Study By Tod
Mikuriya, MD
Photo by- Marcio Jose Sanchez
Associated Press
SUMMARY
Ninety-two Northern Californians using cannabis as an alternative to
alcohol obtained letters of approval from the author. Their records
were reviewed to determine characteristics of the cohort and efficacy
of the treatment —defined as reduced harm to the patient.
All patients reported benefit, indicating that for at
least a subset of alcoholics, cannabis use is associated with reduced
drinking. The cost of alcoholism to individual patients and society-
at-large warrants testing of the cannabis-substitution approach and
study of the drug-of-choice phenomenon.
INTRODUCTION
Physicians who treat alcoholics are familiar with the cycle from
drunkenness and disinhibition to withdrawal, drying out, and apology
for behavioral lapses, accompanied over time by illness and debility as
the patient careens from one crisis to another. (Tamert and Mendelsohn
1969)
“Harm reduction” is a treatment approach that seeks to
minimize the occurrence of drug/alcohol addiction and its impacts on
the addict/alcoholic and society at large. A harm-reduction approach to
alcoholism adopted by 92 of my patients in Northern California involved
the substitution of cannabis —with its relatively benign side-effect
profile— as their intoxicant of choice.
No clinical trials of the efficacy of cannabis as a subtitute for
alcohol are reported in the literature, and there are no papers
directly on point prior to my own account (Mikuriya 1970) of a patient
who used cannabis consciously and successfully to reduce her
problematic drinking.
There are ample references, however, to the use of cannabis as a
substitute for opiates (Birch 1889) and as a treatment for delirium
tremens (Clendinning 1843, Moreau 1845), which were among the first
uses to which it was put by European physicians.
Birch described a patient weaned off alcohol by use of opiates, who
then became addicted and was weaned off opiates by use of cannabis.
“Ability to take food returned. He began to sleep well; his pulse
exhibited some volume; and after three weeks he was able to take a turn
on the verandah with the aid of a stick. After six weeks he spoke of
returning to his post, and I never saw him again.”
Birch feared that cannabis itself might be addictive, and recommended
against revealing to patients the effective ingredient in their elixir.
“Upon one point I would insist —the necessity of concealing the name of
the remedial drug from the patient, lest in his endeavor to escape from
one form of vice he should fall into another, which can be indulged
with facility in any Indian bazaar.” This stern warning may have
undercut interest in the apparently successful two-stage treatment he
was describing.
At the turn of the 19th century in the United States, cannabis was
listed as a treatment for delirium tremens in standard medical texts
(Edes 1887, Potter 1895) and manuals (Lilly 1898, Merck 1899, Parke
Davis 1909).
Since delirium tremens signifies advanced alcoholism, we can adduce
that patients who were prescribed cannabis and used it on a longterm
basis were making a successful substitution.
By 1941, due to prohibition, cannabis was no longer a treatment option,
but attempts to identify and synthesize its active ingredients
continued (Loewe 1950). A synthetic THC called pyrahexyl was made
available to clinical researchers, and one paper from the postwar
period reports its successful use in easing the withdrawal symptoms of
59 out of 70 alcoholics. (Thompson and Proctor 1953).
In 1970 the author reported (op cit) on Mrs. A., a 49-year-old female
patient whose drinking had become problematic. The patient had observed
that when she smoked marijuana socially, on week-ends, she decreased
her alcoholic intake. She was instructed to substitute cannabis any
time she felt the urge to drink.
This regimen helped her to reduce her alcohol intake to zero. The paper
concluded, “It would appear that for selected alcoholics the
substitution of smoked cannabis for alcohol may be of marked
rehabilitative value. Certainly cannabis is not a panacea, but it
warrants further clinical trial in selected cases of alcoholism.”
The warranted research could not be carried out under conditions of
prohibition, but in private practice and communications with colleagues
I encountered more patients like Mrs. A. and generalized that somewhere
in the experience of certain alcoholics, cannabis use is discovered to
overcome pain and depression —target conditions for which alcohol is
originally used— but without the disinhibited emotions or the
physiologic damage. By substituting cannabis for alcohol, they can
reduce the harm their intoxication causes themselves and others.
