What topics does this cannabis study cover?

This study covers research on: Addiction, Mental Health.

Where was this research published?

Published in Substance use & misuse on August 19, 2026.

Cannabis-alcohol co-use rose after COVID, with treatment gaps

Q: What did this research study find?

Combined *cannabis* and alcohol use increased significantly across the study period, with **24,526 respondents (5%)** reporting co-use.

A Random Forest Analysis of Risk Factors and Trends in Substance Use Treatment Among Those Who Use Cannabis and Alcohol Together Before and After the COVID-19 Pandemic.

Substance use & misuse • August 19, 2026 • Highly Relevant

🤖

AI Summary

This national survey analysis examined people who used cannabis during their most recent alcohol use, comparing patterns before COVID-19 with 2023. Across the study period, 24,526 respondents (5%) reported combined use, and co-use increased significantly. Because combining alcohol and cannabis can contribute to injuries, social difficulties, and worsening health conditions, the findings highlight an important public-health concern for people who use both substances together.

Treatment use also rose, from 274 people (2.1%) before COVID-19 to 141 people (4.2%) in 2023, although the authors conclude that treatment rates remain in need of improvement. Random forest and regression analyses identified cannabis accessibility as a major factor in both periods, while stimulant-product use was associated with co-use before COVID-19 and psychotherapeutic medication misuse afterward. The authors suggest that lasting changes in mental health and substance use after the pandemic may be influencing these patterns.

💡 Key Findings

Combined cannabis and alcohol use increased significantly across the study period, with 24,526 respondents (5%) reporting co-use.

High

80%

Reported treatment receipt increased from 2.1% before COVID-19 to 4.2% in 2023, but the authors still identify treatment access and participation as areas needing improvement.

High

80%

Cannabis accessibility was strongly associated with co-use both before and after the pandemic, while associated factors shifted from amphetamine/methylphenidate products to psychotherapeutic medication misuse.

Good

75%

The authors conclude that persistent post-pandemic changes, including rising mental health diagnoses, may have influenced substance co-use patterns.

Good

65%

📄 Original Abstract

The harms of using combined cannabis and alcohol include injuries, social problems, and exacerbating existing conditions. No studies have compared substance use risk factors pre and post pandemic in a large national sample among those who use these substances together. The goal of our study was to determine the relationship between the pandemic and shifts in substance use among those who use cannabis and alcohol together. This was a review of data collected by the National Survey of Drug Use and Health for the time frames (2015-2019 [pre-COVID], 2023 [post-COVID]). We analyzed data pertaining to whether respondents used cannabis during their last alcohol use. We analyzed demographic characteristics (e.g., age, gender, etc.), trends in treatment, and conducted random forest analyses followed by regression models for identifying significant predictors. Between 2015 and 2023 (including years 2020-2022), there were a total of 24,526 (5%) respondents who reported co-use and this increased during the study period (p < 0.001). Pre-COVID, 274 (2.1%) reported receipt of treatment and this increased to 141 (4.2%) (p < 0.0001). Pre-COVID, cannabis accessibility (aOR: 13.9, p < 0.0001) and amphetamine/methylphenidate products (aOR: 5.6, p < 0.001) were associated with co-use. Post COVID, cannabis accessibility (aOR: 10.6, p < 0.001) and psychotherapeutic misuse (aOR: 2.7, p < 0.001) were significant. Remnants of the COVID-19 pandemic, including the rise in mental health diagnoses, may have had a lasting influence on substance co-use. Efforts should be made to improve treatment rates in this population.

Paper Type

📄 Research

Publication

Journal: Substance use & misuse
Published: August 19, 2026
PMID: 42615085
DOI: 10.1080/10826084.2026.2718449

Authors (4)

Christine Ramdin Department of Emergency Medicine, Division of Addiction and Toxicology, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Christopher Meaden Department of Emergency Medicine, Division of Addiction and Toxicology, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Lewis S Nelson Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA.
Ellen T Kurtzman Rutgers Addiction Research Center, Brain Health Institute, Rutgers Health, Piscataway, New Jersey, USA.