The study aims were to examine daily associations between marijuana and alcohol use and the extent to which the association differs as a function of cannabis use disorder (CUD) and/or alcohol use disorder (AUD) diagnosis.


Timeline Followback interview data was collected in a study of veterans (N = 127) recruited from a Veterans Affairs hospital who reported at least 1 day of co-use of marijuana and alcohol in the past 180 days (22,860 observations). Participants reported 40% marijuana use days, 28% drinking days, with 37% meeting DSM-5 criteria for CUD, 40% for AUD, and 15% for both. Use of marijuana on a given day was used to predict a 3-level gender-adjusted drinking variable (heavy: ≥5 (men)/4 (women) drinks; moderate: 1 to 4/3 drinks; or none: 0 drinks). A categorical 4-level variable (no diagnosis, AUD, CUD, or both) was tested as a moderator of the marijuana-alcohol relationship.


Multilevel modeling analyses demonstrated that participants were more likely to drink heavily compared to moderately (OR = 2.34) and moderately compared to not drinking (OR = 1.61) on marijuana use days relative to nonuse days. On marijuana use days, those with AUD and those with AUD + CUD were more likely to drink heavily (OR = 1.91; OR = 2.51, respectively), but those with CUD were less likely to drink heavily (OR = 0.32) compared to moderately, nonsignificant differences between any versus moderate drinking in interaction models.


Heavy drinking occurs on days when marijuana is also used. This association is particularly evident in individuals diagnosed with both AUD and CUD and AUDs alone but not in those with only CUDs. Findings suggest that alcohol interventions may need to specifically address marijuana use as a risk factor for heavy drinking and AUD.

PMID: 29656401 PMCID: PMC5984172 [Available on 2019-06-01] DOI: 10.1111/acer.13639 

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Patients with encounters possibly related to cannabis were younger, more likely to be hospitalized and more likely to be admitted to the psychiatric unit than patients with encounters possibly related to alcohol. Initial and sustained effects of encounter rates possibly related to cannabis demonstrated an increased trend in slope before and after recreational marijuana legalization. The slope became more abrupt following legalization with a significant increase in trend during the post-legalization period,,

Conclusions: Additional research should identify patients at highest risk of an adverse health event related to cannabis and quantify costs associated with cannabis-related healthcare delivery.


December 20, 2018

We already know that cannabis lowers sperm count, but new research suggests that the drug actually causes genetic changes to the sperm itself — which might have implications for the health of a potential baby.

For a study published today in the journal Epigenetics, scientists at Duke University 

Think of your DNA as a list of instructions for making proteins, and genes as small subsets of that list. Our body has little chemical tags (called methyl groups) that get added to the DNA at specific regions, explains Susan Kay Murphy, a professor of gynecology at Duke and co-author of the study. These chemicals don’t mutate the genes themselves, but they do affect how they’re used, like deciding which instructions are followed and which aren’t.

Najari already counsels men who use marijuana regularly to cut back because of the effect on sperm count. “I think one of the important positive things about research like this is that it may further motivate men to change their health,” he adds. “It’s one thing to talk about sperm count, another when you’re talking about the potential health of the child.”

Both Najari and Murphy stress that future research needs to be done, and the Duke team is already working on follow-up studies. Are those changes reversible? Will they even end up affecting a potential baby? “

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A Massachusetts General Hospital (MGH) study finds that one month of abstaining from cannabis use resulted in measurable improvement in memory functions important for learning among adolescents and young adults who are regular cannabis users. The study published in the Journal of Clinical Psychiatry is one of the first to prospectively track over time changes in cognitive function associated with halting cannabis use. “Our findings provide two pieces of convincing evidence,” says Randi Schuster, PhD, director of Neuropsychology at the Center for Addiction Medicine in the MGH Department of Psychiatry, lead author of the paper. “The first is that adolescents learn better when they are not using cannabis. The second – which is the good news part of the story – is that at least some of the deficits associated with cannabis use are not permanent and actually improve pretty quickly after cannabis use stops.” 

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