Although the increasing use of marijuana starting in the late ‘60s had
renewed interest its medical properties —including possible use as an
alternative to alcohol (Scher 1971)— meaningful research was blocked
until the 1990s, when the establishment of “buyers clubs” in California
created a potential database of patients who were using cannabis to
treat a wide range of conditions.
The medical marijuana initiative passed by voters in 1996 mandated that
prospective patients get a doctor’s approval in order to treat a given
condition with cannabis —resulting in an estimated 30,000 physician
approvals as of May 2002. (Gieringer 2002) As this goes to press a year
later, the estimate stands at abut 50,000.
In a review of my records in the spring of 2002 by Jerry Mandel, PhD,
92 patients were identified as using cannabis to treat alcohol abuse
and related problems. This paper describes characteristics of that
cohort and the results of their efforts to substitute cannabis for
alcohol.
METHODOLOGY
Identifying Alcoholism
The initial consultation (20 minutes) provided multiple opportunities
to identify alcoholism as a problem for which treatment with cannabis
might be appropriate. The intake form asked patients to state their
reason for contacting the doctor, and enabled them to prioritize their
present illnesses and describe the course of treatment to date.
The form also asked patients to identify any non-prescribed
psychoactive drugs they were taking (including alcohol), and invited
remarks. A specific question concerned injuries incurred “while or
after consuming alcohol.” My reading of patients’ medical records
provided an additional opportunity to identify alcohol abuse, as did
the taking of a verbal history.
Evaluating Efficacy
At follow-up visits (typically at 12-month intervals) patients were
asked to list the conditions they had been treating with cannabis and
to evaluate their status as “stable,” “improved,” or “worse.” Patients
were asked to evaluate the efficacy of cannabis (five choices from
“very effective to “ineffectual”) and to describe any adverse events.
Patients were also asked to describe any changes in their “living and
employment situation,” and if so, to elaborate. The question about use
of non-prescribed psychoactive drugs, including alcohol, was repeated.
Comparison of responses in a given patient’s initial and follow-up
questionnaires enabled us to assess the utility of cannabis as an
alternative to alcohol.
Patient Background
Gieringer (op cit) notes that “Many patients who find marijuana helpful
for otherwise intractable complaints report that their physicians are
fearful of recommending it, either because of ignorance about medical
cannabis, or because they fear federal punishment or other sanctions.
This is especially true in regions where the use of marijuana is less
familiar and accepted.”
The patients whose records form the basis for this study were all seen
in ad hoc settings arranged by local cannabis clubs —72 in rural
counties of Northern California, 4 in San Francisco.
They form a special but not unique subset, having intentionally sought
out a physician whose clinical use of cannabis—and confidence in its
versatility and relative safety— was extensive and well known in their
communities.
A majority of the patients identified themselves as blue-collar workers:
carpenter (5), construction (3), laborer (3), waitress (3), truck
driver (3), fisherman (3), heavy equipment operator (3), painter (2),
contractor (2) cook (2), welder (2), logger (2), timber faller, seaman,
hardwood floor installer, bartender, building supplies, house
caretaker, ranch hand, concrete pump operator, cable installer,
silversmith, stone mason, boatwright, auto detailer, tree service
handyman cashier, nurseryman, glazier, gold miner, carpet layer,
carpenter’s apprentice, landscaper, river guide, screenprinter,
glassblower.
Eleven were unemployed or didn’t list an occupation; four were
disabled, two retired, and two patients defined themselves as mothers.
Others were in sales (5), musicians (5), clerical workers (3),
paralegal, teacher, actor, actress, artist, sound engineer, computer
technician.
Eighty-two of the patients were men.
Patients’ ages ranged from 20 to 69. Twenty-nine were in their
twenties; 16 in their thirties; 24 in their forties; 20 in their
fifties; three in their sixties.
