Anyone who knows someone who smokes pot daily and also someone who drinks alcohol daily can tell which substance is more hazardous and leads to poorer decisions. It’s likely pretty clear the alcoholic’s quality of life would improve drastically if he substituted a toke of a joint for each drink. Such anecdotal observations have lead users to ask: can cannabis treat alcoholism?
Sometimes it takes science and policy a little time to catch up with common sense, but there’s a growing movement to abandon the marginally effective abstinence-only models for alcoholism treatment with a more nuanced “drug replacement” approach.
“The drug-substitution strategy is based on an assumption that most people use lifestyle drugs rationally for self-medication purposes, to achieve specific desired psychological effects, especially enhanced well-being,” according to a 2005 article in the International Journal of Medicine. “When there is access to an equally effective, but safer, alternative drug, then people would tend to switch to it (especially when the substitute is legal and socially-acceptable).”
What is the Harm Reduction Movement?
The Harm Reduction movement is a trend among some in the substance abuse treatment field to fight addiction incrementally, rather than demanding total abstinence as in traditional treatment models like Alcoholics Anonymous and Narcotics Anonymous. These are the folks who advocate methadone clinics for heroin users and are behind clean needle exchanges to prevent the spread of AIDS and hepatitis.
“We believe that anyone can achieve a resolution of or improvement in substance use via a goal of safer use, reduced use, or total abstinence,” according to the mission statement of HAMS, a Harm reduction, Abstinence, and Moderation Support group.
The harm reduction advocates within the medical community have been excited for years about the potential to treat alcoholics and addicts of other dangerous drugs with medically prescribed marijuana. The wave of pot legalization across the U.S. has provided these researchers with a crucible to develop statistics, theories and practices to substitute cannabis for alcohol in people who otherwise could die of alcoholism.
Is cannabis safer than alcohol?
Myriad medical studies and court cases have shown the behavioral, addictive, toxic, neurodegenerative and carcinogenic effects of alcohol, while marijuana studies show a much more benign effect.
Marijuana use is an extreme hazard for narrow cross sections of people — those who may be predisposed to schizophrenia, for instance, or those with heart conditions, among others. And despite the general consensus among recreational cannabis users, marijuana can be addictive. Chronic heavy, non-medical marijuana use can cause all sorts of social and psychological problems, as well as rewire the brain.
Nevertheless, marijuana is objectively far less hazardous to the health of its users and those close to them when compared with alcohol.
Users should be mindful that mixing cannabis with alcohol (aka Crossfading) can be a dangerous cocktail. Ethanol and cannabis activate many overlapping receptors in the brain. This could be one of the reasons why alcoholics feel satiated by cannabis; it helps them achieve the same feeling that alcohol does.
Can cannabis treat alcoholism?
That being said, the body of research on whether cannabis is as good a substitute for alcohol as nicotine gum is for tobacco or methadone for heroin still isn’t adequate to start widespread prescription.
“There is no clear pattern of outcomes related to cannabis substitution,” states the journal Alcohol and Alcoholism in a 2009 study. “Most importantly, the recommendation to prescribe alcohol-dependent individuals cannabis to help reduce drinking is premature.”
But the research that does exist is promising.
A 2010 study in Harm Reduction Journal looked at people who were in treatment for alcohol, opioid and other addiction treatment in California who were also taking marijuana by prescription under medical supervision.
“In this small sample, cannabis use did not seem to compromise substance abuse treatment amongst the medical marijuana using group, who (based on these preliminary data) fared equal to or better than non-medical marijuana users in several important outcome categories (e.g., treatment completion, criminal justice involvement, medical concerns),” said study author Ronald Swartz.
Indeed, despite the dearth of robust research, many people are already using marijuana to help control their addiction to alcohol and other drugs. Another study published in Harm Reduction looked at anonymous data from 350 patients at one Berkeley cannabis dispensary to see how they were using pot and for which conditions.
“Forty percent have used cannabis as a substitute for alcohol, 26% as a substitute for illicit drugs and 66% as a substitute for prescription drugs,” according to the research. “The most common reasons given for substituting were: less adverse side effects (65%), better symptom management (57%), and less withdrawal potential (34%) with cannabis.”
Alcohol abuse presents a huge cost to families, the health system, the criminal justice system, the economy and society at large. Because of this, marijuana advocates and many in the medical community are pushing for the kind of longitudinal, large-sample studies that could put to rest the question of whether cannabis is a viable treatment for alcoholism and other addictions.
“The cost of alcoholism to individual patients and society at large warrants testing of the cannabis-substitution approach and study of the drug-of-choice phenomenon,” said Tod Mikuriya in the Journal of Cannabis Therapeutics.
He conducted a small, exploratory study of 92 Northern Californian alcoholics who used marijuana as an alcohol substitute under supervision of doctors.
“All patients reported benefit, indicating that for at least a subset of alcoholics, cannabis use is associated with reduced drinking,” he said.
CANNABIS TREAT ALCOHOLISM REFERENCES:
HAMS Harm Reduction Organization
“Cannabis as a substitute for alcohol and other drugs”
Harm Reduction Journal
“Can Cannabis be Considered a Substitute Medication for Alcohol?”
Meenakshi Sabina Subbaraman
Alcohol and Alcoholism
Medical marijuana users in substance abuse treatment
Harm Reduction Journal
“Diazepam with your dinner, Sir? The lifestyle drug-substitution strategy: a radical alcohol policy.”
International Journal of Medicine
“Cannabis as a Substitute for Alcohol: A Harm-Reduction Approach”
Journal of Cannabis Therapeutics
“Alcohol Facts and Statistics”
National Institute on Alcohol Abuse