Substitute for Alcohol

The cost of alcoholism to individual patients and society-at large warrants testing of the Cannabis substitution approach and study of the drug-of-choice phenomenon.

“Harm reduction” is a treatment approach that seeks to minimize the occurrence of drug and/or alcohol addiction and its impacts on the addict/alcoholic and society at large.

Cannabis was once listed as a treatment for delirium tremens (DTs or shaking frenzy) in standard medical texts and manuals from the 19th century.

Delirium tremens signifies advanced alcoholism, we can adduce that patients who were prescribed Cannabis and used it on a long term basis were making a successful substitution.

By 1941, due to prohibition, Cannabis was no longer a treatment option, but attempts to synthesize its active ingredients continued.

A synthetic THC called pyrahexyl was made available to clinical researchers, and one paper from the postwar period reports its successful use in easing the withdrawal symptoms of alcoholics.

Mrs. A., a 49-year-old patient whose drinking had become problematic, had observed that when she smoked marijuana socially on weekends, she decreased her alcohol intake. She was instructed to substitute Cannabis when she felt the urge to drink which helped her to reduce her alcohol intake to zero.


Patients made negative comments with respect to the efficacy of their prescribed analgesics and antidepressants, side-effects, and cost —not surprising, perhaps.

Lance B. a 41-year-old alcoholic also suffering from arthritis, pain from knee- and ankle surgeries, and depression, for which he had been prescribed Librium, Valium, Buspar, Welbutrin, Effexor, Zoloft, and Depakote.over the years; “No help!,” he wrote bluntly. On his return visit he reported “few relapses” and that he was able to take some classes.

The dulling effects of Vicodin and other opiates were mentioned by seven patients.

As Harvey B. put it, “When I can get Vicodin it helps the pain but I don’t like being that dopey.”

Clarence S., whose skull was badly damaged in an accident, also appreciated the pain relief provided by opiates, but asserted, “Opiates make me paranoid and mean.”

Alex A., who was diagnosed with ADHD in ninth grade, touches on some recurring themes in describing the treatment of his primary illness: “I was prescribed Ritalin and Zoloft.

The Ritalin helped me concentrate slightly but caused me to be up all night. The Zoloft made me sick to my stomach and never relieved my stress or depression. I have never been prescribed anything for my insomnia but I usually have a drink to sleep. I have now begun to drink excessive amounts, which affects my stomach.”

Alex first used Cannabis at age 19 and became aware of benefits immediately. “I found myself running to the refrigerator and then sleeping better than I had for years.”

At age 21 he fears permanent damage. “My stomach has been altered, I cannot really eat that much and feel malnourished and weaker than a 21-year-old should. My joints ache constantly and I am not as strong as I used to be. I also fear that I will become or am an alcoholic and I do not want to see myself turn into my dad.”

At his follow-up visit (12 months) Alex reported Cannabis to be “very effective.” He was employed, “not partying,” doing well socially, and trying to give up cigarettes. No negative interactions between Cannabis and other drugs were reported.

Several patients indicated that Cannabis had a welcome amplifying effect on the efficacy of prescription and over-the-counter drugs. “I hurt a lot more without Cannabis and can’t function as well,” reported Liz J. “It seems to relax me so the medicines work better and faster. Additionally, Cannabis is natural, and all these other drugs —Vicodin, Soma, Aleve, Librium, Baclofen, have lots of side effects.”

As Cannabis use widens, it is important that its interactions with other medications be studied and publicized. Cannabis may also have an amplifying effect on alcohol, enabling some patients to achieve a desired level of inhibition reduction or euphoria while drinking significantly less.


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