87% of Medical Cannabis Patients Report Using It as a Substitute for Prescription Drugs, Alcohol, or Illicit Substances

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.

Lucas, Philippe et al.·Drug and alcohol review·2016·Moderate EvidenceCross-Sectional
RTHC-01219Cross SectionalModerate Evidence2016RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=473

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?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?

Trust & Context

Key Stat:
80% of medical cannabis patients substituted cannabis for prescription drugs
Evidence Grade:
Large survey with detailed questioning, but self-selected sample and self-reported substitution without objective verification.
Study Age:
Published in 2016 using 2011-2012 data. Canadian cannabis access has expanded dramatically since full legalization in 2018.
Original Title:
Substituting cannabis for prescription drugs, alcohol and other substances among medical cannabis patients: The impact of contextual factors.
Published In:
Drug and alcohol review, 35(3), 326-33 (2016)
Database ID:
RTHC-01219

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Do medical cannabis patients use fewer other drugs?

In this survey, 80% of medical cannabis patients reported substituting cannabis for prescription drugs, suggesting many patients use cannabis to reduce reliance on other medications.

Does cannabis help people drink less alcohol?

Over half (52%) of medical cannabis patients in this study reported substituting cannabis for alcohol, though whether this leads to better health outcomes requires further research.

Read More on RethinkTHC

Cite This Study

RTHC-01219·https://rethinkthc.com/research/RTHC-01219

APA

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

MLA

Lucas, Philippe, et al. "Substituting cannabis for prescription drugs, alcohol and other substances among medical cannabis patients: The impact of contextual factors.." Drug and alcohol review, 2016. https://doi.org/10.1111/dar.12323

RethinkTHC

RethinkTHC Research Database. "Substituting cannabis for prescription drugs, alcohol and ot..." RTHC-01219. Retrieved from https://rethinkthc.com/research/lucas-2016-substituting-cannabis-for-prescription

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.