The Debate Continues: Alcohol Versus Marijuana

Every year I’m asked the same question about alcohol and marijuana: Which is more dangerous to consume? In truth, this is a difficult question to answer because the two drugs have quite different and complex actions in the brain. Also, it’s difficult to define what “more dangerous” really means concerning the brain, particularly as compared to the well-known consequences of the consumption of alcohol on the body.

The World Health Organization recently concluded that no level of alcohol consumption is safe for our health. Alcohol is a toxic, psychoactive, and dependence-producing substance and has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer decades ago; this is the highest risk group, which also includes asbestos, radiation, and tobacco. The debate about alcohol appears to have been settled.

Is marijuana safe or beneficial?

Studies on animals, and data collected from epidemiological studies, strongly support the use of marijuana for the treatment of chronic pain or in diseases with symptoms produced by inflammation. Thus, if you’re thinking of getting a recommendation to treat your symptoms associated with chronic traumatic encephalopathy, Crohn’s disease, fibromyalgia, glaucoma, inflammatory bowel disease, multiple sclerosis, chronic or severe pain, spinal cord injury, traumatic brain injury or ulcerative colitis, you may experience significant relief. Currently, there is no reliable evidence that marijuana can cure any of these conditions; it can only reduce the severity of some of the symptoms.

The risks and benefits of cannabis are age-dependent.

The prenatal brain is very vulnerable to the presence of cannabis. Overall, the available evidence indicates that the adolescent brain is still vulnerable to exogenous cannabinoids. Essentially, cannabis alters the normal trajectory of brain maturation, although the consequences seem to be less severe than those of prenatal exposure. The combined evidence from numerous human and animal studies suggests that exposure to cannabis during adolescence has the potential to produce subtle, but lasting, alterations in brain function and behavior. The severity differs according to the duration of use, age at first use, and underlying genetic vulnerabilities that are more likely to appear during adolescence, such as various psychopathologies.

Cannabis use is becoming more common in older people. The majority of users in this group, primarily between 50 and 60 years old, report their most common reason for turning to cannabis is for pain reduction due to illness or injury. Most patients report that although cannabis is not more effective, it has fewer unpleasant side effects than over-the-counter or prescription pain medications. A recent study assessed the relationship between long-term medical cannabis use and cognitive function in a sample of middle-aged and older patients with chronic pain. Their results suggest that the use of whole-plant medical cannabis does not harm cognition in older patients. It is critical to take notice that this study, as well as the majority of other epidemiological studies, utilized the whole plant rather than specific extracts. The benefits from specific components of the plant have yet to be fully defined. Indeed, we may discover that the greatest benefits might only be realized from the aggregate actions of all of the components of the plant. Research in my laboratory has demonstrated that a daily low dose of cannabis can significantly reduce brain inflammation and restore neurogenesis in the elderly.