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The key to treating alcoholism with medical marijuana

Alcoholism is a pervasive chemical affliction. Marijuana, which is far more benign, could be used in treatment

By Kent Gruetzmacher
July 10, 2017 1:00AM (UTC)

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This article originally appeared on The Fresh Toast.

Most Americans know someone who is suffering from addiction in one form or another — alcoholism is perhaps the most pervasive of these chemical afflictions. Furthermore, the use of alcohol has become an integral part of almost all ritualized social activities across Western culture. While controlled, social drinking doesn’t pose any adverse physical or psychological side effects, heavy drinking certainly does. For those heavily afflicted alcoholics, medical cannabis can be beneficial as both an alcohol substitute and sedative.

Alcoholism

Drinking on a daily basis can have irreversible consequences on the body and mind. To illustrate, studies show that “[d]ecades of heavy daily heavy drinking can lead to physical dependence on alcohol and life-threatening withdrawal symptoms if one stops drinking without tapering off or entering a medical detox”. Moreover, one of the key elements of alcoholism is “binge-drinking,” which is evidenced in an addict’s inability to stop drinking once they start. These alcohol binges, or “benders,” often last several days for the seasoned alcoholic and more-often-than-not do irreparable damage to one’s family and professional life. Point being, for alcoholics, the only real choice in beating their affliction is to entirely quit drinking. With this notion in mind, many forward thinking recovery programs are replacing the daily use of alcohol with that of medical marijuana.

America needs different recovery programs

The conventional Western model of alcohol treatment has a statistically poor success rate, as approximately 50% “of individuals who begin an addiction treatment program relapse within six months”. Even more, doctors are known to prescribe rather powerful and addictive benzodiazepines to aid in alcohol withdrawal. While it’s obvious that cannabis use as an alcohol recovery tool is quite controversial in the conventional American mindset, studies show that it can be a powerful recovery tool.

Alcoholism Drinking on a daily basis can have irreversible consequences on the body and mind. To illustrate, studies show that “[d]ecades of heavy daily heavy drinking can lead to physical dependence on alcohol and life-threatening withdrawal symptoms if one stops drinking without tapering off or entering a medical detox”. Moreover, one of the key elements of alcoholism is “binge-drinking,” which is evidenced in an addict’s inability to stop drinking once they start. These alcohol binges, or “benders,” often last several days for the seasoned alcoholic and more-often-than-not do irreparable damage to one’s family and professional life. Point being, for alcoholics, the only real choice in beating their affliction is to entirely quit drinking. With this notion in mind, many forward thinking recovery programs are replacing the daily use of alcohol with that of medical marijuana. America Needs Different Recovery Programs The conventional Western model of alcohol treatment has a statistically poor success rate, as approximately 50% “of individuals who begin an addiction treatment program relapse within six months”. Even more, doctors are known to prescribe rather powerful and addictive benzodiazepines to aid in alcohol withdrawal. While it’s obvious that cannabis use as an alcohol recovery tool is quite controversial in the conventional American mindset, studies show that it can be a powerful recovery tool.

Cannabis and quitting drinking

In the nomenclature of recovery studies, cannabis aided alcoholism recovery is referred to as “Marijuana Maintenance”. For starters, Marijuana Maintenance offers a relatively un-impactful solution to alcohol cravings, as addicts will smoke or ingest cannabis instead of taking a drink. Along this line of thought, the Harm Reduction Journal reports that cannabis can curb an addict’s alcohol cravings and it is a viable, natural alternative to prescription medications such as benzodiazepines. Secondly, a large quantity of drinkers medicate with alcohol to relieve psychological conditions such as “depression, anxiety, stress, or PTSD”. Studies show that responsible cannabis use can provide relief from these same emotional ailments, without the dangers of withdrawal and addiction as seen with alcohol or prescription medication drugs.

