The argument surfaces repeatedly in public debates: if society tolerates alcohol, why not cannabis? It’s a question that sounds reasonable until you examine what science actually tells us about marijuana vs alcohol.

According to Harvard Medical School professor Dr Bertha K. Madras, a psychobiologist with decades of research into addiction and neurobiology, this comparison rests on shaky ground. Whilst alcohol undoubtedly causes significant harm, treating marijuana and alcohol as interchangeable risks ignores crucial differences that matter for public health.

About 60% of US adults use alcohol sometime each year, whilst only 15% use cannabis. Yet the consequences tell a surprising story.

Medical Impacts: Comparison Of Marijuana And Alcohol

Take one of the most common comparisons: both substances can make people sick. Advocates often point to alcohol-induced vomiting as equivalent to what cannabis users experience. Dr Madras draws a sharp distinction.

Alcohol-related vomiting typically occurs as an acute toxic response. Your body reacting to excessive intake in a single episode. Once you stop drinking and recover, the symptoms resolve. Unpleasant, certainly, but temporary.

Cannabis hyperemesis syndrome tells a different story entirely. This chronic disorder develops after long-term heavy marijuana use and causes cyclical episodes of severe, relentless vomiting that can occur dozens of times daily. Patients endure significant abdominal pain, and standard anti-nausea medications often prove useless. Many resort to compulsive hot showers for temporary relief.

The condition leads to repeated emergency department visits, severe dehydration, and electrolyte disturbances. The only known effective treatment? Complete abstinence from cannabis. This isn’t an episodic response to overindulgence. It’s a chronic medical syndrome triggered by the drug itself.

Psychiatric Risks: Cannabis vs Alcohol

Another frequent claim suggests that alcohol-induced psychosis and cannabis-induced psychosis carry similar long-term risks. The research contradicts this assumption when examining marijuana vs alcohol effects on mental health.

Dr Madras points to longitudinal studies showing that people who experience psychosis following marijuana use face substantially higher rates of conversion to schizophrenia compared to those whose psychosis stems from alcohol. This isn’t a minor statistical blip. Individuals affected by cannabis-induced psychosis are far more likely to develop chronic psychotic disorders.

The observation isn’t new. As far back as the 19th century, the Indian Hemp Drugs Commission documented stronger associations between cannabis use and psychotic illness than with alcohol. Modern research has repeatedly confirmed this relationship, particularly amongst adolescents and young adults whose brains haven’t finished developing.

Acknowledging this difference doesn’t excuse alcohol’s psychiatric harms. It simply challenges the notion that marijuana and alcohol pose the same mental health risks.

Public Health Consequences Beyond Individual Choice

Some argue that even if cannabis carries unique harms, adults should remain free to make their own decisions. Dr Madras cautions that this framing misses the broader picture when considering marijuana vs alcohol policy.

“Why should marijuana be treated the same as alcohol, by adding it to our already long list of drug-related public health crises?” she asks.

The evidence suggests cannabis use is strongly associated with subsequent opioid misuse. Research links it to greater adverse effects on educational attainment compared to alcohol. High-potency cannabis products appear to carry higher addictive potential than alcoholic drinks. These outcomes don’t just affect individual users. They ripple through families, schools, healthcare systems, and entire communities.

The effects span generations too. When adults use marijuana, particularly parents, their children and young adults aged 12 to 30 become substantially more likely to use it themselves. The idea that adult use exists in isolation from youth exposure doesn’t hold up under scrutiny.

How Marijuana And Alcohol Differ Chemically

The cannabis products available today bear little resemblance to those from previous decades. Potency has increased dramatically, driven by what some describe as an addiction for profit industry. This matters because of how the substances work in the body.

Alcohol is water soluble. The effects of a standard drink last roughly an hour as your body processes and eliminates it. Cannabis, being fat soluble, behaves differently. The impacts of marijuana ingestion can persist for multiple hours, even days, as the compounds remain stored in body fat and gradually release.

Both drugs carry dangers, but the pharmacological differences mean the risks don’t map neatly onto each other.

The Road Safety Reality With Cannabis And Alcohol

Perhaps nowhere is the marijuana vs alcohol comparison more troubling than in traffic safety data. Despite cannabis use rates sitting at roughly 15% of adults compared to 60% for alcohol, marijuana impaired driving deaths and injuries are now rivalling alcohol related crash statistics.

