Study: Cannabis Is A “Potential Exit Drug To Problematic Substance Use”

Three quarters of medical cannabis consumers report using it as a substitute for prescription drugs, alcohol, or some other illicit substance, according to survey data published in the journal Addiction Research and Theory.

An international team of investigators from Canada and the United States assessed the subjective impact of marijuana on the use of licit and illicit substances via self-report in a cohort of 404 medical cannabis patients recruited from four dispensaries in British Columbia, Canada.

Researchers reported that subjects frequently substituted cannabis for other substances, including conventional pharmaceuticals. Authors reported:

“Over 41 percent state that they use cannabis as a substitute for alcohol (n=158), 36.1 percent use cannabis as a substitute for illicit substances (n=137), and 67.8 percent use cannabis as a substitute for prescription drugs (n=259). The three main reasons cited for cannabis-related substitution are ‘less withdrawal’ (67.7 percent), ‘fewer side-effects’ (60.4 percent), and ‘better symptom management’ suggesting that many patients may have already identified cannabis as an effective and potentially safer adjunct or alternative to their prescription drug regimen.”

Overall, 75.5 percent (n=305) of respondents said that they substitute cannabis for at least one other substance. Men were more likely than women to report substituting cannabis for alcohol or illicit drugs.

Authors concluded: “While some studies have found that a small percentage of the general population that uses cannabis may develop a dependence on this substance, a growing body of research on cannabis-related substitution suggests that for many patients cannabis is not only an effective medicine, but also a potential exit drug to problematic substance use. Given the credible biological, social and psychological mechanisms behind these results, and the associated potential to decrease personal suffering and the personal and social costs associated with addiction, further research appears to be justified on both economic and ethical grounds. Clinical trials with those who have had poor outcomes with conventional psychological or pharmacological addiction therapies could be a good starting point to further our under- standing of cannabis-based substitution effect.”

Previous studies have similarly demonstrated cannabis’ potential efficacy as an exit drug. A 2010 study published in the Harm Reduction Journal reported that cannabis-using adults enrolled in substance abuse treatment programs fared equally or better than nonusers in various outcome categories, including treatment completion. A 2009 study reported that 40 percent of subjects attending a California medical cannabis dispensary reported using marijuana as a substitute for alcohol, and 26 percent used it to replace their former use of more potent illegal drugs. A separate 2009 study published in the American Journal on Addictions reported that moderate cannabis use and improved retention in naltrexone treatment among opiate-dependent subjects in a New York state inpatient detoxification program.

Full text of the study, “Cannabis as a substitute for alcohol and other drugs: A dispensary-based survey of substitution effect in Canadian medical cannabis patients,” appears online in Addiction Research and Theory. NORML Advisory Board Member Mitch Earleywine is a co-author of this study.

46 thoughts

  1. If it were legal for me to use I would use it. I have a degenerative spine and have fake discs and steel rods.I have constant pain and take muscle relaxers and pain meds wich have bad side effects in the long run.I want the right to use it medicaly!

  2. Having had my three sons sadly addicted to heroin the using of cannabis had really helped with the anxieties and withdrawal symptoms of this terrible drug. Of all the drugs that are offered to them in their trying to stay off heroin, Suboxone and cannabis have given two of them control of their addictions. The third is in the court system and cannot use either of these helping hands.

  3. here, I wasn’t sure where to post this-
    – I vote that this woman gets ordered to 20 years of Victim Impact Panels, chemical dependency and alcohol drug classes-
    WITH frequent required random UAs and all the crap she made these people endure!

    “Estimates have ranged from 34,000 to 136,000 cases that were prosecuted during her career.”

    “Dookhan also allegedly tainted samples by mixing substances she knew were illegal drugs with samples she knew did not contain illegal substances.”

    to NORML
    hopefully we will win this stupid war shortly,
    but, if it drags on,
    I would ask that maybe you add a forum section
    with just a couple spots for discussion…

    this might benefit those of us in:
    “Eastern Massachusetts, including Suffolk, Plymouth, Middlesex, Norfolk, Essex, and Bristol”

  4. These folks have the sense to use (not abuse) marijuana. Even if they don’t quit drugs, they’re using a less destructive substance. Sounds like a science based approach. I like it better than the ONDCP cruelty strategy.

    “further research appears to be justified on both economic and ethical grounds.”

    –To thwart the advance of medical science is a crime against us all.

  5. “Previous studies have similarly demonstrated cannabis’ potential efficacy as an exit drug.”

    Reproducible Science! This could change everything!!!

    We need to purge the ONDCP of its cruel ideologues and find folks who can execute a strategy based on reason and science.

    And that’s the way it is.

  6. Although exspensive this way Marijuana also helped me quit smoking cigarettes.

    For me one of the pleasurable sensations of smoking cigarettes was the feeling of the smoke in your mouth,and going down your throat.

