What are the Main Differences Between the Effects, Risks & Safety of Alcohol vs Weed?

Photo by Pavel Danilyuk

Cannabis is quickly becoming a major part of the medical industry offering a homeopathic alternative for pain management, sleep aids, and orexigenics (appetite stimulants). Recreational legalization is making cannabis as common as alcohol. Sure, they both get you high, but how similar are they?

While in the past people may have used alcohol as a pain reliever or to clean instruments it’s often considered, medically, more harmful than helpful. How bad is alcohol compared to weed? What are the negative impacts of cannabis and alcohol use? Which one is better to use?

Alcohol and cannabis are vastly different but often get lumped together because they are intoxicants. The way they make you feel may make them seem similar but their impact on your body and any lasting damage are not remotely the same.

Can you get addicted to weed like alcohol? What is an alcohol overdose compared to a cannabis overdose? Ultimately, which is worse, alcohol or weed? This post will explore all the differences between these two intoxicants and explore their impact on your health and society at large.

Is Alcohol Worse Than Weed?

The short answer is yes alcohol is worse than weed. Alcohol is not only more addictive it also can cause more lasting damage to your health than cannabis. While excessive marijuana use can take a negative toll on your health many of these side effects can be reversible.

Additionally, while you can have a cannabis overdose it’s not remotely fatal while an overdose of alcohol can cause lasting damage and even death. Weed is not without its pitfalls but alcohol is by far more problematic.

Alcohol interacts with the body differently and has been the cause of many accidents, negative health conditions and even deaths while cannabis is often used as a homeopathic alternative to many medications and still has additional yet-to-be discovered medical benefits.

This post will elaborate on the impacts of alcohol vs. weed on your health, body, driving skills, fatality numbers, and the toll they can take on your life.

How Many People Die From Weed?

It can be challenging to ascertain how many deaths are caused by cannabis. Marijuana, even in extreme cases, is not particularly fatal. While there can be the odd allergic reaction or bad interaction or even a child may inadvertently consume cannabis, there isn’t sufficient data to point towards any deaths caused by cannabis.

The Centers for Disease Control and Prevention (CDC) does not track cannabis related overdoses because the chances of fatality are so rare. The Institute of Medicine (IOM) report Marijuana and Medicine: Assessing the Science Base has said “epidemiological data indicate that in the general population marijuana use is not associated with increased mortality.”

That roughly translates to cannabis is not directly related to any increase in the chances of death or has a significant impact on your lifespan.

The Drug Abuse Warning Network in 2011 found there were up to 456 000 drug-related emergency department (ED) visits in the USA with marijuana-use mentioned in the medical records (a 21% increase from 2009). However there’s no data on how many, if any, of those visits resulted in death.

Additionally, cannabis is not always the only drug or substance that someone might be using. This also skews any data because someone engaged in an accident or having a health issue may have more than cannabis in their system.

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Weed Deaths Per Year USA

Again, there isn’t significant data to point to specific deaths caused solely by weed. Again, a cannabis overdose can cause increased nausea and vomiting but is not fatal. Even heavy marijuana abuse can at worst cause schizophrenia in people with a history of mental illness.

While the growing increase in medical and recreational cannabis legalization is providing a larger data set there isn’t enough tracking to link specific medical deaths to cannabis.

There was a case of a 35-year old marijuana user who was admitted with chest pains and was diagnosed with marijuana-induced coronary spasm causing myocardial infarction which roughly translates to marijuana-induced spasms causing a heart attack. The patient was treated and did live.

There doesn’t mean there can’t be a possibility of cannabis leading to illness or death but there have been no direct connections to deaths while alcohol-use, specifically alcoholism, has been tied to drunk driving deaths and linked to cancer, heart disease, and liver disease most commonly cirrhosis.

How Many Deaths Are Caused By Driving High?

Now while cannabis deaths caused by disease, illness or drug interactions there are some data points regarding accidents, specifically car accidents. Legalization has provided data points about the potential increase in accidents related to cannabis.

The American Journal of Public Health found that between 2000 and 2018, the percentage of car crash deaths in the United States involving cannabis doubled from 9% to 21.5% and the percentage of deaths involving both cannabis and alcohol have more than doubled from 4.8% to 10.3%. However, this is low compared to 40% of all car crashes that directly involve alcohol.

Thankfully, as more states legalize cannabis and recreational sales we can observe more data about the effect on death and accident rates. One study examined these data points exploring when cannabis was legalized vs. when retail sales began.

