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Cannabis vs Alcohol

Debunking Myths and Understanding the Facts: Cannabis vs Alcohol in the UK

Cannabis vs Alcohol



Cannabis and alcohol are two of the most commonly used recreational substances in the UK. This article aims to provide an overview of their legal status, public perception, and purpose for comparison. Understanding the facts around these substances will allow for more informed personal and policy decisions.

Overview of cannabis and alcohol in the UK

Cannabis is the most widely used illegal drug in the UK, with nearly 7.5% of adults aged 16-59 having used it in the last year. Alcohol consumption is more widespread, with roughly 80% of adults drinking alcohol. Both substances have complex legal statuses - alcohol is legal for adult use while cannabis is a Class B banned substance. Public perceptions also differ greatly.

Alcohol is fully legal for adults over 18 in the UK and widely socially acceptable. Cannabis meanwhile remains illegal, classified as a Class B drug under the 1971 Misuse of Drugs Act with penalties for unauthorised possession or supply. Public views on cannabis legalisation are mixed - around 50% support reforms while over 30% oppose legalisation.

Purpose of the article: comparing effects, risks, and benefits

This article will analyse key effects, health impacts both short and long-term, dependency and addiction potential, mortality rates, and the safety profiles of alcohol versus cannabis. Focus will be given to THC, CBD, and their distinct properties and interactions with the body. By weighing the evidence from scientific studies and health organisations, this aims to be a fact-based comparison of these controversial substances.

Cannabis is currently illegal in the UK. It is classified as a Class B drug under the Misuse of Drugs Act 1971. This means that possession, supply, production, and trafficking of cannabis carry penalties of up to 5 years in prison, an unlimited fine, or both.

In contrast, alcohol is legal for those over 18 to purchase and consume privately under the Licensing Act 2003. However, laws prohibit the sale of alcohol to intoxicated individuals and drinking in public spaces.

Alcohol legality versus cannabis classification as a class B substance

While alcohol is widely available for legal purchase and consumption in licensed establishments, cannabis remains entirely illegal. The classification of cannabis as a Class B substance under the Misuse of Drugs Act criminalizes activities related to the drug with no legal exception.

Campaign groups like Cannabis Law Reform (CLEAR) continue to lobby for legalization or at least decriminalization of cannabis. They argue that the harms associated with alcohol outweigh those of cannabis, yet the legal status of the two drugs remains starkly opposed.

Misuse of Drugs Act 1971 implications

As a Class B substance, penalties for cannabis possession include:

  • Up to 5 years in prison for possession
  • Up to 14 years in prison for supply or production
  • An unlimited fine

Police can issue warnings or on-the-spot fines for minor cannabis possession. However, the lack of legal regulation around cannabis compared to alcohol means any activity involving the drug risks criminal charges.

Understanding Different Drug Types

- Categories of drugs: depressants, stimulants, hallucinogens, opiates

Alcohol acts as central nervous system depressant, reducing neural activity and impairing coordination. Cannabis contains THC which has psychoactive, hallucinogenic properties as well as CBD which does not produce a "high".

- Alcohol and cannabis characteristics

While both may have intoxicating effects, alcohol has a higher addiction potential and toxicity than cannabis compounds like CBD. However, the legal restrictions around cannabis based on its classification limit research into its long-term effects.

Alcohol's Impact on the Body

Alcohol is processed in the body primarily through the liver. As it is broken down, it releases energy and produces potentially harmful byproducts that can damage cells and organs over time. In the short-term, alcohol can provide feelings of relaxation and euphoria, but it also impairs coordination, judgment, and decision-making. It acts as a depressant on the central nervous system, slowing down brain activity. With higher blood alcohol concentration levels, alcohol can lead to nausea, vomiting, blackouts, and even death from alcohol poisoning.

