Emotional Well-Being Among Adults with Comorbid Alcohol and Cannabis Use Disorders: Evidence from the COGA Lifespan Study

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.