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Retired CIA Senior Economic Analyst

Which is the Most Dangerous Drug - Alcohol, Tobacco or Marijuana?

Tough question--it's easier to ask which is the least dangerous, because the answer then is marijuana, and by a huge margin.

"Least dangerous" doesn't mean "completely safe". All drugs have risks and the best choice is not to use any of them. And young people absolutely should not be doing any drugs, because the dangers are magnified if your body and mind are still developing. Unfortunately, current policy fails miserably in this regard, because each of these three drugs will be tried by half or more of our youngsters before they graduate from high school.

For adults, though, the numbers are clear. Tobacco kills about 440,000 people annually in the US, and alcohol something close to 100,000, according to the CDC and many other sources, while the number of marijuana deaths is zero--or at least so close to zero that it can't be detected in epidemiological studies. Tobacco and alcohol each cause a long list of serious diseases--cardio-vascular, lung, and liver ailments, and many kinds of cancer. Marijuana causes bronchitis and excess phlegm production but not much else.

Two scary facts:

  1. The Campaign for Tobacco-free Kids says that more than five million US kids will die from tobacco. The deaths will occur later, of course, but 90 percent of tobacco users acquire the habit before age 18. 
  2. Alcohol induces violent behavior in some of its users, resulting in assaults, murders, and traffic accidents (while marijuana has the opposite effect).

One reason "pot" is less dangerous is that it's much less addictive--although drug experts prefer the term "dependence". They estimate that 32 percent of tobacco users will become dependent--higher than any other drug, including heroin and cocaine--while the figures are 15 percent for alcohol and nine percent for marijuana.

Marijuana's risks are mainly mental. It certainly impairs short-term memory, probably causes some cases of schizophrenia, and inexperienced users may experience a feeling of paranoia that can cause an emergency room visit, but usually without serious consequences.

It also impairs driving ability, although much less than alcohol. The biggest study (in the December, 2005 British Medical Journal) found that drivers with a high blood level of THC (the main active ingredient in marijuana) were about three times as likely as a sober driver to have a fatal accident. But it found about the same increase in risk in drivers with a blood alcohol content (BAC) of 0.05 or less--that's just one or two drinks, depending on your body size. Really loaded drivers--with BAC above 0.20--had a risk 40 times higher than sober ones.

Unlike alcohol and tobacco, marijuana also has well-established medical uses, especially for controlling chemotherapy-induced nausea, boosting appetite in AIDS patients, and relieving neuropathic pain--without the dangers of opioid painkillers. And it may inhibit tumor growth, but this is not well-established. That's why 17 US states and DC have approved it for medical use, as have Canada, Israel, and the Netherlands.

The tragedy is that we knew most of this in 1972, when the US National Commission on Marijuana unanimously recommended that it be decriminalized (even though most of its members were appointed by President Nixon), and Consumers Union, in a major report titled "Licit and Illicit Drugs", recommended that it be regulated like alcohol. Since then more than 20 million people have been arrested for marijuana "crimes"--wasting scarce law-enforcement resources--and more than 10 million have died from alcohol or tobacco. It's time for a change.

Sally Spangler

1:03 pm on Thursday, August 23, 2012

I have watched and buried my father and my brother after a lifetime of their thinking that smoking was just a bad habit! My brother stopped smoking only after he reached the place where I called 911. My brother said again and again, "I can't breathe, I can't breathe. He had smoked from the age of 16 and died at 72.. From that point to the end of his life was about two years of a dresser covered with various pills and inhalers to keep his lungs working. He had not only COPD but a metastized cancer of the eosphagus. He was on air tank to go with the medications. His weight dropped to about 90 pounds. and then he quietly died sitting in his chair. At that moment - his skin went from pink to almost a yellow. I called the funeral home and they came. THINK ABOUT IT! Still grieving

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James Cullum

2:40 pm on Thursday, August 23, 2012

Sorry to hear about your loss, Sally. Cigarettes are dangerous, and have struck down so many, including my grandfather. As my father once told me, though, "Cigarettes will kill you. Alcohol will just ruin your life."

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Sally Spangler

10:30 pm on Thursday, August 23, 2012

If the alcohol just ruins your life, I suppose the drinker is lucky! The drunk likes to think the Alcohol helps them to be sharper thinkers and better able to handle anything that comes along. No, if what I have seen is common. Enough said.

Sally Spangler

10:27 pm on Thursday, August 23, 2012

Thank you James.
The alcohol question means three men, a cousin who seeming drank because his wife didn't have the first idea of how NOT to spend money. The fights between them were out of my hearing, but devastating to their two sons, who became just plain drunks many years later. I loved all three of them as a small child. I was angry at the older of the two brothers and afraid of the younger. Alcohol! By whatever name, rum, gin, rye, scotch, bourbon. Evidently all had various strengths and all caused problems which in the end caused my cousin's deaths. The older son was in the Army during WWII. His brother joined the Navy the day after Pearl Harbor, serving to the end. Made a mess of his life after the war as a civilian. Their father died of cancer caused by the stricture of his throat caused by cancer. Since this was 1944 - not much was known about cancer and vry little about curing it either by surgery or medication. OH NUTS to all the above "things" - they are all killers. Cancer, in whatever manifestation IS A KILLER!

