Does Chronic Pain Fuel Cannabis and Alcohol Use in Youth?

Pain is unavoidable, but how individuals cope with it – especially during critical developmental windows – can have lasting consequences.  One such window is young adulthood, typically ages 18 to 25, a period that sees increased independence and, often, risk-taking behavior that includes substance use.  With that in mind, a recent study¹ published in the Journal of Adolescence highlighted how pain may be a driving factor behind the co-use of alcohol and cannabis among young adults.

Pain as a Predictor of Cannabis and Alcohol Co-Use

The study titled “Pain Predicts Past-Month Co-Use of Alcohol and Cannabis Among Emerging Adults” looked at how physical pain may influence the simultaneous use of cannabis and alcohol in young adults.  It drew upon a sample of individuals within this age group and found that self-reported pain significantly predicted the co-use of both substances over the past month.  Notably, this link remained even when factoring in variables like gender, race, and psychological distress.

Simply put, the findings indicate that young adults who are experiencing pain may be self-medicating with cannabis and alcohol.  While cannabis alone is often reported for pain relief, it is believed that by adding alcohol to the mix, some are attempting to amplify perceived analgesic effects or even cope with the emotional toll of chronic pain.  However, combining the two substances can compound negative health effects, including increased risks of substance dependence, cognitive impairment, and risky behavior.  Needless to say, while cannabis may have a role to play for many in managing pain, self-medicating alongside alcohol is not the smartest of decisions.

The Growing Appeal of Cannabis for Pain Relief

As it stands, this trend towards cannabis being commonly used as a means of pain relief can be attributed to the plant being increasingly viewed as a safer, more natural alternative to conventional painkillers – especially opioids.  Unlike opioids, which carry significant risks of addiction, overdose, and debilitating side effects, cannabis has a relatively favorable safety profile.  Although nothing is without risk, especially when used in combination with alcohol, cannabis does offer several therapeutic mechanisms for pain management that make it an appealing option – particularly among young adults seeking relief without the baggage of pharmaceutical drugs.

Cannabinoids like THC and CBD interact with the endocannabinoid system, which is crucial in modulating pain, inflammation, and immune response.  This system is typically the primary target for medical cannabis therapies, which can offer relief for both nociceptive and neuropathic pain conditions.

Beyond the cannabinoids, cannabis also contains terpenes—aromatic compounds that exhibit pain-modulating effects and may work synergistically with cannabinoids to boost therapeutic programs.  Again, this multifaceted potential has made cannabis a compelling choice for individuals dealing with persistent pain from conditions like Fibromyalgia, Hypermobility, and more.

Moreover, the stigma surrounding cannabis has softened in recent years, particularly in North America, where legalization and expanded access have normalized its use.  This may further explain the uptick in cannabis use for pain relief, especially among populations seeking alternatives to prescription medications with serious side effects.

Insights from Recent Cannabis and Pain Studies

Alongside this most recent study, a recent crop of similar research endeavours have only further underscored the role of cannabis in chronic pain management – each offering deeper context to the behaviors observed in emerging adults.

Cannabis-Derived Pharmaceuticals: One of the most promising developments is VER-01, a cannabis-derived drug developed by a German pharmaceutical company.  In a clinical trial² of 800 individuals suffering from chronic lower back pain, VER-01 significantly reduced pain levels and improved sleep quality—without causing intoxication or addiction.  Unlike opioids, which often require escalating doses and come with severe withdrawal symptoms, VER-01 demonstrated no signs of dependency, positioning it as a potential game-changer in the world of pain management.

Terpenes for Fibromyalgia and Specialized Conditions: Another study³ explored the potential of cannabis terpenes in managing fibromyalgia pain.  Researchers found that specific terpenes, such as myrcene and linalool, may offer anti-inflammatory and analgesic effects, potentially improving outcomes for patients with complex pain disorders.  Additionally, patients with hypermobility syndromes—conditions characterized by joint instability and chronic pain—reported significant symptom relief when using medical cannabis, pointing to the plant’s broader utility beyond standard pain conditions.

Together, these studies are quickly forming a foundation of evidence that supports cannabis as a viable, well-tolerated alternative to conventional pain treatments.  As research progresses, it may also explain why emerging adults, when experiencing chronic pain, increasingly turn to cannabis, even in conjunction with alcohol.  While the combination presents health concerns, the choice to include cannabis likely reflects a belief in its therapeutic value – especially when standard treatment options fall short or feel inaccessible.

Final Thoughts

The link between pain and the co-use of alcohol and cannabis among emerging adults adds another piece to the puzzle of substance use behavior in this demographic.  What is important to remember is that pain, whether acute or chronic, is more than just a physical experience – it is a driving factor in how young adults are self-medicating to manage discomfort.  As research highlights the therapeutic benefits of cannabis, especially its ability to relieve pain with fewer side effects than opioids, it becomes clear why it might be gaining traction among young adults.

However, the co-use of cannabis and alcohol remains a concern, particularly given the risks associated with mixing substances.  So while cannabis may play a role in pain management, the findings currently point to a need for pain management education.

Studies Referenced:

<sup>1. Williams, C. M., Mastroleo, N. R., Lenzenweger, M. F., & Zale, E. L. (2025). Pain predicts past-month co-use of alcohol and cannabis among emerging adults: Results from the Population Assessment of Tobacco and Health (PATH) Study. Alcohol, 124, 111–119. https://doi.org/10.1016/j.alcohol.2025.02.003
2. Rangari, V.A., O’Brien, E.S., Powers, A.S. et al. A cryptic pocket in CB1 drives peripheral and functional selectivity. Nature (2025). https://doi.org/10.1038/s41586-025-08618-7
3. Seekins, C.A., Welborn, A.M., Schwarz, A.M. et al. Select terpenes from Cannabis sativa are antinociceptive in mouse models of post-operative pain and fibromyalgia via adenosine A2a receptors. Pharmacol. Rep 77, 172–181 (2025). https://doi.org/10.1007/s43440-024-00687-1</sup>