Switching Spirits for Strains: Cannabis a Substitute for Alcohol ft. Dr. Amanda Reiman

Switching Spirits for Strains: Cannabis a Substitute for Alcohol ft Dr. Amanda Reiman

Dr. Amanda Reiman: Research can show you how much money you can make, how you can impact the public health and safety of the people in your community. So if a community decides they want to move in the direction of cannabis legalization and needs to defend that decision to the anti-cannabis people in their community, they can trot out the data and say, 'We can have new schools, we can have roads, we can see opiate prescriptions go down, we can see youth use go down.' They can use those talking points. But in terms of really coming out as a champion for policy reform, it's going to be about replacing the feeling that it's not a good idea with the feeling that it is a good idea. Bryan Fields: What's up, guys? Welcome back to another episode of The Dime. I'm Bryan Fields, and with me as always is Kellan Finney. This week we've got a very special guest, Dr. Amanda Reiman, Chief Knowledge Officer at New Frontier Data and founder of My Personal Plants. Dr. Amanda, thanks for taking the time. How are you doing today? Dr. Amanda Reiman: I'm doing fantastic. I woke up thinking it was Tuesday, so I'm very relieved that I'm an extra day toward the weekend, and it's only in the 90s here today, so life couldn't be better. Bryan Fields: That is hot. I think you might be on the West Coast. Kellan, how are you doing? Kellan Finney: I'm doing really good, honestly. Excited to talk to Dr. Reiman about statistics, data, and everything New Frontier provides. I think it's even more relevant now that another West Coaster is coming on to help educate us East Coasters — we need it. How are you, Bryan? Bryan Fields: Yeah, I'm really good, excited for this conversation. The East Coast definitely needs some education. I'm really excited for the alcohol-cannabis conversation because I've had a lot of those questions recently and didn't have good answers, so I think Dr. Amanda is perfect to help clarify that. For our listeners who aren't familiar, can you tell us about yourself and how you got into the regulatory space? Dr. Amanda Reiman: Absolutely. I grew up in the Midwest during the D.A.R.E. era and started using cannabis as a young adult — this was before the internet, so the Midwest really didn't know what the West Coast was doing. In 2002 I moved to Oakland to start a PhD program at UC Berkeley, and I immediately found myself in the middle of this renaissance of medical cannabis and dispensaries. Being able to walk into a store and purchase cannabis really floored me, and I immediately wanted to study it. Early medical cannabis dispensaries were more than just stores — they were community health service providers offering patients a safe place to consume, plus education, entertainment, community support, legal support, and alternative health options. I felt like this was maybe a fleeting model that we wouldn't see once capitalism crept into the cannabis space, and as a researcher I believe the best way to make sure no one forgets it happened is to write about it and publish it. So I did my doctoral dissertation on medical cannabis dispensaries as health service providers back in 2005. At the time there were only a handful of us doing cannabis research at all, let alone on anything besides the harms of cannabis, so it thrust me into a space where I could really pave the way in cannabis research, especially around harm reduction. I stayed at Berkeley as a professor for over ten years teaching courses on cannabis, then went to work for Berkeley Patients Group, one of the oldest dispensaries in the country, which had a whole host of social and health programs. That's when I started researching cannabis as a substitute for alcohol, opiates, and other substances. I then went to work for Drug Policy Alliance as their manager of marijuana law and policy through Prop 64 here in California. After that I went into the private sector at Flow Kana — which we can talk about as a cautionary tale of good intentions — and then I went to New Frontier Data, wanting to get back to the science and help the industry understand where it's going, who consumers are, and how their attitudes are changing. I've been there a couple of years now as Chief Knowledge Officer. Back in 2020 I also founded My Personal Plants, my passion project — an educational platform focused on developing healthy, balanced relationships with psychoactive plants. During prohibition we were robbed of the chance to talk realistically and pragmatically about these plants; the messaging was just 'don't do it, and if you do, something's wrong with you.' Then activists had to hammer home that these plants weren't very dangerous, which is true, but nothing is without risk. If we don't have open, honest conversations about healthy consumption, we're going to have a lot of people who get old — which is when cannabis is really helpful — and realize their relationship with it isn't where it needs to be. My Personal Plants publishes articles about healthy consumption and also about growing your own