Usage patterns tell part of the story. About one in ten alcohol users drink daily. Among regular cannabis users, that figure jumps to one in two using every day. The implications for impaired driving become clearer when you consider both the frequency of use and how long the effects persist.

What The Evidence Tells Us About Marijuana Vs Alcohol

Alcohol remains a serious public health problem deserving continued attention and intervention. Recognising cannabis carries distinct risks doesn’t minimise alcohol’s harms or suggest we should be complacent about alcohol policy.

It simply rejects the logic that one harmful substance justifies adding another to the mix.

As Dr Madras concludes, marijuana should be treated differently from alcohol “because it is different, in its clinical syndromes, psychiatric risks, developmental consequences, and intergenerational effects.”

Effective public health policy depends on recognising those differences rather than papering over them with false equivalence. The question isn’t whether society already tolerates one harmful drug. It’s whether evidence supports treating two different substances as though they pose the same risks.

The science suggests they don’t.

(Source: WRD News)

In a revelation from her recent memoir published last month, Nobel Peace Prize winner Malala Yousafzai shared how cannabis triggered trauma from the 2012 Taliban attack that nearly killed her.

A University Experiment Gone Wrong

Whilst studying at Oxford University, the shooting survivor tried smoking cannabis from a bong with friends in a campus summerhouse. What seemed like a harmless student experience quickly turned into a nightmare.

“I knew this feeling, the terror of being trapped inside my body. This had happened before,” Malala writes in her memoir Finding My Way.

How Cannabis Triggered Trauma She Thought She’d Forgotten

After using the bong, Malala experienced severe physical and psychological reactions. She lost the ability to walk, her muscles locked up, and vivid flashbacks to the shooting began flooding her mind – memories she thought her brain had erased.

The drug use unlocked traumatic memories from her seven-day coma following the Taliban attack. Images replayed relentlessly: her school bus, a man with a gun, blood everywhere, strangers carrying her body through crowded streets.

“There was no escape, no place to hide from my own mind,” she recalled.

The Dangerous Reality of Drug-Induced Trauma

Malala’s friend carried her back to the dormitory, where she spent hours on the bathroom floor, vomiting, screaming, and shaking. She feared closing her eyes, worried the nightmares would trap her in an endless loop of terror.

“If you fall asleep, you will die!” she remembered telling herself, staying awake through the night and into the morning.

The experience revealed a crucial truth: substance use can trigger or worsen serious mental health episodes, particularly in individuals with trauma histories. Cannabis triggered trauma that Malala’s brain had protectively suppressed for years, violently unleashing what she thought she’d forgotten.

A Sobering Warning About Cannabis and Trauma

Malala’s experience demonstrates that cannabis is not the harmless substance many believe it to be. For individuals with underlying trauma, anxiety, or other mental health vulnerabilities, drug use can unleash devastating psychological consequences.

Her friend’s words haunted her afterwards: “It stays in your blood.”

This powerful account serves as a stark reminder that substance use – even experimental or recreational – can trigger unpredictable and severe reactions, particularly in those who have experienced trauma. Cannabis triggered trauma that had lain buried for years, proving that drug use can unlock dangerous psychological responses.

Read the full extract from Malala’s memoir here: WRD NEWS

The New ‘Reefer Madness’?

“Cannabis-induced psychosis is not always ‘denial.’  In many cases, it may well be anosognosia, a brain condition where the person truly cannot recognize that they are ill...To them, the delusions feel real.”  Elle Constantine

To the observer, it may look like denial or defiance. It may not be what can all too often be hedonic recalcitrance perse but actually the manifestation of a condition known as anosognosia. 

Now, let’s be clear from the outset of this read, that this is not just another ‘useful tool’ to avoid accountability for the bio-behavioural disorder commonly referred to as addiction due to the utterly unwise engagement with psychotropic toxins, but it is a ‘flag’ worth having on your diagnostic radar.

I hope I haven’t lost any of you yet – Don’t bail, keep reading!

Walking with a person suffering psychosis or even one of the various forms of dementia, is incredibly difficult and taxing. (This author has very personal experience with this decline) It remains important (and self-care and good personal supports needed for the carer) to maintain a calm demeanour and avoid adversarial, seemingly accusatory or even open ‘corrective’ tones, especially in the dementia dealing context.  Building trust will take time and a consistent affirming of your desire to understand (not agree with the delusions) is part of that. Learning of and working for prevention of a growing dysfunction is also important in assisting you in helping people potentially ‘get’ what they are not currently seeing. 

