can recovering alcoholics smoke pot

The Pros and Cons of Substituting Marijuana for Alcohol

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

Diverse Images / UIG / Getty Images

Some people choose to substitute marijuana for alcohol if they are trying to stop drinking—a controversial practice referred to as marijuana maintenance.  

Those who support the practice argue that marijuana is far less hazardous to a person’s health than alcohol (the same argument is often used when comparing marijuana to cigarettes). Those who are opposed to the practice argue that the goals of sobriety are never truly achieved if a person replaces one mind-altering drug with another.

Here are the pros and cons of replacing alcohol with marijuana, as well as resources you can turn to if you are trying to quit drinking or using substances.

Potential Pros of Marijuana Management

Supporters of marijuana management programs are often quick to point out that the evidence on the effectiveness of traditional recovery programs like Alcoholics Anonymous (AA) is largely split.

The findings from a 2006 Cochrane review of studies demonstrated no significant difference in the results achieved by people in AA compared to other treatment models.   Furthermore, even the studies that attributed benefits to the AA methodology concluded that successful sobriety was more associated with the frequency of meeting attendance than the 12-step model itself.

Alternative to Abstinence-Only

For those who are unable or unwilling to regularly attend AA meetings, the rate of failure was high. Supporters argue that it is these individuals who might benefit from using marijuana management. The model recognizes that for some people, abstinence-based programs are unrealistic and unachievable.

Those who are in favor of the practice argue that many of the ill-effects of alcohol detoxification might be softened if a person is able to taper off alcohol gradually while using marijuana.

Harm Reduction

Supporters of marijuana management programs often argue that the drug has been demonized. Those in favor of its use argue that unlike alcohol, marijuana can be used without the risk of death from binging. They also point out that it has fewer drug interactions than alcohol and possibly has much less of an impact on one’s long-term health.  

Health Benefits

Additionally, proponents argue that marijuana might have some inherent benefits compared to alcohol. While there is ongoing debate about whether moderate drinking has possible health benefits, the effects of alcohol misuse can be catastrophic, contributing to an increased risk for breast cancer, birth defects, and other health issues.  

Marijuana, on the other hand, is purported to have some health benefits that can make it useful in certain situations. For example, marijuana is frequently used to alleviate pain, stimulate appetite, and enhance moods.   For an individual who is recovering from alcohol use disorder, these properties could be beneficial.

Potential Cons of Marijuana Management

Those who are opposed to marijuana maintenance argue that it is founded on the premise that marijuana is not only safer than alcohol but that it is tacitly safe. They argue that because there is no evidence to support that premise, it is unfounded and even unconscionable to advocate for marijuana management.

Marijuana Dependence

The foundation of alcohol recovery is based on recognizing that alcohol is harmful and that a person has no control over their use of the substance.   Softening the blow inherently suggests that marijuana is something over which a person can have greater control. It also infers that the self-awareness a person is meant to achieve during recovery can wait until they are stronger and no longer need marijuana or alcohol.

One of the most significant potential pitfalls of using marijuana as a replacement therapy is the possibility of dependence. Research suggests that 30% of people who use marijuana develop cannabis use disorder to some degree.  

Negative Health Effects

Detractors say that the practice only aims to replace one habit with another under the guise that marijuana is the less-harmful alternative. According to the National Institute on Drug Abuse, this may not be the case.   There are several concerns associated with marijuana use, including:

  • Marijuana can have a long-term impact on a person’s health. For example, it has been associated with bone density loss, reduction of exercise tolerance, impairment of memory and cognitive skills, and an increased risk of lung conditions.  
  • Marijuana might contribute to underlying mental health conditions that are common in people who misuse alcohol.  
  • Marijuana might have the potential to act as a gateway drug. In theory, it could lead people with addictive behaviors to use other dangerous drugs like cocaine and heroin.  

Reduced Treatment Effectiveness

Some evidence also suggests that marijuana use can actually interfere with efforts to stop using alcohol. One 2015 study found that concurrent marijuana use lowers a person’s odds of achieving abstinence from other drug or heavy alcohol use.  

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

Learn about the pros and cons of substituting marijuana for alcohol and why some people in recovery use the controversial practice.

Smoking Weed In Sobriety

I remember the first time I heard it. I was at an AA meeting listening to a middle-aged man share. He spoke about honesty and the importance of working the steps. He talked a good talk. I was still thinking about what he’d said when the person sitting next to me, nudged my leg. I turned to her and she rolled her eyes.

Clearly, she’d seen something that I hadn’t.

