Everything You Need to Know About Cannabis and Harm Reduction

Photo by Sergey Filimonov

What Exactly Is Harm Reduction? 

It seems you can’t turn your head without hearing about harm reduction. While its definition is fairly self-explanatory, here’s a quick explanation: harm reduction simply refers to strategies and practices put in place to minimize negative outcomes. The harm reduction approach acknowledges that abstinence is not a realistic or possible choice for everyone, so, rather than tell people flat out not to do something—to “just say no to drugs”—the harm reduction approach hands out aims to make both medical and recreational drug use as safe as possible. Given the minimal side effects of cannabis compared to substances such as opiates and alcohol, it’s no wonder there’s been a spark of interest in the harm reduction movement with cannabis as of late. Keep reading to learn how to apply harm reduction strategies to your own cannabis consumption, plus the safety considerations to know before embarking on a harm reduction journey.

Harm Reduction and Medical Cannabis 

Harm reduction can be applied to both medicinal and recreational cannabis. And, in fact, the consumption of cannabis in place of other substances is often considered a harm reduction approach in itself. One study found that 64% of medical cannabis patients use cannabis for pain, 50% for anxiety, and 34% for depression and mood disorders. 

This makes a lot of sense when you compare cannabis to opiates. Research suggests that states with medical marijuana programs see a reduction in opioid overdose mortality. And as the CDC reports, opioids were involved in 49,860 overdose deaths in 2019 and accounted for 70.6% of all drug overdose deaths. Meanwhile, the number of people to fatally overdose from cannabis remains at zero. 

"Cannabis goes hand in hand with my mental health and I use it to help me relax and have fun. I like to smoke or have an edible, then go on nature walks and hikes."

Cannabis is also often prescribed for anxiety—perhaps a better alternative to prescription benzodiazepines such as Xanax, Klonopin, and Ativan for anxiety. Researchers go so far as to state: "Benzodiazepine misuse is a worldwide public health concern that is associated with a number of concerning consequences." 

There is a time and place for benzos, such as if one experiences a destabilizing panic attack and needs relief fast. However, cannabis may offer a safer option with fewer side effects for those with anxiety that require regular medication. 

Alison Jang, brand and retail manager at the cannabis company Burb says that she opts for cannabis and connecting with nature for stress relief instead of using prescription drugs. "Cannabis goes hand in hand with my mental health and I use it to help me relax and have fun. I like to smoke or have an edible, then go on nature walks and hikes." 

One could describe Jang's experience as either medical or recreational use, and this is not uncommon. Because we treat anxiety medically with prescriptions and with substances such as alcohol in social situations, it's important to note that the medical and recreational worlds of cannabis overlap.

Harm Reduction and Recreational Cannabis 

The term "Cali sober" is trendy and refers to someone who forgoes alcohol but uses cannabis. This lifestyle choice has been around for a long time—long before the phrase Cali sober—but thanks to ongoing legalization efforts and the spread of information through social media, more and more people are giving it a go. According to the National Institute of Alcohol, In 2019, 25.8% of people ages 18 and older reported that they engaged in binge drinking in the past month. Anyone who's experienced the shame and pain of a bad hangover might understand why switching cannabis can be appealing. 

“If you substitute problematic alcohol use for problematic cannabis use, then you’ve accomplished little."

"I love drinking, but sadly, my body does not enjoy it. My hangovers are rough, and I often find myself feeling depressed for a few days after a night of heavy drinking," says Zachary Zane, a sex expert for Promescent, a sexual health and wellness brand. "I've recently opted to use cannabis instead of drinking, which has been, truly, life-changing. No hangovers. No depression and I end up getting a great night's sleep." 

Zane is not alone. "I stopped drinking alcohol right before the pandemic hit in January 2020," says cannabis writer and activist. Adryan Corcione. "I now incorporate cannabis into my daily yoga and meditation routine, sometimes accompanied by tarot cards and journaling. I felt so incredibly at peace after shutting off everything to focus on my thoughts and feeling." While Corcione never had an alcohol use disorder, they say that they'd likely still be binge drinking if it weren't for cannabis and harm reduction."

Safety Considerations For Cannabis and Harm Reduction

Cannabis may be generally safer than opiates and less likely to cause cringe-worthy blackouts than alcohol. But weed is still an intoxicant—and a highly stigmatized one at that. Thus, cannabis users have a duty to use it responsibly, both for one’s health and to avoid the negative consequences that could roadblock the path to making cannabis safe and accessible for everyone. 

“The cannabis industry is presenting strong messaging that more cannabis use is better. From a medical point of view, this is completely wrong.”

“The cannabis industry is presenting strong messaging that more cannabis use is better. From a medical point of view, this is completely wrong,” says Harvard cannabis specialist Jordan Tishler, MD. “Our approach is always to use the least amount necessary to achieve benefit. Beyond that small amount, there is only the risk of side effects and misuse. This is where the harm reduction message goes awry. Using cannabis to reduce harm must be done with the understanding that it be done without simply substituting one problem for another.”

If you’re considering using cannabis for pain instead of traditional meds, or, as an alcohol replacement, you should speak with a canna-friendly doctor first. They can help you make a plan that meets your needs while keeping you safe and healthy. “If you substitute problematic alcohol use for problematic cannabis use, then you’ve accomplished little. Cannabis use for harm reduction or treatment of any illness needs to be done with precision and professional medical guidance. Otherwise, there is a strong trend toward cannabis use becoming a problem itself,” Dr. Tishler says. 

Embrace harm reduction as a tool to live a healthier life, but do it right. Consult a cannabis MD and your psychiatrist, therapist, or anyone else involved in your health before self-medicating. Inform yourself. The more conscientious you are, the more your cannabis use can reduce your stress—not increase it. And the less you risk spoiling the fun for everyone. 


Harm Reduction Tips For Conscious Cannabis Consumption

  • Check in with yourself before you consume

Take note of your physical and emotional state. Ask yourself why you want to consume. Are you hoping to shift your mood? Gain insight on a certain situation? Relax? Becoming aware of your intentions before you consume can help eliminate anxiety, fear, or stress during your high.

  • Choose your desired high

Everyone’s endocannabinoid system is unique. Do your research. Choosing the terpenes and cannabinoids that elicit your desired effect can take practice. A good rule of thumb for newbs: stick to strains with high CBD and low THC percentages, or a 1:1 ratio. If you’re consuming a higher THC percentage, start low and go slow. And learn what the different terpenes do—they’re the unsung heroes of any high. For example, Linalool, is relaxing; Limonene is uplifting; and Pinene is thought to lessen the effects of THC. More on terpenes here.

  • Set yourself up for success

Often where you consume—and the people you consume with—can make all the difference. If you’re not comfortable in your surroundings sober, you may not be comfortable high. Check in with yourself: if you don’t feel like you’re in a safe space emotionally or physically, don’t consume.

  • Take tolerance breaks

Regular cannabis consumption can cause your cannabinoid receptors to build up a tolerance, making your highs less high. Taking occasional tolerance breaks from THC helps build them back up while providing essential moments that let you reevaluate your consumption habits.

Sophie Saint Thomas is a freelance writer based in Brooklyn originally from the US Virgin Islands. Her writing is published in GQ, Playboy, VICE, Cosmopolitan, Forbes, Allure, Glamour, Marie Claire, and more.