Medical Marijuana in the Treatment of Alcoholism

While some experts confirm the effectiveness of marijuana in treating alcohol dependence, this area of medical cannabis use is still rarely discussed in the media. Overall, doctors note the plant’s effectiveness in treating and alleviating symptoms of many chronic diseases, such as muscular dystrophy, various forms of cancer, arthritis, and neurodegenerative diseases like Alzheimer’s or Crohn’s disease. However, its potential in treating the world’s most common form of chemical dependency—alcoholism—remains largely untapped, even in regions where medical cannabis is already in use.

Nevertheless, in the United States alone, several million people suffer from alcohol-related disorders, particularly Alcohol Use Disorder (AUD) and Alcohol Dependence Syndrome (ADS). In this article, we’ll review the available scientific data on the effectiveness of cannabis in treating these syndromes, as well as practical cases of substituting alcohol with marijuana.

What Is Alcohol Dependence?

The main barrier to cannabis substitution therapy for alcoholics is the belief among many doctors, politicians, and even alcoholics themselves that medical cannabis simply replaces one harmful drug with another. In reality, this is far from the truth. Cannabis does not create a dependency similar to alcoholism, even with chronic use. Moreover, the plant itself is not a neurotoxic substance, unlike fully legal alcohol.

Scientists acknowledge that marijuana can cause psychological attachment in some users, but it does not provoke physical dependence accompanied by painful and life-threatening withdrawal, as is the case with alcohol. Unlike many legal products such as opioid painkillers, cigarettes, and hard liquor, marijuana has not caused a single death due to dependence or health complications, which are common among tobacco and alcohol users worldwide.

Symptoms of alcohol dependence syndrome include seizures, tachycardia, delirious hallucinations, high blood pressure, and noticeable tremors in the limbs. Without medical help, one in three alcoholics attempting to quit dies because the body and nervous system cannot cope with the sudden drop in their usual drug. In addition to harming the dependent individual, alcoholism and its complications also negatively affect those around them—family, colleagues, and friends.

Unlike alcohol, even high doses of marijuana do not pose a similar danger to health or life. Cannabis overdose may cause panic and paranoia, but it is nothing compared to the delirium tremens experienced by alcoholics. Also, unlike drinkers, marijuana users do not become aggressive when intoxicated. While alcoholics often end up in trouble for public misconduct or violence, marijuana users are typically arrested solely for using a prohibited “dangerous” drug.

Comparing Alcohol and Marijuana Overdose

Many people who undergo cannabis substitution therapy may continue to use marijuana after treatment, replacing their lost habit with another recreational substance. Not all former alcoholics will continue using marijuana, but for many, it may be a preferable alternative to alcohol.

Unlike alcohol, cannabis is physically incapable of causing a fatal overdose. To compare the physiological danger of substances, scientists use the LD-50 test, which measures the dose lethal to 50% of test subjects. For alcohol, the lethal dose is around 0.40% blood alcohol concentration. For a person weighing 110 lbs (50 kg), consuming 9–10 standard drinks in one hour can be fatal. For someone weighing 175–200 lbs (80–90 kg), 20–25 drinks over 3–4 hours can be lethal.

In 1988, the U.S. DEA published a review by administrative law judge Francis Young, stating: “To overdose on marijuana, a person would have to consume 20,000 to 40,000 times the amount in a standard joint within 15 minutes, which is physically impossible.” The U.S. Department of Health and Human Services concurs, noting that cannabinoid receptors are not located in brain regions controlling breathing, so marijuana does not suppress respiration like opioids or barbiturates.

According to the UN, over two million people die each year worldwide from excessive alcohol consumption and related complications. In contrast, there has never been a single recorded death from marijuana use alone. Attempts to link marijuana to fatal incidents involving other drugs are quickly debunked by medical and forensic experts. In short, unlike legal alcohol—a poison—marijuana is a medicinal plant under an unjustified ban.

The Low Effectiveness of 12-Step Group Therapy for Alcoholism

Despite their long-standing popularity in the U.S. and elsewhere, group therapy programs like the “12 Steps” developed by Alcoholics Anonymous rarely help most participants quit drinking. Statistics show that about two-thirds of participants drop out before completing the program. Still, over a million Americans attend one of more than 60,000 such support groups nationwide.

Dr. Lance Dodes, a Harvard graduate and clinical psychology professor, writes in his book “The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry” that only 5–10% of participants remain abstinent after completing the program. In other words, 14 out of 15 graduates relapse within months.

