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Alcohol vs. Edibles: Is One Worse for Your Health Than the Other?

Alcohol vs. Edibles: Is One Worse for Your Health Than the Other?

Posted by Story by Karen Ansel, MS, RDN on 26th Feb 2024

Getting buzzed is big business. According to a 2023 report sponsored by the National Institute on Drug Abuse, adults ages 35 to 50 are turning to alcohol and marijuana at record levels. And that’s not just a nightly cocktail or joint. Recently, North American edible sales have soared, climbing to more than $3.5 billion in 2022, per the market research firm Global Market Insights. While there’s no arguing both substances are popular and both come with some risks, it’s less clear whether alcohol or edibles consumption is worse for your health. Here’s what the experts have to say.

Your Body on Alcohol

Nobody has to tell you that alcohol goes straight to your head. Once it gets there, it messes with your brain’s communication system, affecting your judgment, mood and coordination, according to the National Institute on Alcohol Abuse and Alcoholism. On the mild end of the spectrum, that can make you feel pleasantly tipsy. However, a few too many can have devastating consequences, such as falls, accidents and impaired judgement, according to the Centers for Disease Control and Prevention.

In the long term, heavy drinking is responsible for roughly more than 140,000 deaths annually, according to the CDC. But even light to moderate drinking can have hazards, like an increased risk for cancer, for instance. Alcohol is a carcinogen, contributing to 5.6% of cancers and 4% of cancer deaths nationwide, according to the National Cancer Institute, which also points out that as little as one drink a day can increase your cancer odds. Excessive alcohol can also flood the body with toxins that may harm your heart, liver, pancreas, gut, lungs, kidneys and immune system, says the NIAAA.

Your Body on Edibles

Edibles are cannabis-infused foods like gummies, brownies and muffins. They get their buzz-promoting properties from a substance in the cannabis plant called tetrahydrocannabinol (aka THC), explains the National Institute on Drug Abuse. What happens to your body when you eat them? “Depending on the dose, edibles may produce a feeling of relaxation, giddiness or euphoria,” says Janice Newell Bissex, M.S., RDN, a holistic cannabis practitioner at Jannabis Wellness and program director of Cannabinoid Medical Sciences at John Patrick University School of Integrative and Functional Medicine. “But if overconsumed, edibles may cause anxiety, panic, paranoia, dizziness, rapid heart rate and altered perception,” she says. Like alcohol, cannabis can also impair your ability to drive, doubling the risk of having a car accident, according to the UCLA Center for Cannabis and Cannabinoids.

How safe are they over the long haul? “There are few long-term effects of edibles for most people,” says Peter Grinspoon, M. D., a primary care physician and cannabis specialist at Massachusetts General Hospital and author of Seeing Through the Smoke: A Cannabis Specialist Untangles the Truth About Marijuana. Of course, there are exceptions, he explains, namely people who are pregnant, breastfeeding or have a family history of psychosis. Because of concerns about brain development, any kind of cannabis product is also a no-go for teenagers, he adds. While there’s probably little concern if you have the occasional gummy, heavy cannabis use can lead to addiction, known as cannabis use disorder, which affects 30% of users, per the CDC.

Comparing Alcohol vs. Edibles

Short-Term Effects

Depending on whether you’ve eaten recently or not, alcohol’s effects usually hit somewhere between 15 to 45 minutes after consumption. Edibles are far less predictable, kicking in anywhere from 30 minutes to 2 hours later, says Newell Bissex. “People run into problems when they consume an edible and don’t feel much after 30 to 60 minutes and then decide to take another,” says Newell Bissex. “Then by the time it takes effect, they’ve overconsumed to the point of being stoned and uncomfortable.” That’s because edibles hang out in your body for a long time. While alcohol is usually fully metabolized within four to eight hours, edibles don’t even start to peak until after four hours after you eat them, and effects can last for as long as 12 hours, says Newell Bissex.

