Also, commonly known as cannabis among a variety of other street names, marijuana may have both analgesic (pain-relieving) and antiemetic (anti-nausea) effects, which has led to its consideration for medical use among many states. In fact, medical marijuana – cannabis – has been legalized in 24 states and Washington, D.C. (with varying limits and with strict regulation), and in four states and Washington, D.C., it’s legal for recreational use as well. It’s classified as a Schedule I controlled substance by the federal government and impacts nearly every organ within the body.
ProCon.org ranks 20 different substances (drugs and alcohol) in terms of the risks of harm they pose to the user and to others, with cannabis landing near the middle of the pack. The most dangerous substance, despite its widespread use and legality in every U.S. state for persons age 21 and older, is alcohol, followed by heroin, crack cocaine, and methamphetamine.
Cannabis has long been labeled the “gateway drug,” or the drug that most young users first try, gradually resulting in teens and young adults taking greater risks and experimenting with more harmful substances.
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What You’ll Find in This Guide:
In this guide we examine the link between cannabis and alcohol use including the impacts’ marijuana use may have on the risk of alcohol addiction, the ramifications of marijuana use at younger ages, and the potential consequences of alcohol and cannabis use.
- Evaluating Cannabis Use and Use in the U.S.
- Does Cannabis Increase the Risk of Alcohol Addiction?
- The Dangers of Cross-Addiction: When Marijuana and Alcohol Collide
- Appropriate Use Cases: Is Cannabis a Viable Treatment Option for Medical Purposes?
Evaluating Cannabis Use and Use in the U.S.
In this section we examine statistics on the use and dependence of cannabis in the United States among various demographic groups.
According to the National Institute on Drug Abuse (NIDA), marijuana use is prevalent among teens in the United States. The NIDA’s 2015 data indicates that 15.5% of 8th graders, 31.1% of 10th graders, and 44.7% of 12th graders have used marijuana at least once in their lifetime. While these figures are alarming, data on more recent use sheds a bit of hope on the situation.
Not all students who reported having used marijuana at least once in their lifetime have used marijuana in the last day, month, or even year:
- 11.8% of 8th graders have used marijuana in the past year, 6.5% in the past month, and 1.1% within the last day.
- 25.4% of 10th graders have used marijuana in the past year, 14.8% in the past month, and 3% within the last day.
- 34.9% of 12th graders have used marijuana in the past year, 21.3% in the past month, and 6% within the last day.
Research shows that recreational marijuana use is associated with increased impulsivity and hostility on the day that the substance is used. “Marijuana use is associated with changes in impulse control and hostility in daily life. This may be one route by which deleterious effects of marijuana are observed for mental health and psychosocial functioning,” the report explains. “Given the increasing prevalence of recreational marijuana use and the potential legalization in some states, further research on the potential consequences of marijuana use in young adults’ day-to-day life is warranted.”
However, this study shows the correlation between marijuana use and increased hostility and impulsivity, but not causation. It’s not clear whether the marijuana use actually caused increased hostility and impulsivity, or if these characteristics were pre-existing and served as the stressors leading to marijuana use.
Does Cannabis Increase the Risk of Alcohol Addiction?
In this section we evaluate data and statistics aiming to identify correlation and causation between cannabis use and the risk of alcohol or other substance use addiction. While much research has proven a clear link between marijuana use and alcohol addiction or substance use addiction, the findings pointing to causation are less thoroughly evaluated, but connections clearly do exist.
Marijuana use has long been linked to psychiatric disorders, but researchers have been unable to determine if marijuana use is the cause of these disorders or whether they simply share common contributing factors, making it more likely that some individuals who use marijuana also have psychiatric disorders, and vice-versa.
Later research has shed some light on the subject, however: “A new study used data on nearly 35,000 participants in two waves (2001-2002 and 2004-2005) of the longitudinal National Epidemiological Survey on Alcohol and Related Conditions, to prospectively examine associations between marijuana use and various mental health outcomes,” explains the NIDA. “Like earlier studies, unadjusted analyses of the data found marijuana use to be associated with a wide range of psychiatric disorders; but after adjusting for common underlying factors that predict marijuana use (such as age and other sociodemographic characteristics), the only associations with marijuana use that remained significant across all analyses were SUDs—including alcohol use, nicotine dependence, cannabis use disorder, and other drug use disorders.”
