Correlates and 6-month outcomes for co-occurring cannabis use in rural and urban at-risk drinkers.

We know little about the functional correlates of recent cannabis use when such use is additional to an "alcohol disorder" in non-treatment populations. We report on data from a prospective study of a large probability community survey of 733 at-risk drinkers in six Southern U.S. states (Alabama, Arkansas, Georgia, Louisiana, Mississippi, and Tennessee) conducted from 1995 to 1996. Twenty-one percent reported cannabis use during the past six months at the baseline interview. These cannabis users were significantly less likely to be married, employed, or a high school graduate (p < .05). They were also more likely to have a diagnosis of "antisocial personality disorder" or "panic disorder." Recent cannabis users also reported more negative consequences of their alcohol use, including more frequent recent diagnoses of an "alcohol disorder," legal difficulties associated with their drinking, and more social consequences attributed to drinking. At the six-month follow-up interview, negative alcohol outcomes were associated with concurrent cannabis use, including higher frequency and quantity of alcohol consumption, greater frequency of recent "alcohol abuse" and "dependence," and greater social consequences of drinking. These results all point to substantially poorer functioning and experiences of individuals with concurrent at-risk alcohol and cannabis use. We suggest that cannabis use may be a marker for greater impairment associated with at-risk drinking.