Which Is Worse, Alcohol or Weed?

Alcohol and marijuana are two of the most commonly used drugs. However, due to differences in societal acceptance, there seems to be a great debate over which one’s worse. 

Although we may be looking for a clear-cut answer, the truth is, it’s a bit complicated. At face value, they’re both harmful substances — suggesting that a title for “worst” may not be the important answer we’re looking for. To help us come to a conclusion for ourselves, we’ll take a side-by-side look at the different facets of alcohol and marijuana. 

Understanding the Health Effects of Alcohol

As a central nervous system (CNS) depressant, alcohol impacts messaging in our brain and the rest of our body. The toxins cause immediate effects and can also have long-term impacts from prolonged exposure. 

Acute Effects

Alcohol is associated with “feeling drunk,” but it's actually a side effect of alcohol’s impact on the different systems in our body. The exact experience can vary from person to person and depending on the amount of alcohol consumed, but some symptoms of intoxication are common: 

• Loss of coordination
• Lack of judgment
• Increased blood pressure
• Increased heart rate
• Lowered inhibitions
• Change in behavior
• Blurry vision
• Nausea or vomiting

Short-term effects of alcohol can also be felt the day after  — even a few days after — in what we know of as a hangover. 

Long-Term Effects

The long-term effects of alcohol also will vary from person to person. Prolonged or excessive exposure to the toxins in alcohol can cause many different problems:

• Liver disease. Our liver breaks down more than 90% of alcohol. Since drinking alcohol continually exposes our liver to toxins, it’s commonly associated with liver damage and disease.
• Pancreatitis. The toxins in alcohol damage our pancreatic cells over time, leading to chronic inflammation and disease of the pancreas.
• Heart disease. Excessive consumption of alcohol is linked with an increased risk of heart disease as it can lead to permanent effects on our blood pressure. It is associated with a type of heart failure known as alcoholic cardiomyopathy.
• Stomach and GI issues. Alcohol disrupts our gut microbiome, which can lead to discomfort, digestive issues, and the development of ulcers.
• Nerve damage. Prolonged exposure to alcohol can cause numbness and tingling in our limbs due to nerve damage.
• Infertility. Excessive consumption of alcohol can decrease our reproductive hormone levels, affecting fertility in males and females. 
• Mental health conditions. Alcohol has lasting impacts on our brain, which helps regulate our mood and stress. Mental health conditions such as anxiety, depression, and other mental health conditions are more common in those of us who misuse alcohol.
• Increased risk of cancer. The toxic component of alcohol, acetaldehyde, is a known carcinogen, which explains alcohol’s direct tie to the increased risk of developing all types of cancer.

Long-term health effects are the leading cause of alcohol-related mortalities. While the exact effects will vary from person to person, it’s clear that drinking alcohol opens the door to myriad lasting effects on our health. 

Understanding the Health Effects of Marijuana

Marijuana, also known as “weed,” refers to the different parts of the cannabis plant. The plant contains active compounds such as tetrahydrocannabinol (THC), cannabidiol (CBD), and more. Some of these active compounds are mind-altering and have short-term and long-term effects on our body. 

Acute Effects

The “high” feeling associated with marijuana is a result of the effects that the drug has on different systems in our body. The effects of marijuana vary more widely from person to person compared to those of alcohol:

• Dry mouth
• Changes in perception of time
• Lack of coordination
• Impaired judgment
• Relaxation
• Increased hunger
• Drowsiness
• Pain relief
• Dry/red eyes

Like the effects of alcohol, marijuana’s acute effects can linger in the days following its use. Hangover symptoms from weed frequently include brain fog, headache, and drowsiness.

Long-Term Effects

The long-term health effects of marijuana are not as heavily researched as alcohol. While still being studied, marijuana has been associated with various long-term impacts:

• Altered brain development. The effects of marijuana on brain development still require further research. However, the Centers for Disease Control and Prevention (CDC) reports that using marijuana before the age of 18 can affect brain functions such as learning, memory, and attention. 
• Schizophrenia. The connection between marijuana and schizophrenia continues to be studied. However, research has shown that marijuana use is tied to an increased risk of developing schizophrenia and other psychotic disorders. A more recent study came to the same conclusion; it also found the highest risk group to be young men between the ages of 16 and 25.
• Lung damage. Smoking — a common method for using marijuana — has direct impacts on our lung health. According to the CDC, marijuana contains toxins and irritants similar to tobacco when smoked.

