Can People In Recovery From A “Drug of Choice” Use Other Drugs Safely?
In a recent story in the Sunday New York Times Magazine a Native American writer discussed his use of marijuana with his father. Both are in recovery from alcoholism, and he writes about how the burden of the history of Native Americans in the United States leads to the need for relief. “Late at night, Dad and I like to amble down that Red Road, high as kites. Weed takes the edge off. Keeps us from drinking. Gives us a way to dull and address our pains, without barking up the trees of deadlier addictions. Relieves us of the strict codes of sobriety we can’t keep, because we’re rule-breakers, not followers. ”
We have not walked the road of living Native American in the U.S. and do not in any way intend to negate the experience of this man and his father. We celebrate their conviction about recovery from alcoholism and that father and son share such a close relationship. We do want to use this opportunity to stress, again, that using drugs other than one’s drug of choice while in recovery has been proven a very bad strategy.
To start, let us repeat advice that cannabis, especially when smoked as marijuana, is not a harmless or even less harmful drug than alcohol and other schedule 1 narcotics. The National Institutes for Drug Abuse report several issues resulting from marijuana use. NIDA notes issues with short term use including rapidly occurring intoxication and associated motor skill and perception damage, psychotic experiences, other behavioral health impacts including anxiety, fear, and panic, cardiovascular damage from elevated heartrate, and respiratory damage. Long term use exacerbates heart and lung issues, causes gastrointestinal distress, and is known to cause cancer in several parts of the body. Although studies about cannabis are relatively new and less well advanced, early evidence is that cannabis results in dependence and addiction at least twice as frequently as alcohol.
NIDA also noted behavioral health issues including problems in cognitive functions like learning and memory, attention, processing speed, perceptual motor function, and language. Some evidence has linked cannabis use to earlier onset of psychosis in people with genetic risk factors including schizophrenia, as well as worsened symptoms in people who already have these conditions. The largest research study ever conducted recently occurred at the University of Colorado Anschutz School of Medicine and found that heavy cannabis use appeared to reduce brain activity in certain areas of the brain involved in important cognitive functions such as decision-making, memory, attention and emotional processing.
Use of a drug other than one’s “drug of choice” (say marijuana for an alcoholic or alcohol for an opioid addict) has proven very dangerous. An article from New Hope Health summarizes the literature for alcohol use by people in recovery from other drugs nicely.
It is very common for drug addicts in recovery to believe that alcohol is safe as it wasn’t their main issue. Perhaps it is a harmless way to relax, they surmise. In fact, alcohol affects the same brain systems tied to drug addiction. Even casual drinking can lead to loss of control, cravings and relapse. Staying fully abstinent is the safest choice for lasting recovery.
In recovery the brain and body are healing. Alcohol slows that process by interfering with brain function, decision-making, and emotional regulation. Impacting the same reward system that other drugs do activates cravings and may trigger relapse. Alcohol stresses body organs that are already weakened from drug use and may lead to alcohol dependence/addiction and cross addiction. In recovery alcohol adds pressure to a system that’s working hard to heal.
We might ask the same question for people whose drug of choice is alcohol and whether or not they can use other drugs while in recovery from alcohol. The most popular question asked by people in early recovery is about cannabis, usually in the form of marijuana. Most often the question assumes that marijuana is a harmless substance. As we have demonstrated earlier in this essay, research tells us that marijuana is as harmful if not more harmful than alcohol. As reported there, marijuana has been shown to cause and/or hasten the onset of other behavioral health disorders and to exacerbate those conditions once they have evidenced themselves in individuals. Marijuana is, simply, not a safe drug.
According to a paper from New Start Recovery use of other dependence and addictive substances is part of maladaptive behavior among people in recovery from alcohol or other drugs. They report, “Whatever your original drug of choice may be, a simple truth remains: mind-altering substances (including weed) are dangerous maladaptive coping mechanisms for recovering addicts and alcoholics.
If the use of drugs other than one’s “drug of choice” in recovery is maladaptive then treatment programs including twelve step communities offer the alternative. In the Book “Alcoholics Anonymous” people in recovery are advised in the 12th Step “…having achieved a spiritual awakening as a result of these steps we carry the message to other alcoholics and practice these principles in all our affairs.” While this often involves a return to one’s childhood faith or a religious foundation, the step does not necessarily speak to a religious awakening. Rather it speaks to a self-examination, development of a new or renewed set of values and a metaphysical life well balanced and well lived. It seems to us trite to impugn this outlook as “high on life” and it continues the suggestion that appreciating life necessarily involves being “high”.
Our harm reduction colleagues will consider this essay counter productive and perhaps dogmatic. Abstinence has been the core principle of recovery in the most successful programs to date those being 12 step communities. Certainly, abstinence from day one is a high hurdle obviated by the frequency of relapse. However, it is also proven by millions of recovering alcoholics and addicts that abstinence works and that a spiritually aware life, whether religious or not, is an alternative.
Finally, let us repeat our view that our society treats abstinence as a penance for immoral or weak behavior. In a society where 30% of American adults do not use alcohol, 16% use cannabis recreationally, and 7% use other schedule 1 and schedule 2 narcotics, abstinence is the norm.
Gene Gilchrist
October 2025
