challenges for Clinical Cannabis and Cannabinoid Research in the United States. JNCI Monographs, 2021(58), 114-122. https://doi.org/10.1093/jncimonographs/lgab009
De Ternay, J., Naassila, M., Nourredine, M., Louvet, A., Bailly, F., Sescousse, G., Maurage, P., Cottencin, O., Carrieri, P. M., & Rolland, B. (2019). Therapeutic Prospects of Cannabidiol for Alcohol Use Disorder and Alcohol-Related Damages on the Liver and the Brain. Frontiers in Pharmacology, 10, 627. https://doi.org/10.3389/fphar.2019.00627
Downey, L. A., King, R., Papafotiou, K., Swann, P., Ogden, E., Boorman, M., & Stough, C. (2013). The effects of cannabis and alcohol on simulated driving: Influences of dose and experience. Accident: Analysis & Prevention, 50, 879-886. https://doi.org/10.1016/j.aap.2012.07.016
El Hayek, S., Foad, W., de Filippis, R., Ghosh, A., Koukach, N., Mahgoub Mohammed Khier, A., Pant, S. B., Padilla, V., Ramalho, R., Tolba, H., & Shalbafan, M. (2024). Stigma toward substance use disorders: A multinational perspective and call for action. Frontiers in Psychiatry,15, 1295818. https://doi.org/10.3389/fpsyt.2024.1295818
El Marroun, H., Tiemeier, H., Steegers, E. A. P., Jaddoe, V. W. V., Hofman, A., Verhulst, F. C., van den Brink, W., & Huizink, A. C. (2009). Intrauterine Cannabis Exposure Affects Fetal Growth Trajectories: The Generation R Study. Journal of the American Academy of Child & Adolescent Psychiatry, 48(12), 1173-1181. https://doi.org/10.1097/CHI.0b013e3181bfa8ee
Elsohly, M. A., & Slade, D. (2005). Chemical constituents of marijuana: The complex mixture of natural cannabinoids. Life Sciences, 78(5), 539-548. https://doi.org/10.1016/j.lfs.2005.09.011
Fonseca, B. M., Costa, M. A., Almada, M., Correia-da-Silva, G., & Teixeira, N. A. (2013). Endogenous cannabinoids revisited: A biochemistry perspective. Prostaglandins & Other Lipid Mediators, 102-103, 13-30. https://doi.org/10.1016/j.prostaglandins.2013.02.002
Goldschmidt, L., Richardson, G. A., Willford, J., & Day, N. L. (2008). Prenatal marijuana exposure and intelligence test performance at age 6. Journal of the American Academy of Child and Adolescent Psychiatry, 47(3), 254-263. https://doi.org/10.1097/CHI.0b013e318160b3f0
Gunn, R. L., Aston, E. R., & Metrik, J. (2022). Patterns of Cannabis and Alcohol Co-Use: Substitution versus Complementary Effects. Alcohol Research: Current Reviews, 42(1), 04. https://doi.org/10.35946/arcr.v42.1.04
Hai, A. H., Carey, K. B., Vaughn, M. G., Lee, C. S., Franklin, C., & Salas-Wright, C. P. (2022). Simultaneous alcohol and marijuana use among college students in the United States, 2006-2019. Addictive Behaviors Reports, 16, 100452. https://doi.org/10.1016/j.abrep.2022.100452
Hartman, R. L., Brown, T. L., Milavetz, G., Spurgin, A., Gorelick, D. A., Gaffney, G., & Huestis, M. A. (2015). Controlled Cannabis Vaporizer Administration: Blood and Plasma Cannabinoids with and without Alcohol. Clinical Chemistry, 61(6), 850-869. https://doi.org/10.1373/clinchem.2015.238287
Health Canada. (2018). Cannabis health effects. Recuperado de https://www.canada.ca/en/services/health/campaigns/cannabis/health-effects.html
Hôpital le Vinatier. (2023). Cannabidiol for Reducing Drinking in Alcohol Use Disorder and Modifying the Effects of Alcohol on the Brain and the Liver: A Phase 2 Clinical Trial. - The CARAMEL Study (Clinical Trial Registration NCT05159830). Recuperado de https://clinicaltrials.gov/study/NCT05159830
Hourani, W., & Alexander, S. P. H. (2018). Cannabinoid ligands, receptors and enzymes: Pharmacological tools and therapeutic potential. Brain and Neuroscience Advances, 2, 2398212818783908. https://doi.org/10.1177/2398212818783908
Instituto Nacional de Estadística y Geografía [INEGI]. (s.f.). Accidentes de tránsito terrestre en zonas urbanas y suburbanas. Recuperado de https://www.inegi.org.mx/sistemas/olap/consulta/general_ver4/MDXQueryDatos.asp?#Regreso&c= - 12 de octubre de 2023.
Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Instituto Nacional de Salud Pública, Comisión Nacional Contra las Adicciones, & Secretaría de Salud. (2017). Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016-2017 - Reporte de Drogas. Recuperado de https://encuestas.insp.mx/repositorio/encuestas/ENCODAT2016/doctos/informes/reporte_encodat_drogas_2016_2017.pdf
Karoly, H. C., Drennan, M. L., Prince, M. A., Zulic, L., & Dooley, G. (2023). Consuming oral cannabidiol prior to a standard alcohol dose has minimal effect on breath alcohol level and subjective effects of alcohol. Psychopharmacology, 240(5), 1119-1129. https://doi.org/10.1007/s00213-023-06349-z
Karoly, H. C., Mueller, R. L., Andrade, C. C., & Hutchison, K. E. (2021). THC and CBD effects on alcohol use among alcohol and cannabis co-users. Psychology of Addictive Behaviors, 35(6), 749-759. https://doi.org/10.1037/adb0000706
Kovács, M. V., Charchat-Fichman, H., Landeira-Fernandez, J., Medina, A. E., & Krahe, T. E. (2023). Combined exposure to alcohol and cannabis during development: Mechanisms and outcomes. Alcohol, 110, 1-13. https://doi.org/10.1016/j.alcohol.2023.01.004
Lee, C. M., Calhoun, B. H., Abdallah, D. A., Blayney, J. A., Schultz, N. R., Brunner, M., & Patrick, M. E. (2022). Simultaneous Alcohol and Marijuana Use Among Young Adults: A Scoping Review of Prevalence, Patterns, Psychosocial Correlates, and Consequences. Alcohol Research, 42(1), 08. https://doi.org/10.35946/arcr.v42.1.08
Lees, B., Debenham, J., & Squeglia, L. M. (2021). Alcohol and Cannabis Use and the Developing Brain. Alcohol Research, 41(1), 11. https://doi.org/10.35946/arcr.v41.1.11
Legare, C. A., Raup-Konsavage, W. M., & Vrana, K. E. (2022). Therapeutic Potential of Cannabis, Cannabidiol, and Cannabinoid-Based Pharmaceuticals. Pharmacology, 107(3-4), 131-149. https://doi.org/10.1159/000521683
Linden-Carmichael, A. N., & Wardell, J. D. (2021). Combined Use of Alcohol and Cannabis: Introduction to the Special Issue. Psychology of Addictive Behaviors, 35(6), 621-627. https://doi.org/10.1037/adb0000772
Lukas, S. E., & Orozco, S. (2001). Ethanol increases plasma Delta(9)-tetrahydrocannabinol (THC) levels and subjective effects after marihuana smoking in human volunteers. Drug and Alcohol Dependence, 64(2), 143-149. https://doi.org/10.1016/s0376-8716(01)00118-1
Lukas, S. E., Benedikt, R., Mendelson, J. H., Kouri, E., Sholar, M., & Amass, L. (1992). Marihuana attenuates the rise in plasma ethanol levels in human subjects. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 7(1), 77-81.
Meccariello, R. (2020). Endocannabinoid System in Health and Disease: Current Situation and Future Perspectives. International Journal of Molecular Sciences, 21(10), 3549. https://doi.org/10.3390/ijms21103549
National Institute on Drug Abuse [NIDA]. (2022). Reducción de daños. Recuperado de https://nida.nih.gov/es/areas-de-investigacion/reduccion-danos
Nieto, S. J., Venegas, A., Hudson, J., & Ray, L. A. (2022). Cannabis use and subjective response to alcohol in the human laboratory. Drug and Alcohol Dependence, 236, 109481. https://doi.org/10.1016/j.drugalcdep.2022.109481
NYU Langone Health. (2023). Effects of Cannabidiol in Alcohol Use Disorder (Clinical Trial Registration NCT03252756). Recuperado de https://clinicaltrials.gov/study/NCT03252756
Observatorio Mexicano de Salud Mental y Consumo de Drogas. (2023). Contexto de la demanda de sustancias ilícitas en 2022-2023 y acciones del Gobierno de México en materia de salud mental y adicciones. Recuperado de https://www.gob.mx/cms/uploads/attachment/file/835202/Hoja_de_datos_consumo_de_sustancias_2022.pdf
Ortiz-Medina, M. B., Perea, M., Torales, J., Ventriglio, A., Vitrani, G., Aguilar, L., & Roncero, C. (2018). Cannabis consumption and psychosis or schizophrenia development. International Journal of Social Psychiatry, 64(7), 690-704. https://doi.org/10.1177/0020764018801690
Pacula, R. L., Smart, R., Lira, M. C., Pessar, S. C., Blanchette, J. G., & Naimi, T. S. (2022). Relationships of Cannabis Policy Liberalization With Alcohol Use and Co-Use With Cannabis: A Narrative Review. Alcohol Research, 42(1), 06. https://doi.org/10.35946/arcr.v42.1.06
