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Cannabis vs Alcohol in 2020: Drinking Deaths on the Rise, is Marijuana the Answer?

A 2020 look at using cannabis vs drinking alcohol; from marijuana legalization, to the rise in alcohol-related deaths, to the preference in students or liver damage, which drug is gaining momentum vs losing its luster in the new decade and beyond?

A grandiose debate about which is ‘healthier' between using cannabis or drinking alcohol in 2020 has reached new heights. While neither may be optimal in terms of long-lasting wellness, in the battle of picking which poison you prefer to use based on safety, effects and even entertainment purposes is finally coming to a head.

With the marijuana legalization movement underway and the deaths-related to alcohol consumption rising the past two decades, from younger millennials choosing weed over booze to potential toxicity side effects of either drug of choice – where does the controversial cannabis vs alcohol discussion go from here in 2020 and beyond?

As National Institute on Drug Abuse health scientist Ruben Baler put it:

“You can die binge-drinking five minutes after you've been exposed to alcohol. That isn't going to happen with marijuana,” […] “The impact of marijuana use is much subtler.”

But does that mean cannabis' grass is greener or are we simply trading one toxic drug for another? Or are we finally seeing a flippening of these ‘vice substances' where a truly medicinal plant that has a wide range of health benefits in comparison to drinking alcohol and liquor (which are known-carcinogens and predominately is being consumed for an evening's festivities and pleasure) is surfacing as the top preference among people around the world.

From crime rates to driving while intoxicated, to learning and memory impairment or pregnancy effects, to substance abuse or overdosing; the conversation between the dangers and risks of consuming cannabis vs drinking alcohol are a worth-while discussion when all of the facts and figures are painted out. After all, it is your health on the line and that is what matters most at the end of the day.

What is the Legalization of Marijuana Doing for Alcohol Use?

The use and legalization of cannabis has been faced with substantial controversy and stigma through the last few years. There’s been discussions regarding its safety and even whether it should be legal at all, but what impact has it made on alcohol use? Here is a quick summary of how cannabis and marijuana legalization is influencing the alcohol industry:

In the United States, alcohol consumption has been highly popular through the decades. On average, the National Institute on Alcohol Abuse and Alcoholism reports that 86.3% of adults have had alcohol at some point in 2018, and even 26.45% reported binge drinking in the last month during the same survey. However, last year brought about substantial legalization laws for cannabis, and there are more states seeking to even legalize recreational use. Considering that the alcohol industry was worth over $100 billion just five years ago, what impact has legalized cannabis had?

Previously, much of the attention on cannabis has been negative, associated with laziness, the munchies, and getting as stoned as possible. However, as researchers seek to understand the plant more, there are a wealth of health benefits that are slowly changing the controversial stance on it. As marijuana becomes more widely acceptable for use, discussion has now turned to the ways that cannabinoids can be integrated into daily health supplements. Interestingly, as more consumers use cannabis in their personal and medical regimens, the use of alcohol is dropping drastically.

A Brief History of Cannabis

The cannabis plant has been in existence since 500 BC, and it was originally used for medicinal purposes. Hemp was also used in textiles, as the fiber is ideal for clothing, rope, and other uses. Through the years, cannabis has become a social activity for many, and that change has given some people a negative opinion of it with its media portrayal.

Even though the stigma isn’t rooted in truth, it has become the public idea that is difficult to change. As recently as 2018, cannabis has been used around the world for a variety of ailments and to ease the intensity of certain symptoms of treating those conditions, like chemotherapy for cancer. Pain, depression, and many other concerns have greatly benefited from the advancements in cannabis, helping to shed some of the negative opinion of the substance.

A Brief History of Alcohol

Alcohol has also been around for thousands of years, but it has much more of a universally accepted social use. Despite the fact that it has been involved in a substantially high number of accidents and even deaths, it has consistently been acceptable to the point of alcoholism, which didn’t develop until the mid-18th century. At the time, more low-cost spirits became available, which made the consumption of alcohol more affordable.

While alcohol use has some controversy, the substance remains legal around the world.

Cannabis and Alcohol

In the United States, there is some stigma and controversy associated with both marijuana and alcohol, and the rest of the world has much of the same stance. New health reports are constantly emerging to say that one of these substances is much riskier than its opposition, and legal concerns can sway the stance. Some statistics reveal that over 80,000 die annually from alcohol-related incidents, which is part of the reason that cannabis advocates are fighting so hard to make their substance more mainstream.

Alcohol tends to be a social substance, but it is highly addictive when used in abundance. While there are deaths associated with alcohol use, the same is not said with the use of cannabis, making it inherently safer for regular use than alcohol. It is impossible to overdose of cannabis, and even overindulgence simply leads to nausea that can be curbed. With alcohol, the consumption can be so severe that organs shut down over toxicity.