How alcohol is processed

When alcohol is consumed, it travels through the digestive system to the small intestine where it is rapidly absorbed into the bloodstream. From there, it is carried to the liver which breaks down the ethanol present in alcoholic drinks. The liver can process about one standard drink per hour. If more alcohol enters the system than the liver can metabolize, intoxication occurs as the alcohol circulates throughout the body and brain.

Short-term pros and cons

In moderation, alcohol may provide some health benefits like better heart health and reduced risk of diabetes. However, even low levels can impair coordination and decision-making as it acts as a central nervous system depressant. At higher levels, alcohol can cause blurred vision, slurred speech, loss of balance, and emotional volatility. Binge drinking and intoxication dramatically increase the risks of accidents, injuries, alcohol poisoning, risky behavior, and long-term health effects.

Long-term health risks

Over years of sustained drinking, alcohol takes a major toll on physical and mental health. It can lead to liver disease like fibrosis, cirrhosis, and alcoholic hepatitis. The risk of cancer also increases, especially mouth, throat, liver, and breast cancer. Other long-term effects include high blood pressure, heart disease, stroke, pancreatitis, nerve damage, sexual dysfunction, and weakened immune system. Alcohol also causes changes in mood, behavior, and brain structure, leading to depression, anxiety, and loss of impulse control.

NHS guidelines on alcohol consumption

The UK's National Health Service recommends not regularly drinking more than 14 units of alcohol per week. This equates to 6 pints of average strength beer or 6 medium glasses of wine. Drinking should also be spread out over the week rather than bingeing. For special occasions, it suggests avoiding more than 6 units in one session. Children and those with certain medical conditions may need to abstain completely. Following these guidelines can help reduce both short and long-term health risks.

THC and Its Effects

THC, or tetrahydrocannabinol, is the primary psychoactive compound found in cannabis. When consumed, THC binds to cannabinoid receptors in the brain and central nervous system, producing a range of effects.

Immediate and Long-Term Effects on the Body

In the short-term, THC can cause changes in mood, altered senses of sight, sound and time, fatigue, hunger, reduced coordination, and difficulty with memory and problem-solving. The intoxicating effects typically last around 2-3 hours when cannabis is smoked or vaporized.

With regular, heavy use over a long period of time, THC may impact brain development in adolescents and trigger or exacerbate some mental health conditions like schizophrenia. However, moderate cannabis use in adults is not typically associated with long-term cognitive impairments.

Interaction with the Endocannabinoid System

The endocannabinoid system helps regulate many essential bodily functions like appetite, pain sensation, mood, and memory. It produces its own cannabinoid chemicals called endocannabinoids.

THC closely mimics the structure and effects of the body's natural endocannabinoids. By binding to cannabinoid receptors in the brain and nervous system, THC can disrupt the careful balance maintained by the endocannabinoid system, leading to the various effects of being "high."

Further research is still needed, but manipulating the endocannabinoid system with compounds like THC may hold therapeutic potential for treating certain conditions.

CBD Benefits and Considerations

CBD, or cannabidiol, is a non-intoxicating compound found in the cannabis plant. Unlike THC, CBD does not produce a "high" effect. Instead, research shows CBD interacts with the body's endocannabinoid system, which regulates various functions like sleep, mood, pain, appetite, and more.

Non-intoxicating properties of CBD

The key benefit of CBD is that it delivers therapeutic effects without causing intoxication. This makes CBD an appealing option for those looking for the potential benefits of cannabis without the high or other side effects sometimes associated with THC.

Interaction with the endocannabinoid system

When ingested, CBD interacts with the body's endocannabinoid system, which regulates vital functions. Research shows CBD can positively modulate the endocannabinoid system, potentially delivering benefits like pain relief, reduced inflammation, improved sleep, and more.

Potential side effects and FSA recommendations

While generally well tolerated, CBD may cause side effects like diarrhea, changes in appetite, fatigue, and interactions with other medications. The UK Food Standards Agency recommends starting with a low dose of 5mg CBD per day until tolerance is assessed. They also advise against CBD use by those who are pregnant, breastfeeding, or taking other medications.