    Quiting ciagrettes is also extremely addictive from a mental point of view.

    You smoke when your bored,inspired,thinking,and other things like after your eat,drink,and stupidly enough even when your out of breath!So many mental triggers to deal with when quiting cigarettes.

    The Nicotine is out of your body in 7 days.It’s the next 6 months to a year of mental issues you need to overcome/deal with to really get lose of it’s grip.

    So to be able to actually smoke something that delivers all these things except nicotine was a great help in my case.

    Although you can argue smoking anything is bad I’ll take my chances with medicanal MJ,or my own grown stuff that I know doesnt have 4000+ chemicals.

    And of course there are other ways to consume this amazing plant either way.

    But to the point of the article I feel this is another endorsement to the truth of what this article states.

  7. i was a drug addict on Oxycontin and when i decided i wanted to stop after 4 years of intense use i could swear that marijuana helped me get through the withdrawals so much easier and i even have another friend who is getting clean now and is just smoking pot and its really helping him and ive been clean for 6 months now.

  8. I unfortunately became physically and mentally addicted to a cocktail of Adderall combined with an SSRI and a Benzodiazepine prescribed by my doctor for many years and I truly know that I could not have detoxed myself from all of these expensive addictive substances without the aid of cannabis.

    It literally is an EXIT drug and it truly saved my life and I’m a much happier and healthier person as a result.

  9. I got off 220 Oxys a mo. I was taking 6 other drugs also and stopped them all at the same time cold turkey and never looked back at that sickness.

  10. Yeah, you want to have good weed when you’re coming off shrooms acid to exit them. Weed is better than the 2 most common drugs alcohol, tobacco. Medical uses, industrial, recreational, spiritual, bio-fuel and more. 1000s of GOOD uses. Worth more than Gold and you can grow it. Millions of jobs created, millions OUT of prison. Would end cartel’s funding. People would be nicer cause they’d feel better. People under 21 yoa would have way less using of pot. Come on. Let’s do something good!

  11. So tired of this War on (People Who Use) Drugs, the wasted resources and the human toll. I say let’s reassign the DEA to improving school security! Let them do something useful instead of using our tax dollars to terrorize our own people.

  12. An article published in the Journal Pain today sampled only 12 participants and was not a tightly controlled study, but points to characteristics that supports this exit strategy. It turns out that THC (the cannibinoid tested) does not affect areas of the brain related to pain reception. But it DOES affect areas of the brain related to the emotional response to pain. In effect, it distracts people from the pain, allowing a less stressed emotional response.

    To be sure, other cannibinoids may be more effective or ineffective, and the sample size needs to be higher and with tighter controls, but it does seem promising for an exit strategy. Many pain sufferers who have become dependent on opioids state that the hardest thing about initial detox are the hard initial pain impulses they feel. In some cases that’s connected to withdrawal symptoms while in other cases its the injury or disease causing the pain. But in either case these compounds show promise as a strategy for reducing not only opioid usage and withdrawal suffering, but also as an initial treatment strategy to minimize opioids in the first place.

    I also think this could be helpful for inflammatory diseases where te medications may not be addictive per se, but come with a myriad of side affects. Corticosteroids and glucosteroids are affective up to a point. Then they become destructive.

    I’m sure I’m preaching to the choir here but it’s absolutely maddening how the goons at the DEA and other enforcement agencies can continue their stance. People are suffering and dying from diseases that could be relieved and maybe even help in cures. I have no idea how anyone in law enforcement, especially those at the DEA and Justice, can live with themselves.

    @Ben: law enforcement is corrupt at all levels and in all jurisdictions. Did you see the outrageous and grossly disgusting PUBLIC cavity search that occurred near Irving, Texas? And these cops who violated these women on camera, on the roadside, believed they were doing their jobs! This entire world is insane! The injustice continues every single day, where people who hide behind a title, a sworn duty To protect all citizens, and yet have no concern whatever for the suffering they impose on others. These people call themselves Moralists. Lovers of family values and liberty. They are patriots in their own minds. They are guardians and protectors of the citizens. STOP THIS MADNESS!

  13. Cannabis Is A “Potential Exit Drug To Problematic Substance Use”


    Conversely, though…
    Stepped up Reagan / Bush years’ enforcement of
    cannabis PROHIBITION was / is a potential “gateway” to
    destructive, suicidal alcohol abuse.

    (Just in time for own 21st birthday).

    There should be a SAFER choice available for
    those of age-of-majority, (over 18 or 21)…

  14. I was addicted to oxycontin. After years of addiction I decided to get clean. January 18th will be 3 years I have been free of my cage of pharmaceutical addiction. I can attribute 90% of my success to the cannabis plant. It gets me through the tough times, helps me relax, and is a daily part of my life. I can’t go to outpatient treatment or AA because they do not consider me to be clean because I use cannabis. Well if thats the comparison they want to make they can keep their programs. Judge people for using pot to control their opinions and it just shows how hypocritical one can be. I replaced my addiction to Oxy with cannabis yes; but they replaced theirs with meetings, and cigarettes and coffee. its time people opened their eyes to the benefits of this miraculous plant.

