Alcoholism & Addiction

Most Teens Who Smoke Marijuana Pair It With Alcohol

Alcohol and marijuana are the two most frequently used and abused substances among U.S. teens. Apart from their separate effects, the two substances pose special risks when used together.

In a study published in November 2013 in the journal Drug and Alcohol Dependence, a team of American researchers sought to determine how many teenagers simultaneously use alcohol and marijuana. These researchers also examined the underlying reasons for this co-occurring substance intake.

Rates of Alcohol and Marijuana Use

The National Institute on Drug Abuse tracks teens’ use of alcohol, marijuana and a range of other substances of abuse through an annual, University of Michigan-led survey called Monitoring the Future (MTF). According to the figures compiled during the 2012 version of this survey, roughly 42 percent of U.S. high school seniors use alcohol every month. This rate falls to about 28 percent among high school sophomores, and to an even lower 11 percent among eighth-graders. The results from the 2012 version of Monitoring the Future also indicate that roughly 36 percent of U.S. high school seniors use marijuana annually. Slightly less than 28 percent of sophomores use marijuana annually; the rate for eighth-graders is above 10 percent.

The Effects of Simultaneous Use

Alcohol and marijuana are known for their ability to produce increased levels of harm when used simultaneously. Potential consequences of using the two substances together include disproportionately intensifying the central nervous system-depressing effects associated with both alcohol and marijuana, and decreasing the body’s ability to trigger its natural vomiting reflex. This second effect can be especially critical in cases of alcohol poisoning, where the body relies on spontaneous vomiting to sharply reduce the amount of potentially deadly alcohol in circulation. In addition, there is always a certain degree of uncertainty (and added danger) whenever anyone uses alcohol and marijuana (or any other combination of two or more substances) together. Experts call this form of simultaneous, multiple drug use polydrug use.

Current Findings

In the study published in Drug and Alcohol Dependence, researchers from the University of Michigan’s Institute for Social Research used the data gathered from the Monitoring the Future survey to examine the frequency of overlap between alcohol use and marijuana use among high school seniors across the U.S. The researchers looked at long-term trends over 35 years (1976 to 2011), as well as the detailed figures for use in 2011 alone. They undertook their efforts because no previous studies had explored the simultaneous use of marijuana and alcohol in teen populations.

Overall, slightly less than one-quarter (23 percent) of the study’s 2011 participants reported using the combination of alcohol and marijuana at some point in their lifetimes. Among the participants who had used marijuana within the previous 12 months, the rate of overlapping use of the two substances was 62 percent. In addition, 13 percent of study’s participants reported drinking alcohol on all occasions when they used marijuana or on almost all occasions when they used marijuana.

After making a more detailed analysis of their findings, the researchers concluded that the simultaneous use of alcohol and marijuana strongly coincides with a high school senior’s monthly level of alcohol consumption. In brief, this means that increases in alcohol use correspond with increases in the combined use of alcohol and marijuana. In addition, simultaneous use of marijuana and alcohol also corresponds with an overall increase in the amount of substance use. Common motivations for this pattern of use include the desire to increase the effects of either alcohol or marijuana and a stated dependence on the use of alcohol or marijuana. The researchers also concluded that being present in certain public environments (including parties, automobiles and parks) substantially increases the chances of alcohol/marijuana polydrug use.


The authors of the study published in Drug and Alcohol Dependence note that simultaneous alcohol and marijuana use is not a unique phenomenon separate from other forms of substance use. Rather, it represents a single subset of larger patterns of both alcohol and marijuana intake. They also note that a self-perceived physical/emotional need for alcohol (as opposed to objectively measured alcohol dependence) plays a particularly important role in driving alcohol/marijuana polydrug use. Lastly, the study’s authors note that, because of the social settings in which the combined use of marijuana and alcohol occurs, the actions of the involved teenagers commonly place both them and the general public at an increased public health risk.

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