cannabis and making your own products at home, because getting hands-on is a great way to develop a mindful, balanced relationship — just like with food. If I bought hamburger meat at the grocery store but had never seen a cow, it'd be hard to understand the impacts of meat production on the environment or animal welfare. So I encourage people to get to know the plant on a personal level. Kellan Finney: I can only imagine the kind of information available when you first started compared to now. When you began your dissertation, were there assumptions you had early on that turned out different over the following ten years — something that surprised you? Dr. Amanda Reiman: The substitution aspect was very interesting to me. Growing up, cannabis was framed as a gateway drug leading people into hazardous behaviors with other substances. I'll say right here — I believe the real gateway drug is sugar, and we can talk about why. I quickly learned cannabis was not a gateway drug; it was, in fact, an exit drug. This idea of people using cannabis to reduce alcohol or opiate use actually came from my own experience as a medical cannabis patient. My doctor, Dr. Frank Lucito in Berkeley, has been doing this for decades and has an extensive intake process that asks patients what happened to their use of other substances once they started using cannabis. This idea that cannabis could help people move off more dangerous substances was never really something we could investigate, because everything was lumped together — cannabis was treated the same as heroin, cocaine, methamphetamine — when really these are inanimate objects, and it's our behavior toward them that determines risk. Diving into how patients used cannabis as a harm reduction tool was an unexpected, pleasant surprise that has guided my research ever since. Bryan Fields: Cocaine is actually scheduled less restrictively than cannabis, right? Dr. Amanda Reiman: Yes — cocaine is Schedule II, cannabis is Schedule I. Cocaine is Schedule II because its derivatives are used as numbing agents during surgery — Novocaine, lidocaine, used in eye surgery, oral surgery. There's an expressed medical use. The scheduling and legality of substances is completely arbitrary and has nothing to do with actual safety profile or medical benefit. Bryan Fields: Was that mission the driving force behind leaving academia at UC Berkeley? It sounds like a dream job for a lot of researchers — tenure track at a prestigious institution. What conversations were you having with colleagues, and did you feel you needed to leave academia to have more impact? Dr. Amanda Reiman: Not really — Berkeley was always very supportive of my research. When I did my dissertation, it was the first study they'd ever had involving cannabis, and they approved it, whereas colleagues at other universities were told they weren't even allowed to attend cannabis conferences. Berkeley as an institution was always supportive, and I enjoyed teaching there. Honestly, it was the desire to move out of the Bay Area, up to the country, closer to where cannabis was actually being cultivated, to better understand how the cultivation industry connected to rural economies — that's what moved me from Oakland up to Ukiah in Mendocino County, where I live now. I still teach online for a few universities, but I wanted to be in the field rather than just observing. New Frontier Data is a nice hybrid — we're not plant-touching, we're the observers and data collectors, but we're closer to the industry than academia can sometimes feel. Bryan Fields: I want to read a quote from your website: 'The next time your mom tells you she can't sleep...' What does that mean, and why did you put it up there? Dr. Amanda Reiman: There's always been an assumption that cannabis is a young person's substance, about partying — when I was growing up, the examples of cannabis consumers were young people without a care in the world: Cheech and Chong, Jeff Spicoli, the cast of Dazed and Confused. It's important to recognize cannabis is for anybody, but not for everybody — including older people who grew up with Reefer Madness stigma but might want assistance with things like sleep, especially as they age and aren't keen on Ambien or other over-the-counter sleep aids. I try to stress that we shouldn't assume cannabis isn't for someone just because of their age, medication, or ailment. I've been dubbed 'the Dr. Ruth of cannabis' because Dr. Ruth took a stigmatized topic — sex — and made it accessible; that's my goal with cannabis. I want to help people have these conversations, approach parents or others still mired in the Reefer Madness mentality, and understand it doesn't have to mean smoking a joint — which is itself a barrier to adoption for people who don't want to smell like smoke or have secondhand smoke around them. We need evidence-informed, compassionate discussions about the many ways cannabis can fit into someone's life. Kellan Finney: I think some people might move from melatonin to cannabis but still have a glass of wine and then an edible, which doesn't produce the same result. Can you speak to the difference between mixing