Scientists studying the “California Sober” trend, which suggests replacing alcohol consumption with cannabis can help manage alcohol addiction, have found that THC—the plant’s psychoactive component—does temporarily reduce alcohol cravings and consumption in heavy drinkers.
The research team behind the findings said their study does not address how cannabis use may affect long-term alcohol consumption, arguing that problematic alcohol use may not benefit from replacement with potentially addictive cannabis use instead. However, the team also said they are planning future experiments to investigate the effects of cannabis on long-term alcohol consumption to determine the actual viability of the “California Sober” approach.
“What we found was consistent with this idea of the substitution effect popularized by the California sober trend,” explained study author Jane Metrik, a Brown University professor of behavioral and social sciences and of psychiatry and human behavior. “Instead of seeing cannabis increase craving and drinking, we saw the opposite. Cannabis reduced the urge for alcohol in the moment, lowered how much alcohol people consumed over a two-hour period, and even delayed when they started drinking once the alcohol was available.”
California Sober Trend Replaces Alcohol with Cannabis
According to a statement detailing the Brown University team’s research, excessive drinking is the third leading cause of preventable death in the United States. Along with early death, the authors note that collateral effects of excessive alcohol consumption can include lost labor and lower worker performance, property damage, automotive crashes, and injuries to third parties, resulting in an estimated $249 billion a year in lost productivity and added costs.
In recent years, select Hollywood personalities and social media influencers have begun to champion the idea of replacing alcohol consumption with purportedly less damaging cannabis use.
Known colloquially as “California Sober,” the trend has drawn the attention of scientists and healthcare professionals hoping to judge the actual effectiveness of the approach, since about 60% of people with a preexisting cannabis use disorder also meet the general criteria for alcohol use disorder.
While previous studies have used surveys to assess the effectiveness of a California Sober approach, the Brown University team designed laboratory-based experiments to improve the data.
Results Show Temporary Alcohol Reduction Benefit
First, the researchers enlisted 157 adult volunteers between 21 and 44 years of age who reported heavy drinking and cannabis use at least two times per week. Once selected, each volunteer participated in three laboratory sessions where they smoked cannabis cigarettes with higher and lower levels of THC, or a placebo.
Metrik, who is also affiliated with Brown’s School of Public Health and Warren Alpert Medical School, noted that placebo-controlled trials where neither researchers nor subjects know who is receiving the actual drug versus a placebo, “are considered the gold standard for establishing what drives behavior.”
After each study participant smoked cannabis, they were presented with a well-established drinking behavior test designed to be performed in a laboratory environment designed to resemble a bar, called the Alcohol Choice Task. The test’s first step asks participants to choose between their preferred alcoholic beverage, presented on a tray, or a small cash payment. The team said the cash payments were deliberately kept small to provide a “subtle” alternative to the drink without “meaningfully” swaying each participant’s choice.
Each Alcohol Choice Task session lasted two hours, during which participants were provided enough alcoholic drinks to raise their blood alcohol level to around 0.10%. For comparison, the legal limit for intoxicated driving in many states is 0.08%, meaning participants were offered sufficient alcoholic drinks to exceed the legal intoxication limit.
When analyzing their results, the Brown University team found that participants who smoked cannabis with either higher or lower concentrations of THC drank less alcohol compared to participants who smoked the THC-free placebo. The team also found that the concentration of THC affected the alcohol reduction effect of cannabis.
For example, participants who smoked the lower concentration cannabis with an average dose of 3.1% THC consumed 19% less alcohol than the placebo group. When participants smoked the higher concentration cannabis that contained an average THC dose of 7.2%, their alcohol consumption was reduced by 27%. The higher dose of THC also resulted in a longer delay time before participants took their first drink of alcohol.
Long-term Viability of Cannabis to Reduce Alcohol Consumption Still Unknown
When interviewed by the researchers about their experience, participants who smoked cannabis with THC reported less immediate urges to drink compared to smoking the placebo cigarette. However, the team did not measure whether this effect was long-lasting or temporary.
“We saw that cannabis reduces the urge in the moment,” Metrik said. “What we don’t know from this study is ‘what is the long-term effect?’”
Although the study identified the possible short-term viability of the California Sober approach, the Brown team said it does not necessarily mean that cannabis should be used as a “therapeutic” substitute for alcohol. They also noted that cannabis has been shown in other studies to be addictive, meaning that California Sober could end up replacing one problematic behavior with another.
“The risk that using cannabis may actually increase drinking is higher for people who tend to combine cannabis and alcohol to enhance the effects of each or if they use the substances together in social settings,” they explain.
Because the work was performed in the lab, the research team said it remains unclear if the results would “hold up” in a real-world setting. The team also noted that such social drinking situations may also include a higher-potency cannabis than the two strains used in the study.
Moving forward, Metrik and colleagues are already conducting a new clinical trial funded by the National Institutes of Health designed to measure the effects of concurrent alcohol and cannabis use as opposed to the subsequent use in the initial trials. The new study is also designed to evaluate how the cannabis plant’s other cannabinoids, such as CBD, may affect alcohol consumption in both laboratory and real-world settings.
Combined with their recent work, the team hopes that their new study will shed more light on the viability of the California Sober approach. Until then, the team cautions that simply replacing alcohol with cannabis has not been proven as a long-term or healthy approach to alcohol use disorder, and it is up to them to help discover the best methods.
“Our job as researchers is to continue to answer these questions,” Metrik said. “We can’t tell anyone yet, ‘you should use cannabis as a substitute for problematic or heavy drinking.’”
The study “Acute Effects of Cannabis on Alcohol Craving and Consumption: A Randomized Controlled Crossover Trial” was published in the American Journal of Psychiatry.
Christopher Plain is a Science Fiction and Fantasy novelist and Head Science Writer at The Debrief. Follow and connect with him on X, learn about his books at plainfiction.com, or email him directly at christopher@thedebrief.org.