  15. people always claim legalisation or decriminalisation is being successful if levels of use do not increase. This article just shows that an increase in use is not an increase in harm since cannabis is such a beneficial substance.
    I look forward to the day when cannabis use replaces alcohol use in our society. How many lives would that save ? how many lives have already been lost by denying cannabis it’s natural place in our society ?
    I also have benefited from cannabis as an exit drug. I used to smoke tobacco and (being in the UK) I used to smoke cannabis mixed with tobacco as well. My partner and I gave up tobacco together and cannabis was the only thing that got us through. 1 year later I was able to give up smoking cannabis as well. I have since returned to cannabis in a vaporiser to alleviate back pain and cramps but I have not smoked for over 7 years

  16. i was smoking crack and doing LOTS of powder coke was to easy to get i would always stop and start again this went on for about 15 to 20 years about ten years ago i realized that cannabis was always what i really loved and that the coke was to destructive to me i went and got two 8 balls and did them to my self when i was done i went and reupped on my green but this time got a quarter pound ITS BEEN ALL ABOUT MARY EVER SINCE i have always loved mary jane and since that day i let her know every day the only thing i would cheat on her with would be acid which around here the quality isnt what i would do —

  17. I’m so glad that this is being published and made known. I have used it while getting off a number of things,and I’m always amazed at how helpful it is.

  18. I also want to say thank you to everyone who shared their success. It’s inspiring. I have been on Suboxone for 2 years, and am going off of it now. While I’m glad to be rid of the daily search for money and pills, the fact is that I am still dependent on a pill ! The $65 a month I spend for it could be better spent at a dispensary. When I am able to renew my med pot card,that will hopefully become my only medicine.

  19. Dr. J.B. Matteson in 1891 used cannabis for morphine addiction. He favored it, however, for the treatment of migraines which were extremely difficult to treat at that time. This is reported by Dr. Lester Grinspoon, M.D., on Aug. 16, 2005 in a history of cannabis as medicine that was delivered to a DEA administrative law judge.

  20. Marijuana has helped me get off a 12 year Opiate addiction. I overdosed on pills which almost took my life and it was a scare from hell. I was one pill or two minutes away from death or permanent brain damage and after that happened, I picked up the bowl and never looked back.

  21. come to India….
    I’ll be the first one to join the NORML to make it legalize in India.
    and i’ll be the most happiest person on this planet if it happens in India & if people understands the use of pot instead of being alcoholic and drug addict..

  22. Hello I have been saying this for years. I know a lot of people who used Cannabis to get off crack, meth, coke, and heroin. I am told it helps a lot getting through with-drawl. One woman I met, who was using crack daily, found out she was pregnant and she smoked cannabis to get off crack completly and the baby came out fine.

  23. I was taught that cannabis was the “gateway drug, leading too…’harder drugs”

    Who is being dyslexic now?

  24. Cannabis is great. Alcohol tastes bad, gives you headaches, makes you vomit, you could OD off it, it destroys your organs and brain, it’s addictive, causes auto accidents, starts fights AND numbs you to life. Cannabis has all goof effects and uses except like coughing more. I’m not lying. Jesus, wake up! CANNABIS SHOULD BE ALLOWED!!! Let that information sink in…………. Weed is healthy, safe and good to use. Vote to smoke.

  25. Taking up smoking marijuana helped me break my cocaine addiction. I hadn’t smoked in years, but really needed something (besides alcohol) to help get me over the compulsion to use.

    Worked like a charm, I haven’t used cocaine in 6 years. Marijuana has also helped me cut back on my drinking. Win-win all around.

  26. I recently ran 1st 5k last month due to Cannabis! After a 20 yrs battle w/ alcohol/coke/crack I turned to cannabis four yrs ago and life has never been better! Family oriented,stability,and true happiness!Also, the alcohol/cocaine induced depression that accompanied my use afterwords has been a thing of the past as well!

  27. Yeah, good story indeed. Pity about the headline though, shouldn’t it read “Potential Exit Drug FROM Problematic Substance Use”?

  28. I can only echo what Ed said.

    I used to be a nicotine addict, cannabis helped me give up. The nicotine cravings last quite long, and the psychological dependency is as strong as the physical. But thanks to Bubba Kush, Cheese and a little Haze, i havent smoked that deadly addictive tobacco for over 2 months. I dont even smoke that much cannabis. When it comes to the harm smoke does, well lets just say tobacco smoke doesnt come with cannabinoids which have anti carcinogenic properties. Seek Donald Tashkins research for more information.

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