Exactly half —46 patients— had taken some college courses, but only
four had college degrees. Five did not complete high school.
Thirteen were veterans, all branches of the Armed Forces being
represented.
All but six—five native-Americans, one African-American— were Caucasian.
Slightly more than half (49) reported being raised by at least one
addict/lcoholic parent.
Prioritizing Alcoholism
Fifty-seven of the patients identified alcoholism or cirrhosis of the
liver as their primary medical problem. Secondary problems reported by
this group were Depression (15), Pain (14), Arthritis (7), PTSD (6),
Insomnia (6), Cramps (4)
Hepatitis
C (4)
Anxiety (3),
Stress
(2), gastritis, and
ADHD.
Thirty-one patients identified themselves as alcohol abusers, but
reported other problems as primary: Pain (12),
Depression
(8),
Headache (4), Bipolar Disorder (2) Anxiety (2),
Arthrtitis (2),
Asthma (2)
Spinal
Cord Injury/Disease (2), Paraplegia,
PTSD,
Crushed skull, Aneurysms aggravated by stress,
ADHD,
Multiple broken bones.
Eighteen patients reported having been injured while or after drinking
heavily.
Fourteen had incurred legal problems or been ordered into rehab
programs.
Cannabis Use
Awareness of Medicinal Effect
Patients were asked when they started using cannabis and when they
realized it exerted a medicinal effect.
Three reported first using at age 9 or younger; 61 between ages 10 and
19; nine began using in their 20s; three in their 30s; six in their
40s; two at age 50; and one at age 65.
Twenty-four patients reported realizing immediately upon using cannabis
that it exerted a beneficial medical effect. Some of their responses
still seem to reflect their relief at the time.
• “In 1980 I had quit drinking for a month. My niece asked me if I ever
tried marijuana to calm me down. So I tried it and it worked like a
miracle.”
• “Helped pain very much! Helped sleep —excellent.”
Thirty-five patients answered ambiguously with respect to time —“When
realized preferred to alcohol,” for example, or, “when I smoked when
suffering.”
Seven reported becoming aware of medical effect within a year of using
cannabis. Ten became aware within one to five years.
Three became aware of medical effect 12-15 years after first using. Ten
became aware between 20 and 30 years after first using. All but one of
these patients had resumed using cannabis after years of abstinence.
Efficacy
As could be expected among patients seeking physician approval to treat
alcoholism with cannabis, all reported that they’d found it “very
effective” (41) or “effective” (38).
Efficacy was inferred from other responses on seven questionnaires. Two
patients did not make follow-up visits.
Nine patients reported that they practiced total abstinence from
alcohol and attributed their success to cannabis. Their years in
sobriety: 19, 18, 16, 10, 7, 6, 4 (2), and 2.
Twenty-nine patients reported a return of symptoms when cannabis was
discontinued. Typical comments:
• “I quit using cannabis while I was in the army and my drinking
doubled. I was also involved in several violent incidents due to
alcohol.”
Use of Other Drugs
Patients were asked to list other drugs —prescribed, over-the-counter,
and herbal— that they were currently using or had used in the past to
treat their illnesses. Most common of the prescription drugs were SSRIs
(31), opiates (23) NSAIDs (18) disulfaram (15) and Ritalin (8).
Delivery Systems
Seventy-eight patients smoked joints —the average amount being one
joint a day (assuming 3.5 joints per 1/8 ounce of high-quality
marijuana).
All were strongly advised that smoking involves an assault on the
lungs, and that vaporization is a safer method of inhaling cannabinoids.
Twelve patients reported using a pipe, and three owned vaporizers. All
were strongly advised that smoking involves an assault on the lungs,
and that vaporization is a safer method of inhaling cannabinoids.
OBSERVATIONS
Alcoholic Parents
That a slight majority patients (51) reported being raised by at least
one alcoholic parent was not surprising. The children of alcoholics
enter adulthood with two strikes. They have endured direct emotional
abuse and/or abandonment by parent(s); and they lack role models for
coping with uncomfortable feelings other than by inebriation. It is to
be expected that many, when encountering problems early in life, are
treated with, or seek out, mind-altering drugs.