They ultimately found a 5.8% increase in injury crash rates and a 4.1% increase in fatal crash rates when comparing the data of cannabis being legalized and when states opened recreational sales. They did find that recreational sales did not increase crash rates as much as the initial legalization did.

It’s important to note that when cannabis gets legalized many people may use cannabis semi-legally by consuming illegally purchased cannabis which can lead to them consuming more than standard dosages. This almost points to the importance of regulation so people can use standardized dosages to track their usage of cannabis.

Legalization does not remove the risk but it’s still significantly lower than confirmed alcohol-related deaths. Where does alcohol fit into this?

Alcohol Deaths Vs Weed Deaths

Considering the statistics you just read about marijuana-based crashes, 40 percent of car crash deaths in the US involve alcohol, and 30 percent of deaths involve alcohol above the legal limit for driving.

Additionally, while the CDC does not track marijuana related deaths since there’s negligible numbers it reports more than 36,000 annual U.S. deaths are attributed to chronic alcohol use. The CDC even has a Alcohol-Related Disease Impact (ARDI) application that tracks deaths caused by alcohol. In the year 2020-2021 alcohol was responsible for 488 deaths per day.

Research published in the journal Alcoholism: Clinical & Experimental Research found 36% of hospitalized assaults and 21% of all injuries are attributable to alcohol use by the injured person.

Suffice to say that alcohol causes more deaths due to violence, accidents, car crashes, and disease than cannabis to the point where there are ever-growing statistics tracking these numbers. While there is the possibility for occasional deaths and accidents caused by cannabis use there isn’t sufficient data to compare it to alcohol.

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Driving On Weed Vs Alcohol

While the death toll may not be the same, the effect on drivers has been sufficiently observed. It’s illegal to drive under the influence of cannabis or alcohol. While, due to alcohol being legal for decades and drunk driving being illegal for a significant amount of time the law has preset blood alcohol levels to dictate how much alcohol is too much in your system while driving.

It’s possible over time the same may happen with cannabis? How different are they in affecting your ability to drive?

Cannabis can affect your ability to pay attention, memory, and decision-making. It can overall slow your reaction time and your general perception of time and distance which can increase your likelihood of getting into an accident. It also can potentially affect your motor skills.

Alcohol on the other hand can heavily impact your cognitive function. It can lead to impaired judgment, decreased reaction times, and difficulty concentrating. It can also lower your inhibitions making you more likely to make riskier or rash decisions that can lead to an accident.

Both alcohol and cannabis should not be consumed when driving. They both have a history of impairing judgment and can directly increase your chances of having an accident. There currently isn’t a Blood Marijuana Level federally recognized but as more states adjust to legal cannabis use we can have clearer and more stringent measures to monitor driving while intoxicated on cannabis.

Let’s further explore the effect of both on your brain.

Weed Vs Alcohol On Brain

Cannabis has compounds that mirror the endocannabinoids your body creates. The endocannabinoid system regulates various body functions including relaxation, inflammation, and hunger.

THC can bind to some of your CB1 receptors. Over time, it can temporarily decrease the prevalence of CB1 receptors which can cause memory issues but, overall, the compounds in cannabis including many of the terpenes can be neuroprotective. This means that they can help protect nerve cells from damage which can decrease your chances of developing Alzheimer’s disease.

Weed can impact your memory and in some severe cases cause or exacerbate schizophrenia or psychosis. Despite there being issues, most issues caused by cannabis can be reversible if you stop using cannabis.

Alcohol on the other hand, is a neurotoxin. It can damage brain cells and lead to deficiencies in neurotransmitters. It affects gamma-aminobutyric acid (GABA) which can cause relaxation but long term use of alcohol can affect your levels of GABA or glutamate in the nervous system. Alcohol can lower inhibitions but it can also impair judgment, coordination, and memory.

Excessive alcohol use can cause brain damage and degenerative conditions like Wernicke-Korsakoff syndrome, which can cause severe memory impairment and other cognitive deficits. It can even decrease brain matter and this damage can be permanent.

Alcohol can also cause a physical dependence or addiction. Speaking of, let’s examine the addictive tendencies of these substances.

How Addictive Is Alcohol Vs Weed?

Alcohol is significantly more addictive than weed. Prolonged alcohol use can lead to physical dependence, where the body becomes reliant on alcohol to function normally.This can cause the shakes and can affect your ability to lead a normal life. This can require you to seek medical treatment to come clean.