We’ve established a long list of health effects of alcohol and marijuana, but what’s the verdict?

Analyzing the Health Effects of Marijuana vs. Alcohol

As we’ve looked more in depth at the health effects of alcohol and marijuana, we might find ourselves comparing the long list of impacts. At a quick glance, the extensive list of alcohol’s effects may have us wondering, “Is alcohol worse than weed even though weed is illegal in many places?”

Actually, alcohol and marijuana impact our cognitive abilities and motor function in similar ways. Although our individual experiences may vary, both substances can have dangerous effects. 

Comparing long-term impacts, alcohol seems to be associated with significantly more risks. However, lack of research could be the reason for the discrepancy. Currently, alcohol is tied to greater health issues, but it’s too soon to come to the conclusion that alcohol is worse, as more information is needed. That said, let’s explore another facet of alcohol and marijuana — their misuse.

Comparing the Potential of Misuse: Alcohol vs. Marijuana

Alcohol and marijuana are both drugs that can cause dependence and lead to misuse. According to the American Psychological Association (APA), substance misuse refers to continued use of a substance despite impaired control, risky use, and substance-related problems. Diagnoses for alcohol use disorder (AUD) and cannabis use disorder (CUD) must meet certain criteria in the DSM-5, professional reference book on mental health and brain-related conditions. The criteria refer to the cognitive, behavioral, and physiological symptoms associated with the misuse of a substance.

The 2022 National Drug Survey on Drug Use and Health (NSDUH) reported:

• 29.5 million people or 10.5% of those aged 12 and older had AUD within the past year.
• 19 million people or 6.7% of those aged 12 and older had CUD within the past year.
• AUD and CUD were most common in young adults between the ages of 18 and 25. 

While data show that alcohol misuse today is more prevalent than marijuana misuse, both are alarmingly common. Could social perception play a factor in these numbers?

A Side-by-Side Look at the Social Impacts

Social acceptance of a substance can contribute to substance use, which can have effects aside from our health. Let’s explore the social impacts of alcohol and marijuana.

Alcohol is one of the most commonly used drugs according to the National Institute on Drug Abuse (NIDA); that fact may be attributed in part to the high social acceptance of drinking. While high alcohol consumption may benefit individual companies, it has detrimental impacts on our economy. The CDC reports that excessive alcohol use cost the U.S. roughly $249 billion in 2010 due to healthcare expenses, decreased workplace productivity, motor vehicle crashes, and criminal justice expenses. In addition to the toll on our economy, alcohol production also causes negative environmental impacts. Individually, alcohol can cause great harm to our health, but by zooming out and looking at the population as a whole, we can get a clearer picture of the extensive social impacts of alcohol. 

Like alcohol, marijuana is also highly accepted socially, which also makes it one of the most highly used illicit drugs. Marijuana is becoming legal in more areas, which may explain the growth in use and positive impacts on our economy. Although we may see some benefits economically due to tax revenue, investment opportunities, and job growth, research has shown that marijuana is associated with an increased risk of violence. Although more research is needed, current findings suggest marijuana use has negative impacts on public safety. Shifts in legality and public perception continue to occur, but presently, marijuana is still highly controlled through regulation and taxation.

While alcohol and marijuana are similar in many ways, we can also see their different impacts on our society as a whole. Let’s take a closer look at these differences by laying out the facts. 

Sobering Statistics on Related Harms: Alcohol vs. Weed

Different facets of weed and alcohol make it difficult to compare the two. Statistics comparing weed and alcohol are revealing.