A 2000 study in the journal “Alcoholism Treatment Quarterly” analyzed AA membership from 1968 to 1996 and found that 81% of participants left within the first month. After two months, only 10% remained, and after a year, just 5% continued attending. Similar results are seen in group therapy for other addictions, from opioids to internet use, with only 5–10% achieving lasting abstinence.

It’s clear that a new method—cannabis therapy—may be more effective for alcoholics, showing promising results despite its relatively recent introduction.

Health Risks of Alcohol Consumption

Despite the lingering stigma of marijuana users as lazy or mentally unstable, scientific research shows that cannabis actually helps strengthen the nervous system and protect against age-related diseases like Alzheimer’s. Even frequent, daily cannabis use does not cause significant physiological or psychological harm. Alcohol, on the other hand, quickly leads to serious liver problems, stomach and intestinal ulcers, memory loss, heart and vascular diseases, and chronic depression.

Interestingly, cannabis can not only mitigate the damage alcohol causes to these organs and systems but also help repair already damaged tissues. From a public health perspective, a nation that uses marijuana will spend far less on healthcare than one that drinks heavily. Studies show that marijuana users are more physically and intellectually active than alcohol users. Legalization has already helped some U.S. states reduce crime, teen pregnancies, and traffic accidents, likely because marijuana clarifies the mind rather than clouding it. However, organizations like Mothers Against Drunk Driving are still reluctant to support marijuana legalization, likely due to the lingering “drug” stigma.

Research on Cannabis Therapy for Alcoholism

The late Dr. Tod Mikuriya was a strong advocate for legalizing marijuana for various medical uses, including as a substitute therapy for alcoholism. In 2004, he published a study on 92 volunteers with different forms of alcohol dependence. According to Mikuriya, “After the experiment, 45% of participants described cannabis as ‘very effective’ in suppressing alcohol cravings, and another 38% found it ‘quite effective.’ Effectiveness was measured using seven different patient surveys.”

Nine participants were able to completely abstain from alcohol for a year. Follow-up showed that some remained sober for up to 19 years, while others relapsed after two years. Many reported that their desire to drink returned after the experiment ended, as they no longer had access to marijuana. Notably, 29 participants had used alcohol to manage chronic pain, but after the study, all switched to medical cannabis for pain relief.

44% of participants used alcohol to cope with depression or PTSD. All in this group found cannabis extremely effective for long-term symptom relief, with fewer side effects and faster action than alcohol or pharmaceutical antidepressants.

In 2009, a study published in the journal “Harm Reduction Journal” by researchers at UC Berkeley recommended marijuana for substitution therapy in alcoholism. Of 350 cannabis users surveyed, 40% said it helped control alcohol cravings, and 66% found it effective in replacing pharmaceutical drugs, mainly antidepressants and painkillers. Additionally, 26% said cannabis helped them overcome dependence on “hard” drugs like cocaine and heroin.

Researcher Amanda Reiman stated, “We found marijuana to be highly effective in substituting for various substances, from tobacco and alcohol to hard drugs. Given its potential in treating alcoholism, marijuana could be recommended to countries with strong drinking cultures, like the UK, as a healthier recreational alternative.”

65% of participants chose cannabis because it has fewer negative effects than alcohol or other substances. 34% noted that, unlike alcohol, cannabis does not cause physical dependence. 58% found marijuana more effective in relieving their symptoms than other substances.

Legalization Expands Access to Therapy

Currently, in many countries and even in many U.S. states, people do not have legal access to therapeutic marijuana for alcohol dependence. This type of therapy is rarely included in regional medical legalization programs. However, in Colorado and other states with full reform, any alcoholic can self-medicate by purchasing pure products at affordable prices from recreational stores. In some cases, quality marijuana is already cheaper than a bottle of whiskey or a case of beer, though prices vary by region.

Dr. D.B. Barton from the UK notes, “Hundreds of thousands of people in the British Isles binge drink on weekends due to the abundance of bars and drinking culture. This habit causes significant harm in terms of health, public disorder, and lost work hours due to hangovers. Still, we can’t simply deny people recreational substances to relieve stress. As a safer alternative, I propose that authorities in Ireland and the UK legalize recreational marijuana in a regulated market.”

Many people still prefer legal substances like tobacco and alcohol over the “illegal and dangerous” marijuana, not realizing that cannabis is a healthier and more pleasant alternative. However, public opinion in many European, North, and South American countries is shifting in favor of legalization. Polls show that the majority of Americans and Canadians now support full legalization, citing its safety and therapeutic effectiveness. In these regions, formal substitution therapy programs are on the near horizon, but much of the world is not yet ready to accept the facts about marijuana. Hopefully, as prohibition falls in the U.S., reform will spread more actively to other countries.

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