Weed is less addictive than alcohol or even nicotine. Cannabis is more likely to lead to a use disorder where you are habitually or are psychologically addicted to cannabis and want to use it. However, unlike alcohol there is no need to take it.

Alcohol detox can take a significant amount of time and have heavy withdrawal symptoms, while cannabis withdrawal can last anywhere from a few days to a couple weeks. It can also be completely out of your system in 1-3 months with you returned to normal levels and function.

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Weed Addiction Vs Alcohol Addiction

It’s important to understand the distinct difference between alcohol and cannabis addiction.

Alcohol is highly addictive and some people can have a genetic predisposition to alcoholism. Chronic use of alcohol can cause a physical dependency that will require outside intervention to treat this and help you become sober.

Cannabis can be addictive but this is more a psychological dependency than a physical one. It can be more habitual or emotional in nature and can be aided by therapy and not necessarily require outside intervention. Additionally, any deficits or issues caused by heavy cannabis use can be reversible.

With proper tolerance breaks, you can lower your tolerance of THC and become less reliant on large amounts of cannabis to feel the same way and regulate your cannabis use.

Weed Vs. Alcohol Feeling

Some people may consider both substances similar because of how they make you feel. Alcohol can help you relax and lower your inhibitions. People attribute it to be a social lubricant that allows people to stave off social anxiety and be more outgoing and talkative. Alcohol can help you relax and even get tired.

Alcohol can also impact your emotional state. It can cause mood swings and we’re all familiar with people who are “angry drunks.” The impact of alcohol can vary based on how much you’re using and how your body interacts with it.

Cannabis on the other hand can make you feel relaxed as well decrease your depression or anxiety. However, excessive use can actually cause paranoia or nervousness.

Cannabis can make you feel more euphoric, creative, energized or it can help you relax or fall asleep depending on if the strain is sativa vs. indica.

Cannabis can make you feel different depending on the strain and the amount of THC.

If they can make you feel somewhat similar, which one is better?

Weed Vs Alcohol Pros And Cons

You may be wondering if you should use weed or alcohol. While both are intoxicants they can affect the body differently and can also impact your health differently. Here are the pros and cons of weed vs. alcohol.

Pros

• Cannabis is less toxic and less likely to cause overdose or direct fatalities.
• Weed is less likely to cause physical addiction or serious withdrawal symptoms.
• Cannabis can provide untold medical benefits like pain relief, appetite stimulation, and many of the compounds in cannabis are potent antioxidants.
• Cannabis can cause less of an impairment to motor skills and coordination than alcohol.
• Many of the effects of cannabis can be reversible either from abstaining or eliminating the high. If you’re ever too high, you can use CBD or pinene to reverse the effects.

Cons

• Cannabis can impair short-term memory, concentration, and cognitive function while you’re intoxicated.
• Cannabis can negatively impact your motivation and ambition.
• Smoking can harm lung health
• Cannabis is not legal everywhere and traveling out of state or purchasing cannabis in some states can be illegal.
• Some people have a stigma about cannabis use and have “stoner” stereotypes about even casual cannabis use which can impact your employment or social standing.

Overall, cannabis use can be healthier and less addictive than alcohol use. Many of the issues have to do with legality and preconceived judgment of cannabis. Alcohol has been legal significantly longer compared to cannabis and some of these stigmas can impact people’s judgment about cannabis use.

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Alcohol Vs Weed Pros And Cons

Alcohol is legal and can be purchased almost anywhere and everywhere. Cannabis is only legal in some states. However, is available necessarily a sign that it’s better for you? If you’re comparing alcohol vs. weed here are some pros and cons.

Pros

• Alcohol is legal for adults of age almost everywhere.
• Alcohol is a part of many social traditions like toasts and other special occasions.

There are some potential cardiovascular benefits with light-to-moderate use like 1-2 glasses of wine per day.

• Alcohol is more socially acceptable by many than marijuana use.

Cons

• Alcohol can be highly toxic and can directly cause fatal overdoses.
• Excessive alcohol use can impact many different parts of your body and cause serious health issues like liver disease, cancer, brain damage and pancreatitis.
• Alcohol significantly impairs motor skills and judgment.
• Alcohol has a high addiction potential and can cause potentially fatal withdrawal effects.
• There is an increased risk of injuries, violence, and other behavior issues while intoxicated.

