A Qualitative Examination of Positive and Negative Consequences Young Adults Experience From Simultaneous Alcohol and Cannabis Use

Public Health Significance Statement This qualitative study found consequences overlapped between simultaneous alcohol and cannabis use and single substance use occasions, but young adults did discuss unique combinations of positive consequences during simultaneous use. Patterns of use were reported to influence consequences and were sometimes approached intentionally to reduce harms. These findings may inform future quantitative studies such that better quantitative assessment and characterization of simultaneous use consequences may help us to better understand simultaneous use outcomes. Objective: Alcohol and cannabis are two of the most commonly used substances among young adults, and most individuals who use both substances use them simultaneously, that is, on the same occasion such that their effects overlap. Given the high prevalence of simultaneous alcohol and cannabis use, it is important to understand the relationship between simultaneous use and consequences. This study presents a qualitative examination of positive and negative consequences of simultaneous use. Method: We conducted individual interviews among 36 young adults who engage in simultaneous use (23 women, 12 men, 1 trans man). Interviews included open-ended questions examining negative and positive consequences of simultaneous use and how simultaneous use differed from single substance use (alcohol only use, cannabis only use). Interviews were analyzed using applied thematic analysis. Results: Young adults reported numerous negative and positive consequences of simultaneous use, many overlapping with single substance use. Yet, they also reported unique combinations of positive consequences not experienced by single substance use. Young adults discussed patterns of use that were sometimes approached intentionally (e.g., quantity of substances used, order) that influenced consequences. Conclusions: Together these findings provide further insight into young adults' simultaneous use experiences. Next steps should include quantitative exploratory research to identify and determine the frequency of specific consequences experienced during simultaneous use and examine the relationship between simultaneous use consequences and particular patterns of use.