Medical cannabis patients who reduced alcohol use tended to have anxiety, PTSD, and used cannabis for sleep | Research

The takeaway

Among 112 dispensary patients, those who reduced alcohol after starting medical cannabis were more likely to have anxiety, PTSD, and sleep disorders, and were more likely to use cannabis specifically for sleep, compared to those who did not change alcohol use.

Addiction medicine specialists, medical cannabis patients who also drink alcohol, and harm reduction researchers.

Alcohol abaters more likely to have anxiety (60% vs 41%)

What the researchers found

Alcohol abaters and non-abaters did not differ in age, sex, or prior drug history. However, abaters were more likely to have anxiety (59.6% vs 40.6%), PTSD, and sleep disorders. They also used higher cannabis doses and were more likely to use cannabis for sleep.

Why it matters

If certain patient profiles are more likely to reduce alcohol after starting medical cannabis, this could help identify patients for whom cannabis might serve as a harm reduction tool for alcohol misuse.

The numbers in context

47 abaters, 65 non-abaters. Abaters: 59.6% anxiety vs 40.6% non-abaters. Abaters used higher cannabis doses and more frequently used cannabis for sleep.

How the study worked

Exploratory cross-sectional study comparing 47 medical cannabis patients who reduced alcohol use (abaters) to 65 who did not (non-abaters) at dispensaries. Demographics, dosing, and health conditions were compared.

What this study cannot tell us

Small, self-selected sample from dispensaries. Self-reported alcohol reduction without objective verification. Cross-sectional design cannot confirm that cannabis caused the alcohol reduction. No control for overall alcohol use levels.

How to read the evidence

Preliminary: small exploratory cross-sectional study without objective outcome measures.

When this study was published

Published in 2020 in Journal of Psychoactive Drugs.

The bigger picture

The pattern suggests that some patients may be substituting cannabis for alcohol specifically to manage anxiety, PTSD, and sleep problems, conditions that are common reasons for problematic alcohol use.

Questions still open

Would a prospective study confirm that medical cannabis reduces alcohol use in these patient subgroups? Is the alcohol reduction sustained over time? Are there patients for whom cannabis substitution would be harmful rather than helpful?

Common questions

Does medical cannabis help people drink less?

This study found that some patients reported drinking less after starting medical cannabis, but it cannot prove that cannabis caused the reduction. The patients who reduced alcohol had specific characteristics (anxiety, PTSD, sleep problems) that may explain the pattern.

Is substituting cannabis for alcohol safer?

That depends on individual circumstances. While alcohol carries significant health risks, cannabis also has potential harms. The study suggests that for some patients with anxiety and sleep disorders, cannabis may address the underlying reasons they were drinking.

Read the original research

Characteristics of Dispensary Patients that Limit Alcohol after Initiating Cannabis.

Journal of psychoactive drugs, 52(2), 145-152

View on PubMed ↗Publisher’s paper ↗

Citation

Hayat, Assad; Piper, Brian J. (2020). Characteristics of Dispensary Patients that Limit Alcohol after Initiating Cannabis.. Journal of psychoactive drugs, 52(2), 145-152. https://doi.org/10.1080/02791072.2019.1694199