General

• In 2008, research on marijuana’s risk to health commissioned by nonpartisan British think tank the Beckley Foundation found: “The public health impact of contemporary patterns of cannabis use are modest by comparison with those of other illicit drugs (such as the opioids) or with alcohol. In the former case this reflects the absence of fatal overdose risk from cannabis. In the latter case, it reflects the much lower risks of death from cannabis than alcohol-impaired driving, fewer adverse effects on health, lower rates of regular use to intoxication for cannabis use are cannabis than for alcohol, and the lower rate of persistence of cannabis use into older adulthood.”¹ 
• In 2007, a team of experts was formed to conduct an analysis on the relative harms of marijuana, alcohol, and other drugs for the esteemed British medical journal The Lancet. It concluded that marijuana posed far fewer health and safety risks than alcohol.² That same year, research commissioned by the Australian Institute of Health and Welfare arrived at the same conclusion. Specifically, it determined that alcohol was a significant contributor to death and responsible for 3.2% of the total burden of disease and injury in Australia, whereas marijuana was responsible for zero deaths and just 0.2% of the total burden of disease and injury.³ 
• In 2005, a University of Oxford meta-analysis on marijuana concluded that even long-term marijuana use does not cause “any lasting physical or mental harm. … Overall, by comparison with other drugs used mainly for ‘recreational’ purposes, cannabis could be rated to be a relatively safe drug.”⁴ 
• In 2002, an exhaustive review of marijuana and health performed by a special Canadian Senate committee found that “scientific evidence overwhelmingly indicates that cannabis is substantially less harmful than alcohol and should be treated not as a criminal issue but as a social and public health issue.”⁵ 
• In the mid 1990s, the World Health Organization commissioned a study on the health and societal consequences of marijuana compared to alcohol, nicotine, and opiates. It concluded: “Overall, most of these risks [associated with marijuana] are small to moderate in size. In aggregate, they are unlikely to produce public health problems comparable in scale to those currently produced by alcohol and tobacco. … On existing patterns of use, cannabis poses a much less serious public health problem than is currently posed by alcohol and tobacco in Western societies.”⁶ 
• On September 6, 1988, after hearing two years of testimony, Drug Enforcement Administration (DEA) chief administrative law judge Francis Young ruled: “In strict medical terms marijuana is far safer than many foods we commonly consume. For example, eating 10 raw potatoes can result in a toxic response. By comparison, it is physically impossible to eat enough marijuana to induce death. Marijuana, in its natural form, is one of the safest therapeutically active substances known to man.”⁷

Impact on the Consumer     

Alcohol is more addictive than marijuana. According to a 1998 report by Drs. Jack E. Henningfield of the National Institute on Drug Abuse (NIDA) and Neal L. Benowitz of the University of California at San Francisco, alcohol’s addiction potential is significantly greater than that of marijuana based on a number of indicators.⁸ A comprehensive federal study conducted by the National Academy of Sciences Institute of Medicine arrived at a similar conclusion: "Millions of Americans have tried marijuana, but most are not regular users [and] few marijuana users become dependent on it … [A]lthough [some] marijuana users develop dependence, they appear to be less likely to do so than users of other drugs (including alcohol and nicotine), and marijuana dependence appears to be less severe than dependence on other drugs."

According to the IOM report, 15% of alcohol users ever meet the clinical criteria for a diagnosis of marijuana "dependence" based on the Diagnostic Statistical Manual of Mental Disorders (3rd edition, revised), compared to 9% of marijuana users.⁹ Some experts believe significantly fewer than 9% of marijuana users are actually dependent because the DSM considers moderate, non-problematic marijuana use a "mental disorder," but goes out of its way to make the case that the moderate use of alcohol is not a disorder.¹⁰

Alcohol use is more damaging to the body than marijuana. The health-related costs associated with alcohol use far exceed those for marijuana use. Health-related costs for alcohol consumers are eight times greater than those for marijuana consumers, according to an assessment published in the British Columbia Mental Health and Addictions Journal. More specifically, the annual cost of alcohol consumption is $165 per user, compared to just $20 per user for marijuana.¹¹ According to a 2006 report published by the Scientific Research Society, alcohol is one of the most toxic drugs and using just 10 times the amount one would use to get the desired effect could lead to death. Marijuana is one of the least toxic drugs, with a fatal overdose near impossible.¹²