Cannabis for Analgesia
The large number of patients using cannabis for pain relief (28)
reflects the high percentage of blue-collar workers who suffer
musculoskeletal injury during their careers. As expressed by a
carpenter, “Nobody gets to age 40 in my business without a bad back.”
Nurses who must lift gurneys, farmworkers, desk-bound clerical workers,
and many others are also prone to chronic back and neck pain.
Fights and accidents — vehicular, sports- and job-related— also create
chronic pain patients, many of whom self-medicate with alcohol.
Eighteen patients reported having been injured while or after drinking
heavily. This comment by Jamie R., a 26-year-old truck driver,
describes a typical chain-reaction of alcohol-induced trouble: “Injured
in a fight after consuming alcohol, resulted in staph infection of
right knuckle, minor surgery and four days in hospital.” Injuries
suffered while drunk add to pain and the need for relief by alcohol …or
a less destructive alternative.
A total of 26 patients reported using cannabis for both pain relief and
as an alternative to alcohol. Mike G., a 47-year old landscaper who was
run over by a vehicle at age 5, requiring multiple surgeries and
leaving him with pins in his right ankle, first used cannabis at age 16
and appreciated its benign side-effect profile: “Given pain pills for
my right ankle, I got too drowsy. Smoked herb to relieve pain.” And
when he had to discontinue cannabis use, “was unable to ease pain in
ankle without herb, and drink when unable to have cannabis to smoke.”
Cannabis for Mood Disorders
Twenty-three patients reported using cannabis to treat depression —39
if the category is expanded to include anxiety, stress, and PTSD— and
their comments frequently touched on the negative synergies between
mood disorders and alcoholism.
• Wendy S., a 44-year-old paralegal, suffering from depression,
alcoholism, and PMS noted simply, “Alcohol causes more depression.”
When she does not have access to cannabis, “Alcohol consumpion
increases and so does depression.” At her initial visit she reported
consuming 5-10 drinks/day. At a follow-up (16 months) she had reduced
her consumption to week-ends.
• Albert G., a 33-year-old river guide (and decorated Army vet) put it
this way: “I have had a problem with violence and alcohol for a long
time and I have a rap sheet to prove it. None of the problems occurred
while using cannabis. Not only does cannabis prevent my violent
tendencies, but it also helps keep me from drinking.” On his follow-up
visit (12 months) Albert reported improved communication with family
members and fewer problems relating to other people. His alcohol
consumption had decreased from 36 drinks/week to zero (one month of
sobriety).
• Carol G. presented initially at age 35 as homeless and unemployed,
suffering “severe depression. Anxiety. Pain.” Her problem with alcohol
was inferred from her response concerning non-medical-psychoactive drug
use: “I drink and smoke too much —started when I couldn’t get
marijuana.”
Carol had shyly requested a recommendation for cannabis from a Humboldt
County physician but, as she recounted, “I’m paranoid and local Drs are
scared, too. They gave me paxil & stop smoking pamphlet.”
At a follow-up visit (14 months) Carol reported a change in
circumstance: “Now have a room. But am on G.R. and am paying too much.”
She was still using alcohol “a little. I’m doing good dealing with not
drinking. Being able to medicate with cannabis has helped a lot.”
Eighteen months later the pattern hadn’t changed: “Alcohol several
times/week. Depends on if I have cannabis, stress still triggers.”
Fewer Adverse Effects
Patients made negative comments with respect to the efficacy of their
prescribed analgesics and anti-depressants (22), side-effects (26), and
cost (11) —not surprising, perhaps, in a cohort seeking an herbal
alternative.
• Lance B. presented as a 41-year-old alcoholic also suffering from
arthritis, pain from knee- and ankle surgeries, and depression, for
which he had been prescribed Librium, Valium, Buspar, Welbutrin,
Effexor, Zoloft, and Depakote over the years; “No help!,” he wrote
bluntly. On his return visit (one year) he reported “few relapses” and
that he was able to take some classes.
