Are Weed (Cannabis) and Alcohol Equally Dangerous, or Is One Safer Than the Other?

More people than ever have access to cannabis, using it for personal and medical reasons. The beverage sector of the cannabis industry is booming, as consumers look for ways to substitute alcohol for cannabis. But how do cannabis and alcohol measure up when it comes to health and safety?

What are the dangers and health risks of alcohol use?

Alcohol is well known to impair thinking and coordination, but it also has a direct impact on our brains and bodies. Drinking too much, either on a single occasion or over a long period of time, can have serious health consequences. The less you use alcohol, the lower your risks are.

The CDC defines several kinds of excessive drinking:

• Binge drinking: a pattern of drinking where blood alcohol levels exceed 0.08% (about 4 drinks in a single occasion for women, and 5 drinks for men)

• Heavy drinking: more than 15 drinks per week for men, or 8 drinks per week for women

• Alcohol use disorder: the inability to stop drinking, despite negative consequences

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Must be 21 years or older to purchase. Cannabis is not recommended for women who are pregnant or nursing or those who are suffering from bipolar disorder or schizophrenia. Cannabis use may increase risk of falls. Always consult with your doctor before beginning any new medical treatment.

Excessive drinking has serious consequences on both personal and societal levels. The CDC estimates that in the U.S., the cost of excessive drinking surpasses $249 billion every year. From a health perspective, excessive alcohol use is linked with:

• Cancer

• Chronic diseases such as heart disease

• Problems with the liver, pancreas, brain, and immune system

• Accidental injuries (like vehicle crashes, falls, and drowning)

• Harming others (intimate partner violence and fetal alcohol exposure, for example)

• Memory and learning problems

• Addiction

• Shorter life span

• Death from alcohol poisoning

Even for people who do not drink excessively, alcohol can still have negative impacts such as:

• Dehydration

• Inflammation

• Hangovers

• Upset stomach and nausea

• Poor sleep

• Dangerous medication interactions

• Toxic chemical exposure — when the liver breaks down alcohol, it creates a bi-product called acetaldehyde, which can cause cancer

There are some people who should avoid alcohol altogether. These include people under 21 years old and those who are pregnant or could be pregnant.

Underage alcohol use can have long-lasting effects on the developing brain, causing memory and learning problems, as well as a higher chance of alcohol problems in adulthood. Excessive alcohol at any stage of pregnancy can cause serious birth defects.

What are the dangers and health risks of cannabis use?

Historically, widespread alcohol use has been much more common than cannabis use. And due to federal restrictions on cannabis research, we know a lot less about the long-term consequences of cannabis use compared to alcohol.

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However, there do appear to be some similarities between alcohol and cannabis use. People who are under 21, pregnant, or breastfeeding should avoid them. Both substances can:

• Contribute to memory, thinking problems, and addiction

• Cause medication interactions

• Affect the developing brain

There is also building evidence that cannabis use is bad for your heart. Data from over 400,000 adults demonstrated a link between regular cannabis use and increased risk of heart attack or stroke. It may also lead to heart rhythm problems. And studies suggest that smoking cannabis is associated with a greater risk for bronchitis and other lung injuries.

Much of what we know about the risks of cannabis is based on research conducted prior to legalization. Law-abiding cannabis users may use cannabis differently and/or less frequently than people who use cannabis illegally. Because of this, the risks are probably different too. One of the benefits of cannabis legalization is that it makes it easier to conduct research on topics like this.

The health benefits of alcohol vs. weed

There are very few health benefits of alcohol. Previously, experts believed moderate use of alcohol (about one drink per day) was linked to cardiovascular health benefits. But the research is fairly clear that any benefits do not outweigh the risks. 

Again, research into the benefits of cannabis to date has been limited. But it does suggest that cannabis use may help:

• Relieve pain 

• Reduce nausea and vomiting from chemotherapy

• Promote sleep in people with chronic pain

• Improve mood and quality of life in people with health conditions

Ongoing research is focused on other potential health benefits of cannabis, such as its ability to help with cancer, inflammatory bowel disease, and autism, as well as neurodegenerative diseases and many more.

How many deaths are associated with cannabis use compared to alcohol use?

The CDC estimates that 95,000 people die from excessive drinking every year. Most of these deaths are caused by the negative health effects of too much alcohol over long periods of time (like heart disease). The CDC also estimates that about 2,200 Americans die directly from alcohol poisoning every year. 

An overdose from cannabis is highly unlikely. Experts estimate that it would take amounts so large (pounds), that it would be impossible for a person to consume that much at one time. That said, many people have died with THC in their blood, for example after a car accident.

Although extremely uncommon, there have been several reports of young children who go into a coma or stop breathing after accidentally consuming cannabis.

Is it safer to use marijuana and drive than to drink and drive?

Cannabis and alcohol both negatively affect a person’s ability to drive. Many studies have shown that reaction time, body coordination, and attention, in addition to concentration, are all negatively impacted by alcohol and cannabis. 

About 28% of motor vehicle deaths are caused by alcohol-impaired drivers, taking more than 10,000 lives every year.

It’s harder to measure cannabis impairment than alcohol impairment, and there is conflicting research when it comes to cannabis’s impact on traffic safety. What is clear, however, is that using cannabis before driving increases the chance of being in an accident.

In some states, traffic fatalities increase after cannabis legalization. However, in other states, there is no change in fatalities after legalization. More long-term research is needed to fully understand cannabis-impaired driving.

Are the risks of overusing weed as dangerous as overusing alcohol?

Excessive use of either cannabis or alcohol is associated with the greatest risks. Moderation is a key harm-reduction strategy for both substances.

An acute overdose of alcohol can directly cause liver damage or death. Indirectly, excessive alcohol can contribute to poor decision making, risky behavior, and accidents that cause bodily injury.

An overdose of cannabis is rarely deadly but can require medical care. High doses of THC can trigger intense anxiety, hallucinations, or delusional thoughts. In this state, it can be difficult to make logical decisions or avoid dangerous situations.

Why trust our experts?

Written by:

Adie Rae, PhD

Adie Rae, PhD, is a neuroscientist known for her extensive expertise on cannabis. She has been conducting peer-reviewed research about cannabis since 2004.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

Reviewed by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

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If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-HELP (4357) to learn about resources in your area.

Keep in mind that cannabis is legal in some states for recreational and/or medicinal use, but not in others. Cannabis is still illegal under federal law. Before you use cannabis products, find out the laws in your state.