Perez-Reyes, M., Hicks, R. E., Bumberry, J., Jeffcoat, A., & Cook, C. E. (1988). Interaction between Marihuana and Ethanol: Effects on Psychomotor Performance. Alcoholism: Clinical and Experimental Research, 12(2), 268-276. https://doi.org/10.1111/j.1530-0277.1988.tb00193.x
Ramírez-Toscano, Y., Canto-Osorio, F., Carnalla, M., Colchero, M. A., Reynales-Shigematsu, L. M., Barrientos-Gutiérrez, T., & López-Olmedo, N. (2023). Patrones de consumo de alcohol en adolescentes y adultos mexicanos: Ensanut Continua 2022. Salud Pública de México, 65, s75-s83. https://doi.org/10.21149/14817
Richardson, G. A., Ryan, C., Willford, J., Day, N. L., & Goldschmidt, L. (2002). Prenatal alcohol and marijuana exposure: Effects on neuropsychological outcomes at 10 years. Neurotoxicology and Teratology, 24(3), 309-320. https://doi.org/10.1016/s0892-0362(02)00193-9
Rojo-Gaxiola, M. G., Jiménez-Castellanos, P. M., Ochoa-Cisneros, I. Z., Sánchez-Martínez, R. B., & Barrera-de León, J. C. (2021). Perfil sociodemográfico de madres embarazadas consumidoras de drogas ilegales atendidas en un Hospital Materno Infantil. Revista Salud Jalisco, 8(3). Recuperado de https://www.medigraphic.com/pdfs/saljalisco/sj-2021/sj213c.pdf
Ronen, A., Chassidim, H. S., Gershon, P., Parmet, Y., Rabinovich, A., Bar-Hamburger, R., Cassuto, Y., & Shinar, D. (2010). The effect of alcohol, THC and their combination on perceived effects, willingness to drive and performance of driving and non-driving tasks. Accident Analysis & Prevention, 42(6), 1855-1865. https://doi.org/10.1016/j.aap.2010.05.006
Secretaría de Salud, Subsecretaría de Prevención y Promoción de la Salud, & Dirección General de Epidemiología. (2022). Sistema de Vigilancia Epidemiológica de las Adicciones. informe SISVEA 2021. Recuperado de https://www.gob.mx/cms/uploads/attachment/file/760957/informe_sisvea_2021.pdf
Shi, Y., Zhu, B., & Liang, D. (2021). The associations between prenatal cannabis use disorder and neonatal outcomes. Addiction, 116(11), 3069-3079. https://doi.org/10.1111/add.15467
Smith, T. H., Sim-Selley, L. J., & Selley, D. E. (2010). Cannabinoid CB1 receptor-interacting proteins: Novel targets for central nervous system drug discovery? British Journal of Pharmacology, 160(3), 454-466. https://doi.org/10.1111/j.1476-5381.2010.00777.x
Terry-McElrath, Y. M., & Patrick, M. E. (2018). Simultaneous Alcohol and Marijuana Use Among Young Adult Drinkers: Age-Specific Changes in Prevalence from 1977 to 2016. Alcoholism: Clinical and Experimental Research, 42(11), 2224-2233. https://doi.org/10.1111/acer.13879
Toennes, S. W., Schneider, K., Kauert, G. F., Wunder, C., Moeller, M. R., Theunissen, E. L., & Ramaekers, J. G. (2011). Influence of ethanol on cannabinoid pharmacokinetic parameters in chronic users. Analytical and Bioanalytical Chemistry, 400(1), 145-152. https://doi.org/10.1007/s00216-010-4449-2
United Nations Office on Drugs and Crime [UNODC]. (2018). World Drug Report 2018. Recuperado de https://www.unodc.org/wdr2018/prelaunch/WDR18_Booklet_1_EXSUM.pdf
United Nations Office on Drugs and Crime [UNODC]. (2023). World Drug Report 2023. Recuperado de https://www.unodc.org/res/WDR-2023/WDR23_Exsum_fin_DP.pdf
Varghese, J., & Dakhode, S. (2022). Effects of Alcohol Consumption on Various Systems of the Human Body: A Systematic Review. Cureus, 14(10), e30057. https://doi.org/10.7759/cureus.30057
Waddell, J. T. (2021). Between- and within-group effects of alcohol and cannabis co-use on AUD/CUD in the NSDUH 2002-2019. Drug and Alcohol Dependence, 225, 108768. https://doi.org/10.1016/j.drugalcdep.2021.108768
World Health Organization [WHO]. (2016). The health and social effects of nonmedical cannabis use. WHO. Recuperado de https://apps.who.int/iris/handle/10665/251056 - 23 de enero de 2024
World Health Organization [WHO]. (2024). Global status report on alcohol and health and treatment of substance use disorders. WHO. Recuperado de https://iris.who.int/bitstream/handle/10665/377960/9789240096745-eng.pdf?sequence=1
World Health Organization [WHO]. (s.f.). Harmful use of alcohol. Recuperado de https://www.who.int/health-topics/alcohol - 23 de enero de 2024.