Cannabis & Substitution

Article by Colin Bambury, High! Canada

Cannabis & Substitution

Cannabis has long been stigmatized and labeled a “gateway drug”. New evidence-based research is proving that the complete opposite is actually true. Marijuana can be an effective substitution for a variety of other substances. This article will explore these drugs and the long-term effects of replacing them.

The “Substitution Effect” occurs when a substance is introduced that can displace or alter the use of another substance. One example of this is consumers replacing tobacco with e-cigarettes and vaporizers. Another example is methadone clinics, which have opened to assist those struggling with opioid addictions by providing them with a chemical substitute.

Prescription Drugs & Opioids

Prescription painkillers and illicit opioids are fuelling a national epidemic of fatal overdoses, killing more than 2800 people in Canada in 2016 alone. The rate of opioid poisoning hospitalizations has steadily increased in the country for the past decade. The average North American is more likely to die from an overdose than a car crash. Public health officials are desperate for a viable solution.

Philippe Lucas, VP of Patient Research and Access at Tilray, conducted a survey of authorized Canadian medical cannabis patients about the substitution effect. 69% of respondents reported that they use cannabis instead of pharmaceutical drugs. Out of those respondents, 60% stopped using opioids completely in favor of medical marijuana. These numbers are substantial and will only continue to grow as more and more Canadians gain access to cannabis. Many patients find that by using the plant they can avoid the negative side effects of using prescription drugs.

States that legalized medical marijuana saw a 25% reduction in opioid overdose mortalities. The longer the program has been in effect the more positive outcomes it produces.

Canadians mostly turn to prescriptions for pain management and mental health. The most common medications that can be replaced are opioids, antidepressants, and non-opioid painkillers. Marijuana is an effective analgesic and is known to produce feelings of euphoria. This combination makes it the perfect substance to help treat depression, anxiety, and pain.


Alcohol is by far the most widely used psychoactive drug in North America. Almost 80% of residents aged 15 or older regularly partake in drinking. It is estimated that around 4% of the Canadian population are physically dependent on alcohol (around 600 000 people). Consistent over-consumption can lead to kidney and liver failure. Toxic levels of alcohol can slow or stop the functions of the brain stem (telling your lungs to breathe, heart to pump) often resulting in death without early intervention.

44% of respondents in the aforementioned medical cannabis survey reported that they successfully replaced alcohol consumption with cannabis. Marijuana is a natural plant medicine with therapeutic benefits that has never directly caused any deaths. It is arguably much safer to consume cannabis recreationally than alcohol.

70% of suicides in North America are associated with alcohol use. States that legalized recreational and medical cannabis saw a significant reduction in the number of these suicides. These same states also saw a reduction in the number of vehicle motor crashes and associated deaths due to fewer individuals driving under the influence of alcohol. These statistics ly in the face of the scare tactics that some Canadian public health organizations have used to convince us that cannabis will cause more accidents. It seems that the opposite is proving to be true.


Smoking tobacco is the number one preventable cause of death in Canada. Most surprisingly, cannabis can be used as a tobacco smoking cessation agent. 31% of surveyed patients use marijuana as a substitute for cigarettes and tobacco. 50% of those respondents have completely quit consuming tobacco. If cannabis can help users transition off of tobacco-based products, there could be massive positive implications for public health.


Caffeine is a popular substance that stimulates the central nervous system and can cause mild physical dependence with regular use. Those who try to quit caffeinated beverages will usually experience withdrawal symptoms. Caffeine interferes with sleep patterns and can cause serious insomnia in sensitive individuals.

Long-term caffeine use kills between 1,000 to 10,000 people every year in the US, from “stress, ulcers and triggering irregular heartbeats,” according to the US Bureau of Mortality Statistics. Cannabis overuse deaths come to a total of zero, according to the same source. Cannabis, specifically sativa-dominant strains, can provide users with a boost of uplifting energy and focus. Patients report that certain strains can help them deal with chronic fatigue. Cannabis is a unique substance that can act as both a stimulant and depressant depending on the combinations of terpenes and cannabinoids. A bowl of green may sufficiently replace your morning cup of Joe.

Other Illicit Drugs

Cocaine is reportedly the most popular drug that is being substituted with cannabis, followed by psychedelics and non-prescribed opioids. Cannabis products are much safer and have helped a large number of people get off of these illicit drugs completely. With recreational legalization coming soon, users won’t have to worry about the criminal charges associated with cannabis. These criminal charges are arguably the worst side effect of the plant.


Cannabis is not without its drawbacks but has been found to be less harmful to the individual and society than all of these other substances. Teen and adolescent use decline when states legalize cannabis for recreational use. There is a measurable decline in homicide and violent crime in these same states. There is a drop in workplace absences due to illness when medical marijuana programs are implemented.

No matter what side of the issue you stand on, legalizing cannabis will bring positive effects for every Canadian. It will be exciting to watch the substitution effect take place across the country over the next few years. It is time to collect more data and progress forward with evidence-based policies.

See original article here.

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