I looked again, but the man had already sat down.

I turned to the woman beside me and shrugged. She mouthed, “Pot head.”

Rather judgmental, I thought to myself.

In the meetings half time, she explained that the man who was speaking, was on the ‘marijuana maintenance’ program. There was a marijuana maintenance program? I was confused. How could that be? I’d never heard such a thing before.

Ready to make a change?
Call to speak to a treatment specialist.

Weren’t you supposed to be clean and sober, if you were claiming sobriety?

The meeting ended with the serenity prayer. As I was stacking chairs, I noticed that the man who spoke had slipped out the back door. It was smoker’s corner, and every meeting had one.

I finished stacking chairs and walked out after him. I’d just quit smoking cigarettes, so it was a dangerous place for me to be. I stood outside with the smokers feeling embarrassed. I didn’t want the others to notice that I was checking up on this guy.

Through the gray haze I scanned his face, searching for the tell-tale signs. His eyes were red, but it was smoky. He didn’t engage with any of the other smokers, instead he inhaled his cigarette at warp speed. I’m not sure why I felt the need to be doing this. It was important to me for no other reason, then this was an honest program, and if he was stoned, he wasn’t being honest.

In fact, in my mind, he was dangerous.

If I could make smoking dope okay in sobriety, I could make doing anything else okay, too.

I watched longingly as he inhaled his cigarette, the tip burning cherry-red. The suspect sober/stoned guy – butted his cigarette out against his boot heel and then flicked the butt into the can, which was being used as an ashtray. He sauntered back in the door and disappeared.

An old timer noticed my confused look and crooked a finger at me.

As we walked back into the church, I talked to him about my confusion. He let me run on. When I’d finished, he spoke. He reminded me of the third tradition.

The only requirement for membership is a desire to stop drinking.

Third tradition didn’t state anything about smoking weed with marijuana vaporizer we find now at Higher Grounds, or popping pills, or any of the other many ways we can over stimulate the pleasure pathway, inside our brain.

Third tradition only requires a desire to stop drinking. You don’t even have to be stopped. You just have to desire it.

When you take away the alcohol, you have a lot of recovering alcoholics running around looking for their next sugar fix. Third tradition doesn’t say anything about sugar, either.

However, there is a big difference – at least in my mind – between eating too many donuts and smoking pot. Although I imagine smoking pot leads too eating more donuts, it also leads to something far more dangerous.

Dishonest thinking, which is also known as stinking thinking.

Stinking thinking is what gets you into this mess in the first place.

Since then, I’ve seen very few successfully recovered, stoned, AA members. Almost all of them go back out.

But we’re dealing with alcoholics here, and some like to play the odds. While a minor percent of pot smokers in recovery might be living successfully, the majority of them, aren’t.

Why play Russian roulette with a loaded gun?

I don’t define my sobriety by what I don’t drink, or use, although that’s a part of it. But the majority of sobriety is about changing unhealthy behaviors and dealing with your ISM.

Questions About Treatment?

Call now to be connected with one of our compassionate treatment specialists.

ISM’s are all those sneaky little buggers like: lying, cheating, stealing, manipulating, procrastinating, blaming, avoiding, denying, exaggerating, gossiping, self-centeredness, excuses, self-pity, grandiosity, abusing, and any of the other unhealthy behaviors, that go hand in hand with addiction.

It’s alcohol-ISM – not wasim, folks.

The ISM is what takes you back to using, every single time.

If you’re sober, you already have the prize. For this gal, life doesn’t get any better than this. There are days I wake up and want to pinch myself. I am living the dream.

I don’t need to be stoned. Not even, a little.

The high I found in recovery is better than any chemically induced high, I’ve ever been on. And it doesn’t come with a hangover, or broken hearts.

Personally I think if you’re smoking pot in recovery, you haven’t done the work. Your ISM’s are still running the show.

Half measures availed us nothing. We stood at the turning point. Take another toke, and you’ll see the old familiar curve of that turning point – The one that leads to all roads, ‘back out.’

Truth is, you’re already there. Sobriety is precious.

If you’re smoking pot, I have a news flash for you. You’re not sober, you’re stoned! You still have a long, long way, to go.

Need help?
Let’s talk.

If you or someone you know needs help, please call this confidential support line for assistance
1 (888) 614-2379.

Best wishes,
Lorelie Rozzano.


We offer 100% confidential substance abuse assessment and treatment placement tailored to your individual needs.

Lorelie Rozzano talks about her time at an AA meeting, and observing individuals who were trying to achieve sobriety, but yet also smoking weed.