Emotional Well-Being Among Adults with Comorbid Alcohol and Cannabis Use Disorders: Evidence from the COGA Lifespan Study
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Background. Alcohol use disorder (AUD) and cannabis use disorder (CUD) are often comorbid. Concurrent or simultaneous use of alcohol and cannabis is associated with poorer mental health outcomes in cross-sectional studies. Here, we examined whether lifetime history of comorbid AUD and CUD is associated with emotional well-being, above and beyond current substance use and lifetime major depression. Methods. Participants were 1,393 adults from the Collaborative Study on the Genetics of Alcohol Lifespan assessment (Mage= 52.0, 59.7% female). Emotional well-being was assessed across six domains from the NIH Toolbox Emotion Battery: loneliness, perceived stress, negative affect, social satisfaction, psychological well-being, and self-efficacy. Associations between lifetime diagnostic group (comorbid AUD + CUD, AUD without CUD, CUD without AUD, or neither disorder) and emotional well-being outcomes were assessed using multivariate linear regression. Covariates included age, sex, and past-year nicotine, cannabis, and alcohol use. Sensitivity analyses adjusted for lifetime major depressive disorder.Results. Individuals with comorbid lifetime AUD + CUD reported higher loneliness, perceived stress, and negative affect, and lower social satisfaction, psychological well-being, and self-efficacy compared to other groups. Individuals with lifetime AUD without CUD or CUD without AUD generally resembled those with neither disorder across several emotional well-being domains, though those in the AUD without CUD group reported greater negative affect and lower social satisfaction and psychological well-being than the group with neither disorder. Conclusions. A lifetime history of comorbid AUD and CUD is associated with diminished emotional well-being, underscoring the need for additional psychosocial supports to address these challenges in this population.
Authors: Fatima Hijazi, Jiawen Zhao, Megan Cooke, Sally I Kuo, Kathleen Bucholz, Grace Chan, Genevieve Fullerton Dash, Fanghong Dong, Christina Elizabeth Garasky, Chella Kamarajan, Jacquelyn L Meyers, Zoe Elizabeth Neale, Ashwini Kumar Pandey, Gayathri Pandey, Bernice Porjesz, Martin H. Plawecki, Jessica E Salvatore
Institution: Virginia Commonwealth University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7223227482