The U.S. Centers for Disease Control and Prevention (CDC) reports that more than 37,000 annual U.S. deaths are attributed to the health effects of alcohol use, including hundreds of alcohol overdose deaths. The CDC does not have a category for deaths caused by marijuana use, and a government-funded study conducted by researchers at the Kaiser Permanente HMO and published in the American Journal of Public Health found no association between marijuana use and premature death in otherwise healthy people.¹³

Whereas alcohol use is associated with a wide variety of cancers, including cancers of the esophagus, stomach, colon, lungs, pancreas, liver and prostate, marijuana use has not been conclusively associated with any form of cancer. According to the U.S. National Academy of Sciences Institute of Medicine, “There is no conclusive evidence that marijuana causes cancer in humans, including cancers usually related to tobacco use.”¹⁴ This was reaffirmed in 2006 by the largest case-controlled study on the respiratory effects of marijuana smoking which, found “no association at all” between marijuana smoking and an increased risk of developing lung cancer, even among subjects who reported smoking more than 22,000 joints over their lifetimes.^{15, 16}

Impact on Society     

Alcohol is more likely to contribute to acts of violence than marijuana. According to research published in the journal, Addictive Behaviors, "Alcohol is clearly the drug with the most evidence to support a direct intoxication-violence relationship," whereas, "Cannabis reduces the likelihood of violence during intoxication.”¹⁷

The U.S. Department of Health and Human Services estimates that 25% to 30% of violent crimes and 3% to 4% of property crimes in the U.S. are linked to the use of alcohol.¹⁸ According to a report from the U.S. Department of Justice, that translates to nearly 5,000,000 alcohol-related violent crimes per year.¹⁹ By contrast, the government does not even track violent acts specifically related to marijuana use, as the use of marijuana has not been associated with violence.

Alcohol is a particularly significant factor in the prevalence of domestic violence and sexual assault, whereas marijuana is not. This is not to say that alcohol causes these problems; rather, its use makes it more likely that an individual prone to such behavior will act on it. For example, investigators at the Research Institute on Addictions reported, “The use of alcohol… was associated with significant increases in the daily likelihood of male-to-female physical aggression,” whereas the use of marijuana was “not significantly associated with an increased likelihood of male partner violence.”^{20, 21} Specifically, the odds of abuse were eight times higher on days when men were drinking; the odds of severe abuse were 11 times higher. The Rape, Abuse and Incest National Network’ (RAINN) webpage dedicated to educating the public about “Drug Facilitated Sexual Assault” highlights alcohol as the "most commonly used chemical in crimes of sexual assault" and provides information on an array of other drugs that have been linked to sexual violence.²² The word "marijuana" does not appear anywhere on the page.

Alcohol is more likely to contribute to reckless behavior than marijuana. Research published in 2011 in the journal Alcoholism: Clinical & Experimental Research, concluded that an estimated 36% of hospitalized assaults and 21% of all injuries are attributable to alcohol use by the injured person.²³ Meanwhile, the American Journal of Emergency Medicine reported that lifetime use of marijuana is rarely associated with emergency room visits.²⁴ According to the British Advisory Council on the Misuse of Drugs: "Cannabis differs from alcohol … in one major respect. It does not seem to increase risk-taking behavior.”²⁵

¹ The Beckley Foundation, Global Cannabis Commission Report — Cannabis Policy: Moving Beyond Stalemate (Oxford, 2008).

² Nutt, et al., “Development of a Rational Scale to Assess the Harms of Drugs of Potential Misuse,” Lancet 369 (2007): 1047-53.

³ Australian Institute of Health and Welfare, The Burden of Disease and Injury in Australia, 2003 (Canberra: 2007).

⁴ Iverson, Leslie, “Long-term Effects of Exposure to Cannabis,” Current Opinions in Pharmcacology 5 (2005): 69–72.