The study abstract, published on JAMA Psychiatry, explains,
Within the general population, cannabis use is associated with an increased risk for several substance use disorders. Physicians and policy-makers should take these associations of cannabis use under careful consideration.
In the NIDA’s Monitoring the Future Study: Trends in Prevalence of Various Drugs report, which analyzes 2012-2015 data, the statistics reveal that students in grades 8, 10, and 12 report higher rates of alcohol use than marijuana use. The same is true for other age groups, including adults over age 26, among which 46.1% report having used marijuana at least once in their lifetime, while 88.3% report having used alcohol at least once during their lifetime. While marijuana is clearly not the sole gateway to alcohol use and use, it can play a role in leading to addictive behaviors during adolescence, young adulthood, and later in life as well.
“Research has indicated that there are health risks associated with youth marijuana use, including poorer education/employment outcomes, poorer cognitive outcomes, increased likelihood of vehicle crashes, and increased addiction risk,” according to SAMHSA’s report on the research.
Even though research indicates that youth marijuana use is a health risk, nationally only 1 in 5 adolescents perceived great risk from monthly marijuana use in 2014, which is lower than in any other year from 2002 to 2013.
That said, the prevalence of marijuana use is on the rise among teens, a trend largely attributed to the decreased risk perception of cannabis as an illicit drug. Teens may believe that if a substance is legally used for medical purposes in some states, that it must be safe – but like opioids, cannabis for medical use is only safe when used as prescribed and for legitimate medical needs.
The Dangers of Cross-Addiction: When Marijuana and Alcohol Collide
Alcohol and cannabis are commonly used together, sometimes in an effort to intensify the effects of one or both substances. In this section we examine the dangers of cross-addiction and the complications that arise when cannabis and alcohol are simultaneously used or used – and particularly when an individual develops an addiction to both substances.
AddictionsandRecovery.org explains that marijuana is often one of the most difficult substances to give up – not because it has stronger physical or psychological addictive properties, but merely because addicts often view the substance as their last remaining vice that enables them to cope with their mental or physical ailments that create stress, anxiety, or other unwanted effects in their daily lives.
This resource also points out several key statistics that explain the danger in thinking that marijuana is a relatively safe substitute for alcohol or other substances:
- People who use marijuana are four times more likely to develop depression.
- Marijuana users have nearly three times the risk of developing psychotic symptoms compared to the population as a whole.
- Significant abnormalities in the brain’s emotion and reward centers are found in the brains of 18 to 25 year olds who smoke marijuana at least once per week.
- To the adolescent brain, marijuana is neurotoxic, resulting in a decrease in IQ by an average of six points by 38 years old – a time period during which the IQs of most people remain stable or increase.
One addiction can lead to other addictions, AdditionsandRecovery.org points out. “That’s one of the consequences of a brain that’s wired for addiction. Suppose you’re addicted to cocaine. If you want to stop using cocaine then you have to stop using all addictive drugs including alcohol and marijuana,” the article notes. “You may never have had a problem with either of them, but if you continue to use alcohol or marijuana, even casually, they’ll eventually lead you back to your drug of choice. Recovery requires total abstinence.”
Many of the side effects resulting from mixing marijuana and alcohol, including:
- Headaches and nausea
- Decreased coordination
- Increased appetite
- Tremors and/or shaking
- Breathing problems
- Memory lapses
- Inability to focus or concentrate
- Hallucinations and paranoia
“A person addicted to both can experience the same symptoms, but to a wholly unpredicted level. This may be due to the psychedelic properties of marijuana, which can affect the mind in different ways,” explains ProjectKnow.com. “These psychedelic effects may be heightened with the sedative effect of alcohol. This, in turn, can increase the risk for psychological problems and psychotic symptoms.” Furthermore, both drugs are shown to be contributing factors in vehicle accidents, and the National Highway Traffic Safety Administration (NHTSA) found that marijuana is the most common illicit drug involved in incidents of driving under the influence within the past several years.
Mixing alcohol and marijuana can increase the risk of developing psychotic symptoms, explains NCPIC.
There is some evidence to support that having alcohol in your blood causes a faster absorption of THC (the active ingredient in cannabis that causes intoxication).
Indeed, research from the American Association for Clinical Chemistry (AACC) finds that, “A study shows for the first time that the simultaneous use of alcohol and cannabis produces significantly higher blood concentrations of cannabis’s main psychoactive constituent, THC, as well as THC’s primary active metabolite than cannabis use alone.”