Alcoholism is a pervasive chemical affliction. Marijuana, which is far more benign, could be used in treatment

The Pros and Cons of Substituting Marijuana for Alcohol

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

Diverse Images / UIG / Getty Images

Some people choose to substitute marijuana for alcohol if they are trying to stop drinking—a controversial practice referred to as marijuana maintenance.  

Those who support the practice argue that marijuana is far less hazardous to a person’s health than alcohol (the same argument is often used when comparing marijuana to cigarettes). Those who are opposed to the practice argue that the goals of sobriety are never truly achieved if a person replaces one mind-altering drug with another.

Here are the pros and cons of replacing alcohol with marijuana, as well as resources you can turn to if you are trying to quit drinking or using substances.

Potential Pros of Marijuana Management

Supporters of marijuana management programs are often quick to point out that the evidence on the effectiveness of traditional recovery programs like Alcoholics Anonymous (AA) is largely split.

The findings from a 2006 Cochrane review of studies demonstrated no significant difference in the results achieved by people in AA compared to other treatment models.   Furthermore, even the studies that 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.

Alternative to Abstinence-Only

For those who are unable or unwilling to regularly attend AA meetings, the rate of failure was high. Supporters argue that it is these individuals who might benefit from using marijuana management. The model recognizes that for some people, abstinence-based programs are unrealistic and unachievable.

Those who are in favor of the practice argue that many of the ill-effects of alcohol detoxification might be softened if a person is able to taper off alcohol gradually while using marijuana.

Harm Reduction

Supporters of marijuana management programs often argue that the drug has been demonized. Those in favor of its use argue that unlike alcohol, marijuana can be used without the risk of death from binging. They also point out that it has fewer drug interactions than alcohol and possibly has much less of an impact on one’s long-term health.  

Health Benefits

Additionally, proponents argue that marijuana might have some inherent benefits compared to alcohol. While there is ongoing debate about whether moderate drinking has possible health benefits, the effects of alcohol misuse can be catastrophic, contributing to an increased risk for breast cancer, birth defects, and other health issues.  

Marijuana, on the other hand, is purported to have some health benefits that can make it useful in certain situations. For example, marijuana is frequently used to alleviate pain, stimulate appetite, and enhance moods.   For an individual who is recovering from alcohol use disorder, these properties could be beneficial.

Potential Cons of Marijuana Management

Those who are opposed to marijuana maintenance argue that it is founded on the premise that marijuana is not only safer than alcohol but that it is tacitly safe. They argue that because there is no evidence to support that premise, it is unfounded and even unconscionable to advocate for marijuana management.

Marijuana Dependence

The foundation of alcohol recovery is based on recognizing that alcohol is harmful and that a person has no control over their use of the substance.   Softening the blow inherently suggests that marijuana is something over which a person can have greater control. It also infers that the self-awareness a person is meant to achieve during recovery can wait until they are stronger and no longer need marijuana or alcohol.

One of the most significant potential pitfalls of using marijuana as a replacement therapy is the possibility of dependence. Research suggests that 30% of people who use marijuana develop cannabis use disorder to some degree.  

Negative Health Effects

Detractors say that the practice only aims to replace one habit with another under the guise that marijuana is the less-harmful alternative. According to the National Institute on Drug Abuse, this may not be the case.   There are several concerns associated with marijuana use, including:

  • Marijuana can have a long-term impact on a person’s health. For example, it has been associated with bone density loss, reduction of exercise tolerance, impairment of memory and cognitive skills, and an increased risk of lung conditions.  
  • Marijuana might contribute to underlying mental health conditions that are common in people who misuse alcohol.  
  • Marijuana might have the potential to act as a gateway drug. In theory, it could lead people with addictive behaviors to use other dangerous drugs like cocaine and heroin.  

Reduced Treatment Effectiveness

Some evidence also suggests that marijuana use can actually interfere with efforts to stop using alcohol. One 2015 study found that concurrent marijuana use lowers a person’s odds of achieving abstinence from other drug or heavy alcohol use.  

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Learn about the pros and cons of substituting marijuana for alcohol and why some people in recovery use the controversial practice.