Alcohol and cannabis: which is more harmful?

Alcohol, or ethanol, acts as a central nervous system depressant and is metabolised mainly by the liver. Cannabis acts on the endocannabinoid system through its cannabinoids, notably THC for its psychoactive effects. Comparing the two amounts to comparing two families of molecules with distinct mechanisms of action, which limits the relevance of a single ranking of "harmfulness".

Alcohol carries a well-documented risk of physical dependence, with a withdrawal syndrome that can be severe. Excessive consumption is associated with liver and cardiovascular damage and with an increased risk of certain cancers, according to the data relayed by Santé publique France and the World Health Organization. Unlike cannabis, acute alcohol intoxication — in other words an overdose — can be fatal.

Cannabis, particularly when smoked, exposes users to respiratory risks comparable to those of tobacco when it is mixed with it. Regular and early use, especially in adolescents, is associated with cognitive disturbances and an increased risk of psychological dependence, documented by the OFDT. To date, the scientific literature records no documented case of death from an overdose of cannabis alone, unlike alcohol.

The two substances act differently, on different organs, with distinct dependence profiles. Alcohol carries a risk of acute toxicity that cannabis does not present in the same way, while cannabis raises specific questions linked to the mode of consumption, notably smoke, and to the age of first use. Adding these risks together in a single ranking conceals more than it clarifies.

Legal CBD, as defined in France with a THC threshold at or below 0.3%, does not have the same psychoactive properties as recreational cannabis. Consuming it does not carry the same risks of acute intoxication. To understand this distinction, our article on the definition of CBD sets out the applicable legal framework. CBD is no substitute for medical advice and remains inadvisable when driving or during pregnancy.

Can you die from a cannabis overdose?

The scientific literature records no documented case of death from an overdose of cannabis alone, unlike alcohol, where acute intoxication can be fatal.

Is alcohol more addictive than cannabis?

Both substances carry a potential for dependence, but of a different nature: marked physical dependence for alcohol, more psychological dependence for cannabis.

Does CBD carry the same risks as cannabis?

No, legal CBD has no psychoactive effect comparable to that of THC and does not present the same risk profile as recreational cannabis.

Is smoking cannabis dangerous for the lungs?

Yes, combustion exposes users to respiratory risks similar to those of tobacco, especially when cannabis is mixed with it.