Is Marijuana Really Safer Than Alcohol?


A common refrain from pro-marijuana individuals and organizations is that using marijuana is safer than using alcohol.

At first blush this statement seems true, given how much more we know about the negative effects of alcohol use than we seem to know about marijuana consumption harm.

However, rather than rely on individual opinions or personal experiences, I reviewed some recent research that compared marijuana and alcohol use outcomes.

Key results from each of the recently published comparison studies, along with a summary of findings with recommendations, are presented below.

  • Alcohol and Marijuana Use Trajectories in Adolescents

A longitudinal study published in Addiction (2016) followed middle school students into high school.  Results showed that adolescents with higher alcohol use reported greater academic unpreparedness and delinquency, while adolescent with higher marijuana use reported greater academic unpreparedness and delinquency, as well as poorer academic performance and mental health.  https://www.ncbi.nlm.nih.gov/pubmed/27130360

  • Negative Outcomes Among Young Adults

A longitudinal study published in Addictive Behaviors (2016) compared adolescent alcohol and marijuana use effects in urban young adults.  Marijuana use with moderate levels of alcohol was associated with more negative outcomes than alcohol use without marijuana. http://www.sciencedirect.com/science/article/pii/S0306460315300435

  • Sexual Risk Outcomes Among Adolescent African American Females

A study published in the Archives of Sexual Behavior (2016) examined alcohol and marijuana use sexual outcomes on African American females.  Results indicated that marijuana use predicted non-use of condoms, and alcohol and marijuana use together predicted pregnancy and sexually transmitted infections.  http://link.springer.com/article/10.1007/s10508-015-0518-0

  • Adolescent Cortical Thickness

A study published in Neuortoxicology and Teratology (2016) examined the cortical thickness of adolescents pre- and post-marijuana and alcohol use.  Results showed that cortical thinning in adolescents using marijuana may be linked to poorer neurocognition and depression, while alcohol and marijuana use together may also interfere with neurodevelopment and cortical thinning.    http://www.sciencedirect.com/science/article/pii/S089203621630085X

  • Psychosocial Outcomes Among High School Students

A study published in the American Journal of Drug and Alcohol Abuse (2014) compared the adverse psychosocial outcomes resulting from marijuana and alcohol use in a nationally representative sample of high school students.  Results indicated that marijuana use was more commonly reported to compromise relationships with teachers or supervisors, result in less energy or interest, and result in lower school or job performance.  Alcohol was more commonly reported to compromise relationships with friends and significant others, and to lead to more regret (particularly among females), and driving unsafely. http://www.tandfonline.com/doi/abs/10.3109/00952990.2014.943371



  • Reflection Impulsivity in Adolescents

A study published in Psychopharmacology (2012) examined adolescent reflection impulsivity; a failure to gather and evaluate information before making a decision.  Results indicated that marijuana users, compared to alcohol users and controls, had the lowest degree of certainty before making a decision.  Author’s concluded that marijuana use during adolescence is associated with increased risky and impulsive decision making.  http://link.springer.com/article/10.1007/s00213-011-2486-y

  • Simulated Driving Effects

A study published in Accident Analysis & Prevention (2013) evaluated the effects of marijuana and alcohol use on simulated driving of participants.  Results indicated that driving simulator performance was most impaired when marijuana and alcohol was combined, while regular marijuana users displayed more driving errors than non-regular marijuana users.  http://www.sciencedirect.com/science/article/pii/S0001457512002709

  • Cognitive Decrements in Adolescents

A study published in the Journal of International Neuropsychological Society (2014) examined cognitive effects on teens with histories of heavy episodic drinking and protracted marijuana use.  Results showed that both substances individually and combined were linked to poorer performance in specific cognitive areas.  https://www.cambridge.org/core/journals/journal-of-the-international-neuropsychological-society/article/heavy-alcohol-use-marijuana-use-and-concomitant-use-by-adolescents-are-associated-with-unique-and-shared-cognitive-decrements/E615AB95F5B3991089D31F1F2531D8C6

  • Unsafe Driving Among High School Seniors

A study published in the Journal of Studies on Alcohol and Drugs (2014) examined associations between alcohol and marijuana use and self-reported unsafe driving among US high school seniors.  The highest rate of engaging in any unsafe driving was significantly and positively associated with simultaneous use of alcohol and marijuana, followed by concurrent use, and then by use of alcohol alone.  http://www.jsad.com/doi/abs/10.15288/jsad.2014.75.378

  • Cognition, Brain Structure and Function Among Adolescents

A review of research published in Frontiers in Psychiatry (2013) examined the impact of early onset alcohol and marijuana use on neurocognition of adolescents.  Reviewed studies showed that adolescents and emerging adults who initiate binge drinking or use marijuana regularly show inferior cognitive skills compared to teens that abstain or use lightly, or compared to individuals who begin substance use in adulthood.  https://books.google.com/books?hl=en&lr=&id=uLJFCgAAQBAJ&oi=fnd&pg=PA25&dq=marijuana+and+alcohol+comparisons&ots=YG9zG5yM-t&sig=NuiNRoBI7-ZddWzMAFBQ8R-t72M#v=onepage&q&f=false




Recently published studies comparing alcohol and marijuana outcomes show that using marijuana is not safer than drinking alcohol, particularly among youth.

Rather, research shows that marijuana use typically results in different types of negative outcomes than alcohol use, or even greater negative effects, especially when marijuana and alcohol use are combined.

For example, adolescent marijuana consumption alone was associated with diverse types of sexual risks, cortical thinning, psychosocial problems, and poorer cognitive performance and skills, than alcohol use alone.

In addition, marijuana use alone was linked to poorer academic performance and mental health, as well as impaired decision making.

In one study, marijuana use combined with moderate alcohol use was associated with the greatest number of negative outcomes among young adults, compared to alcohol use alone.  Combined alcohol and marijuana use was also linked to greater sexual risks and unsafe driving among adolescents, and greater driving simulator errors.




Marijuana is not a safe alternative to drinking alcohol, particularly for youth and young adults.

Prevention and health specialists, organizations, lawmakers, and parents should target preventing the early, heavy, and frequent use of marijuana and alcohol individually and in combination among youth.

Given current retail marijuana efforts to continue to increase the potency of marijuana products, there will likely be even greater numbers of negative outcomes from cannabis use by adolescents and young adults unless prevention programs and legislation are significantly increased to protect young people from the side-effects of legalizing adult marijuana use.

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4 Responses to Is Marijuana Really Safer Than Alcohol?

  1. That marijuana doesn’t lead to as many deaths as alcohol does doesn’t mean it’s without any serious side effects. At the end of the day, both are considered to be psychoactive drugs that affect mental processes and cognition when taken or administered, WHO reported.

  2. These are two different substances and should be treated as such. The pro/cons for marijuana flower/ Edibles outweigh alcohol 20/1. People who tend to think otherwise are set in their 1940’s way and will not change their minds. Indoctrination and the ‘Reefer Madness’ era is at an end and people just don’t want to admit being wrong.
    yes, anything lit on fire and consumed has a potential to cause harm/health issues on the other hand the plant it self when consumed by eating the THC shows little to no health effects.

    Do your own research on the matter and don’t let others tell you how to think.

    Stay Reasonable

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