In general, marijuana is considered less harmful than alcohol but alcohol can be considered more socially acceptable. After all, you can only purchase cannabis products at dispensaries where in some states you can purchase alcohol in supermarkets. Additionally, alcohol is more socially acceptable in public use or work situations while using cannabis at a work function could be looked down upon.

Health Effects Of Weed Vs. Alcohol

Now that we’ve explored the various impacts of both cannabis and alcohol, what are the potential impacts on your body? How will weed and alcohol impact your health? What do both of these substances do to your body?

Weed

Cannabis can have cognitive effects including short-term memory loss and difficulties concentrating. There can also be respiratory health issues associated with smoking marijuana. Smoking can have an impact on your lung health similar to cigarette smoke.

Cannabis has been found to potentially increase your chances of developing anxiety, paranoia, and psychotic symptoms.There is ongoing research on the relationship between marijuana use and mental health disorders.

While there are negative benefits, cannabis does have many medicinal benefits including treatment of pain, nausea, issues with eating or keeping down food, and can help treat anxiety and depression.

Additionally, compounds in cannabis can help prevent some diseases, stunt oxidative damage, and can also help prevent major conditions. Some compounds in cannabis have been found to be anticancer, antibiotic, and antifungal.

Alcohol

As mentioned, alcohol can cause many different negative effects on your body, most notably the liver. Chronic alcohol use can lead to liver diseases such as fatty liver, alcoholic hepatitis, and cirrhosis, gastritis and pancreatitis.

Alcohol can impact your cardiovascular system. Moderate alcohol consumption may have cardiovascular benefits but excessive drinking can put you at an increased risk of high blood pressure, cardiomyopathy, and arrhythmias.

Alcohol can cause cognitive impairment which can lead to poor judgment, decreased coordination, and memory loss and in some cases blackouts.

Alcohol is also highly addictive and over time addiction can increase your chances of developing health issues and even a physical dependency. Over time, this can increase the toll it takes on your body.

Alcohol can contribute to social and behavioral issues, including aggression, mood swings, outbursts, relationship issues, and legal troubles.

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Edibles Vs Alcohol

One of the main negative issues of weed vs. alcohol is all of the issues with smoking marijuana. Are edibles better than alcohol? Edibles cut down on one of the major issues with cannabis because they don’t require smoking and eliminate many of these risks.

Edibles do function differently than smoking or vaping cannabis. There’s a delay in when you feel edibles because it can take time for the THC to be absorbed into your bloodstream. Edibles need to be digested and it can take anywhere from 20 minutes to 2 hours to understand how you feel.

Alcohol you can feel its effects within a shorter window and it can tend to last for less time. Edibles can be healthier than alcohol but some users report paranoia or anxiety from edibles vs. consuming weed in other ways because THC is metabolized differently and is a different compound: 11-Hydroxy-THC.

That being said, alcohol still faces all of the same aforementioned tolls on your health and risks of addiction.

Are Edibles Better Than Alcohol?

Edibles remove a significant amount of the issues associated with smoking weed. By eliminating the smoking factor, it frees up many of the benefits of cannabis. Cannabis can be less unhealthy than alcohol so using edibles can potentially eliminate what few risks there are associated with cannabis.

However, dosing with edibles can be imperfect and take time to ascertain so when using edibles it’s best to pace yourself and examine how you feel. However, ultimately cannabis edibles can take less of a toll on your health and provide you with a high or relaxation without causing too much damage to your body or health.

Final Thoughts

Alcohol is everywhere yet we are well aware of the risks and dangers of alcohol use and abuse. The cannabis industry is making marijuana as readily available thanks to recreational legalization; it could be as common as alcohol. While there are some issues to the abuse of cannabis they are nowhere near as hazardous as alcoholism and the toll of alcohol on the body.

One thing that’s clear about the alcohol vs. weed debate is that both should be used responsibly and driving while intoxicated on anything should be avoided at all costs.

One way to develop a healthy relationship with cannabis is to use it intentionally. If you want to seek out medical marijuana for a specific condition consider finding a doctor with Green Health Docs. Getting a medical marijuana card can ensure that you have access to regulated medical marijuana simply and easily.

This article has been reviewed by Dr. Anand Dugar, an anesthesiologist, pain medicine physician and the founder of Green Health Docs. Graduating from medical school in 2004 and residency in 2008, Dr. Dugar has been a licensed physician for almost 20 years and has been leading the push for medical cannabis nationwide.