Long-Term Effects

Comparing the long-term health effects of alcohol and edibles is a little bit like comparing apples and oranges. Sure, we have decades of research on alcohol. “By contrast, commercially produced edible cannabis products haven’t been available in the U.S. for very long, so we haven’t had much chance to study them,” says Ellicott Matthay, Ph.D., an assistant professor in the Department of Population Health at the NYU Grossman School of Medicine. “The combination of these products being relatively new plus the regulatory barriers to conducting cannabis research means that we know far less than we would like to about their short- and long-term effects on health and behavior,” Matthay explains.

Still, experts do have some thoughts on the matter, especially when addiction is concerned. “I would say that alcohol is more addictive, and that the addiction is far more life-destroying than cannabis use disorder,” says Grinspoon. “That said, people can become addicted to cannabis, and they need to be treated with skill, empathy and compassion.” On the flip side, cannabis may have some genuine health benefits. Alcohol, not so much. Although alcohol was once believed to protect against heart disease, the latest research in JAMA Network Open reveals that alcohol may not be so great for your heart after all and has lots of other downsides. Cannabis, however, may provide relief for people living with chronic pain, multiple-sclerosis-related spasticity or nausea and vomiting from chemotherapy, according to emerging evidence from the National Academies of Sciences, Engineering and Medicine.

Other Factors to Consider

How Much and How Often

The CDC recommends limiting alcohol to one drink a day for women and two for men. Since edibles aren’t federally regulated, they’re more like the Wild West. “It’s important to start low and go slow,” says Newell Bissex. “I start my clients with 2.5 milligrams THC, but bear in mind that some dispensaries sell edibles with 10 to 25 milligrams per serving, which for a new user would likely cause unwanted side effects.” To prevent dependence, she recommends that long-term users take tolerance breaks for a day or two each week, or a week off every month or so.

Legal and Social Issues

“Cannabis and alcohol have very different effects on the brain and there will be social implications,” says Grinspoon. “For example, cannabis can make you peaceful, increase your connection with other people and give your personal insights, while alcohol can make people loud and bellicose,” he says. There is one caveat, and that’s if a person uses both alcohol and edibles together, which is the least healthy option.

Matthay also has concerns about consuming alcohol and cannabis together. “Proponents of cannabis legalization emphasized that greater access to legal cannabis products could lead to substitution of alcohol for cannabis and thus reductions in alcohol use and alcohol-related harms,” she explains. “However, emerging evidence seems to suggest that instead of substitution, people seem to use both alcohol and cannabis more often, both in sequence and at the same time, which appears to confer extra risks.”

Frequently Asked Questions

Are edibles as bad for your liver as alcohol? What about your kidneys?
“No. Edibles are not hard on the kidneys,” says Grinspoon. In fact, he says, using cannabis for pain in lieu of NSAIDs, such as ibuprofen, is better for your kidneys. Since cannabis doesn’t cause cirrhosis or liver failure, edibles are also much safer for the liver, he adds.

Are edibles actually good for sleep?

Maybe. “Alcohol can be a significant sleep disruptor, while low-dose edibles tend to calm the body to promote a restful night’s sleep, without unpleasant side effects or next-day grogginess,” says Newell Bissex. Still, it’s important not to rely too much on edibles for sleep.

Are edibles better for your body than alcohol?

The answer appears to be yes. “Generally, cannabis is safer than alcohol, especially if used responsibly,” says Grinspoon. And, unlike with alcohol, fatal overdoses of cannabis are very uncommon, if not impossible. That said, it's crucial to keep all cannabis products out of the reach of children, and for adults to partake mindfully and be aware of the risk of developing cannabis use disorder.

The Bottom Line

Whether you consume alcohol or edibles, the choice is up to you. There are so many reasons why someone may choose to use alcohol or edibles, and both options aren’t without risk. But if you’re looking to make an informed choice between one or the other, Newell Bissex says that edibles are a safer option. “I would not have believed this for the vast majority of my life, but research shows that the deleterious effects of alcohol—physical, mental and societal—are far worse than with cannabis consumption,” she says. If you use either cannabis or alcohol and feel like you may be developing substance use disorder, reach out to your primary medical provider or another trusted source for support.