How Cannabis Alters Alcohol’s Emotional Effects in Real Time

A new study¹ from the University of Missouri School of Medicine has brought forth new insights into how the simultaneous use of alcohol and cannabis affects our emotions.  Its findings suggest that using both substances together may not only alter the experience of alcohol but also reinforce its continued use, particularly among those who drink to cope with stress or negative emotions.

What the Study Explored

Over multiple weeks, the research, titled ‘Affective reinforcement of simultaneous versus single use of alcohol and cannabis‘, which was spearheaded by Andrea M. Wycoff and Timothy J. Trull, took into account data from 88 individuals, which amounted to over 6,300 ecological momentary assessment (EMA) entries.  The goal was to develop a greater understanding of the effect and role such substances have with regard to

• public health
• substance use treatment
• efforts to prevent alcohol use disorder.

Before diving into the findings, it is important to understand ‘simultaneous use’.  This is where individuals consume alcohol and cannabis close enough in time that their effects overlap – something increasingly common among young adults.

While previous studies have looked at its association with higher alcohol consumption, greater social consequences, and elevated risk of alcohol use disorder, the psychological reinforcement mechanisms behind this trend remain less understood.

So, does the simultaneous use of alcohol and cannabis reinforce the effects of either substance? Do users experience the emotional benefits they seek when using both substances together versus separately? And, how do motives for use, such as coping or enhancement, interact with affective outcomes?

Methodology: Real-Time Mood and Motive Tracking

The participants, aged 18 to 44, saw the study capture both their emotional state before and after use, providing insight into how people felt during real-world episodes of alcohol and cannabis use, either alone or in combination.  On average, participants used:

• Alcohol: 5.2 days during the study

• Cannabis: 8.6 days

• Both simultaneously: 3.4 days

Cannabis Alters the Emotional Effects of Alcohol

When participants used cannabis during drinking moments, notable shifts in emotional outcomes were observed.  For those drinking to cope with stress or negative emotions, the addition of cannabis seemed to ‘soften the blow’, reducing both anxious and depressed mood – perhaps unsurprising when considering recent findings from similar studies.  Specifically, anxiety dropped significantly (b = −0.11, p = .016), as did feelings of depression (b = −0.14, p = .003).

However, when alcohol was consumed for enjoyment or enhancement, simultaneous cannabis use appeared to dull that sense of pleasure.  Participants reported a marked decline in the subjective pleasure they associated with drinking (b = −0.34, p < .001), suggesting that cannabis may moderate both the lows and the highs of alcohol use.

Alcohol Does Not Alter Cannabis’s Emotional Effects

In contrast, when alcohol was used during cannabis moments, there was no significant change in how users experienced the effects of cannabis.  This one-sided influence seemed to underscore the ability of cannabis to play a prominent role in shaping emotional outcomes during simultaneous use.  Furthermore, it suggests the plant may act as a modulator of sorts for alcohol’s effects rather than the other way around.

Broader Context: How Simultaneous Use Fits Into Emerging Patterns Among Young Adults

The findings of this study are especially relevant when considering broader substance use trends among young adults.  As research continues to highlight shifting motivations and usage patterns involving cannabis and alcohol, it is becoming increasingly clear that simultaneous use is not occurring in isolation.  Rather, it is occurring as part of a complex landscape to navigate coping, social reinforcement, and evolving norms.  The following are other recent examples of trends involving the use of both alcohol and cannabis that may shed further light onto the situation.

Chronic Pain and Coping Motives Among Youth:  In our article titled “Does Chronic Pain Fuel Cannabis and Alcohol Use in Youth?” we looked at findings of a study that revealed chronic pain is a major driver of both cannabis and alcohol consumption among adolescents and young adults.  Many individuals in this group turn to these substances not for recreation, but to manage emotional or physical discomfort.  Notably, this aligns with the most recent study discussed above, with findings that suggest simultaneous cannabis use may help dampen the emotional distress associated with coping-motivated drinking, reinforcing continued use under the false perception of relief.

Cannabis, Alcohol, and Relationship Dynamics:  There is also a social layer to this behavior.  In “Cannabis, Alcohol & Relationships: What the Research Tells Us”, we discuss findings that explore how co-use can influence romantic and peer relationships.  For some, using substances together becomes a form of bonding or coping with interpersonal stress, while others experience conflict, codependency, or reinforcement of unhealthy patterns.  This further supports Wycoff and Trull’s conclusion that simultaneous use may be sustained by perceived emotional and social benefits, even when those benefits are limited or come at a long-term cost.

Shifting Usage Trends in the U.S.:  Finally, a broader usage trend highlighted in “Daily Cannabis Use Outpaces Drinking in the U.S.” shows that daily cannabis use has now surpassed daily alcohol consumption among U.S. adults for the first time in decades.  With cannabis becoming increasingly accessible and socially acceptable, it is unsurprising that more individuals are co-using it with alcohol, sometimes to manage the aftereffects of one substance with the perceived benefits of the other.

Future Research and Implications: Short-Term Relief, Long-Term Risk?

Based on their findings, the researchers behind this study emphasize that their findings should inform both clinical and preventive approaches:

• Treatment programs may need to screen for simultaneous use patterns and tailor interventions accordingly.

• Public health messaging should acknowledge the nuanced emotional effects of co-use.

• Further research is needed to explore these reinforcement mechanisms in individuals undergoing treatment for substance use.

Overall, the study adds further context to a growing behavioral health challenge.  While cannabis may offer momentary relief from the emotional fallout of drinking, that very effect may encourage riskier patterns of alcohol consumption, masking harmful consequences and increasing vulnerability.

Studies Referenced:

^{1. Wycoff, A. M., & Trull, T. J. (2025). Affective reinforcement of simultaneous versus single use of alcohol and cannabis. Drug and Alcohol Dependence, 267, 112612. https://doi.org/10.1016/j.drugalcdep.2025.112612}