From Paul Armentano, NORML Deputy Director September 29, 2015. 

Patients who possess legal access to cannabis frequently substitute it in place of alcohol and prescription drugs, according to survey data published online in the journal Drug and Alcohol Review.

Investigators from the University of Victoria in British Columbia assessed the influence of medical marijuana access on other drug-taking behaviors in a cohort of 473 Canadian adults licensed to engage in cannabis therapy.

“Substituting cannabis for one or more of alcohol, illicit drugs or prescription drugs was reported by 87 percent of respondents, with 80.3 percent reporting substitution for prescription drugs, 51.7 percent for alcohol, and 32.6 percent for illicit substances,” they reported.

Rates of substitution were highest among respondents between the ages of 18 and 40. Patients using cannabis for pain were most likely to use pot as a substitute for prescription drugs.

Authors concluded, “The finding that cannabis was substituted for alcohol and illicit substances suggests that the medical use of cannabis may play a harm reduction role in the context of use of these substances, and could have implications for substance use treatment approaches requiring abstinence from cannabis in the process of reducing the use of other substances.”

Evaluations of patients enrolled in state-specific medical marijuana programs, including those in Arizona, California, and Rhode Island, yield similar results — finding that patients are particularly likely to substitute cannabis for opioids. According to a recently published National Bureau of Economic Research report, states that permit qualified patients to access medical marijuana via dispensaries possess lower rates of opioid addiction and overdose deaths as compared to states that do not.

An abstract of the study, “Substituting cannabis for prescription drugs, alcohol and other substances among medical cannabis patients: The impact of contextual factors,” appears online at

[Ed. Note: Of course this report describes important progress, but I couldn’t suppress a sarcastic thought: “At last, real scientific proof instead of flimsy anecdotal stuff like Mikuriya’s Cannabis as a Substitute for Alcohol!”  I much appreciate Paul Armentano’s keeping us abreast of advances in the literature.  Whenever I’m with him, I think of Willie Nelson’s great song Me and Paul, which makes reference to the herb, but not by name, and Willie sings the slambang line, “After taking several readings I’ve decided that my mind’s still fairly sound.”  Which is reassuring on many levels.]