Alcohol and Cannabis Co-Use and Social Context as Risk Pathways to Sexual Assault

Objective: Simultaneous use of alcohol in combination with cannabis ("co-use") is common among young adults, and associated with myriad consequences. Yet no studies have examined how co-use may confer vulnerability for sexual assault (SA). Further, though both co-use and SA commonly occur in social settings, there have been no examinations of the role that co-use may play in the broader social context that leads to assault risk. This was the objective of the present study. Method: In a community sample of young adult women, (N = 174; Mage = 22.6), we examined risk pathways to SA, guided by Routine Activities Theory (Mustaine & Tewksbury, Criminal Justice Review, 2002, 27, 89). Using a longitudinal burst design with 27 daily assessments across 1 year, women reported on their own and others' alcohol, cannabis, and co-use, and on social context and assault experiences. Results: Multilevel path model results showed alcohol and cannabis co-use to confer unique risk for SA, above and beyond the influence of use of either substance alone. Intoxication and components of the co-use social context (proximity to offenders) mediated this risk. Importantly, we observed a key role for co-use by others within the social context in assault risk. Conclusions: This study adds to the literature by providing a nuanced and contextual account of how cannabis-alcohol co-use may lead to assault vulnerability in young adult women. Findings underscore the need for intervention efforts that expand their focus to include the broader social context, and the role that the use and co-use behaviors of others may play within this context. Public Health Significance Statement This study of community young adult women shows co-use to be related to sexual assault risk. The social context is an important part of this risk. Findings underscore the need for intervention efforts that expand their focus to include the broader social context.