The following are some of the signs of Anosognosia in Psychosis:

• Insists nothing is wrong even when symptoms are clear to others.
• Rejects treatment or medication because they don’t believe they’re ill.
• Explains away delusions or hallucinations as “real” experiences.
• Gets angry or defensive when told they need help.
• Stops follow-up care after a hospital stay, claiming they’re “fine now.”
• Blames others for problems caused by their illness (e.g., paranoia, loss of work, family conflict).
• Lives with complete conviction inside their false beliefs, unable to recognize them as symptoms.

Anosognosia is a neuropsychiatric condition characterized by a person's lack of awareness or denial of their neurological or psychiatric deficits, often despite clear evidence of impairment. (1)  

Where Did This Come From? Anosognosia means “without knowledge of disease.” The term was introduced in 1914 by the French neurologist Joseph Babinski, who observed that some stroke patients lacked awareness of their paralysis (hemiplegia). (2)

Main Affected Populations: Anosognosia most commonly occurs in individuals with:

• Stroke (especially right hemisphere lesions)
• Traumatic brain injury
• Dementia (notably Alzheimer’s disease)
• Schizophrenia (also drug induced Schizo-affective states)
• Bipolar disorder (3)
• Substance Use Disorders (growing)

Whilst stats on substance users experiencing this are not as readily available, yet it’s important to note that up to 80% of Alzheimer’s patients, around 50–98% of those with schizophrenia, and 40–50% of those with bipolar disorder exhibit anosognosia. One can reasonably speculate that growing numbers of substance users will be experiencing this, as the anecdata below will affirm. (4)  

Symptoms and Presentation: Individuals with anosognosia may:

• Fail to recognize they have a medical or mental health condition
• Not perceive the symptoms they experience
• Be unable to link symptoms to their condition
• Deny the severity or need for treatment (5)

Possible examples of these symptomatic realities are never more clearly manifest than with so called ‘medicinal cannabis’ users who self-medicate with non-pharmaceutical grade offerings.

One such manifestation that goes beyond mere denial or recalcitrant conduct may be found in Cannabis Hyperemesis presentations in areas where cannabis is both legal for ‘recreational’ and ‘medicinal’ use

The following is a synoptic summary of just one Emergency Doctor from Colorado (Ground Zero for cannabis legalisation in the USA). Note how corrupted pro-cannabis bureaucracy and the accompanying of exhaustion of trying to confront the irrationality, not just denial, that led to way UNDER reporting and recording of Cannabis Hyperemesis Syndrome (CHS). 

The following in their own words.

With regards to CHS (Cannabis Hyperemesis Syndrome), we saw it EVERY SINGLE DAY.  

Only ONCE did I have a patient and his girlfriend recognize and accept that it might be the weed.  I had one guy - who had been to the ER every day for a week with ‘scromiting’ [Screaming and vomiting simultaneously] and his 6 previous work ups (including blood work, CT, ultrasound etc) were all negative except that persistently + urine drug screen for THC [tetrahydrocannabinol].  I suggested it might be CHS and his father (who was probably 60) took a swing at me yelling “it’s not the pot!  I’ve smoked pot all my life and look at me!” (BTW, he was not the picture of health)

We had a girl who started with CHS at 15. She presented so frequently to the ED that her parents stopped going to the ER with her.  Just sent by ambulance, get the vomiting controlled, and send her home by whoever would pick her up.  Sadly, after 2 years of this, I think she graduated to other drugs.  She obviously wasn’t in school.  No education, no skills, just an addiction and vomiting.  For her 17th year, I think she had over 70 visits to the ER.  And no, never acknowledged that it was the pot.

I had another guy 63 - also having CHS.  He also refused to believe it was the pot.  

So, honestly, only one person that I can recall admitted (at least to me while in the ED) that it might actually be the pot.

And we literally had at least one a day. 

(Veteran E. R Medicine Doctor and Cannabis trained medical expert)

The lack of insight may be selective, affecting awareness of some deficits but not others. For example, someone may realize they have language difficulties but not recognize their memory loss. (6)

Causes and Pathophysiology: Anosognosia often results from damage to the brain’s right parietal lobe but can also occur with lesions in the temporoparietal area, thalamus, basal ganglia, or prefrontal cortex. (7) Substance use, and particularly illicit and novel psychoactive substances, will mess with brains and these regions of the brain, potentially adding to the development of this condition beyond mere denial.

