Cannabis as a Substitute for Alcohol: A Harm-Reduction Approach

Mikuriya, Tod H.

doi:10.1300/j175v04n01_04

Cited by 34 publications

(33 citation statements)

References 5 publications

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“…Mikuriya found in 2001 and 2004 that 55% and 53% of patients respectively reported having one or two alcoholic parents [12,13]. One quarter of this sample reported growing up in an alcoholic or abusive household.…”

Section: Discussionmentioning

confidence: 95%

Cannabis as a substitute for alcohol and other drugs

2009

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BackgroundSubstitution 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.MethodsAnonymous 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.ResultsFifty 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.ConclusionThe 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.

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Section: Discussionmentioning

confidence: 95%

Cannabis as a substitute for alcohol and other drugs

2009

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“…Consistent with previous findings (Compton et al, 2017), medical use only was negatively associated with drug or alcohol use disorders and unmet need for drug use disorder treatment among both males and females. This is probably due to use of medical marijuana as a substitute for alcohol or other drugs (Lucas et al, 2016; Reiman, 2007; Reiman, 2009), which might be related to reduction in alcohol use and alcohol-related problems (Mikuriya, 2004). Medical use only was also negatively associated with opioid use disorder among females.…”

Section: Discussionmentioning

confidence: 99%

Differences in behavioral health disorders and unmet treatment needs between medical marijuana users and recreational marijuana users: Results from a national adult sample

Park

2017

Drug and Alcohol Dependence

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Background Available data suggest that medical marijuana users may have more mental health problems than recreational marijuana users. There is limited information about differences in behavioral health disorders and unmet treatment needs between medical and recreational marijuana users. Methods We compared past-year prevalence of behavioral health disorders and unmet treatment needs across three marijuana subgroups (recreational use only, medical use only, and both). Sex-stratified logistic regression was performed to determine their associations with marijuana use status. We analyzed data from adults (≥18 years) who used marijuana in the past year (N=15,440) from 2013-2014 National Surveys on Drug Use and Health. Results Among 15,440 past-year marijuana users, 90.2% used recreational marijuana only, 6.2% used medical marijuana only, and 3.6% used both. Both users had the highest prevalence of behavioral health disorders and unmet treatment needs overall, with no significant sex differences. In the sex-specific logistic regression analysis, medical only users and both users showed somewhat different patterns of associations (reference group=recreational only users). Medical only users had decreased odds of alcohol or drug use disorders, and unmet need for alcohol or drug treatment among males and females. Additionally, female medical only users had decreased odds of opioid use disorder. Both users had increased odds of major depressive episode, hallucinogen use disorder, and unmet need for mental health services among males, and cocaine use disorder among females. Conclusions Different approaches tailored to individuals' sex and motives for marijuana use is needed for the prevention and treatment of behavioral health problems.

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“…Despite some evidence that cannabis use impacts alcohol use severity adversely, there are a number of contradictory findings from case report and correlational studies suggesting that cannabis can substitute for alcohol and reduce drinking . High rates of cannabis substitution for alcohol have been reported by medical cannabis patients and their doctors , although results are limited by retrospective self‐report and selection bias. A 30‐year prospective study of alcohol abusers showed that almost half maintained a year of alcohol abstinence, with some claiming to substitute cannabis for alcohol .…”

Section: Introductionmentioning

confidence: 99%

“…A 30‐year prospective study of alcohol abusers showed that almost half maintained a year of alcohol abstinence, with some claiming to substitute cannabis for alcohol . Some even propose that medical cannabis could help individuals with AUD reduce drinking ; however, these recommendations are based upon retrospective data, highlighting the need for more rigorous research in this area.…”

Section: Introductionmentioning

confidence: 99%

Cannabis use during treatment for alcohol use disorders predicts alcohol treatment outcomes

et al. 2017

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Aims (1) Compare post-treatment alcohol use between those who use cannabis and those who abstain during treatment for alcohol use disorders (AUD). (2) Examine potential cannabis use thresholds by comparing post-treatment alcohol use between four frequency groups of cannabis users relative to abstainers. Design Secondary analyses of the COMBINE Study, a randomized control trial of AUD treatments. The current study compares longitudinal drinking data between those who used cannabis vs. those who abstained during COMBINE treatment. Setting The COMBINE Study treatments were delivered on an outpatient basis over 16 weeks. The current analyses include 206 cannabis users and 999 cannabis abstainers. Participants All participants met diagnosis of primary alcohol dependence (N = 1,383). Measurements Primary exposures were any cannabis use and quartiles of cannabis use (Q1: 1–4 use days during treatment, Q2: 5–9 days, Q3: 10–44 days, Q4: 45–112 days). Outcomes were percent days abstinent from alcohol (PDA), drinks per drinking day (DPDD), and percent heavy drinking days (PHD), all measured at treatment end and one year post-treatment. Findings Compared with no cannabis use, any cannabis use during treatment was associated with 4.35% (95% CI: −8.68, −0.02), or approximately four fewer alcohol abstinent days at the end of treatment. This association weakened by one-year post-treatment (95% CI: −9.78, 0.54). Compared with no cannabis use, only those in the second quartile of cannabis use (those who used once or twice per month during treatment) had 8.81% (95% CI: −17.00, −0.63), or approximately ten fewer days alcohol abstinent at end of treatment, and 11.82% (95% CI: −21.56, −2.07), or approximately 13 fewer alcohol abstinent days one-year post-treatment. Neither any cannabis use nor quartiles were associated with DPDD or PHD at either time-point. Conclusions Among individuals in alcohol treatment, any cannabis use (compared with none) is related to significantly lower percent days abstinent from alcohol post-treatment, though only among those who used cannabis once or twice per month.

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Cannabis as a Substitute for Alcohol: A Harm-Reduction Approach

Cited by 34 publications

References 5 publications

Cannabis as a substitute for alcohol and other drugs

Cannabis as a substitute for alcohol and other drugs

Differences in behavioral health disorders and unmet treatment needs between medical marijuana users and recreational marijuana users: Results from a national adult sample

Cannabis use during treatment for alcohol use disorders predicts alcohol treatment outcomes

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