What would our society look like if cannabis replaced alcohol as the socially acceptable means of celebrating, unwinding, and getting loose on the weekends? Let's have a look at the evidence for this thought experiment.

Alcohol is almost twice as addictive as cannabis, and nicotine is about three times more addictive than cannabis. Cannabis use disorder is a real medical diagnosis: Some individuals use so much cannabis that they develop physical dependence, experience withdrawal symptoms, and use it to the extent that it negatively affects their economic or social well-being. However, only 9 percent of people who've ever tried cannabis end up with this diagnosis.

Alcohol is almost twice as addictive as cannabis, and nicotine is about three times more addictive than cannabis. Click To Tweet

A substance abuse diagnosis has profound effects on individuals and families, but excessive alcohol use doesn't necessarily require a medical diagnosis, and it has far-reaching societal impacts as well. In the United States, the Centers for Disease Control and Prevention (CDC) estimates that the societal cost of excessive drinking in the U.S. is $249 billion per year. The vast majority of these costs come from lost worker productivity in the form of hangovers. In states with the least restrictive cannabis laws, work absences drop by 13 percent after legalization, according to a July 2016 study published in the Wiley journal Health Economics.

But what about the health risks and benefits?

Alcohol use has many short- and long-term health risks. Some of the more obvious short-term risks are accidents, injuries, and involvement in violent crimes. For instance, blood alcohol levels of 0.05 percent increase a person's risk of being involved in a motor vehicle crash by 575 percent. To date, no correlation has been identified between detectable levels of THC in the bloodstream and vehicular crashes. This does not mean it is safe to drive while high, however.

There are also well-established relationships between alcohol use and domestic violence and other violent crimes. These relationships have not been found for cannabis, and in fact, cannabis users experience lower rates of domestic violence, according to a 2014 study published in the journal of the Society of Psychologists in Addictive Behaviors.

Long-term alcohol use has profound effects on the human body and psychology. People who use alcohol chronically are more likely to have high blood pressure, heart disease, stroke, liver disease and digestive problems. Regular cannabis users however, have lower rates of diabetes, lower body mass index, and lower rates of fatty liver disease. Alcohol is significantly correlated with several types of cancer, whereas cannabis may actually help to inhibit tumor cells.

Alcohol and cannabis have some things in common

One thing alcohol and cannabis have in common, however, is that they both cause memory loss and dysfunction. These effects persist for several weeks after individuals stop using cannabis. For alcohol users however, the negative impact on brain function can persist even after years of abstinence, according to findings in an August 2017 study published in the journal Alcoholism, Clinical, and Experimental Research by the American Medical Society on Alcoholism.

These health effects have a significant influence on mortality. For example, in the US, in 2014, 30,700 people died from alcohol-induced causes, according to data from the CDC. The lifespan of these individuals was shortened by an average of 30 years. That same year, not a single person died from cannabis.

The good news in all of this is that we're beginning to see a fundamental shift in society as a result of incremental cannabis legalization. Researchers at the University of Connecticut and Georgia State University have shown that in states with legal cannabis, alcohol sales are down by at least 15 percent. These findings were based on alcohol purchases at grocery, liquor, and other retail locations, but did not include bars.

Speaking of bars: This brings up the single major benefit that alcohol has, compared with cannabis — accessibility. Despite its major negative impacts on health, violence, life expectancy, and productivity, alcohol is available to every adult in every neighborhood in the U.S. “Getting a drink” is the default option when it comes to many types of social interactions in our culture: first dates, retirement celebrations, and a lot more. Through years of research, I have come to believe that, when used properly, cannabis is the safest intoxicating substance on the planet, yet only 21 percent of U.S. adults have legal access to use it recreationally.

The social consumption challenge remains

Even in states where cannabis is legal for adult use, there is still a major challenge to overcome: social and public consumption. In the interest of public health, it makes a lot of sense to disallow people from consuming cannabis in public places. But this creates problems for the millions of tourists flocking to states with legal cannabis markets. If you can't consume in a hotel room or in public, what are your options? How can people safely, legally, and comfortably consume? These issues could all be overcome by allowing licensed social consumption venues to sell, serve, and provide advice and oversight of the consumption process.

Imagine if we could stimulate our appetites with cannabis, rather than a cocktail. Click To Tweet

What would our culture look like if people could use cannabis as a context for getting together? Imagine if we could stimulate our appetites with cannabis, rather than a cocktail. How much more healthy, productive, and better off would we be?  What would happen if we replaced the most commonly abused substance on Earth with a substance that has comparatively more genuine health benefits?

A mountain of scientific evidence supports the legalization of cannabis for both medical and adult-use. When this happens, and cannabis becomes as acceptable and accessible as alcohol, we are likely to experience a dramatic cultural and health revolution.

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