This can lead to people feeling sick after smoking cannabis, becoming dizzy, nauseous, and possibly even vomiting – often, individuals experiencing such side effects feel as though they need to immediately lie down.
This may not seem like a serious detrimental consequence, but it’s only one of the more common experiences from mixing cannabis and alcohol.
Other consequences include:
- Panic, anxiety, and paranoia
- Reduced ability to concentrate, leading to dangerous driving if behind the wheel
- Losing awareness of your surroundings
- Reduced ability to maintain control of situations and impulses (someone may choose to engage in risky sexual behaviors they otherwise would not engage in, for instance)
- Substitution – replacing one drug with another in an effort to relieve the symptoms associated with decreased use of a different substance
These effects represent some of the more acute effects of mixing the two substances and don’t even account for the potential long-term consequences of marijuana use alone such as harming child development when consumed during pregnancy, mental impacts such as a loss of motivation and interest in everyday activities, breathing problems, cardiovascular risks, and more.
Even in low doses, the combined effects of alcohol and marijuana can be dangerous. Long-term use and use leads to a greater severity of withdrawal symptoms compared to the withdrawal effects of alcohol or marijuana alone. While some may say that marijuana is not addictive, Marijuana Anonymous begs to differ: “The belief that marijuana cannot be addictive is widely circulated throughout the world. Well, somehow, we managed to get addicted to this ‘non-addictive’ substance. We recovering marijuana addicts don’t need to play with fire by checking out other addictive substances.”
Appropriate Use Cases: Is Cannabis a Viable Treatment Option for Medical Purposes?
In this section we provide resources and information related to the use of cannabis for medical purposes, a trend on the rise due to the legalization of medical marijuana in many states. We examine research on the potential treatment uses for cannabis including both risks and possible positive outcomes.
It’s been suggested that treating alcohol addiction is one potential use of medical marijuana. There have been few studies examining the benefits of cannabis as a potential treatment option, although smaller-scale studies have been conducted with somewhat mixed results. “To date there have been no placebo-controlled double-blind studies of the success of cannabis as a substitute for alcohol for people with alcohol dependence,” explains HamsNetwork.org. This resource further explains findings from one advocate for medical marijuana use as a treatment for alcoholism addiction – primarily as a means to ease withdrawal symptoms – in which the researcher reports the participants found the treatment either “effective” or “very effective.”
The concerning aspect of this research, however, is that study participants experienced a return of symptoms upon discontinuation of cannabis use, ranging from increased anxiety to drinking more frequently and in larger amounts, increased cravings for alcohol, increased stress, and other negative impacts.
Much like turning to alcohol as a means to self-medicate for mental illness such as depression and anxiety, the short-term relief offered by marijuana use in recovery from alcohol addiction is merely a false reprieve that often ends up compounding issues later.
Other sources have pointed out that marijuana is shown to be “habit-forming” but not necessarily addictive, meaning there are no withdrawal symptoms upon discontinuation. This position is interesting and not entirely untrue, although, marijuana is at best a temporary aid for relieving withdrawal symptoms and cravings – but offers no real long-term potential for curing addictions and may hinder recovery in the long term through increased cravings upon discontinuation of cannabis use. These sources do not make a convincing case that alternative approaches should be investigated to make strides in aiding addicts in long-term recovery, however.
Research findings reported as recently as 2014 conclude the following:
“There is no clear pattern of outcomes related to cannabis substitution. Most importantly, the recommendation to prescribe alcohol-dependent individuals cannabis to help reduce drinking is premature. Future studies should use longitudinal data to better understand the consequences of cannabis substitution.”
It’s important to not discredit the medicinal purposes of cannabis for certain circumstances, as there have been benefits shown in reducing pain among cancer patients, reducing symptoms from Chron’s disease, and other potential benefits. However, the use of marijuana for medical purposes should be carefully weighed against the individual’s risk of developing addiction. Considering genetic factors, the patient’s personal history, and other influences through an individual risk versus benefit analysis to determine the safety and potential outcomes from medical marijuana use.
The landscape surrounding cannabis is evolving as more states move to legalize it for medicinal use or even recreational use. These legal changes are shifting perceptions and attitudes regarding the risks of cannabis, particularly among young people. With clear links between marijuana use and alcohol addiction, these shifts in attitude could prove dangerous to many. The need for continued, ongoing public education regarding the appropriate use of any prescribed substance, and the risks associated with mixing two or more substances – either recreationally or for medical purposes.