A survey of college students found associations between simultaneous alcohol and cannabis use and mental health.
The study, “Monthly simultaneous cannabis and alcohol use: effects on depression, anxiety, and stress in male and female college students,” published in the Journal of Cannabis Research in Nov. 2025, included questions on monthly simultaneous cannabis and alcohol (SCA) and symptoms of depression, anxiety, and stress. Overall, the study found monthly SCA use is associated with increased depression in both male and female college students. The survey additionally determined anxiety and stress are predicted by monthly SCA use in males, and alcohol use frequency also negatively predicted stress, anxiety, and depression among males.
The researchers concluded that the results offered insights into the connection between substance use in college students and its impact on their mental health. They also noted programs aimed at preventing depression could be particularly beneficial for male students, Cannabis Science and Technology reports.
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“Mental health providers working with college students may wish to consider incorporating detailed assessments of alcohol and cannabis co-use, as SCA use may be a useful intervention target. SCA use could also be an important factor to assess in a prevention or mental health promotion context,” the researchers wrote. “Future research in this area should incorporate more representative sample populations, deeper assessments of substance co-use, and longitudinal designs in order to further examine the connection between the simultaneous use of alcohol and cannabis and mental health.”
The researchers note that the study’s limited sample size and demographic scope restrict its generalizability, “highlighting the need for more representative and longitudinal research.” The groups also significantly differed on typical alcohol use frequency and on most recent cannabis use occasion.
The study included responses from 367 college students — 245 females and 122 males — from a Colorado university psychology student research pool. The authors note Colorado was the first state to legalize recreational cannabis, adding, “Thus individuals in Colorado may have different overall attitudes toward cannabis compared to college students living in other states, particularly those with more stringent legal policies and presumably more negative attitudes toward cannabis.”
