Abstract Objective: Amidst the evolving policy surrounding cannabis legalization in the United States, cannabis use is becoming increasingly prevalent as perceptions of harm decrease, particularly among adolescents. Cannabis and alcohol are commonly used by adolescents and are often used together. However, developmental research has historically taken a “single substance” approach to examine the association of substance use and adolescent brain and behavior rather than examining co-(or poly-substance) use of multiple substances, such as cannabis and alcohol. Thus, the acute effects of cannabis and alcohol, and the impact of co-use of cannabis and alcohol on the adolescent brain, cognitive function and subsequent psychosocial outcomes remains understudied. This narrative review aims to examine the effects of cannabis and alcohol on adolescents across a number of behavioral and neurobiological outcomes. Methods: The PubMed and Google Scholar databases were searched for the last 10 years to identify articles reporting on acute effects of cannabis and alcohol administration, and the effects of cannabis and alcohol on neuropsychological, neurodevelopmental, neural (e.g., structural and functional neuroimaging), and psychosocial outcomes in adolescents. When adolescent data were not available, adult studies were included as support for potential areas of future direction in adolescent work. Results: Current studies of the impact of cannabis and alcohol on adolescent brain and behavior have yielded a complicated pattern. Some suggest that the use of cannabis in addition to alcohol during adolescence may have a “protective” effect, yielding neuropsychological and structural brain outcomes that are better than those for adolescents who use only alcohol. However, other adolescent studies suggest that cannabis and alcohol co-use is associated with negative health and social outcomes such as poorer academic performance and impaired driving. Conclusion: Variation in study methodologies, policy-level limitations and our limited understanding of the developmental neurobiological effects of cannabis preclude the straightforward interpretation of the existing data on adolescent cannabis and alcohol use. Further research on this topic is requisite to inform the development of effective intervention and prevention programs for adolescent substance users, which hinge on a more comprehensive understanding of how cannabis—and its intersection with alcohol—impacts the developing brain and behavior.

中文翻译：

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探索大麻和酒精在青少年中的共同使用：证据的叙述性审查

摘要 目标：在美国围绕大麻合法化不断发展的政策中，随着危害认知的减少，大麻的使用变得越来越普遍，尤其是在青少年中。大麻和酒精是青少年常用的，并且经常一起使用。然而，发展研究历来采用“单一物质”方法来检查物质使用与青少年大脑和行为的关联，而不是检查多种物质（如大麻和酒精）的共同（或多种物质）使用。因此，大麻和酒精的急性影响以及同时使用大麻和酒精对青少年大脑、认知功能和随后的社会心理结果的影响仍未得到充分研究。这篇叙述性评论旨在检查大麻和酒精对青少年的一系列行为和神经生物学结果的影响。方法：在过去 10 年中搜索了 PubMed 和 Google Scholar 数据库，以识别报告大麻和酒精给药的急性影响以及大麻和酒精对神经心理学、神经发育、神经（例如结构和功能神经成像）、和青少年的心理社会结果。当青少年数据不可用时，成人研究被包括在内，以支持青少年工作未来方向的潜在领域。结果：目前关于大麻和酒精对青少年大脑和行为影响的研究得出了一个复杂的模式。一些人认为，在青春期除了酒精之外使用大麻可能具有“保护”作用，产生比仅使用酒精的青少年更好的神经心理和大脑结构结果。然而，其他青少年研究表明，大麻和酒精的共同使用与不良的健康和社会后果有关，例如较差的学习成绩和驾驶障碍。结论：研究方法的差异、政策层面的限制以及我们对大麻发育神经生物学影响的有限理解妨碍了对有关青少年大麻和酒精使用的现有数据的直接解释。需要对该主题进行进一步研究，以便为青少年吸毒者制定有效的干预和预防计划，