• The dulling effects of Vicodin and other opiates were mentioned by
seven patients. As Harvey B. put it, “When I can get Vicodin it helps
the pain but I don’t like being that dopey.” Clarence S., whose skull
was badly damaged in an accident, also appreciated the pain relief
provided by opiates, but asserted that opiates “make me paranoid and
mean.”
• Alex A., who was diagnosed with ADHD in ninth grade, touches on some
recurring themes in describing the treatment of his primary illness: “I
was prescribed Ritalin and Zoloft. The Ritalin helped me concentrate
slightly but caused me to be up all night. The Zoloft made me sick to
my stomach and never relieved my stress or depression. I have never
been prescribed anything for my insomnia but I usually have to drink
some liquor to get to sleep. I think that is a bad thing as I have now
begun to drink excessive amounts of whisky, which has really started to
affect my stomach.” Alex first used cannabis at age 19 and became aware
of benefits immediately. “I found myself running to the refrigerator
and then sleeping better than I had for years.” At age 21 he fears
permanent damage. “From drinking (I believe) my stomach has been
altered, along with my appetite… I cannot really eat that much and feel
malnourished and weaker than a 21-year-old should. My joints ache
constantly and I am not as strong as I used to be. I also fear that I
will become or am an alcoholic and I do not want to see myself turn
into my dad.”
At his follow-up visit (12 months) Alex reported cannabis to be “very
effective.” He was employed, “not partying,” doing well socially, and
trying to give up cigarettes.
Drug Interactions (studies)
No negative interactions between cannabis and other drugs were
reported. Several patients (3) indicated that cannabis had a welcome
amplifying effect on the efficacy of prescription and OTC medications.
“I hurt a lot more without cannabis and can’t function as well,”
reported Liz J. “It seems to relax me so the medicines work better and
faster. Additionally, cannabis is natural, and all these other drugs
—Vicodin, Soma, Aleve, Librium, Baclofen, have lots of side effects.”
As cannabis comes into wider use in California and elsewhere, it is
important that its interactions with other medications be studied and
publicized.
As cannabis comes into wider use in California and elsewhere, it is
important that its interactions with other medications be studied and
publicized. Cannabis may also have an amplifying effect on alcohol,
enabling some patients to achieve a desired level of
inhibition-reduction or euphoria while drinking significantly less.
Defining Success
The harm-reduction approach to alcoholism is based on the recognition
that for some patients, total abstinence has been an unattainable goal.
Success is not defined as the achievement of perpetual sobriety. A
treatment may be deemed helpful if it enables a patient to reduce the
frequency and quantity of alcohol consumption; if drunken episodes
and/or blackouts are reduced; if success in the workplace can be
achieved; if specific problems induced by alcohol (suspended driver’s
license, for example) can be resolved; if ineffective or toxic drugs
can be avoided.
As noted, all of the patients in this study were seeking physician’s
approval to use cannabis medicinally —a built-in bias that explains the
very high level of efficacy reported.
However, the majority were using cannabis for other conditions as
well, and would have qualified for an approval letter whether or not
they reported efficacy with respect to alcoholism. Although medicinal
use of cannabis by alcoholics can be dismissed as “just one drug
replacing another,” lives mediated by cannabis and alcohol tend to run
very different courses. Even if use is daily, cannabis replacing
alcohol (or other addictive, toxic drugs) reduces harm because of its
relatively benign side-effect profile. Cannabis is not associated with
car crashes; it does not damage the liver, the esophagus, the spleen,
the digestive tract. The chronic alcohol-inebriation-withdrawal cycle
ceases with successful cannabis substitution. Sleep and appetite are
restored, ability to focus and concentrate is enhanced, energy and
activity levels are improved, pain and muscle spasms are relieved.
Family and social relationships can be sustained as pursuit of
long-term goals ends the cycle of crisis and apology.