Affordability and Legal Matters

Still, there are other factors to consider when comparing the two substances, like their affordability and legal status. Cannabis is much harder to legally access, since the laws may differ from state to state, which leaves some consumers with only the ability to purchase alcohol as their chosen substance. Affordability is another concern, and getting inebriated can cause as little as $10, even with liver damage on the way.

Negative Aspects

Both cannabis and alcohol use come with their share of negative effects. Cannabis, for instance, is most commonly smoked, which is risky for the lungs. In the US, the consumption of smoke is the leading cause of death, but there are many forms of cannabis that don’t require any smoke, like tinctures and edible formulas.

With alcohol, the big health risks involve liver damage, heart failure, and mental health concerns. Furthermore, when high amounts of alcohol are consumed, the body cannot metabolize it effectively, which is how vital organs end up getting shut down.

Impact of Cannabis Consumption on Alcohol Use

Through the last century, the benefits that cannabis has to offer has become more well-known, as well as its lack of negative side effects with different methods of use. The medicinal properties are still being researched to see the full extent of cannabis’s benefits, but over 30 states have already made laws that permit it for exactly this purpose.

In December 2017, a study evaluated the sale of alcoholic beverages up to 2015 to find that the decrease in sales correlated with the rise of cannabis legalization. Forbes recently reported that alcohol sales have dropped by 15% or more in the states that medical marijuana has been legalized. A recent study by ScienceDirect even found that states that have legalized medical use have seen a drop in workplace fatalities. Clearly, in the states that have cannabis as an option, consumers seem to be forming a very particular preference.

What's Next in the Cannabis vs Alcohol Debate?

No matter what consumers choose, moderation is critical, and precautions should be taken. While cannabis may not lead to fatal consequences, there’s been a connection between THC and the increased likelihood of psychosis. Alcohol, while legal, has been linked to many types of fatal consequences. Researchers have a long way to go to learn more about cannabis, but it is clear that alcohol use is, in fact, dwindling as a result of legalization efforts.

Deaths Due to Drinking in the United States Increased

An analysis of death certificates of Americans ages 16 and over, from the years 1999 to 2017, suggests that the number of deaths due to drinking has doubled. In 1999, such deaths were 35,914, while in 2017, the figure reached 72,588. This is a 50.9% increase, according to a report by National Institute on Alcohol Abuse and Alcoholism.

The analysis appeared in a study titled Using Death Certificates to Explore Changes in Alcohol-Related Mortality in the United States, 1997-2017. The analysis explains that nearly half of all alcohol-related deaths were from liver disease or overdoses in alcohol, either alone or in combination with other drugs.

The research also looked at the groups that experienced the highest rate of alcohol-related deaths. For instance, such deaths were the highest among males, persons between the ages of 45 to 74, and non-Hispanic American Indians or Alaskan Natives. As for annual increase per year, the most significant group in this area are white females.

Additionally, there has been an increase in alcohol-related harms. The study indicates that from 2006 to 2014, alcohol-related emergency room visits have increased 47.3% among persons ages 12 and over, and the number of such visits also increased 61.6%.

The evidence accumulated during the study further suggests that alcohol related deaths related to the consumption of alcohol have increased, too.

This all begs to the question of what is behind the prevalence of alcohol. For one, it could be the alcohol culture in the United States. According to a report by This Naked Mind, events seem to revolve around drinking, and that it is on the rise in the United States.

Students Are Less Likely to Choose Alcohol When Cannabis Is an Option, According to New Study


  • The use of alcohol has dropped by an average of 6% in areas that have legalized recreational marijuana.
  • Despite legalizing recreational use, alcohol use still surpasses cannabis use in Canada, where multiple shortages have been recorded.

Cannabis legalization is making some huge changes in the US as more states make recreational use available. While sales have been substantial, the availability of cannabis is impacting another industry as well, alcohol.

Recently, a new study was published in Addictive Behaviors that examined the last decade of data collected via surveys involving college students in the US. The responses of 1.1 million participants were recorded and came to an interesting conclusion, adults over age 21 are less likely to binge drink alcohol in states that have legalized the recreational use of marijuana.

The study goes over the trends in alcohol, nicotine, prescription opioid, and other types of drug use, following the legalization of recreational marijuana. Much of the study focused on the connection between decreased binge drinking and the presence of new recreational marijuana laws, recording a decrease of 6%.

Zoe Alley, one of the authors of the study and an Oregon State University PhD student, stated that the widespread availability of marijuana is likely the cause. She stated,

“When you reach the legal drinking age, suddenly a lot of people transition to using more alcohol because now it’s more available and marijuana is not.”

