The Pros and Cons of Substituting Marijuana for Alcohol

Man smoking marijuana joint

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In order to stop drinking, some people have taken the controversial step of substituting marijuana for alcohol, a practice commonly known referred to marijuana maintenance.

Those who support the practice argue that marijuana is far less hazardous to a person's health than alcohol (essentially the same argument used when comparing marijuana to cigarettes). While the rationale is not without its merits, those opposed to it argue that the goals of sobriety are never truly achieved if a person replaces one mind-altering drug with another.

Who is right?

Cons of Marijuana Management of Alcohol Abuse

What irks people opposed to marijuana maintenance is not only that it is founded on a premise that marijuana is not only safer than alcohol but that it is tacitly safe. It endorses the use of marijuana as a "step-down" therapy that is no more or less harmful than e-cigarettes used for smoking cessation.

Given that no such evidence exists to support the premise, advocating marijuana management is not only unfounded but unconscionable, say opponents. The very foundation of alcohol recovery is based on the recognition that alcohol is harmful and that the affected person has no control over it.

Softening the blow inherently suggests that marijuana is something over which you have greater control and infers that the self-awareness you are meant to achieve during the recovery can wait until you are stronger and no longer need either marijuana or alcohol.

In the end, say the detractors, the practice only aims to replace one habit with another under the guise that marijuana is the less-harmful alternative. And this, says the National Institute on Drug Abuse, may not be the case. Among the possible concerns:

  • Marijuana may contribute to underlying mental health problems common in people with alcohol dependence.
  • Marijuana can have a long-term impact on a person's health, including bone density loss, the reduction of exercise toleration, impairment of memory and cognitive skills, and the increased risk of lung infections and cardiovascular events in later years.
  • Marijuana can sometimes act as a gateway drug, potentially leading those with an addictive behavior to other, more dangerous drugs like cocaine and heroin.

Moreover, between 10 percent and 20 percent of people who use cannabis daily ​become dependent, perhaps the largest, single challenge to its use in replacement therapies.

Pros of Marijuana Management of Alcohol Abuse

On the other side of the fence, supporters of marijuana management programs are quick to point out that evidence has largely been split on how effective recovery programs like Alcoholics Anonymous (AA) truly are.

A 2006 Cochrane review of studies found no significant difference between the results of AA achieved compared to other treatment models. Even those studies which 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. For those who are unable or unwilling to regularly attend, the rate of failure was high.

It is these individuals that marijuana management may prove beneficial, say supporters. It recognizes that abstinence-based programs are not only unachievable but unrealistic for some people. By allowing a person to taper off gradually with marijuana, many of the ill-effects of detoxification may be softened or entirely avoided (including depression, anxiety, and withdrawal symptoms).

In terms of safety, marijuana has largely been demonized. When compared to alcohol, it can be used relatively safely without the risk of death from binging, with few drugs interactions, and with far less impact on one's long-term health.

And, unlike alcohol, which has absolutely no health benefits, marijuana is frequently used to alleviate pain, stimulate appetite, and enhance moods—three properties that can be invaluable to those in the throes of alcohol recovery.

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Article Sources

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  3. National Institute on Drug Abuse. What is marijuana? NIDA. Published June 2019.

  4. Ferri M, Amato L, Davoli M. Alcoholics Anonymous and other 12-step programmes for alcohol dependence. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD005032. DOI: 10.1002/14651858.CD005032.pub2

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Additional Reading

  • Andrade, C. Cannabis and Neuropsychiatry, 1: Benefits and Risks."Clin Psych. 2016; 77(5): e551–4. DOI: 10.4088/JCP.16f10841.

  • Kaskutas, L. Alcoholics Anonymous Effectiveness: Faith Meets Science. J Addict Dis. 2009; 28(2):145-57. DOI: 10.1080/10550880902772464.