Co-Use of Alcohol and Cannabis During COVID-19: Associations Between Sociodemographic Factors and Self-Reported Mental Health Symptoms and Heavy Episodic Drinking in Canadian Adults

This study estimates the prevalence of co-use of alcohol and cannabis, assesses the sociodemographic risk factors of co-use, and examines the associations between mental health and heavy episodic drinking (HED) and co-use of alcohol and cannabis in Canada during the early years of the COVID-19 pandemic. Nine successive cross-sectional surveys, held from May 2020 to January 2022, of adults (aged ≥18 years) living in Canada were pooled for 9,011 participants. The prevalence of co-use was calculated across sociodemographic groups. Logistic regressions were used to assess associations. Co-use of alcohol and cannabis was associated with a greater likelihood of engaging in HED and experiencing symptoms of anxiety, depression, and loneliness. The prevalence of co-use of alcohol was different across sociodemographic groups. The highest prevalence was among TGD people (35.5%), followed by individuals aged 18-39 years (14.5%). Additionally, being TGD, separated/divorced/widowed, living in an urban area, and having a high household income increased the likelihood of reporting co-use of alcohol and cannabis. These findings underscore the fact that developing public health and clinical interventions for preventing and treating excessive alcohol or cannabis use must consider both alcohol and cannabis use patterns and should be tailored to the highest-risk TGD and young adults.