Sex differences in the acute pharmacological and subjective effects of smoked cannabis combined with alcohol in young adults.
Madison Wright, Christine M Wickens, Patricia Di Ciano, Beth Sproule, Andrew Fares, Justin Matheson, R. Mann, J. Rehm, P. Shuper, T. George, Marilyn A. Huestis, G. Stoduto, Bernard Le Foll, Bruna Brands
Psychology of Addictive Behaviors June 3, 2021 DOI: 10.1037/adb0000749 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Within-subjects laboratory experiment Peer reviewed |
|---|---|
| Sample size | 28 |
| Population | Young adults aged 19-29 years who are regular cannabis users (16 males, 12 females) |
| Intervention | Alcohol |
| Dose | alcohol target 0.08% breath alcohol content; cannabis 12.5% Δ⁹-tetrahydrocannabinol (THC), ad libitum smoking |
| Topics | Cannabis |
| Key findings | In the combined alcohol-cannabis condition, females smoked significantly less of the cannabis cigarette than males, yet showed minimal differences from males in THC blood concentrations, vital signs, subjective effects, or cognitive measures. The authors conclude that females experienced similar acute pharmacological and subjective effects after smoking less cannabis, with potential implications for education and policy. |
Abstract
Objective: The prevalence of co-use of alcohol and cannabis is increasing, particularly among young adults. Sex differences in the effects of alcohol alone and cannabis alone have been observed in animals and humans. However, sex differences in the acute pharmacological effects of cannabis combined with alcohol have not yet been studied. In young adults, aged 19-29 years, we aimed to examine sex differences following an intoxicating dose of alcohol (target 0.08% breath alcohol content) combined with a moderate dose of cannabis (12.5% Δ⁹-tetrahydrocannabinol; THC) using an ad libitum smoking procedure.
Method: Using a within-subjects design, 28 regular cannabis users (16 males; 12 females) received in random order: (a) placebo alcohol and placebo cannabis, (b) active alcohol and placebo cannabis, (c) placebo alcohol and active cannabis, and (d) active alcohol and active cannabis. Blood samples for THC were collected and measures of vital signs, subjective drug effects, and cognition were collected.
Results: In the alcohol-cannabis combined condition, females smoked significantly less of the cannabis cigarette compared to males (p < .001), although both sexes smoked similar amounts in the other conditions. There was minimal evidence that females and males differed in THC blood concentrations, vitals, subjective effects, or cognitive measures.
Conclusions: In the alcohol-cannabis combined condition, females experienced the same acute pharmacological and subjective effects of alcohol and cannabis as males, after smoking less cannabis, which has potential implications for informing education and policy. Further research is warranted on sex differences in cannabis pharmacology, as well as the combined effects of alcohol and cannabis. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Comparable studies
Other experimental studies on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Smoked Cannabis' Psychomotor and Neurocognitive Effects in Occasional and Frequent Smokers Occasional (<2x/week) and frequent (≥4x/week) cannabis smokers | 2015 | Controlled within-subjects study | n = 25 |
| Dissociable effects of cannabis with and without cannabidiol on the human brain’s resting-state functional connectivity Healthy volunteers experienced with cannabis but not regular users | 2019 | Within-subjects experimental design | n = 17 |
| Which biological and self-report measures of cannabis use predict cannabis dependency and acute psychotic-like effects? Young cannabis users | 2018 | Observational study (naturalistic, within-subject counterbalanced design) | n = 410 |
| Cannabis Essential Oil: A Preliminary Study for the Evaluation of the Brain Effects Healthy volunteers | 2018 | Experimental study | n = 5 |
| Coming off cannabis: a cognitive and magnetic resonance imaging study in patients with multiple sclerosis Patients with multiple sclerosis who began using cannabis after disease onset, used it... | 2019 | Quasi-experimental study with odd-even allocation | n = 40 |
Citations in the library
Cited by 3
- Sex differences in acute cannabis effects revisited: Results from two randomized, controlled trials Addiction Biology December 22, 2021
- Sex differences in the acute effects of cannabis on human cognition: A systematic review. Frontiers in neuroendocrinology October 1, 2025
- Investigating sex differences in the acute effects of smoked cannabis: a potency-ranging, controlled administration, human laboratory experiment. Psychopharmacology August 11, 2026