Marijuana plus alcohol is one of the most frequently detected drug combinations in car crashes nationwide, yet the interaction of these two compounds has been poorly understood…until now.

A study appearing online in Clinical Chemistry, the journal of the American Association for Clinical Chemistry, proves that the simultaneous use of alcohol and cannabis produces significantly higher blood concentrations of cannabis’s main psychoactive constituent, THC, as well as THC’s primary active metabolite, 11-hydroxy-THC (11-OH-THC), than cannabis use alone.

Currently, 23 states and the District of Columbia have legalized medical cannabis, and Colorado, Washington, Oregon, and Alaska have decriminalized recreational cannabis use. Experts agreed in previous studies that the combination of cannabis and alcohol raises the chance of crashing more than either substance by itself.

For this study, scientists examined 19 people drinking alcohol, or a placebo, in low doses ten minutes before inhaling vaporized cannabis in either a low or high dose. When alcohol was consumed, a far higher blood concentration of THC emerged.

“The significantly higher blood THC…values with alcohol possibly explain increased performance impairment observed from cannabis-alcohol combinations,” said lead researcher Marilyn A. Huestis, PhD, of the National Institute on Drug Abuse, in a news release. “Our results will help facilitate forensic interpretation and inform the debate on drugged driving legislation.”

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