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Andrea Weber

12:50 am on Saturday, August 25, 2012

Well like anyone else living today I have seen the effects of all. And pot doesn't come close to causing the destruction that alcohol does. Alcohol isn't called a tool of the devil for nothing. So many abusive homes and abused children and spouses. Cigarettes on the other hand are a silent killer. My father got an abdomonal anyerism and copd from those things. I watched in his last days struggling to get a breath, the best disciption that I can explain is like watching a fish on dry land. It was horrible having to watch, I couldn't imagine the fear he felt. TERRIBLE!. Now my experience with pot. My husband is an aggressive person (an alcoholic) and he was screaming and yelling about whatever one day, and I went and got my hands on some pot, went up to our room and lit up. of course my husband folloed yelling and screamng at me. I hand over the jjoint (pot) to him and it only took 2 maybe 3 hits he calmed down. I never pointed that out to him for obvious reasons, but I was sold , POT SHOULD BE LEGAL. i'm not a user at all, but I am an advocate

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Sally Spangler

10:35 am on Saturday, August 25, 2012

Yes, I know an advocate - and for a time, until arrested and prisoner in a roving prison system which never left the prisoner in one compound, but moved prisoners from one county to another, He opened his mouth and was injured by a guard. The end of that was that he is still having to see his parole officer, from the outside. I think he is more aware of what the LAW is, he just keeps his mouth shut. Not the way to live, I'd say. Whether he is still a user? Shrug. I don't ask.

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Sally Spangler

10:41 am on Saturday, August 25, 2012

Smoking? Alcohol? Killers, both of them. But then so is pot! Casual pot use? maybe not. The way to get a dedicated pot user off the stuff is cold turkey. Andrea - that is what you should see happen! Ask a person who has been through it. And dedicated pot use is a killer. It just isn't seen that often. Yes, Holland allows pot iuse n certain places, much like a tobacco bar. Gather around and enjoy your friends while enjoying "the weed"

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Andrea Weber

7:57 pm on Sunday, September 2, 2012

Sally I'm about the straightest person you will meet, I've never felt the need to alter my brain , but if I had to chooses what vises I think is the least harmful it would be pot

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Dick Kennedy

10:32 am on Monday, September 3, 2012

Andrea,
I'm with you--don't use any mind-altering drugs, but if I did it would be marijuana, because of the low risk compared with alcohol or tobacco. And if I had one of the medical conditions that it's good for, I would want to use it because it's safer than most pharmaceuticals.

Sally Spangler

10:42 pm on Sunday, September 2, 2012

During the height of the pot issue - young people were getting high and staying high until they scrambled their brains and couldn't do anything useful to their lives. I watched that happen to a nice young man who bolstered his personal feelings/emotions and abilities with staying high. Then he found the job he wanted in the fairly new computer world. Then he found that he couldn't do the work he wanted to do and the job and many others went south as his bosses found he was a pot head. Took not so many months to sink to that. Not dangerous? Yes it is. There is a difference between the casual user and the daily/all day/night user. Yes, Holland has places where the people can go to get a "lift" and sit and talk to like users. When they want to they get up and leave. If they over use - the police will do something. At that point it becomes a non-casual drug with all that drug use becomes a crime.

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Dick Kennedy

10:38 am on Monday, September 3, 2012

Sally,
You're basically saying that marijuana can have bad consequences and no one disagrees with that. But your statement that it kills is factually incorrect, except for some traffic accident deaths. Many studies have looked at this and found no significant health differences between marijuana users and non-users. You can find this information from government sources such as NIDA, CDC, or SAMHSA, or private sources such as Merck Pharmaceuticals.

Andrea Weber

1:08 pm on Monday, September 3, 2012

Well said Dick.
Sally you keep talking about people who abuse, abuse and abuse their sustance they use. Most marijuana smokers use it for medical uses or are casual users. And marijuana unlike tabacco, alcohol and other drugs is nonaddictive.