Alley also suggested that the legalization could even prevent students that are just reaching their 21st birthday from reaching for alcohol, as they may opt for cannabis instead.

Researchers are only at the cusp of understanding the substitution of one substance for another as they consider availability and convenience. Still, for the US and Canada, researchers believe legalizing recreational use will create new trends.

While the legal age is lower for both alcohol and cannabis use in Canada, shortages and a lack of availability have left consumers continually turning to alcohol instead. If availability increases, experts believe that consumers may shift their attention to cannabis, considering that medical and recreational use are both legal in the USA’s northern neighbor.

Risk could potentially play a role in this preference. The risks of drinking alcohol are proving to be much more dangerous and common than that of using cannabis instead. However, the relationship between legal cannabis use and other substances is still difficult to determine. Most other substances have no correlation, but the reaction of alcohol drinkers shouldn’t be ignored. Alley remarked,

“The biggest takeaway from our paper is the problem from binge drinking in college students who are 21 and over changes after the implementation of recreational marijuana use.”

Liver Damage from Drinking May Be Avoidable with Cannabis Use

alcohol liver damage

  • Researchers are still unsure of what specific compounds in marijuana help to reduce the risk of liver disease.
  • The recent study, led by Dr. Adejumo, covered 320,000 people with a history of alcohol abuse.

It is no secret that excessive drinking puts substantial pressure on the liver, causing long-term damage and even disease. While there is plenty of data on the effects that cannabis can have on deterring consumers from the use of alcohol, recent studies indicate that there’s much more that can be done with its use. In fact, a report from Daily Mail states that individuals who both smoked marijuana and drank heavily experienced “significantly lower odds” of liver issues, like cirrhosis and some types of cancer.

Cannabis is frequently praised for its ability to reduce inflammation in the body, and this effect has already been studied in hundreds of trials. While the combination with alcohol appears to have a positive effect on the liver, scientists are still unsure of the reason for this reaction. Presently, additional trials are needed to get to the root of the cause.

The recent study referenced in the Daily Mail article was led by Dr. Adeyinka Charles Adejumo, who works at the North Shore Medical Center in Massachusetts. The study involved 320,000 people with a history of abusing alcohol. Of those participants, only about 10% had ever used cannabis at all – 8% that presently smoked and 2% that felt dependent upon it. The study showed that 10% that had any kind of current use had a 45% lesser risk of alcoholic steatosis and were 55% less likely to develop cirrhosis. They also had a 38% lesser risk of developing the most common cancer associated with the liver called hepatocellular carcinoma, though depended users had the lowest risk for any of these diseases.

Liver disease impacts about 4.5 million Americans, primarily caused due to obesity, alcohol abuse, or undiagnosed hepatitis infection. Most of the time, these individuals don’t even know that they have the disease until symptoms arise, which are rare until the disease has reached an advanced stage. Most commonly, when these symptoms do appear, the individual can appear jaundice, can lose weight and may have a smaller appetite. In extreme cases, a liver transplant is needed, though there is medication available in some instances.

In Liver International, the researchers wrote,

“While cannabis has demonstrated anti-inflammatory properties, its combined use with alcohol and the development of liver disease remain unclear.”

The same team recently performed research on five million people with no known history of alcohol abuse, finding lowered rates of non-alcoholic steatosis in individuals who smoke cannabis.

The receptors in the body connected with the endocannabinoid system have the ability to reduce the collection of fat in the liver when activated by cannabis. In doing so, this lack of fat collection prevents disease, though researchers are still unsure of which part of the cannabis plant is protective of the liver.

Speaking with Healthline, co-author Dr. Terence Bukong of the University of Massachusetts stated,

“Our studies could not ascertain which cannabis strains were used. So we couldn’t determine the cannabinoid content of what each individual ingested.”

Dr. Bukong added that there was no way to verify the dosage or the method of use, but he predicts that the cannabis was consumed “most likely through smoking.”

Even with this promising remedy, it is highly unlikely that experts will end up recommending the use of cannabis use in consumers with alcohol disorders. There are already studies that suggest that recovery from a relapse in alcohol abuse could be achieved by smoking marijuana.

Final Thoughts on Cannabis vs Alcohol in 2020

The new 2020 decade is dawning upon us all and as the war wages on between which is better, if any, between alcohol and cannabis – one can not help but start looking at the facts, figures and trends starting to unfold where cannabis usage and preference is becoming a much more viable option for people looking for a subtle release.

While this battle between the two most popular drugs of choice will likely not stop anytime soon, from alcohol's aggressive behavior side effects to marijuana's calming relaxation benefits, it will be interesting to see if the shift and demand continues to favor using cannabis over drinking alcohol in 2020 and beyond.


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