Romantic Highs and Regrets Linked to Alcohol Use

Heavy drinking & simultaneous cannabis use in young adults

Heavy drinking, or binge drinking, is defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) as four or more drinks on one occasion for females and five or more for males. High-intensity drinking (HID), or extreme binge drinking, involves consuming double this amount on one occasion: eight or more drinks for a female and 10 or more for a male. ^[1] A standard drink is 0.6 fluid ounces or 14 grams of alcohol, which amounts to a small can of beer or a small glass of wine.

Many young adults engage in heavy or high-intensity drinking, and a proportion of these individuals simultaneously engage in cannabis use. Results of the National Survey of Drug Use and Health 2023 indicate that 28.7% of young adults aged 18 to 25 engaged in binge drinking in the past month. The Monitoring the Future (MTF) Panel Study 1976-2023 shows that 8.5% of 19-30 year-olds have engaged in HID in a two-week period. ^[2][3] Additionally, around 30% of people aged 19-22 who consume alcohol also use cannabis. The use of cannabis among young people (both those who drink and those who do not drink) has increased in recent years, and there are growing numbers of young adults simultaneously using cannabis and alcohol. ^[4]

Key findings: Romance highs and regrets on the same night

A new study (López, G. et al, 2025) investigated the impact of simultaneous alcohol and cannabis use on the prevalence of regretted and positive romantic/sexual experiences.

Many people who use alcohol and substances encounter romantic or sexual experiences while under the influence. For example, substances might enhance emotional or physical pleasure, leading to positive experiences. Conversely, people using substances might be at increased risk of sexual assault, including coerced, unprotected, or regretted sexual activity.

Some people experience both positive and negative encounters on the same day. The study found that consuming a larger number of alcoholic drinks correlates with a higher likelihood of both positive and negative romantic or sexual experiences. ^[5]

However, the simultaneous use of both alcohol and cannabis is not associated with increased likelihood of regretted experiences. For males, simultaneous use had no impact on the likelihood of regretted experiences, whereas, for females, simultaneous use (compared to alcohol use only) decreased this likelihood. This suggests a somewhat protective factor for females with simultaneous use, although more research is needed to further explore and fully understand this effect. ^[5]

Understanding the emotional rollercoaster

Alcohol and drugs can alter a person’s perceptions, emotions, and decision-making abilities. For some, substances might decrease inhibition and improve social interactions, potentially increasing the likelihood of engaging in positive romantic and sexual encounters.

However, some people might find that this has the opposite effect and causes increased vulnerability to exploitation, unwanted sexual encounters, or poor judgment and decision-making. Intoxication can cause people to be more likely to engage in impulsive or risky behaviors, which can lead to regrets once the effects have worn off.

Additionally, people might be more likely to use drugs and alcohol if they have underlying mental health concerns. As such, they may experience symptom exacerbation and an increased risk of adverse events. For example, borderline personality disorder is commonly associated with risky, impulsive, and self-destructive behaviors. Substance use is common among people with BPD, which can increase emotional instability, risks, and vulnerability. ^[6]

People can respond differently to the effects of alcohol and drugs, and some may be at higher risk of negative experiences than others. It can be helpful for individuals to understand how drugs and alcohol affect them and put protective measures in place where necessary.

Informed drinking: Tips for emotional safety

The use of any substance can impact emotions and decision-making abilities. The following could be useful tips to help keep individuals safe while drinking, using cannabis, or taking other substances:

• Stay with friends: When intoxicated, remaining with your group of friends can help you stay safe, as you may be more vulnerable when alone or more likely to interact with people you don’t know.
• Have a plan to get home: Make a plan about how you will get home, such as who will stay sober and drive you home or if you will get a taxi, and stick to this plan.
• Set yourself a limit: Set a limit on how much you will drink/smoke.
• Have a safe word or back-up plan with your friends: It might be helpful for you and your friends to have a way to indicate to one another that you want to leave or get away from someone who is making you feel uncomfortable.
• Practice safe sex: People can be more vulnerable to regretted or unsafe sex when intoxicated. Always carry condoms and practice safe sex to help reduce this risk.
• Arrange another meeting: If you are in doubt about whether or not you want to engage in romantic or sexual experiences with someone, you could arrange to meet them another day, when you are both sober. This way, you have time to think about it clearly and can better judge the situation when you are not intoxicated.

When to seek professional help and support

It might be necessary or helpful to seek professional advice and support if you:

• Often engage in sexual or romantic experiences when intoxicated, which you later regret or feel bad about
• Can’t remember events that occurred while intoxicated
• Are told by your friends that they are concerned about your behavior when you are intoxicated
• Are using drugs or alcohol with increasing frequency and amounts
• Have experienced physical or emotional harm due to your use of drugs or alcohol

A professional can offer you advice about harm reduction strategies or ways to cut down on substance use. They can also refer to appropriate services, such as substance use disorder treatments, mental health support, or sexual health services.