Alcohol vs. Cannabis
Comparisons and contrasts of the two substances
Comparisons and Contrasts of the Two Substances
Image via Eddie Parker.
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Portions of this article first appeared in Business Insider on August 28th, 2018. We’ve made edits and changes to terminology, specifically replacing “marijuana” with “cannabis.” More on the meaning behind this here.
Trigger warning: topics and studies mentioned include anxiety, depression, schizophrenia, binge-drinking, self-harm, suicide, death, addiction, drug abuse, violence, overdose.
When comparing substances like cannabis and alcohol, it’s easy to wonder if one is more dangerous or poses more risks than the other. Formally, the answer to this is not entirely conclusive, but the following information leads us to the short answer: it appears that alcohol poses far more risks than cannabis does.
Simply comparing the number of consumption-related deaths per year speaks for itself: alcohol coming in with around 30k but closer to 90k deaths per year when considering drinking-related accidents and homicides. Cannabis alone cannot lead to a lethal overdose, but there are, of course, still opportunities for cannabis-related car crashes and other incidents.
The AAA Foundation found that the percentage of Washington state drivers in fatal crashes who tested positive for THC increased from about 9 percent in the five-year period before legalization to about 18 percent in the five years afterward. About 1 in 5 drivers involved in fatal crashes in 2017 tested positive for THC.
A large review published in August in the medical journal, The Lancet found that among people aged 15-49, alcohol use was the leading health risk factor across the globe in 2016, with 3.8% of all female deaths and 12.2% of all male deaths attributable to alcohol use.
The review looked at published data from nearly 600 studies that comprised data on 195 countries and territories between 1990 and 2016. The results showed that among people of all ages, alcohol was the seventh leading risk factor for deaths in 2016.
The more people drank across the globe, the more their risk of dying and their risk of cancer rose, the study authors found. As a result of these findings, they concluded that there was no "safe" level of alcohol consumption.
"Alcohol use is a leading risk factor for global disease burden and causes substantial health loss," the researchers wrote in their paper, "and the level of consumption that minimizes health loss is zero." More than 30,700 Americans died from alcohol-induced causes in 2014.
There have been zero documented deaths from cannabis use alone.
In 2014, approximately 30,722 people died from alcohol-induced causes in the US— and that does not count drinking-related accidents or homicides. If those deaths were included, the number would be closer to 90,000, according to the Centers for Disease Control and Prevention.
Meanwhile, no deaths from cannabis overdoses have been reported, according to the Drug Enforcement Administration. A 16-year study of more than 65,000 Americans, published in the American Journal of Public Health, found that healthy cannabis users were not more likely to die earlier than healthy people who did not use cannabis.
Image via Eddie Parker.
For a 1994 survey, epidemiologists at the National Institute on Drug Abuse asked more than 8,000 people from ages 15 to 64 about their drug use. Of those who had tried cannabis at least once, roughly 9% eventually fit a diagnosis of addiction. For alcohol, the figure was about 15%. To put that in perspective, the addiction rate for cocaine was 17%, while heroin was 23% and nicotine was 32%.
Unlike alcohol, which slows your heart rate, cannabis speeds it up, which could negatively affect the heart in the short term. Still, the largest-ever report on cannabis from the National Academies of Sciences, released in January, found insufficient evidence to support or refute the idea that cannabis may increase the overall risk of a heart attack.
On the other hand, low to moderate drinking — about one drink a day — has been linked with a lower risk of heart attack and stroke compared with abstention. James Nicholls, a director at Alcohol Research UK, told The Guardian that those findings should be taken with a grain of salt since "any protective effects tend to be canceled out by even occasional bouts of heavier drinking."
In November 2017, a group of the nation's top cancer doctors issued a statement asking people to drink less. They cited strong evidence that drinking alcohol — as little as a glass of wine or beer a day — increases the risk of developing both pre- and postmenopausal breast cancer.
The US Department of Health lists alcohol as a known human carcinogen. Research highlighted by the National Cancer Institute suggests that the more alcohol you drink, particularly the more you drink regularly, the higher your risk of developing cancer.
For cannabis, some research initially suggested a link between smoking and lung cancer, but that has been debunked. The January report found that cannabis was not connected to any increased risk of the lung cancers or head and neck cancers tied to smoking cigarettes.
It's impossible to say whether drinking alcohol or using cannabis causes violence, but several studies — including a recent analysis published in the journal Cognitive, Affective, and Behavioral Neuroscience — suggest a link between alcohol and violent behavior.
For the study, which was published in January, researchers used fMRI scans to see how two alcoholic drinks impact brain function in 50 healthy adult males. Compared with sober participants, the intoxicated volunteers were found to have reduced functioning in the prefrontal cortex, an area of the brain linked with moderating social behavior. That reduced functioning was also linked with aggressive behavior.
The finding aligns with some previous research on alcohol's connections with violence. According to the National Council on Alcoholism and Drug Dependence, alcohol is a factor in 40% of all violent crimes, and a study of college students found that the rates of mental and physical abuse were higher on days when couples drank.
On the other hand, no such relationship appears to exist for cannabis. A recent study looking at cannabis use and intimate partner violence in the first decade of marriage found that cannabis users were significantly less likely to commit violence against a partner than those who did not use the drug.
Both cannabis and alcohol temporarily impair memory, and alcohol can cause blackouts by rendering the brain incapable of forming memories. The most severe long-term effects are seen in heavy, chronic, or binge users who begin using in their teens.
Studies have found that these effects can persist for several weeks after stopping cannabis use. There may also be a link between daily weed use and poorer verbal memory in adults who start smoking at a young age.
Chronic drinkers display reductions in memory, attention, and planning, as well as impaired emotional processes and social cognition — and these can persist even after years of abstinence.
The largest review of cannabis studies found substantial evidence of an increased risk among frequent cannabis users of developing schizophrenia: something that studies have shown is a particular concern for people already at risk.
Cannabis can also trigger temporary feelings of paranoia and hostility, but it's not yet clear whether those symptoms are linked with an increased risk of long-term psychosis.
On the other hand, self-harm and suicide are much more common among people who binge drink or drink frequently. But scientists have had a hard time deciphering whether excessive alcohol use causes depression and anxiety or whether people with depression and anxiety drink in an attempt to relieve those symptoms.
Weed gives you the munchies. It makes you hungry, reduces the natural signals of fullness, and may even temporarily make food taste better.
But despite eating over 600 extra calories when smoking, cannabis users generally don't have higher body-mass indexes. In fact, studies suggest that regular smokers have a slightly reduced risk of obesity.
Alcohol, on the other hand, appears to be linked with weight gain. A study published in the American Journal of Preventive Medicine found that people who drank heavily had a higher risk of becoming overweight or obese. Plus, alcohol itself is caloric: A can of beer has roughly 150 calories, and a glass of wine has about 120.
All things considered, alcohol's effects seem markedly more extreme — and riskier — than cannabis’s.
When it comes to addiction profiles, risk of death or overdose, and links to cancer, car crashes, violence, and obesity, the research suggests that cannabis may be less of a health risk than alcohol.
Still, because of cannabis’s largely illegal status, long-term studies on all its health effects have been limited — meaning more research is needed.
Information on this page should not be considered professional medical advice or conclusive information. Please consult a physician before use of any mentioned products or substances.