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People’s Use Of Alcohol Or Opioids Causes Greater Secondhand Harms Than Marijuana Consumption Does, Study Finds



A new study of thousands of people nationwide suggests that secondhand harm caused by marijuana use is far less prevalent than that of alcohol, with respondents reporting secondhand harm from drinking at nearly six times the rate they did for cannabis. Perceived harms from opioids and other drugs also outweighed those related to marijuana.

Looking at responses from 7,799 people to the 2020 U.S, National Alcohol Survey, researchers found that more than a third (34.2 percent) said they’d experienced secondhand harms related to alcohol use over the course of their lives. Just 5.5 percent, meanwhile, said they’d ever experienced secondhand harms related to cannabis.

As for other substances, 7.6 percent of people said they’d ever been harmed by others’ use of opioids, while 8.3 percent reported ever experiencing harm from unspecified “other” drugs.

When respondents were asked about just the past 12-month period, alcohol still caused the most secondhand harm, with 6.2 percent of people saying they’d been harmed by others’ use. Next were other drugs (2.2 percent), opioids (2.0 percent) and then cannabis (1.8 percent).

“Our estimates for secondhand drug harms were lower than anticipated given the ongoing opioid overdose crisis and the trend toward recreational cannabis legalization,” the authors from the Alcohol Research Group and RTI International wrote in the study, which was published in the Journal of Studies on Alcohol and Drugs.

“Secondhand harms from others’ alcohol use were substantially more prevalent than those from others’ use of any other drug.”

They also noted that the experience of secondhand harms from substance use differed among groups of people. People who were female, white, had a family history of alcohol problems and were separated, divorced or widowed reported significantly more secondhand harms.

Those harms included family and marriage difficulties, traffic accidents, vandalism, physical harm and financial difficulties.

As for cannabis, a higher prevalence of secondhand harm was found among Black people—though authors note that may harms may stem from punitive policies around marijuana rather than the drug itself.

“This may derive, at least in part, from systemic differences,” they wrote. “Black individuals are more likely than their white counterparts to face legal repercussions from cannabis use and to be randomly drug tested, resulting in financial harms (e.g., paying legal fees after an arrest, losing a job) and family difficulties (e.g. marital disputes and stress, having children taken away) that could negatively impact those around them,”

Notably, the analysis found that people who used alcohol themselves had “marginally higher” odds of reporting secondhand alcohol harms, which authors say could be “because heavier drinkers are more frequently exposed to other heavy drinkers.”

“In contrast,” they continued, “people who use cannabis frequently had significantly lower odds of reporting secondhand cannabis harms, which is also consistent with previous findings.”

Despite far more respondents reporting secondhand harm from alcohol than from marijuana or other drugs, however, authors repeatedly questioned whether participants’ responses could be trusted.

Regarding the finding that cannabis users reported lower secondhand cannabis harms, for example, they suggest it “could be because cannabis use frequently co-occurs with both alcohol and opioids, and respondents may be more likely to attribute harms to alcohol or opioids than to cannabis.”

They also said the lower reported rates of harm from cannabis and other drugs may be due to “the stigmatization of reporting harm from drug use” or because of the types of harm they cause.

“Both cannabis and opioids are less linked with violence than alcohol,” authors wrote. “As such, secondhand harms associated with these substances may be less discernible than those for alcohol (e.g., more amenity harms like trash in the neighborhood or being bothered/scared by those under the influence vs. physical harms) and, therefore, are not as easily recalled by respondents.”

“Further, those impacted by secondhand harms from someone else’s substance use may self-blame, especially if they also use substances,” they added. “This is potentially worsened in the context of opioids or other drugs, which are more stigmatized than alcohol.”

Authors said the new research is meant to broaden the understanding of drug-related harms by attempting to measure and explain harm not to drug users themselves but to friends and family of people who use drugs.

“We often don’t consider how alcohol and drug use affects people other than the person using them,” study lead Erika Rosen, a postdoctoral fellow at ARG, said in a press release. “It is critical to understand how far these harms extend into our communities so we can develop more effective policies and interventions to better support both the individual and those around them.”

Legalization advocates, meanwhile, said the study‘s findings affirm what past research has already shown.

“It’s well established that cannabis’ public health effects are far less than those associated with the use of alcohol.” Paul Armentano, deputy director for NORML, said in a blog post about the new report, “and most adults now acknowledge this reality,”

That’s despite growing evidence that frequent marijuana use is now more common among Americans than regular alcohol use. A recent study found that more Americans now consume cannabis every day than drink alcohol on a daily basis. Since 1992, it found, the per capita rate of daily cannabis consumption in the country has increased nearly 15 times over.

A multinational investment bank said in a report late last year that marijuana has become a “formidable competitor” to alcohol, projecting that nearly 20 million more people will regularly consume cannabis over the next five years as booze loses a couple million drinkers. It also says marijuana sales are estimated to reach $37 billion in 2027 in the U.S. as more state markets come online.

Data from a Gallup survey published last August also found that Americans consider marijuana to be less harmful than alcohol, cigarettes, vapes and other tobacco products.

Another study out of Canada, where marijuana is federally legal, found that legalization was “associated with a decline in beer sales,” suggesting a substitution effect.

Separate research published earlier this year found that the use of marijuana alone was not associated with higher risk of a car crash, while alcohol—whether used by itself or combined with marijuana—showed a clear correlation with increased odds of a collision.

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Ben Adlin, a senior editor at Marijuana Moment, has been covering cannabis and other drug policy issues professionally since 2011. He was previously a senior news editor at Leafly, an associate editor at the Los Angeles Daily Journal and a Coro Fellow in Public Affairs. He lives in Washington State.


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