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The public health case for legalizing pot: it could replace alcohol

Matt Cardy / Getty Images News

The New York Times's Maureen Dowd earlier in the week chronicled a bad marijuana edibles trip in a weird column. But even if she had a truly terrible trip, there's at least one reason to believe it could have been good for society as a whole: It apparently substituted her alcohol use for the night.

"For an hour, I felt nothing," Dowd wrote. "I figured I'd order dinner from room service and return to my more mundane drugs of choice, chardonnay and mediocre-movies-on-demand."

The column goes on to describe a high so potent that it freaked Dowd out for eight hours — and she never got to that chardonnay as a result.

If this happens again and again, with legal marijuana displacing alcohol use, that would be a huge public health win.

There are legitimate concerns about pot's health effects and the lack of regulation surrounding marijuana edibles. But it appears those problems can be largely managed with good policies and informed personal use, and legal marijuana states like Colorado and Washington are working to make that reality.

Alcohol, on the other hand, is already quite regulated, yet it's demonstrably worse for society as a whole than marijuana. Not only does alcohol lead to drunk driving, but it can cause fatal health effects and even more crime.

So if alcohol use is being displaced by marijuana, that's actually great news.

Marijuana does seem to substitute alcohol use for some people

The research in this field is admittedly early, but the findings so far are promising for legal pot.

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Mark Ralston / AFP via Getty Images

In a recent review of the scientific literature, researcher Meenakshi Subbaraman, of the Alcohol Research Group at the Public Health Institute, found that marijuana can act as a substitute for alcohol for some people. In one survey of Canadian medical marijuana users, 41 percent said they replace alcohol with marijuana because pot causes less withdrawal, fewer side-effects, and better symptom management. In another survey, medical marijuana patients in California reported alcohol use at two-thirds the national rate.

As Subbaraman explained by phone, some people just want to wind down at the end of the day; whether they do it through alcohol or marijuana is personal preference. Legalizing marijuana, then, could allow some people to pick pot over alcohol without worrying about the potential repercussions of engaging in illicit activity.

A lot of this research is, however, based on medical marijuana, not recreational marijuana, users. It's not totally clear what the full effects of legal recreational pot would be, mostly because marijuana hasn't been legal in many places for long. That's one reason Subbaraman is looking into longitudinal data to develop stronger conclusions.

Another point of caution: For some, marijuana use is going to compliment alcohol use, since substance abuse often occurs through multiple drugs. That's obviously not good, as Subbaraman notes in her review.

Alcohol is much worse for society than marijuana

For all the debate about legalizing marijuana, the research is pretty clear that alcohol is much more dangerous — not just to an individual, but to society as a whole.

For one, there have never been any deaths directly linked to a marijuana overdose or marijuana-caused health problems. Alcohol, on the other hand, causes health problems that kill tens of thousands each year.

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These direct deaths don't cover drunk and drugged driving. It's true that if those were taken into account, there would be some marijuana-caused deaths. But there's good reason to believe, based on Columbia University research, that alcohol is much, much deadlier on the road than any other drug, including marijuana.

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On top of these two issues, there's a substantial body of research that links alcohol to all sorts of external problems. In a big review of the evidence, Alexander Wageneaar, Amy Tobler, and Kelli Komro concluded that getting people to drink less alcohol would significantly reduce violence, crime, and other negative repercussion of alcohol use.

Meanwhile, Colorado's experience with legalization and a study on medical marijuana published in PLOS ONE suggest that relaxed marijuana laws do not increase violent or property crimes.

Take all these factors together, and it's readily clear why UK researchers deemed alcohol the most dangerous drug to society as a whole.

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Chart by the Independent Scientific Committee on Drugs

None of that is to suggest that alcohol should be illegal. Drug experts and historians overwhelmingly agree alcohol prohibition failed. But it does suggest that if we can reduce alcohol consumption — perhaps by legalizing marijuana — it's probably a good idea.