Carl S., a 42 year old journeyman carpenter, is a success story from a
harm-reduction perspective. At his initial visit he defined his problem
as “intermittent explosive disorder,” for which he had been prescribed
Lithium. Although drinking eight beers/day, he reported “Cannabis has
allowed me to just drink beer when I used to blackout drink vodka and
tequila.” By the time of a follow-up visit (12 months), Carl had been
sober for four months. He also reported “anger outbreaks less severe,
able to complete projects,” and, poignantly, “paranoia is now mostly
realism.” He plans to put his technical skill to use in designing a
vaporizer.
As a certified addictionologist I have supervised both inpatient and
outpatient treatment for thousands of patients since 1969. In the
traditional alcoholism medical-treatment model, the physician is an
authority figure to a patient whose life has spun out of control.
The patient enters under coercive circumstances, frequently under court
order, with physiologies in toxic disarray. Transference dynamics cast
the physician into a parental role, producing the usual parent-child
conflicts. After detoxification when cognition has returned from the
confusional state of withdrawal, the patient leaves —usually with
powers of denial intact. Follow-up outpatient treatment is oriented to
AA and/or pharmacologic substitutes.
Treating alcoholism by cannabis substitution creates a different
doctor-patient relationship. Patients seek out the physician to confer
legitimacy on what they are doing or are about to do. My most important
service is to end their criminal status —Aeschalapian protection from
the criminal justice system— which often brings an expression of
relief. An alliance is created that promotes candor and trust. The
physician is permitted to act as a coach —an enabler in a positive
sense.
As enumerated by patients, the benefits can be profound: self-respect
is enhanced; family and community relationships improve; a sense of
social alienation diminishes. A recurrent theme at follow-up visits is
the developing sense of freedom as cannabis use replaces the
intoxication-withdrawal-recovery cycle —freedom to look into the future
and plan instead of being mired in a dysfunctional past and present;
freedom from crisis and distraction, making possible pursuit of
long-term goals that include family and community.
Re: Alcoholics Anonymous
Although nine patients made voluntary reference to attending 12-step
meetings (three presently, six in the past), it is likely that many
more actually tried the 12-step program —but the question was not posed
on the intake form. A future study should examine the relationship
between cannabis-only users and Alcoholics Anonymous.
At AA meetings, cannabis use is considered a violation of sobriety.
This puts cannabis-only users in a bind. Those who attend meetings
can’t practice the “rigorous honesty” that AA considers essential to
recovery; and those who avoid meetings are denied support and
encouragement that might help them to stay off alcohol. Support-group
meetings at which cannabis-using alcoholics are welcome would be a
positive development.
• Frank R., first seen at age 29, was diagnosed as an alcoholic in 1987
and began attending AA meetings, which he found helpful although he
could not achieve sustained sobriety. In 1998, after realizing that
cannabis reduced his cravings for alcohol, he received approval to use
it. At a follow-up in November ’99 he reported, “Have stopped drinking
for the first time in many years. I have not taken a drink of alcohol
in 14 months. I attribute some credit for this to daily use of
cannabis. My life has improved with this treatment.”
Frank R. was seen again in April ’01 and reported, “I continue to
maintain sobriety regarding alcohol. Have not had a drink for 2 1/2
years. I drank alcohol heavy for about 10 years, and had difficulty
stopping drinking and staying stopped until I began this treatment.
Pain symptoms from back spasms/scoliosis also better.”
Factors in Drug of Choice
British psychiatrist G. Morris Carstairs spent 1951 in a large village
in northern India and reported on the two highest castes, Rajput and
Brahmin, and their traditional intoxicants of choice —alcohol and
cannabis, respectively. The Rajputs were the warriors and governors;
they consumed a potent distilled alcohol called daru. The Brahmins were
the religious leaders; they were vegetarians and drank a cannabis
infusion called bhang.
