Since becoming legal in many places, the use of THC during sobriety has become a more difficult conversation. It’s easy to justify telling someone not to do something when it’s illegal, whether you’re in treatment, recovery, or otherwise. For people who are in a substance abuse treatment program, you’ll be advised not to use any drugs or alcohol in your recovery, regardless of whether or not the substance in question was your original problem. If you’re in treatment for alcohol and want to smoke marijuana, you’ll likely be told not to if you wish to remain sober. When marijuana was illegal, it was less of a morality issue and more of an issue from a legal standpoint when therapists or counselors would advise against the use of marijuana during sobriety. Now with the legality being changed, it seems like a legitimate question to ask what the potential risks might be for someone in recovery from alcohol to use THC in their sobriety.
Many people believe that if you’re in recovery from any substance, you should abstain from using anything that is mood-altering which could include caffeine and nicotine, which are also addictive. It’s common for alcoholics and addicts in early recovery to substitute one addiction for another because people who have an addiction typically aren’t craving a physical substance; they’re craving a fulfillment of an emotional need. Due to this behavior, most people in AA and NA or any treatment program will advise you to stay away from all addictive substances in recovery.
Regarding substituting cannabis for alcohol for those with alcohol use disorder, some studies link moderate cannabis use to persistent alcohol problems. People with a lifetime alcohol use disorder (AUD) who used cannabis moderately had 2.83 times the number of drinks and experienced 6.82 times greater odds of alcohol-related harm than abstainers. Mid-level cannabis users also had more heavy drinking episodes and greater odds of alcohol dependence than people who didn’t use cannabis. The study showed no significant differences between cannabis abstainers and heavy cannabis users in how much they drank, the number of heavy drinking occasions, or alcohol-related harms. Heavy use was defined as using cannabis weekly or more. Mid-level use was categorized as more than monthly or less than weekly.
These studies were done to compare post-treatment alcohol use between those who use cannabis and those who abstain during treatment for alcohol use disorders (AUD); and to examine potential cannabis use thresholds by comparing post-treatment alcohol use between four frequency groups of cannabis users relative to abstainers. Among individuals in alcohol treatment, any cannabis use (compared with none) is related to a significantly lower percentage of days abstinent from alcohol post-treatment, although only among those who used cannabis once or twice per month. So while cannabis may help some people reduce their alcohol intake, it can also lead to worse drinking outcomes.
Among individuals who consume cannabis that were seeking to reduce or stop drinking and were engaged in relapse prevention treatment, cannabis consumption was associated with decreased same-day alcohol consumption regardless of frequency of cannabis use. Future work is needed to determine how cannabis impacts alcohol consumption at later time-points post-treatment, as well as how the cannabis/alcohol use association may differ among different populations and those diagnosed with alcohol use disorder and/or cannabis use disorder.
For individuals and families seeking recovery, cannabis consumption may help some individuals seeking to reduce or stop drinking to reduce their alcohol intake; however, it’s not clear from this study how cannabis consumption affects long-term drinking or how it helps or harms individuals with alcohol or cannabis use disorder. Using cannabis to manage a drinking problem confers risk for developing cannabis use disorder, or their co-use may exacerbate other functional impairments. Safer, more effective strategies for reducing rather than quitting alcohol use include Cognitive Behavioral Therapy (CBT). If alcohol abstinence is the goal, then programs such as AA and SMART Recovery might be helpful .
Each person’s recovery journey is different, and it’s certainly not uncommon for individuals who are seeking to reduce or stop drinking alcohol to use cannabis as a substitute, but it truly varies from person to person. It’s important not to base your recovery on someone else’s. Don’t assume that if someone can use cannabis while in alcohol recovery and not drink, you will be able to also. If you’re in treatment, you should discuss these with your therapist if you have questions or concerns. If you are a member of AA and you’re thinking about incorporating cannabis use in your recovery, maybe discuss it with your sponsor or another group member so you can talk through the pros and cons and what would be best for you in your recovery. Again, what works for someone else might not work for you.
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 Some People With Alcohol Use Disorder May Be Able To Substitute Cannabis For Alcohol: Alcohol Research Group https://arg.org/news/aud_and_cannabis/
 Cannabis Use During Treatment For Alcohol Use Disorders Predicts Alcohol Treatment Outcomes: National Library of Medicine https://pubmed.ncbi.nlm.nih.gov/27865015/
 Can Cannabis Substitute for Alcohol in People Receiving Treatment to Reduce Their Drinking: Recovery Research Institute https://www.recoveryanswers.org/research-post/can-cannabis-substitute-alcohol-people-receiving-treatment-reduce-drinking/