Cannabis used as Substitute

Victoria, Canada: A majority of medical cannabis consumers report using the plant as a substitute for prescription drugs, alcohol, or some other illicit substance, according to survey data published in the October issue of Addiction Research and Theory.

An international team of investigators from Canada and the United States assessed the subjective impact of marijuana on the use of licit and illicit substances via self-report in a cohort of 404 medical cannabis patients recruited from four dispensaries in British Columbia, Canada.

Researchers reported that subjects frequently substituted cannabis for other substances, including conventional pharmaceuticals, finding: "Over 41 percent state that they use cannabis as a substitute for alcohol (n=158), 36.1 percent use cannabis as a substitute for illicit substances (n=137), and 67.8 percent use cannabis as a substitute for prescription drugs (n=259). The three main reasons cited for cannabis-related substitution are 'less withdrawal' (67.7 percent), 'fewer side-effects' (60.4 percent), and 'better symptom management' suggesting that many patients may have already identified cannabis as an effective and potentially safer adjunct or alternative to their prescription drug regimen."

Overall, 75.5 percent (n=305) of respondents said that they substitute cannabis for at least one other substance. Men were more likely than women to report substituting cannabis for alcohol or illicit drugs.

Authors concluded: "While some studies have found that a small percentage of the general population that uses cannabis may develop a dependence on this substance, a growing body of research on cannabis-related substitution suggests that for many patients cannabis is not only an effective medicine, but also a potential exit drug to problematic substance use.

Given the credible biological, social and psychological mechanisms behind these results, and the associated potential to decrease personal suffering and the personal and social costs associated with addiction, further research appears to be justified on both economic and ethical grounds. Clinical trials with those who have had poor outcomes with conventional psychological or pharmacological addiction therapies could be a good starting point to further our understanding of cannabis-based substitution effect."

For more information, please contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, "Cannabis as a substitute for alcohol and other drugs: A dispensary-based survey of substitution effect in Canadian medical cannabis patients," appears in Addiction Research and Theory.