Marijuana users are five times more likely to develop an alcohol addiction, according to a Columbia University report. The study, published Wednesday, also found that adults who already struggle with alcohol abuse or dependence are more likely to see the problem continue if they use marijuana.

“Our results suggest that cannabis use appears to be associated with an increased vulnerability to developing an alcohol use disorder, even among those without any history of this,” said Renee Goodwin, associate professor of epidemiology at Columbia’s Mailman School of Public Health. “Marijuana use also appears to increase the likelihood that an existing alcohol use disorder will continue over time.”

Columbia researchers looked at findings from the National Epidemiologic Survey on Alcohol and Related Conditions, which surveyed 27,461 adults who used pot before they had any history with alcohol disorders. Respondents who continued to use cannabis over the three-year period were five times more likely to develop an alcohol problem. The full results of the study were published online in the journal Drug and Alcohol Dependence and can be viewed here

“From a public health standpoint we recommend that further research be conducted to understand the pathways underlying these relationships as well as the degree to which various potentially vulnerable population subgroups — youth, for example — are at increased risk,” Goodwin said in a statement. “If future research confirms these findings, investigating whether preventing or delaying first use of marijuana might reduce the risk of developing alcohol use disorders among some segments of the population may be worthwhile.”

The findings come as marijuana legalization gains momentum across the country. Since California first legalized medical marijuana in 1998, 22 other states and Washington, D.C., have approved some degree of pot use. Four states and Washington have gone on to legalize pot entirely.