Driving Under the Influence

Drink driving is a serious issue in the UK. In 2019, there were around 5,890 casualties in drink drive accidents, including around 220 deaths and 1,280 serious injuries (GOV.UK, 2020). This represents around 15% of all road casualties that year.

The legal alcohol limit for driving in the UK is:

  • 80mg alcohol per 100ml blood
  • 35mcg alcohol per 100ml breath

Being over this limit significantly impairs driving ability and increases the risk of causing an accident. Reaction times are slowed, coordination reduced, and judgement impaired.

Cannabis and Driving

It is illegal to drive in England and Wales with any amount of certain drugs in the body, including cannabis. The limit for THC is 2μg/L in blood (GOV.UK, 2022). Driving under the influence of cannabis has been shown to double the risk of causing a fatal road accident (Mail Online, 2014).

However, CBD on its own does not seem to impair driving ability. One study found that CBD did not affect measures like reaction time, lateral control, and motor control during simulated driving tests (Arkell et al, 2019). More research is still needed though.

Comparing Alcohol and Cannabis Impairment

Both alcohol and cannabis can negatively impact driving, but some key differences exist:

  • Alcohol has a clearer dose-response relationship with impairment
  • THC impairment may depend on tolerance level
  • Alcohol primarily impairs motor skills while THC impairs cognitive function more

Ultimately both substances pose risks and driving under the influence should be avoided, whether drunk, high, or even hungover.

Addiction and Dependency

Alcohol dependency is a major issue in England. According to government statistics, there were an estimated 586,780 alcohol dependent adults in England in 2016/17. This equates to a rate of 16 per 1,000 adults. Alcohol dependency rates were highest among adults aged 55 to 64, at a rate of 28 per 1,000. There are also high rates of hospital admissions related to alcohol abuse, with over 1 million in 2016/17.

Genetic factors and addiction risks

Genetics play a role in addiction risk for both alcohol and cannabis. Research shows that genetic factors account for 40-60% of the risk for alcoholism. Specific genes such as GABRA2 and OPRM1 have been associated with alcohol dependence. For cannabis, a recent large scale genome-wide analysis found genes related to risk of cannabis dependence, including CADM2 and SCOC.

Cannabis use disorder and addiction rates

While cannabis has a lower addiction potential than other substances like alcohol or opioids, cannabis use disorder is possible. According to the NHS, up to 1 in 10 cannabis users become addicted. With increased potency of modern cannabis preparations, addiction rates may be rising. In the US, studies show that around 30% of those who use cannabis may have some degree of cannabis use disorder.

More research is still needed to clarify addiction rates related to specific cannabis preparations and methods of use. However, it is clear that a subset of users do develop problematic, compulsive patterns of use qualifying as genuine addiction.

Mortality Rates: Alcohol vs Cannabis

Alcohol-related deaths in the UK remain high, with 7,556 alcohol-specific deaths in England in 2021. This equates to a mortality rate of 13.9 per 100,000 population. In contrast, the rate of death relating to drug misuse, including cannabis, was much lower at 53.2 deaths per million people in 2021.

Alcohol was detected in 39% of cannabis-related deaths between 1998-2020, but did not increase over time. This suggests that while alcohol likely exacerbates the risks, cannabis itself can be lethal, especially with long-term heavy use.

Several factors contributed to the rise in cannabis-related deaths from 1998-2020:

  • Increased cannabis use prevalence among people who use other substances
  • Older average age of decedents (average age increased over time)
  • Higher deprivation levels (more deaths among those in deprived areas)

However, cannabis was the sole drug detected in only 4% of the deaths. This suggests cannabis alone rarely causes fatalities.

