Dear Alice,

What is, overall, safer for your body: alcohol or marijuana?

Dear Reader,

The health impact of any drug can depend on how it's used, who's using it, how much is used, and under what circumstances. Marijuana and alcohol are no exception, so comparing their level of safety directly is difficult — each possesses the potential for unique risks and benefits. If you’re curious or concerned about how your body might react to either alcohol or marijuana, it may be wise to speak with a health care provider first.

While this may come as a surprise, both marijuana and alcohol could have some beneficial effects for some users. For instance, there's some research that indicates that for some types of alcohol, a moderate amount could provide protective effects against heart disease for some folks. Similarly, for certain medical conditions such as glaucoma, or for those undergoing chemotherapy, marijuana can possess therapeutic properties. These positive effects, however, aren’t necessarily generalizable to everyone who use either substance, nor is it recommended to start using either to reap potential benefits without medical guidance or advice.

Before getting into more about safety, it may be helpful to understand some of the key differences between alcohol and marijuana relating to this discussion. To begin, the alcohol that can be purchased in stores is highly regulated, with a measurement of alcohol by volume printed on each container. Marijuana, on the other hand, tends to be less regulated; it comes in various strains that vary in potency and effects. There are also more ways to consume marijuana, such as ingesting and inhaling, while alcohol is typically consumed by ingestion via a beverage. Another difference is that based on what has been reported, overdosing from smoking or eating marijuana doesn’t seem to be an issue. On the flip side, consuming a lot of alcohol in a brief period of time can lead to alcohol poisoning, an emergency medical condition that can be fatal. One caveat to this difference, however, is that synthetic cannabinoids (sometimes erroneously referred to as “synthetic marijuana”) carry no therapeutic benefit and have been associated with serious health consequences and overdosing. Its use can even be fatal.

While both alcohol and marijuana can have some positive effects, both have the potential to be less than safe. People using either with the intention of getting high or drunk (intoxicated) are more likely to experience the more commonly recognized negative consequences of these drugs. Alcohol use may contribute to memory loss, impaired judgment, and academic, relationship, or work problems, along with long-term impacts such as liver disease, heart disease, peptic ulcers, and dependency. Marijuana use could contribute to problems thinking clearly, memory loss, cognitive deficiencies, and dependency as well. Marijuana’s long-term effects on cognition are not completely understood, but it’s thought that its use can result in a less severe impact than the effect of alcohol. Further, if smoked, marijuana may contribute to smoking-related health conditions, such as throat and lung cancer and respiratory issues. In terms of mental health, alcohol is thought to impact mental health, being associated with depression and anxiety, while marijuana’s connection to mental health concersn is less clear. Finally, alcohol use is the third leading cause of preventable death in the United States, while marijuana is not listed.

You might also be wondering more about dependence, since there is a risk when using either substance. The risk tends to be higher for alcohol than for marijuana. However, some research suggests that marijuana use increases the likelihood of developing dependencies on other substances, such as alcohol and cigarettes, though these results are not fully understood.

Aside from direct impacts on health effects and dependency, it’s also key to point out that getting behind the wheel while intoxicated by either substance poses significant risks to the user and others. Marijuana and alcohol have both been shown to significantly reduce reaction ability, focus, and motor coordination — skills that are essential to safely operate a motor vehicle. In fact, many activities, such as playing a sport or even riding the subway, could become dangerous when drunk or high. In general, being intoxicated compromises sound judgment and may lead to unhealthy or risky decisions that a person might not make when sober.

The list of facts and comparisons goes on and on, so it might be helpful to check out the other Q&As in the Go Ask Alice! Alcohol, Nicotine, and Other Drugs archive for more information. In short, used moderately (in the case of alcohol) or under the direction of a health care provider (in places where medical marijuana is legal), these substances may have positive health effects. However, they may vary based on who is using either substance, how much they are using, and in what ways their using it. But as is often the case, it is clear that heavy use of either drug may lead to serious health risks.

Hope this helps satiate your thirst for knowledge on these substances!

Alice!

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