A survey of 473 Canadian medical cannabis patients found that 87% used cannabis as a substitute for at least one other substance, with 80% substituting for prescription drugs, 52% for alcohol, and 33% for illicit substances.
Read this if you are interested in whether medical cannabis can replace other medications or substances.
80% of medical cannabis patients substituted cannabis for prescription drugs
What the researchers found
This large survey of Canadian medical cannabis patients revealed remarkably high rates of substance substitution. Among 473 respondents, 87% reported substituting cannabis for at least one other substance category.
The most common substitution was for prescription drugs (80.3%), followed by alcohol (51.7%) and illicit substances (32.6%). Patients under 40 were more likely to substitute cannabis for all three categories.
An important finding was that patients who substituted cannabis for prescription drugs were more likely to report difficulty affording enough cannabis, suggesting that cost barriers may limit the substitution effect. The authors argue this points to a harm reduction role for medical cannabis.
Why it matters
The finding that 80% of medical cannabis patients reduce prescription drug use has enormous implications for the opioid crisis, polypharmacy management, and healthcare costs. If cannabis can safely replace even a fraction of prescription medications, the public health impact could be substantial.
The numbers in context
473 medical cannabis patients surveyed. 87% substituted cannabis for at least one substance. 80.3% for prescription drugs. 51.7% for alcohol. 32.6% for illicit substances. Patients under 40 more likely to substitute across all categories. Cost barriers limited substitution.
How the study worked
Cross-sectional survey (414 questions) of 473 Canadian medical cannabis patients, available online and in hard copy in 2011-2012. Assessed demographics, medical conditions, use patterns, substitution behavior, and access barriers.
What this study cannot tell us
Self-selected sample of patients already committed to medical cannabis. No objective verification of reduced prescription drug use. Patients who substituted successfully may be more likely to respond. Cannot determine whether substitution led to better or worse health outcomes. Cross-sectional design.
How to read the evidence
Large survey with detailed questioning, but self-selected sample and self-reported substitution without objective verification.
When this study was published
Published in 2016 using 2011-2012 data. Canadian cannabis access has expanded dramatically since full legalization in 2018.
The bigger picture
This study adds to growing evidence that medical cannabis may function as a harm reduction tool. The prescription drug substitution finding is particularly relevant given the opioid epidemic, suggesting cannabis may provide an alternative for some patients currently relying on opioids and other potentially harmful medications.
Questions still open
- Does substituting cannabis for prescription drugs lead to better health outcomes? Would insurance coverage for medical cannabis increase substitution rates? Which specific prescription drugs are most commonly replaced?
Common questions
Do medical cannabis patients use fewer other drugs?
Does cannabis help people drink less alcohol?
Read the original research
Substituting cannabis for prescription drugs, alcohol and other substances among medical cannabis patients: The impact of contextual factors.
Drug and alcohol review, 35(3), 326-33
Citation
Lucas, Philippe; Walsh, Zach; Crosby, Kim; Callaway, Robert; Belle-Isle, Lynne; Kay, Robert; Capler, Rielle; Holtzman, Susan. (2016). Substituting cannabis for prescription drugs, alcohol and other substances among medical cannabis patients: The impact of contextual factors.. Drug and alcohol review, 35(3), 326-33. https://doi.org/10.1111/dar.12323
Explore the wider topic
- Surviving 4/20 Sober: A Practical Survival Guide
- CBD Oil Quality Guide: How to Avoid Snake Oil
- CBT for Cannabis Recovery: How Cognitive Behavioral Therapy Works
- Anxiety After Quitting Weed: When to Consider Medication
- Cannabis for Chemotherapy Nausea: What the Evidence Actually Shows
- Cannabis for Chronic Pain: What the Research Actually Supports
- Cannabis and Epilepsy: The Epidiolex Story and What It Means
- The Cannabis Relapse Cycle: Quit, Feel Good, Get Complacent, Repeat
- Does CBD Actually Work for Anxiety? What the Evidence Shows
- Does CBD Help with Weed Withdrawal? What Studies Show
- CBD vs THC: The Differences That Actually Matter
- Cold Turkey vs Tapering: Which Way to Quit Weed
- Dating Sober After Years of Being High: What Nobody Tells You
- Exercise as Medicine: Working Out After Quitting Weed
- Grieving Weed Itself: Mourning the Loss of a Companion
- How to Help Someone Quit Weed (When They're Not Ready)
- How to Quit Weed: A No-Judgment Step by Step Guide
- Journaling Through Weed Withdrawal: Why Writing Helps You Heal
- MA vs SMART Recovery vs Therapy: Comparing Your Options
- The Proven Medical Benefits of Cannabis: What Research Supports
- Meditation and Mindfulness for Weed Withdrawal
- Your Partner Still Smokes Weed: How to Navigate It
- Quitting Weed While Your Partner Still Smokes
- The Pink Cloud Effect: When Quitting Weed Feels Too Good
- How to Quit Smoking Weed Cold Turkey: What to Expect
- Quit Weed or Cut Back: Which Is Right for You?
- I Quit Weed and Regret It: An Honest Look at Non-Linear Recovery
- Quitting Weed in Your 20s: Career, Social Life, Starting Over
- Quitting Weed in Your 30s: It's Not Too Late
- Quitting Weed After 10+ Years of Daily Use: What to Expect
- Quitting Weed Before Surgery
- Quitting Weed During a Life Crisis: Divorce, Job Loss, and Other Bad Timing
- Quitting Weed and Working Out: How Exercise Helps Recovery
- Quitting Weed After Loss: When Grief Comes Flooding Back
- Quitting Weed When It's Legal Everywhere
- Weed and Medications: What Changes When You Quit
- Quitting Weed During Pregnancy: What You Need to Know
- Quitting Weed While Pregnant: What You Need to Know
- Weed Withdrawal Success Stories: Real People Who Made It Through
- Quitting Weed Long Distance: When You Can't Remove Triggers
- I Relapsed on Weed. Now What? A Practical Reset Guide
- I Relapsed After Quitting Weed: What Now?
- Cannabis and Older Adults: Risks Seniors Should Know
- Should I Quit Weed? A Decision Framework (Not a Lecture)
- Quitting Weed at Music Festivals and Concerts: A Sober Survival Guide
- Supplements That Actually Help with Weed Withdrawal (And Ones That Don't)
- How to Tell Your Friends You're Quitting Weed
- Cannabis and Breastfeeding: THC in Breast Milk
- Relapse Prevention Plan for Cannabis: A CBT-Based Approach
- Why Weed Relapse Happens: The Science Behind Going Back
- Replacing the Ritual: What to Do When You Quit Weed
- How Cannabis Damaged My Relationships: Before and After
- Social Media Detox from Weed Content