The Pros and Cons of Substituting Marijuana for Alcohol
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
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Some people choose to substitute marijuana for alcohol if they are trying to stop drinking—a controversial practice referred to as marijuana maintenance.
Those who support the practice argue that marijuana is far less hazardous to a person’s health than alcohol (the same argument is often used when comparing marijuana to cigarettes). Those who are opposed to the practice argue that the goals of sobriety are never truly achieved if a person replaces one mind-altering drug with another.
Here are the pros and cons of replacing alcohol with marijuana, as well as resources you can turn to if you are trying to quit drinking or using substances.
Potential Pros of Marijuana Management
Supporters of marijuana management programs are often quick to point out that the evidence on the effectiveness of traditional recovery programs like Alcoholics Anonymous (AA) is largely split.
The findings from a 2006 Cochrane review of studies demonstrated no significant difference in the results achieved by people in AA compared to other treatment models. Furthermore, even the studies that attributed benefits to the AA methodology concluded that successful sobriety was more associated with the frequency of meeting attendance than the 12-step model itself.
Alternative to Abstinence-Only
For those who are unable or unwilling to regularly attend AA meetings, the rate of failure was high. Supporters argue that it is these individuals who might benefit from using marijuana management. The model recognizes that for some people, abstinence-based programs are unrealistic and unachievable.
Those who are in favor of the practice argue that many of the ill-effects of alcohol detoxification might be softened if a person is able to taper off alcohol gradually while using marijuana.
Supporters of marijuana management programs often argue that the drug has been demonized. Those in favor of its use argue that unlike alcohol, marijuana can be used without the risk of death from binging. They also point out that it has fewer drug interactions than alcohol and possibly has much less of an impact on one’s long-term health.
Additionally, proponents argue that marijuana might have some inherent benefits compared to alcohol. While there is ongoing debate about whether moderate drinking has possible health benefits, the effects of alcohol misuse can be catastrophic, contributing to an increased risk for breast cancer, birth defects, and other health issues.
Marijuana, on the other hand, is purported to have some health benefits that can make it useful in certain situations. For example, marijuana is frequently used to alleviate pain, stimulate appetite, and enhance moods. For an individual who is recovering from alcohol use disorder, these properties could be beneficial.
Potential Cons of Marijuana Management
Those who are opposed to marijuana maintenance argue that it is founded on the premise that marijuana is not only safer than alcohol but that it is tacitly safe. They argue that because there is no evidence to support that premise, it is unfounded and even unconscionable to advocate for marijuana management.
The foundation of alcohol recovery is based on recognizing that alcohol is harmful and that a person has no control over their use of the substance. Softening the blow inherently suggests that marijuana is something over which a person can have greater control. It also infers that the self-awareness a person is meant to achieve during recovery can wait until they are stronger and no longer need marijuana or alcohol.
One of the most significant potential pitfalls of using marijuana as a replacement therapy is the possibility of dependence. Research suggests that 30% of people who use marijuana develop cannabis use disorder to some degree.
Negative Health Effects
Detractors say that the practice only aims to replace one habit with another under the guise that marijuana is the less-harmful alternative. According to the National Institute on Drug Abuse, this may not be the case. There are several concerns associated with marijuana use, including:
- Marijuana can have a long-term impact on a person’s health. For example, it has been associated with bone density loss, reduction of exercise tolerance, impairment of memory and cognitive skills, and an increased risk of lung conditions.
- Marijuana might contribute to underlying mental health conditions that are common in people who misuse alcohol.
- Marijuana might have the potential to act as a gateway drug. In theory, it could lead people with addictive behaviors to use other dangerous drugs like cocaine and heroin.
Reduced Treatment Effectiveness
Some evidence also suggests that marijuana use can actually interfere with efforts to stop using alcohol. One 2015 study found that concurrent marijuana use lowers a person’s odds of achieving abstinence from other drug or heavy alcohol use.
If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
Learn about the pros and cons of substituting marijuana for alcohol and why some people in recovery use the controversial practice.