• Alcohol use within the past month was reported by 137.4 million people (48.7%) among those aged 12 or older, as outlined by the 2022 NSDUH report.
• Marijuana use within the past month was reported by 42.3 million people (15%) among those aged 12 or older, as outlined by the 2022 NSDUH report. 
• Alcohol-impaired driving fatalities account for about 31% of traffic crash fatalities in the United States per year, as reported by the National Highway Traffic Administration (NHTSA).
• Marijuana-impaired driving accidents aren’t well reported, but a 2022 study on traffic crash rates found that legalization of recreational marijuana use was associated with a 6.5% increase in injury crash rates and a 2.3% increase in traffic crash fatalities.
• Alcohol-related mortalities account for over 178,00 deaths per year in the United States, according to a report from the CDC. 
• Marijuana-related mortalities aren’t well documented; however, the Drug Abuse Warning Network (DAWN) reports that 597 per 100,000 people between the ages of 18 and 25 visited the emergency room for a marijuana-related emergency in 2022. These emergencies range from severe nausea and vomiting to injury from impaired motor function.

Data help us compare alcohol and marijuana more tangibly, but it’s important to note that external factors such as how likely people are to report using each substance can influence the information and how we interpret it.

Is Weed or Alcohol Worse?

While it’s easy to compare the visible effects of alcohol and weed, there’s a lot more to consider when trying to determine which substance is more harmful. It’s helpful to keep in mind those factors that can influence the comparison of alcohol and weed:

• Amount of research. We’ve studied alcohol for much longer than we’ve studied marijuana — meaning, we know a lot more about it. While it may seem like the evidence shows that alcohol has significantly more risks than marijuana, the lack of long-term studies on the impact of weed can contribute to this gap. 
• Variation in products. Alcohol is primarily consumed orally whereas marijuana can be used in a variety of ways. The variation between the effects of weed through different methods such as smoking, infusions, and topicals adds to its complexities and the lack of conclusions on its impacts.
• Biological differences. The way alcohol and marijuana affects us varies due to our biological differences. For example, some of us may find it difficult to function without alcohol but don’t have any issues with misusing weed. On the other hand, some of us may not be as affected by alcohol but have a low tolerance for weed. These individual differences make it difficult to compare alcohol and weed at face value.

Despite all the different factors that can influence whether alcohol or marijuana is considered more harmful, the bottom line is that they’re both harmful.

Preventing Alcohol and Substance Misuse

Working to improve our relationship with alcohol and other substances isn’t just for those of us who are diagnosed with substance use disorder. Early intervention is one of the most effective tools in preventing misuse. There are several practices we can implement to develop a better relationship with alcohol and other harmful substances:

• Reach out for support. Having a strong support system is crucial in helping us reach our goals. Different types of social support help us in different areas of our journey and can be the difference between staying trapped in misuse and achieving a healthier lifestyle.
• Quit or cut back. Quitting or cutting back on harmful substances helps to minimize the effects they have on our body. While it’s easier said than done, mindful practices such as tracking consumption, finding alternatives, and setting limits can help us make effective changes. 
• Find a treatment that fits. Finding an effective treatment option can be a bit like finding the right therapist. It’s okay to try different treatment models as some options may work better for us than others. 
• Don’t wait until it’s an issue. It’s a common misconception that taking steps to develop a better relationship with alcohol or other substances is just for those of us with a diagnosis. However, mindful consumption practices are for anyone and will only be beneficial to our health!

While we may not have settled the debate as to whether alcohol or marijuana is worse, we’ve established that both are harmful — refocusing our attention on limiting the consumption of each.

The Final Verdict

We’ve explored just about every significant facet of the effects of alcohol and marijuana. Although it may not be the answer we’d hoped for, there is no definitive conclusion as to whether alcohol or marijuana is worse for our health. Current research and data suggest that greater harm is associated with alcohol consumption. However, external factors that influence these findings make it difficult to declare a verdict at this time. While we may not have a clear answer as to which substance is worse, we do know that both alcohol and marijuana have detrimental impacts on our health and well-being — suggesting that a winner for the worst may not be what’s important. The evidence tells us to limit harmful substances, both alcohol and marijuana.