“By virtue of their role as warriors, the Rajputs were accorded certain
privileged relaxations of the orthodox Hindu rules,” writes Carstairs,
“in particular, those prohibiting the use of force, the taking of life,
the eating of meat and drinking of wine.” The Rajputs viewed the
daru-inspired release of emotions —notably sexual and aggressive
impulses— as admirable. Rajput lore, as shared with Carstairs,
glorified sexual and military conquests.
The priestly Brahmins, on the other hand, “were quite unanimous in
reviling daru and all those who indulged in it. They described it as
foul, polluting, carnal and destructive to that spark of Godhead which
every man carries within him.” Bhang, a Brahmin told Carstairs, “gives
good bhakti.” He defined bhakti as “emptying the mind of all worldly
distractions and thinking only of God.”The Brahmin emphasis on
self-denial includes “the avoidance of anger and or any other unseemly
expression of personal feelings; abstinence from meat and alcohol is a
prime essential.” Carstairs’s stated goal was to understand how the
Brahmins could rationalize intoxicant use.
He concluded:
“There are alternative ways of dealing with sexual and aggressive
impulses besides repressing them and then ‘blowing them off’ in
abreactive drinking bouts in which the superego is temporary dissolved
in alcohol. The way which the Brahmins have selected consists in a
playing down of all interpersonal relationships in obedience to a
common, impersonal set of rules of Right Behavior. Not only feelings
but also appetites are played down, as impediments to the one supreme
end of union with God... Whereas the Rajput in his drinking bout knows
that he is taking a holiday from his sober concerns, the Brahmin thinks
of his intoxication with bhang as a flight not from but toward a more
profound contact with reality.”
Two aspects of Carstair’s report resonate strongly with my own
observations:
• The disinhibition achieved via alcohol is the Rajput kind —a flight
from reality, becoming “blotto”— whereas the disinhibition achieved via
cannabis is the result of focused or amplified contemplation.
• “Drug of choice” is strongly influenced by social and cultural
factors, and, once determined, becomes a defining element of individual
self-image, i.e., possible but not easy to change in adulthood.
Prohibition of marijuana, the intense advertising of alcohol, and its
widespread availability encourage the adoption of alcohol as a drug of
choice among U.S. adolescents.
It is likely that legal access to cannabis would result in fewer young
adults adopting alcohol as their drug of choice, with positive
consequences for the public health and countless individuals.
Ring Lardner, Jr., on Cannabis as a Substitute for Alcohol
Screenwriter Ring Lardner, Jr. won an Oscar in 1938 for “Woman of the
Year” and another in 1970 for “M*A*S*H.” His memoir “I’d Hate Myself in
the Morning” (which takes its title from his line to the House
Un-American Activities Committee) includes this description of his
colleagues Ian Hunter and Waldo Salt.
“Ian, too, had an alcohol problem —one that, unlike mine, increased in
severity to the point of debilitation. During the period when we had to
come up with an episode for a half-hour television program every week,
there were times when I had to perform the task by myself. On occasion,
he would pull himself together and make a big effort to match what I
had done single-handed. Eventually, though, he came to the conclusion
that he would have to give up drinking for good. And he proceeded to do
just that, first by enlisting in Alcoholics Anonymous, as he went cold
turkey, then, to fortify his abstinence, by substituting marijuana for
alcohol. It happened that a friend of ours, the blacklisted writer
Waldo Salt, had made the same medicinal switchover. Since Ian and Waldo
also shared a love of drawing, they could pool the cost of a model and
spend an evening indulging in pot and art. Neither of them drank again,
as far as I know.
“Some years earlier, when the film community was still
disproportionately Jewish, my good friend Paul Jarrico announced a
discovery. He had been wondering why a small grup of his fellow
screenwriters —Ian, Dalton Trumbo, Hugo Butler, Michael Wilson, and I—
were such a close, cozy group. What bound us together, Paul reported,
was the fact that we were all gentiles. ‘Nonsense,’ Ian declared, ‘It’s
that we’re all drunks.’ Instantly, I knew he was right. It was by far
the stronger bond.”
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