Cannabis as a substitute for alcohol and other drugs

Self medication and substitution can be operationalized as the conscious choice to use one drug (legal or illicit) instead of, or in conjunction with, another due to issues such as: perceived safety; level of addiction potential; effectiveness in relieving symptoms; access and level of acceptance. This study examined drug and alcohol use, and the occurrence of substitution and self medication among medical cannabis patients. Anonymous survey data were collected at the Berkeley Patient's Group (BPG), a medical cannabis dispensary in Berkeley, CA. (N=350) The sample was 68% male, 54% single, 66% White; the mean age was 39. Seventy one percent report having a chronic medical condition, 52% use cannabis for a pain related condition, 75% use cannabis for a mental health issue. Fifty three percent currently drinks alcohol, one quarter currently uses tobacco, and eleven percent have used a non-prescribed, non OTC drug in the past 30 days. Sixteen percent reported previous alcohol and/or drug treatment, and 2% are currently in a recovery program. Forty percent have used cannabis as a substitute for alcohol, 26% as a substitute for illicit drugs and 66% as a substitute for prescription drugs. The most common reasons given for substituting were: less adverse side effects (65%), better symptom management (57%), and less withdrawal potential (34%) with cannabis. Medical cannabis patients engaging in self medication and substitution are also exerting self determination by choosing to use a substance with which they have experienced better outcomes than alcohol, other drugs, or drugs prescribed by their doctor.