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Doctors’ Choice: Marijuana Over Alcohol



The New York Times recently ran a piece by prominent pediatrician Dr. Aaron E. Carroll where the good doctor actually emphasized that cannabis created fewer harms than alcohol. Of course, he’d prefer that kids would experiment with neither, as any parent would, but he acknowledged that such a preference is probably unrealistic.

When I picked my jaw up off the floor, I was delighted to see he’d dismissed alarmist nonsense about cannabis causing psychosis, lung cancer, or lower academic achievement. The psychosis data are correlational, at best. People experiencing odd symptoms might turn to cannabis in an attempt to self-medicate. The strongest data suggests there might be a small subset of folks at risk for psychosis who could have worse symptoms earlier in life if they hit the weed pipe hard, but replications are inconsistent. In truth, if you’ve got a schizophrenic identical twin, cannabis might not be for you. Decades of follow-up confirm that smoking cannabis does cause coughing and wheezing, but no lung cancer. The data on lower academic achievement looks scary until you go back to data from grade school and find those who are using cannabis and botching school are the same ones who did poorly long before they were involved with the plant.

Dr. Carroll also stressed that alcohol contributes to 40% of violent crime, highlighting its involvement in 37% of rapes and 27% of aggravated assaults. Data from my own lab shows that drunk people are not only mean to those who provoke them, they’re even hostile to innocent third parties… Binge drinking is markedly worse on brain function than cannabis has ever appeared. And booze kills people. Literally kills them. Cannabis, after 5,000 years of use, might have maybe raised some old guy’s heart rate in a dangerous way. There’s really no comparison. I’m just so glad to see the fact reach the paper of record.

But Dr. Carroll didn’t go the next step to explain how to use cannabis as safely as possible. I can only guess why he wouldn’t take this step, but I think we all have our hypotheses. So let’s get into a few key ideas to keep cannabis as safe as possible for everyone: use later in the day, keep doses small, vaporize, and don’t drive.

Using later in the day sounds like a bit of a drag, but let’s be honest: if you don’t get high until the evening, right before Netflix binging, bedroom hijinks, and nodding off for the night, you can’t get into much trouble. Those who wake and bake right before classes are doomed to find out what research has already proven: the plant is no friend to encoding new memories. Sure, there’s not enough cannabis in the world to get you to forget your first grade teacher’s name. (I assume you still know it!) But learning new material after a hit from the vaporizer is a lot of effort. In addition, it’s one hell of a buzzkill. If your classes are so bad that you’re tempted to get high first, perhaps it’s time to change your major.

Less is more with the cannabis plant, too. We’ve all seen those bong sessions run like some kind of competitive athletic event, but they usually end up leaving everyone short of cash and energy. It’s a lot friendlier, and a lot more economical, to turn down a second hit with a friendly wave and the chant of “I’m high.” The plant often takes a while to have its full effect, anyway. Odds are high that if you aren’t quite feeling exactly how you want to feel, you’ll be there in 15 minutes or so without an extra dose. The few adverse reactions to the plant that have been reported almost invariably stem from ignoring the idea that a little goes a long way.

Vaporizers remain a good friend to fans of the plant. Although scares about lung cancer are certainly nonsense, the respiratory irritation from smoking is very real. Data from my lab show that switching to the vaporizer can decrease symptoms like coughing, shortness of breath, and wheezing, while increasing the amount of air your lungs can hold.

Finally, don’t drive. I know that many a hater will take me to task for this, and the data are against me. Paul Armentano reviewed this research recently, showing that THC + drivers are no more likely to cause crashes than others. Antihistamines are probably worse for driving. So why am I so down on this? Most young folks aren’t experienced drivers, and few studies have examined the data based on age. It’s possible that those who haven’t spent enough time behind the wheel to be experts need more experience. Driving’s particularly tough with the radio on, the phone beeping, and buddies in the car cracking jokes. The potential cost seems so much higher than any potential benefit. And, God forbid, should anyone have an accident while positive for THC, it’ll undoubtedly give the prohibitionists a bunch of headlines.

So cannabis is definitely safer than alcohol. The safest cannabis of all is probably vaporized, low doses consumed late in the day when driving’s unnecessary.