Key factors include:

• Disruption of brain regions involved in self-monitoring and error awareness (e.g., prefrontal and insular cortex, default mode network)
• Impaired ability to update self-image or incorporate new information about one’s deficits ²

It can also arise with psychiatric disorders, where functional (rather than structural) brain changes affect insight.(8)

Clinical Assessment and Diagnosis: Diagnosis relies primarily on clinical interviews and observation. Physicians assess whether patients recognize, understand, and respond appropriately to their own deficits. (9)  However, as we have seen with the previously mentioned cannabis hyperemesis issue, it can be a tough ask and that is why gathering data on this is slow, but still vital. 

Impact and Importance: Anosognosia can hinder rehabilitation, treatment adherence, and safety. In conditions like Alzheimer’s disease, it is linked to faster progression, greater caregiver burden, and increased risk of dangerous behaviours. Concerningly, this applies very much to recovery efforts with substance users as well. (10)

Correctly identifying, understanding and properly managing anosognosia, especially in the substance using demographic is vital for effective care planning, patient support and ‘substance use exiting’ recovery.

Shane Varcoe - Executive Director, Dalgarno Institute 

Further Reading:  Educate Before Eight

Classified briefings and explosive Congressional testimony reveal the shocking extent to which Chinese cannabis criminal networks have infiltrated American soil, ultimately transforming what politicians promised would be harmless marijuana legalisation into a sophisticated weapon of mass social destruction.

What Congressional testimony has uncovered will shock even seasoned observers of organised crime: specifically, a meticulously orchestrated invasion that exploits America’s drug liberalisation policies to fund human trafficking, finance deadly fentanyl operations, and potentially compromise national security infrastructure.

THE SMOKING GUN: $153 BILLION IN MISSING CANNABIS

Evidence proves damning and undeniable. Furthermore, internal documents examined show that in Oklahoma alone, a single American state, Chinese cannabis criminal networks have actively created what can only be described as a parallel economy worth ten times the state’s entire government budget.

The numbers stagger beyond comprehension: Between March 2024 and March 2025, licensed grow sites reported 87.2 million cannabis plants. However, dispensaries sold merely 1.6 million pounds of marijuana.

Subsequently, Donnie Anderson, Director of the Oklahoma Bureau of Narcotics, delivered the devastating calculation to a hushed Congressional hearing room: “Over 85 million plants are unaccounted for, representing an estimated $153 billion in missing product and proceeds.”

To put this criminal enterprise in perspective: Oklahoma’s entire state budget amounts to just $13 billion. Consequently, the illegal cannabis trade controlled by Chinese cannabis criminal networks generates ten times what it costs to run an entire American state.

CALIFORNIA PRECEDENT: THE 100-HOUSE SEIZURE OPERATION

(Complete Article WRD News)

California Cannabis Legalisation Failure: Black Market Volumes Surge Despite Legal Dispensaries: New data reveals California cannabis legalisation failure as black market volumes increase by 20% whilst consumption soars among heavy users - A comprehensive report on California’s cannabis market has delivered a damning verdict on the state’s cannabis legalisation failure, revealing that the promised elimination of criminal drug networks has spectacularly failed to materialise. Instead, the data shows that black market volumes have actually increased whilst overall consumption has rocketed by 90%. 

Consumption Explosion Undermines Public Health Claims

The data reveals another concerning aspect of the California cannabis legalisation failure that undermines public health arguments. The 90% increase in consumption since 2017 has been “primarily driven by an increase in heavy cannabis users,” according to the report’s findings.

This contradicts assurances from legalisation proponents that regulated markets would promote responsible use. Instead, the evidence suggests that legal availability has enabled existing users to dramatically increase their consumption levels, with obvious implications for dependency and associated health harms.

The report notes that California’s per capita consumption remains “still lower than in states that legalised recreational cannabis before California,” suggesting that further increases may be inevitable as this policy continues to unfold.

Economic Incentives Favour Criminal Networks

Whilst criminal organisations face some pricing pressure from legal competition, the California cannabis legalisation failure report suggests they may actually benefit from reduced operational costs. Operating “from within the cover of a wider legal market” appears to have made distribution and production easier for illegal suppliers.

The document notes that wholesale prices have declined substantially, which from a public health perspective represents a particularly troubling development, as “cheaper drug drives up use & harms.”

(And we want to bring this disaster into Australia!) (Source: WRD News)