"Most of the people in the Brown trial met the criteria for "cannabis use disorder," and about 40% for alcohol use disorder. That could indicate their "drug of choice" was not necessarily alcohol in the first place, says Rajita Sinha, a professor of psychiatry at Yale University. For people with problem drinking, cannabis might be a potential treatment, she says. This approach, on the other hand, "may also be promoting more cannabis use and that would be problematic.""
""We would have to choose which one for a given individual might be less harmful and make sure that it's not inadvertently just replacing one problem with another," he says. In her role as a clinical psychologist, Metrik at Brown has seen some patients with severe alcoholism who successfully stopped drinking with the help of cannabis, though some have then gone on to develop issues with that drug."
Individual differences influence whether cannabis reduces alcohol use or increases other substance problems. Many participants in the Brown trial met criteria for cannabis use disorder and about 40% met criteria for alcohol use disorder, suggesting cannabis may be their preferred drug. Cannabis may help some people with problem drinking stop alcohol use, but it may also promote increased cannabis use and dependence. Cannabis carries risks including cognitive and memory impairment, cannabinoid hyperemesis syndrome, increased psychosis risk, and social and relationship harms. Alcohol causes more preventable deaths, yet long-term comparative harms remain unclear. Clinicians must weigh which substance is less harmful for each individual to avoid replacing one addiction with another.
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