So far in this series we have discussed the approach of harm reduction and how to reduce the potential harms of consuming cannabis. But, cannabis works on the other side of harm reduction as well, as a harm reduction tool.
In 2004, I was at my doctor’s office to get my medical cannabis card renewed and I was filling out the paperwork. One of the questions on the intake form asked if I was using cannabis as a substitute for prescription drugs, alcohol or illicit drugs. This concept was very interesting to me and not something I had seen covered in cannabis research (which at the time was very limited). Since cannabis had always been touted as a “gateway drug”, the idea that it could help people move away from hazardous substance use was something I wanted to explore. So, the next year when I was designing the survey for my dissertation research, I decided to add the question about substitution in there. In my sample of 130 medical cannabis patients, a little over half reported using cannabis instead of alcohol, and 75% reported using it instead of prescription drugs. Wanting to see if that result was real or just related to my particular sample of patients, I did another study a few years later and increased my sample size to 350. I got the same results and published them in the Harm Reduction Journal. This was one of the first times a researcher had suggested that cannabis could be used as a substitute for alcohol and other drugs by people looking to reduce or eliminate their use. The study was then replicated again in Canada and the results stayed the same. We were now confident that using cannabis as a harm reduction tool was happening and subsequent research confirmed this. In the decades that followed, patient reports illustrated the use of cannabis instead of prescription drugs and the ability of patients to reduce or eliminate their use of prescription drugs once they had access to cannabis.
There are three main ways that cannabis can be used as a substitute for alcohol, illicit or prescription drugs. However, people who are interested in using cannabis as a substitute should always consult with their physician before reducing/stopping any prescription medications. Also, if you have a physical dependency on alcohol or other illicit/prescription drugs, please consult a health care provider before stopping their use as withdrawals may require medical attention.
Bottom line: All drugs are not created equal when it comes to safety and dependence risk. And, the legal status of a drug tells us very little about its overall safety. The goals of harm reduction include supporting the personal choice to reduce/eliminate hazardous substance use while providing alternatives and strategies for improving the life experience. Cannabis can fit into this plan as a substitute for alcohol, prescription and illicit drugs. If you are wishing to reduce your alcohol intake, or see if cannabis is a better fit than Ambien for sleep, talk to your doctor and/or find a group dedicated to cannabis as a harm reduction tool.