Have you been following the noise about decriminalizing and legalizing marijuana in the United States? How can anyone not? Every day, at least one new news report is out there and up for fiery debate. Proponents of pot, whether for medicinal or recreational use, say that it’s much less hazardous, health-wise, than alcohol and might even be good for you.

But is this true? We all know that heavy drinking is bad for you from all angles, but is it less dangerous to get high on pot than to, say, have a couple glasses of wine every day? How does each substance affect your body?

This has clearly become an emotional debate when what it should be is a scientific debate. We’re all entitled to our opinions on marijuana (and alcohol)…but they should be based on facts. To get a firm handle on those facts, I contacted J. Wesley Boyd, MD, PhD, coauthor of Almost Addicted: Is My (or My Loved One’s) Drug Use a Problem? and his take on the matter might surprise you…


We all know that alcohol lowers your inhibitions and can mess up your judgment. Just remember what went on at the last big holiday party or group night out. Who was sloshed, and what kind of embarrassment did that person make of him or herself? Drink enough alcohol and your spatial reasoning falters along with your balance (from where we get the term falling down drunk). Hard-core drinkers can have “blackouts,” periods where they can’t remember where they were, what they did or what they said.

Pot, meanwhile, makes the brain release dopamine, the body’s “feel good” hormone, which is why users report feeling euphoric, or “high,” Dr. Boyd said. But it too can undermine your judgment and focus and affect your coordination and balance. Plus, although pot temporarily raises dopamine levels, long-term use makes the brain produce less dopamine—which, in part, explains the persistent lethargy and addictive behavior of some frequent users. What’s more, marijuana has an impact on the hippocampus, the part of the brain where memories are stored. Studies have shown that some regular pot smokers have trouble forming new memories. Some users also set themselves up for quirky mood changes and psychiatric risks. Just like heavy drinkers, they may feel anxious and depressed when they’re not high.

Marijuana can even set off psychotic episodes in some people. Decades worth of research shows that early and heavy pot use can put you at higher risk for psychosis, including schizophrenia, later in life. What’s more, acute episodes of psychosis can occur immediately after using pot, can last even after the pot has left your body and even be so bad and lasting that medical help is needed.

What about your heart and liver? Everyone knows that heavy drinking can cause severe liver damage—cirrhosis, in which the liver gets so fibrous and scarred up that it stops working. Alcohol can hurt your heart, too, causing it to become enlarged, leading to heart failure and heart attack.

Whether marijuana can damage your liver is currently under debate among medical researchers, with some saying that it can aggravate fatty liver disease (which leads to liver fibrosis and then cirrhosis), especially if you already have hepatitis, and others saying that even daily marijuana use has no impact on the liver.

Although the jury is still out on what pot might do to your liver, there’s no doubt that it can damage your heart, said Dr. Boyd. When you inhale marijuana, your heart rate speeds up to such a rate that some researchers claim that, within the first hour of smoking it, your chances of having a heart attack are five times higher than that of a nonuser. Even though there are no definitive studies on whether smoking marijuana causes lung cancer, pot smoke does have some of the same harmful substances as cigarette smoke. And ironically, although marijuana is an effective treatment for nausea in, for example, chemotherapy patients, marijuana causes nausea and vomiting in some users.


Although some pot smokers—like drinkers—say that the stuff helps them sleep better, the truth is that both pot and alcohol interrupt sleep, preventing users from getting to the deepest stages of sleep that allow them to wake up feeling as rested as they should. Sure, both substances can make you fall asleep faster or more easily, but many users find themselves awake and edgy or in a light sleep later in the night, lacking restorative sleep, which makes them feel tired the next day.


We all know about the effects of drinking and driving, but what about driving while high on pot? Fact is, we just don’t know yet. No major studies paralleling the kind we have on drunk driving have yet to be done. What is known is that marijuana affects depth perception and, although this and other short-term effects may lessen after three or four hours, marijuana lingers in your body for up to a month after using it. Plus, the heavier and more frequently you use it, the more of it is lingering in your body. This means that you may actually be “under the influence” for several days to weeks after the high wears off, impacting your driving and other coordination skills.


Some people who use either alcohol or marijuana for a high need ever-increasing amounts to get where they want to be. They are addicts. I’d guess that almost everyone knows at least one active alcoholic, so I don’t have to describe how sad those stories can be. In case you don’t know any addicted pot users, meet one of Dr. Boyd’s. “I have a patient who was in his late 30s when he first visited me. He had a job in construction and smoked marijuana before work, on his break, and in the evening. He told me, ‘Marijuana is my girlfriend, my hobby and my main job. I have no life.’ I have worked with this patient for six years, and he has not been able to fully kick his habit.”

Besides interfering with work and relationships, addiction to either alcohol or pot runs users down the rabbit hole of all the health problems we’ve already discussed. And when a heavy-duty alcoholic “goes dry” and attempts to stop drinking, the physical reaction can be overwhelming—delirium tremens, or the “DTs,” can set in, with shaking, confusion, hallucinations, nightmares and high anxiety. The tremors, racing heartbeat (tachycardia) and seizures that occur during the DTs can even be fatal.


The moral of the story is pretty simple—both substances can be ruinous to your lifestyle if overused. And certainly, like with food sensitivities and allergens, if you have a bad reaction to pot or alcohol, don’t feel pressured to try it again. You may need to avoid it. How much pot do you have to use and for how long before damaging health effects occur? This varies from person to person. In short, enjoy what life has to offer in moderation and within the limits that are best for you. I agree with Dr. Boyd when he says, “Just as people are able to drink responsibly, marijuana smokers can do that as well. Users of alcohol and marijuana should all aim for moderation.”