⁵ Special Senate Committee on Illegal Drugs, Final Report: Cannabis: Our Position for a Canadian Public Policy (Ottawa, 2002).H

⁶ Hall, Wayne, A Comparative Appraisal of the Health and Psychological Consequences of Alcohol, Cannabis, Nicotine, and Opiate Use  (University of New South Wales: National Drug and Alcohol Research Centre, 1995).

⁷ “In the Matter of Marijuana Rescheduling Petition,” DEA Docket No. 86–22, September 6, 1988.

⁸ Hilts, Phillip, “Is Nicotine Addictive? It Depends Whose Criteria You Use,” The New York Times, August 2, 1994. Charts accessible online at http://www.drugsense.org/mcwilliams/www.marijuanamagazine.com/toc/addictiv.htm

⁹ U.S. National Academy of Sciences, Institute of Medicine, Marijuana and Medicine: Assessing the Science Base (Washington, D.C: National Academy Press, 1999).

¹⁰ Aggarwal, Sunil, "'9 Percent of Those Who Use Cannabis Become Dependent' Is Based on Drug War Diagnostics and Bad Science," The Huffington Post, January 29, 2014.

¹¹ G. Thomas and C. Davis, "Cannabis, Tobacco, and Alcohol Use in Canada: Comparing Risks of Harm and Costs to Society," Visions: British Columbia's Mental Health and Addictions Journal 5 (2009).

¹² Gable, Robert. “The Toxicity of Recreational Drugs: Alcohol is more lethal than many other commonly abused substances,” American Scientist 94 (3), May-June 2006: 206-208.

¹³ Sidney S., et al., “Marijuana Use and Mortality,” American Journal of Public Health 87(4), April 1997: 585-590.

¹⁴ Institute of Medicine, Marijuana and Medicine: Assessing the Science Base (Washington, D.C.: National Academy Press, 1999).

¹⁵ Hashibe, et al., “Marijuana Use and the Risk of Lung Cancer and Upper Aerodigestive Tract Cancer: Results of a Population-based Case-control Study,” Cancer Epidemiology Biomarkers and Prevention 15 (2006): 1829–34.

¹⁶ Mark Kaufman, “Study Finds No Cancer-Marijuana Connection,” Washington Post, May 26, 2006.

¹⁷ Hoaken, P. & Stewart, S. (2003). Drugs of abuse and the elicitation of human aggressive behavior. Addictive Behaviors 28, 1533-1554.

¹⁸ U.S. Department of Health and Human Services, 10th Special Report to the U.S. Congress on Alcohol and Health, June 2000.

¹⁹ U.S. Department of Justice Bureau of Justice Statistics, Alcohol and Crime: Data from 2002 to 2008. Available at http://www.bjs.gov/content/acf/apt1_crimes_by_type.cfm

²⁰ Fals-Stewart, F., Golden, J., & Schumacher, J. (2003). Intimate partner violence and substance use: A longitudinal day-to-day examination. Addictive Behaviors 28, 1555-1574.

²¹ Fals-Stewart, F., Golden, J., & Schumacher, J. (2003). Intimate partner violence and substance use: A longitudinal day-to-day examination. Addictive Behaviors 28, 1555-1574.

²² Rape, Abuse and Incest National Network. Drug Facilitated Sexual Violence. Retrieved August 21, 2014, from https://rainn.org/get-information/types-of-sexual-assault/drug-facilitated-assault

²³ Alcoholism: Clinical & Experimental Research, "Alcohol consumption greatly increases serious injury risk for heavy and moderate drinkers." ScienceDaily, October 14, 2011.

²⁴ Perron, B., Bohnert, A., Monsell, S., Vaughn, M., Epperson, M., & Howard, M., Patterns and correlates of drug-related ED visits: results from a national survey. American Journal of Emergency Medicine 29 (7), September 2011: 704-710.

²⁵ Advisory Council on the Misuse of Drugs, “The Classification of Cannabis Under the Misuse of Dugs Act 1971,” Submitted March 2002: 7.