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Cannabis as a substitute for alcohol and other drugs

Cannabis as a substitute for alcohol and other drugs

  1. Terrapinzflyer
    Aannabis as a substitute for alcohol and other drugs

    Amanda Reiman

    School of Social Welfare, University of California, Berkeley, 120 Haviland Hall,
    Berkeley, CA 94720.


    Substitution can be operationalized as the conscious choice to use one drug
    (legal or illicit) instead of, or in conjunction with, another due to issues such as:
    perceived safety; level of addiction potential; effectiveness in relieving symptoms;
    access and level of acceptance. This practice of substitution has been observed among
    individuals using cannabis for medical purposes. This study examined drug and
    alcohol use, and the occurrence of substitution among medical cannabis patients.

    Anonymous survey data were collected at the Berkeley Patient’s Group
    (BPG), a medical cannabis dispensary in Berkeley, CA. (N=350) The sample was
    68% male, 54% single, 66% White, mean age was 39; 74% have health insurance
    (including MediCal), 41% work full time, 81% have completed at least some college,
    55% make less than $40,000 a year. Seventy one percent report having a chronic
    medical condition, 52% use cannabis for a pain related condition, 75% use cannabis
    for a mental health issue.

    Fifty three percent of the sample currently drinks alcohol, 2.6 was the average
    number of drinking days per week, 2.9 was the average number of drinks on a
    drinking occasion. One quarter currently uses tobacco, 9.5 is the average number of
    cigarettes smoked daily. Eleven percent have used a non-prescribed, non OTC drug in
    the past 30 days with cocaine, MDMA and Vicodin reported most frequently. Twenty
    five percent reported growing up in an abusive or addictive household. Sixteen
    percent reported previous alcohol and/or drug treatment, and 2% are currently in a 12-
    step or other recovery program. 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. The most common reasons given for substituting were: less adverse side effects
    (65%), better symptom management (57%), and less withdrawal potential (34%) with cannabis

    The substitution of one psychoactive substance for another with the goal of
    reducing negative outcomes can be included within the framework of harm reduction.
    Medical cannabis patients have been engaging in substitution by using cannabis as an
    alternative to alcohol, prescription and illicit drugs.