Research Poster 36 x 60 - A

1
Substance use among medical cannabis users
Substituting cannabis for alcohol and other
substances
 
P. Lucas1, K. Crosby2, Z. Walsh2 R. Callaway, L.
Belle-Isle1, R. Capler2, S. Holtzman2, B. Kay3
1. Centre for Addictions Research of British
Columbia, 2. University of British Columbia. 3.
Green Cannapy Research and Development, Kelowna,
BC
INTRODUCTION
RESULTS
RESULTS
ABSTRACT
Psychoactive/pharmacological substitution occurs
when the availability of one substance affects
the use of another (Hursh et al., 2005). Among
cocaine-dependent patients receiving addictions
treatment, moderate cannabis use was associated
with higher retention rates than cannabis
abstainers, suggesting cannabis may provide an
effective substitute (Aharonovich et al.,
2006). In a sample of over 400 medical cannabis
(MC) patients, approximately 75 report
substituting cannabis for another substance
(e.g., alcohol, illicit drugs, prescription
drugs Lucas et al., 2012). Approximately 40-50
MC patients substitute cannabis for alcohol, and
25-50 substitute cannabis for illegal drugs
(Lucas et al., 2012 Reiman, 2009) It appears
that cannabis may provide an alternative for
potentially more harmful substances, and as such
may have a place in harm-reduction strategy.

• 55.7 (N262) report using cannabis as a
  substitute for alcohol and/or illegal drugs
• Past/current treatment for substance use reported
  by 15.7 (N74)
• Patients with treatment histories were more
  likely to substitute cannabis for illegal drugs
  than those without treatment history (X2 33.55,
  p lt .01)
• Patients with no treatment history were more
  likely to substitute cannabis for alcohol (X2
  6.00, p lt .05)
• Rates of substitution were consistent across
  primary illness, with the exception that MS
  patients reported significantly lower rates of
  substitution (X2 5.68, p lt .05)

This study examined the use of cannabis as a
substitute for alcohol and other psychoactive
drugs among medical cannabis users with and
without histories of substance use treatment. The
aim of this study was to examine the stability of
the substitution effect with regard to treatment
history among medical cannabis users.

DISCUSSION

• Findings indicate that cannabis use is perceived
  to substitute for alcohol and other drugs among
  users of cannabis for therapeutic purposes
• Clinical implications for those undergoing
  treatment for problematic alcohol and illegal
  drug use
• Findings that substitution was generally
  consistent across illnesses and among those with
  and without treatment histories suggests good
  generalizability of substitution effects
• Highlights importance of research on interaction
  of cannabis use with other psychoactive substances

CONTACT
METHODS
Zach Walsh University of British
Columbia zachary.walsh_at_ubc.ca
This study is a part of the larger Cannabis
Access for Medical Purposes Survey (CAMPS), the
largest and most comprehensive polling of
Canadian medical cannabis patients to
date. Participants 470 self-selected Canadian
adults who endorsed current medical cannabis
use. Measures Participant completed online or
in-person survey that queried attitudes and
behaviors associated with medical cannabis use,
substance use treatment history, and substitution
of cannabis for alcohol and/or illicit drugs.

REFERENCES
FINANCIAL SUPPORT
Aharonovich, E., Garawi, F., Bisage, A., Brooks,
D., Raby, W. N., Rubin, E., Nunes, E. V.,
Levin, F. R. (2006). Concurrent cannabis use
during treatment for comorbid ADHD and cocaine
dependence Effects on outcome. The American
Journal of Drug and Alcohol Abuse, 32, 629-635.
Hursh, S. R., Galuska, C. M., Winger, G.,
Woods, J. H. (2005). The economics of drug abuse
A quantitative assessment of drug demand.
Molecular Interventions, 5, 20-28. Lucas, P.,
Reiman, A., Earleywine, M., McGowan, S. K.,
Oleson, M., Coward, M. P., Thomas, B. (2012).
Cannabis as a substitute for alcohol and other
drugs A dispensary-based survey of substitution
effect in Canadian medical cannabis patients.
Addiction Research and Theory, 1-8. Reiman, A.
(2009). Cannabis as a substitute for alcohol and
other drugs. Harm Reduction Jounral, 6(35).
This research was supported by a grant to Dr.
Zach Walsh from the University of British
Columbia Institute for Healthy Living and Chronic
Disease Prevention