Lethal Dosages of Alcohol and THC


  • Blood alcohol concentration (BAC) of 0.40% can be fatal
  • Impairs judgment and motor functions
  • Depresses central nervous system


  • No known lethal dose in humans
  • Higher doses cause anxiety, panic attacks
  • Chronic use linked to mental health risks

While both substances carry risks at high doses, alcohol has a much lower threshold for lethality. However, the risks of cannabis should not be ignored, especially with the rise in THC potency.

Comparative analysis of lethal amounts

In summary, alcohol is significantly more toxic and lethal than cannabis:

  • Over 7,500 alcohol-specific deaths per year in England
  • BAC above 0.40% often fatal
  • No known lethal dose of THC established
  • Cannabis rarely the sole cause of death

However, cannabis can exacerbate health issues and lead to accidental deaths, especially when combined with alcohol or other substances.

Safety Profile of CBD

The World Health Organization (WHO) has conducted extensive research on the safety and tolerance of CBD. In a 2018 report, the WHO concluded that CBD is generally well tolerated, with a good safety profile. The report stated that "CBD is not associated with abuse potential, does not induce physical dependence, and is generally well tolerated."

WHO reports on CBD tolerance

Specifically, the WHO report highlighted the following regarding CBD tolerance:

  • No evidence of recreational use of CBD or any public health-related problems
  • No evidence of tolerance building when people take CBD, even in high doses
  • CBD does not induce physical dependence and people do not seem to get addicted to CBD on its own

This suggests that CBD has a wide safety margin and is well tolerated by most people under a range of dosing conditions.

Toxicity studies and safety considerations

In animal studies, extremely high doses of CBD (up to 1,500 mg/kg per day) did not produce signs of toxicity. This suggests CBD has a favorable safety profile, especially compared to other drugs.

However, some minor side effects have been reported with CBD use, including:

  • Diarrhea
  • Appetite changes
  • Fatigue

Additionally, CBD can interact with certain medications by inhibiting cytochrome P450 enzymes. Checking with a doctor before using CBD is advisable, especially for those on other medications.

Overall, most studies indicate CBD has a wide safety margin, but more research is still needed, especially on long-term use.


In summary, this article has explored key differences between alcohol and cannabis, including their legal status, effects on health and behavior, risks of addiction and overdose, and overall safety profiles. While both substances can pose risks if used irresponsibly, the evidence suggests alcohol is more harmful at both the individual and societal levels.

Alcohol contributes to 88,000 deaths per year in the UK and is associated with over 200 health conditions. Its toxicity can lead to organ damage, cancer, and poisoning deaths. Alcohol also impairs judgment and motor coordination to a greater degree than cannabis, making it more dangerous for activities like driving.

In contrast, cannabis overdose deaths are nearly impossible and it poses lower risks for addiction and long-term health problems. Cannabis is not without risks, especially for youth, but moderate adult use has not been causally linked to severe or irreversible health effects thus far.

The potential future of cannabis regulation and CBD use in the UK

As more countries reform their cannabis laws and recognize potential therapeutic uses, the UK may eventually follow suit. Legalizing and regulating cannabis could weaken the black market, ensure product safety, limit youth access, and stimulate economic growth through new jobs and tax revenue.

In the meantime, CBD products remain legal and popular in the UK. With proper oversight and research, CBD may offer a promising alternative for those seeking the health benefits of cannabis without the high. More studies are still needed on long-term CBD use.

Final thoughts on safety and societal impact

When used moderately by adults, neither cannabis nor alcohol pose grave health risks for most people. However, excessive or irresponsible use of either substance can lead to personal and public harm. Open conversations around safety, regulation, and responsible use are needed rather than stigma.

Compared to alcohol, moderate cannabis use is less likely to result in violence, addiction, or overdose deaths based on current evidence. While more research is warranted, these findings challenge historical perceptions of cannabis as an inherently dangerous substance.

As with any substance, the dose makes the poison. Ensuring access to credible education around cannabis and alcohol can empower the public to make informed decisions about use and recognize potential harms early.