New Cannabis Laws Tied to Higher Binge Drinking Rates

Pauline Anderson

June 21, 2023


After passage of state laws that allow recreational cannabis use, binge drinking declined among those younger than 21 but increased among those aged 31 and older.


  • Among adolescents, binge drinking, defined as having five or more drinks for men and four or more drinks for women at one time, is associated with poor academic performance, sexual risk, and injury in the short term, as well as the development of alcohol use disorder and academic disengagement in the long term.

  • Current evidence regarding the association between recreational cannabis laws (RCLs) and binge drinking is limited.

  • States in which RCLs have been implemented include Colorado, Washington, Alaska, Oregon, Nevada, California, Massachusetts, and Vermont, as well as the District of Columbia.

  • The study included 817,359 people aged 12 and older who participated in the 2008–2019 National Survey on Drug Use and Health (NSDUH), a nationally representative survey of the US population.


  • Overall, states that have not enacted cannabis laws showed consistently lower rates of binge drinking over time among all age groups.

  • In all states, there were substantial declines in reporting of past-month binge drinking in some age groups ― from 17.5% (95% CI, 16.9 – 18.2) in 2008 to 11.1% (10.4 – 11.8) in 2019 among those aged 12–20 and a drop from 43.7% (42.4 – 44.9) to 40.2% (39.1 – 41.1) among those aged 21–30.

  • There were overall increases in binge drinking in all states regardless of cannabis laws among individuals aged 31 and older. The most extensive increases were among people aged 31– 40 (from 28.1% [95% CI, 26.6 – 29.6] to 33.3% [32.1 – 34.6]), followed by participants aged 51 and over (from 13.3% [95% CI, 12.2 – 14.4] to 16.8% [15.8-17.7]).


"Our findings support calls to reinforce healthcare providers' discussions about alcohol use with older adults," particularly in RCL states, the researchers write.


The study was conducted out by Priscila Dib Gonçalves, PhD, Department of Epidemiology, Columbia University Mailman School of Public Health, New York City, and colleagues. It was published in the International Journal of Drug Policy.


Alcohol-related measures, including binge drinking, were self-reported, which may introduce recall bias and underreporting. NSDUH binge drinking measures were not adjusted for sex differences from 2008 to 2014, which may result in underreporting of binge drinking in females before 2015. The researchers did not examine cannabis policy provisions, such as cultivation restrictions, pricing control, the tax imposed, and consumption restrictions.


The study received support from the National Institutes of Health, the National Institute on Drug Abuse, the National Center for Injury Prevention and Control, and the Centers for Disease Control and Prevention. The authors report no relevant conflicts of interest.


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