Side by side
Cannabis vs. alcohol: it isn't close.
Compare them on toxicity, dependence, organ harm, and deaths, and you'll see why so many people are swapping the bottle for the plant.
The head-to-head
| Measure | Alcohol | Cannabis |
|---|---|---|
| Toxicity (margin of exposure) | "High risk": at the population level, the only substance in the high-risk band1 | Population MOE above 10,000, the lowest risk of every drug studied1 |
| Overall harm (expert ranking) | Ranked #1 most harmful drug overall (score 72), and the most harmful to other people2 | Not in the top three. Alcohol (72) scored above heroin (55) and crack cocaine (54)2 |
| Chance of dependence after first use | 22.7% lifetime8 | 8.9% lifetime8 |
| U.S. deaths | About 178,000 per year, cutting an average of 24 years off each life3 4 | The National Academies found insufficient evidence of any link between cannabis and overdose death11 |
| Cancer | A causal link to at least 7 cancers, including breast, colorectal, liver, mouth, and throat, per the U.S. Surgeon General7 | Moderate evidence of no association between smoking cannabis and lung or head-and-neck cancers11 |
| Global toll | 2.6 million deaths worldwide in 2019 (4.7% of all deaths)5 | Lowest toxicological risk of the drugs compared1 |
| Safe amount | The Global Burden of Disease study found the level of drinking that minimizes health loss is zero6 | Has FDA-approved medicines and a federal finding of accepted medical use21 55 |
Lifetime chance of becoming dependent after first use
Toxicity: margin of exposure (higher = safer)
Substitution
Swapping the bottle for the plant
Evan's story isn't unique. Researchers have been documenting it for years.
29%
fewer drinks on cannabis days among heavy drinkers in treatment, who were also about half as likely to binge15
44%
of Canadian medical-cannabis patients drank less often after starting cannabis, and 8% quit alcohol entirely14
44.5%
of patients in Canada's federal medical-cannabis program reported substituting cannabis for alcohol52