Binge alcohol and cannabis co-use associated with depression in Black men

This study examined the relationship between depression symptoms and co-use of cannabis and binge drinking by establishing substance use patterns in a sample of Black men. Center for Epidemiologic Studies-Depression Scale scores were compared across four mutually exclusive categories of past-30-day use: cannabis only, binge-drinking only, co-use, and nonuse. We hypothesized that men who engaged in both binge drinking and cannabis use would report the highest depression scores compared to other user groups.

Past 30-day substance use data were collected between 2015 and 2016 from 786 Black adult men (M_age = 30.4, SD = 8.0, range = 18-44) as part of Menhood, a cross-sectional observational study assessing the effects of neighborhood and individual-level factors on Black men's HIV risk.

Using both analysis of covariance and linear regression models, we found a significant main effect of depression scores regressed on substance user types (nonusers, cannabis only, binge-drinking only, and co-users; F = 12.96, df = 3, p < .001), controlling for age, employment status, previous incarceration, education, and income. Compared to nonuse, mean depression scores were statistically highest among past 30-day co-use (M = 1.02, SE = 0.05), followed by cannabis only (M = 0.84, SE = 0.04) and binge-drinking only (M = 0.75, SE = 0.06). Higher frequency of use of either substance, and co-use, was linked to greater depressive symptoms.

As a between-subjects analysis, findings offer insight into population-level affect regulation patterns and may reconcile mixed evidence from within-person studies by highlighting stable risk associations in a structurally disadvantaged group. Results further underscore the need for culturally tailored mental health screening and intervention strategies for minoritized adult populations reporting co-use. (PsycInfo Database Record (c) 2026 APA, all rights reserved).