Alcohol & cannabinoid co-use: Implications for impaired fetal brain development following gestational exposure

Highlights

• Young adults of child-bearing age are increasingly engaging in simultaneous alcohol and cannabinoid (SAC) use.

• SAC users demonstrate distinct preferences and drug-seeking behaviors from single-drug users.

• Studies investigating prenatal alcohol (PAE) & prenatal cannabinoid exposure (PCE) share common neurodevelopmental targets.

• Prenatal SAC exposure may augment offspring deficits from single-drug exposure across several neurodevelopmental domains.

• SAC is an under-investigated area of research, and more controlled studies of prenatal polysubstance exposure are mandated.

Abstract

Alcohol and marijuana are two of the most consumed psychoactive substances by pregnant people, and independently, both substances have been associated with lifelong impacts on fetal neurodevelopment. Importantly, individuals of child-bearing age are increasingly engaging in simultaneous alcohol and cannabinoid (SAC) use, which amplifies each drug's pharmacodynamic effects and increases craving for both substances. However, to date, investigations of prenatal polysubstance use are notably limited in both human and non-human populations. In this review paper, we will address what is currently known about combined exposure to these substances, both directly and prenatally, and identify shared prenatal targets from single-exposure paradigms that may highlight susceptible neurobiological mechanisms for future investigation and therapeutic intervention. Finally, we conclude this manuscript by discussing factors that we feel are essential in the consideration and experimental design of future preclinical SAC studies.