Research study · American Journal of Psychiatry · 2026
Acute Effects of Cannabis on Alcohol Craving and Consumption: A Randomized Controlled Crossover Trial
A 2026 randomized controlled trial in American Journal of Psychiatry tested dronabinol in alcohol craving. Cannabis use is linked with heavy drinking and worse alcohol treatment outcomes. In a single laboratory session, heavy drinkers who also use cannabis regularly drank less alcohol after smoking cannabis than after a placebo cigarette, though how strongly they said.
Study overview
Clinicians should be aware of the complex relationship between cannabis use and alcohol consumption, as THC may have varying effects on alcohol craving and consumption.
Findings
Cannabis use is linked with heavy drinking and worse alcohol treatment outcomes. No human studies have established a causal effect of cannabis on alcohol motivation. The trial aims to examine the acute effects of THC on alcohol craving and consumption.
Why this matters
In a single laboratory session, heavy drinkers who also use cannabis regularly drank less alcohol after smoking cannabis than after a placebo cigarette, though how strongly they said they craved alcohol did not change. This is one short session in one specific group, so it does not show that cannabis helps people drink less over time, and it should not be read as a reason to use cannabis to cut down on drinking.
Abstract
Objective: Cannabis use is strongly linked with heavy drinking and worse alcohol treatment outcomes; however, it may also contribute to decreased alcohol consumption. To date, no human studies have established a causal effect of cannabis on alcohol motivation. The aim of this double-blind crossover randomized clinical trial is to examine dose-dependent acute effects of Δ9-tetrahydrocannabinol (THC) on alcohol craving and consumption. Methods: Across three experimental days, 157 participants reporting heavy alcohol use and cannabis use ≥twice weekly were randomized to smoke placebo, 3.1% THC, and 7.2% THC cigarette followed by exposures to neutral and personalized alcohol cues and an Alcohol Choice Task for alcohol self-administration. 138 participants completed ≥two experimental sessions (Mean(SD) age: 25.6(5.1) years; 35% women; 45% ethnic/racial minorities). Primary outcomes include craving, Alcohol Craving Questionnaire-Short Form-Revised (ACQ-SF-R) and an alcohol urge question; secondary outcome was percent of total available ml of alcohol consumed. Results: There were no significant effects of cannabis on the ACQ-SF-R post-smoking and during alcohol cue exposure, but 7.2% THC reduced alcohol urge immediately post smoking. Participants consumed significantly less alcohol after smoking cannabis with 3.1% THC and 7.2% THC, reducing consumption by 19% and 27%, respectively. Conclusions: Following cannabis abstinence, smoking cannabis acutely decreased alcohol consumption compared to placebo. Further controlled research on a variety of cannabinoids is needed to inform clinical alcohol treatment guidelines.
Citation
Metrik J, Aston ER, Gunn RL, Swift R, MacKillop J, Kahler CW Acute Effects of Cannabis on Alcohol Craving and Consumption: A Randomized Controlled Crossover Trial. American Journal of Psychiatry (2026). PubMed 41254853 · DOI
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Condition: Alcohol consumption Condition: Craving Topic: THC
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Reviewed by Dr. Caplan on September 17, 2026.
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