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Sally Spangler

5:34 pm on Monday, September 3, 2012

Andrea - Dick - Ever try to give a pot smoker help from being high on his latest binge? Ever see a pot smoker shaking and half off his/her head from a Pot high?
As a mother I have, my son! Then he went back and did it again. Took those two trips to make him understand that POT is a problem,! The dedicated pot user looses part of his ability to reason. Tobacco - my brother smoked three packs a day from the time he was 16 until his death at 72! He wouldn't stop smoking until he could no longer breathe and went to the hospital breathing oxygen. Then he stopped. Then it was more than too late. He was on an air tank from then until his death, not mention pain killers for his cancer of the esophagus at either end of the esophagus as well the COPD "Congestive Obstructive Pulmonary Congestion" His death was within 8 months after being diagnosed. His last words, "I can't breathe, I can't breathe."! He was on his air tank, his skin color went from the normal pink (with a gray tone) to a yellow tone. Then he was dead! A terrible thing to watch - someone dying right in front of you and there is nothing you can do!
You are kidding yourselves. Alcohol whether beer or whiskey is a killer also. It will also drive you to insanity. My husband died of "Lou Garige's Disease. That goes from being just drunk to the point your lungs don't work and you can't breathe. Then? death! Believe it!

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Dick Kennedy

11:04 am on Tuesday, September 4, 2012

Sally, I can see why you hate drugs, since you have had way more than your share of tragic experiences resulting from their use. But I think you have actually backed up my point that marijuana is less dangerous than alcohol or tobacco. Your experience with the latter two ended with someone dying whereas it doesn't appear that your son had any permanent damage from his misuse of marijuana, after he came down from his bad trips.

Sally Spangler

6:04 pm on Monday, September 3, 2012

3 sites on our subject:alcohol:wikipedia.org/wiki/alcoholismism National Institute on Alcohol abuse & alcoholism www.niaaa.nih.gov
Marijuana|National Institute on Drug Abuse www.drugabuse.gov.drugabuse/marijuana
National Institute on Drug Abuse www.drugabuse.gov/drugabuse/marijuana
three from the horses mouth. and many more to look up. Sally

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Dick Kennedy

11:42 am on Tuesday, September 4, 2012

Some time ago I copied some NIDA info on tobacco and marijuana, which I called products X and Y. Below is part of it--try to figure out which is which.
Y use accounts for one-third of all cancers and has been linked to about 90 percent of all lung cancer cases. In addition to lung cancer, Y use also causes lung diseases such as chronic bronchitis and emphysema, and it has been found to exacerbate asthma symptoms. Y use is also associated with cancers of the mouth, pharynx, larynx, esophagus, stomach, pancreas, cervix, kidney, ureter, and bladder. The overall rates of death from cancer are twice as high among Y users as among nonusers. Y use substantially increases the risk of heart disease, including stroke, heart attack, vascular disease, and aneurysm. It is estimated that nearly one-fifth of deaths from heart disease are attributable to Y use. Product Y kills more than 430,000 U.S. citizens each year - more than alcohol, cocaine, heroin, homicide, suicide, car accidents, fire, and AIDS combined.

X: Short-term effects include loss of coordination and increased heart rate. Long-term use produces changes in the brain similar to those seen after long-term use of other major drugs of abuse. Someone who uses X regularly may have daily cough and phlegm, symptoms of chronic bronchitis, and more frequent chest colds. Continuing to use X can lead to abnormal functioning of lung tissue

Andrea Weber

7:06 pm on Monday, September 3, 2012

Sally I think your son was smoking pot spiked with something, people can, and do that to get higher and as you have winessed they lose their minds. No law saying soething is legal or illegal will make any more or less users that YOU see, but it will make it easier for the people who need it for medical use to get it. And like it or not it's a plant, and as far as I'm concerned from GOD, and not man made like their other choices for medical relief that have many side effects and many of them harmful. Yes if abused anything has its dangers, but the debate is which is less dangerous. IF it is not altered by another substance its hands down, marijuana is the safest product

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Sally Spangler

10:01 pm on Monday, September 3, 2012

Considering the hell he put me through, it was pot, whether pure or adulterated - it was poison in his system. If the patient was on a dose of medical provided pot - ?
is it done in an office visit to the doctor who perscribed it - or go get it with a perscription and used at home? Let us hope the patent used it only as stated and not something he dreamed up for a dose. It is still dangerous when misused.
Any drug misused is dangerous! There are patients who decide that their meds can be doubled or maybe not taken at all as perscribed. Some of those meds should be taken ONLY as perscribed.

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Abby Adams

12:42 pm on Tuesday, September 4, 2012

I think the main point being raised here is that since marijuana is less dangerous than alcohol and tobacco (two admittedly dangerous substances that we agree as a society can be used in a regulated way by adults), pot should also be regulated by the government in the same fashion. Our government doesn't regulate these substances for the smaller percentage of people who misuse them (see: individual liberty in US policy), it regulates them for the vast majority who use them responsibly. The same policy should apply to marijuana. I think a more interesting question might be why this hasn't already occurred. I have always thought it was because there wasn't as much money to be made off of marijuana (essentially a trash plant that will grow anywhere). Maybe we need a powerful, corporate marijuana lobby, instead of the more grass-roots folks who have been promoting its decriminalization for years.

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Liam Beveridge

8:13 am on Thursday, March 21, 2013

Is Marijuana safest then the use of Alcohol and pot ?

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