Insights Into the Context of Simultaneous Alcohol and Cannabis Use Among Young Adults

Simultaneous alcohol and cannabis use (simultaneous use) is common among young adults and is associated with a greater number of substance use-related consequences compared to single substance use. Understanding what drives simultaneous use among young adults is crucial. This study aimed to gather qualitative data on physical, social, and situational characteristics of simultaneous use among young adults. Participants were 36 heavy drinking young adults (M-age = 21.79) who engaged in simultaneous use at least twice during the past 30 days. Individual semistructured interviews were conducted via Zoom videoconferencing. Thematic analyses were used to analyze interview data. Findings indicated that young adults are selective of where and with whom they engage in simultaneous use with. Physical characteristics associated with simultaneous use included being in familiar and safe locations. Young adults were less likely to engage in simultaneous use in public spaces. Social characteristics associated with simultaneous use included being at parties, being around close peers, and if others are approving of and/or also using alcohol and cannabis so their effects overlap. Being around family or being alone decreased the likelihood of simultaneous use. Situational characteristics associated with simultaneous use included having access to alcohol and/or cannabis, being a weekend and/or evening, pregaming, and using cannabis at the end of a drinking occasion. Young adults based their decision to engage in simultaneous use on a range of physical, social, and situational contextual factors. Future research should examine multiple characteristics of the context in order to identify specific context with an increased risk of simultaneous use. Public Health Significance This study highlights various contexts associated with simultaneous use among young adults. Understanding contextual factors associated with using alcohol and cannabis so their effects overlap may help to identify risky simultaneous use occasions. Identifying contexts of simultaneous use could inform prevention and intervention efforts aimed at reducing simultaneous use and associated harms.