Cannabis Abstinence Is Tied To More Alcohol Use For Teens And Young Adults, Study Finds

The world is becoming increasingly more accepting of cannabis use as more and more governments are allowing for medical or recreational cannabis legalization. But one big area of concern remains for many – teen cannabis use. Researchers have yet to fully determine what risks cannabis might pose for teens, but some evidence points to potential mental health implications for those who initiate cannabis use early on. Given this, most recommend that teens avoid cannabis use, and those who have already begun use should stop.

But now researchers are considering a new question; what risks might be associated with cannabis abstinence for teens who have already begun using cannabis? A recent study found that one such risk could be increased use of alcohol.

The study, published in Progress in Neuropsychopharmacology & Biological Psychiatry, found that teens and young adults between the ages of 14 and 25 were more likely to increase their use of alcohol when abstaining from cannabis. The study raises questions about harm reduction, and whether teens would be better off using cannabis or alcohol – a substance which takes more than 3,500 underage lives every year. While avoiding any recreational substance use would likely be best for teens, this data suggests that teens avoiding cannabis use may be more likely to simply substitute their cannabis use for drinking than give up substance use entirely.

The researchers on the study, a collaboration between Massachusetts General Hospital, Harvard Medical School, Loyola University and the University of Miami, came to their conclusions after observing 160 cannabis users between the ages of 14-25. Participants in the study were randomly assigned to either continue their regular cannabis use, or give up cannabis for a period of 4 weeks. Notably, these participants were not seeking treatment for their cannabis use, but were simply healthy cannabis users willing to participate in the study. Those asked to give up cannabis were paid for the 4 weeks of abstinence.

All participants were assessed for their alcohol and cannabis use before, during and after the 4 week period of time, with assessments at baseline and 4, 6, 10, 17, 24, and 31 days after the study began. A follow-up visit was also conducted about 2-4 weeks after cannabis abstinence was no longer required.

The results showed a significant increase in alcohol use for those who were abstaining from cannabis. 64% of the teens and young adults who were in the abstinence group increased their alcohol use – both in terms of the frequency and quantity of their alcohol consumption. This effect began the first week of abstinence and was consistent throughout the 4 week period. The temporary increase in alcohol use ended when cannabis consumption resumed. Those in the study who continued using cannabis throughout the 4 week period saw no changes in their alcohol use.

Interestingly, not all those who abstained increased their alcohol consumption. 23% actually decreased their alcohol consumption and 17% didn’t shift their alcohol use at all. But the overwhelming statistical trend was toward increased alcohol use – suggesting that this may be a risk for teens and young adults attempting (or being forced into) cannabis abstinence. The authors suggest that while we may not see increased alcohol use for every individual abstaining from cannabis, at a population level, we should expect to see a trend in this direction.

This means that those monitoring teens and young adults who are in the process of cannabis abstinence may want to be particularly careful to watch for signs of alcohol abuse. Still, the researchers point out that the clinical significance of this increased alcohol use may not be that big. The increases were generally mild, and didn’t lead to increased binge drinking or alcohol use disorder. The authors say that “future studies should carefully consider whether the mild increase in the frequency and quantity of alcohol consumption in youth outweighs the known health, psychiatric, and cognitive benefits of full cannabis abstinence.”