title: Adverse psychosocial outcomes associated with drug use among US high school seniors: a comparison of alcohol and marijuana.
abstract: OBJECTIVE
  There is debate about whether marijuana (cannabis) use is more dangerous than alcohol use. Although difficult to make objective comparisons, research is needed to compare relative dangers in order to help inform preventive efforts and policy.
  
  
  METHODS
  Data were analyzed from a nationally representative sample of high school seniors in the Monitoring the Future study (2007-2011; Weighted n = 7437; modal age: 18) who reported lifetime use of alcohol or marijuana. Students were asked to indicate whether they experienced various adverse psychosocial outcomes resulting from use of each substance. We examined which outcomes were more prevalent for each substance.
  
  
  RESULTS
  Compared to alcohol use, marijuana use was more commonly reported to compromise relationships with teachers or supervisors, result in less energy or interest, and result in lower school or job performance. Compared to marijuana use, alcohol was more commonly reported to compromise relationships with friends and significant others; it was also reported to lead to more regret (particularly among females), and driving unsafely. Marijuana users were more likely to report no adverse outcomes. Females and white students were more likely to report various adverse outcomes and higher frequency use of each substance also increased occurrences of reported adverse outcomes.
  
  
  CONCLUSIONS
  Marijuana and alcohol are associated with unique adverse psychosocial outcomes. Outcomes differ by sex and race/ethnicity, and perception or experience of outcomes may also be related to legal status and associated stigma. Public health interventions may be more effective by focusing on harm reduction strategies for these drug-specific outcomes.
authors.affiliation: New York University Langone Medical Center, Department of Population Health , New York .
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Palamar
authors.forename: Michael
authors.initials: M
authors.lastname: Fenstermaker
authors.forename: Dimita
authors.initials: D
authors.lastname: Kamboukos
authors.forename: Danielle C
authors.initials: DC
authors.lastname: Ompad
authors.forename: Charles M
authors.initials: CM
authors.lastname: Cleland
authors.forename: Michael
authors.initials: M
authors.lastname: Weitzman
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology / Q000523:psychology; D001334:Automobile Driving / Q000706:statistics & numerical data; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects* / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D012737:Sex Factors; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D044465:White People
keywords: Adolescents; adverse outcomes; alcohol; cannabis; marijuana