alcohol and cannabis versus using cannabis alone for sleep? Dr. Amanda Reiman: A hundred percent. I used to tell my students cannabis and alcohol have a synergistic relationship — one plus one equals four. Anyone who's had too much of one and then added the other knows you can get an effect you don't want. We don't have much research on this, but from experience, order of consumption seems to matter. If you've had a lot to drink, I don't recommend then consuming cannabis, especially as a newer consumer, because you're likely to get nauseous or get the spins. But if people start with cannabis and then add alcohol, they often find they need a lot less alcohol — someone who normally has two glasses of wine might only need half a glass for the same effect. Still, I encourage people to be careful, ideally use only one or the other, and be aware of their surroundings and the risks of over-intoxication. Kellan Finney: This probably changes based on age. One of your recent New Frontier Data reports found Gen Z is something like 56% less likely to consume alcohol versus cannabis compared to older generations. Is that a product of a decade of education and slowly breaking down stigma and propaganda? Dr. Amanda Reiman: I think behaviors around intoxicants are like a pendulum. Back when I worked at the Alcohol Research Group at UC Berkeley — because there was no cannabis research group at the time — researchers talked about how each new generation wants to do what their parents aren't doing. If parents drink Scotch, kids drink beer; if parents drink beer, kids drink wine, and so on. Young people want to define themselves as independent from their parents. Aside from cannabis, we're seeing a generation reject alcohol as part of their social experience — sober bars, elixirs and cocktails using adaptogens and mushrooms instead of alcohol. We've also done a lot of public health education about alcohol's harms, and now cannabis is available as an alternative, increasingly normalized, and coming in product forms that mimic the alcohol drinking experience — which was previously a big barrier, since edibles take an hour to kick in and don't match the immediacy of alcohol. Now that we're seeing fast-acting beverages, I think people will start to see cannabis as a true one-to-one substitute — you can drink a cannabis beverage while your friend drinks a beer, and in ten minutes you're both where you want to be. That's been the missing piece for cannabis to be viewed as a viable substitute. Bryan Fields: It's wild — we're talking about a complete shift in consumer behavior, from people understanding alcohol as essentially poison that causes hangovers, to cannabis which typically doesn't. That's a big headwind for alcohol companies watching these trends and wondering how to get that demographic back. Dr. Amanda Reiman: The alcohol companies are already getting on board. Two of my favorite cannabis beverages right now are made by Lagunitas and one by PBR — they know how to formulate, mass distribute, and maintain quality control, which matters a lot for beverages. I believe there's alcohol company involvement behind some of these. The marketing of these beverages is starting to resemble the alcohol marketing I saw growing up in the '80s — young, good-looking, energetic people having fun — because alcohol companies realize Gen Z isn't lining up to drink, so they're shifting messaging toward an older crowd and exploring other verticals: non-alcoholic versions of their products, elixirs replacing hard liquor, bars offering elaborate non-alcoholic cocktails instead of just an O'Doul's. They wouldn't make that shift unless they felt the audience — the Gen Z customer — was there. Kellan Finney: Anecdotally, there's been a lot more research published in the last five years on the harms of alcohol, plus wearables like the Oura Ring and Whoop letting people see the physical effects of alcohol on their sleep. Do you think that's driving different purchasing decisions? Dr. Amanda Reiman: I think people base decisions more on personal experience and the experience of people they know. Research very rarely trickles down accurately to the general public — even news outlets often exaggerate findings for clicks. But we do have unprecedented ability to monitor our sleep, fitness, and brain activity, and these systems are also gamified with badges and streaks, so if people want a five-day sleep streak, they'll change behavior — including swapping alcohol for cannabis in the evening — to achieve it. That's probably more motivating than research studies. That said, there are people who've had two glasses of wine a day for 40 years and don't feel affected and aren't interested in the data — those people may need a different path forward, since drinking is such an ingrained part of their lifestyle. Bryan Fields: Right, and ultimately alcohol companies have such a strong hold that it might never change for some people. Dr. Amanda Reiman: What I've learned after delivering thousands of petitions to elected officials is that people don't change their minds with their heads, they change them with their hearts — that's why data alone doesn't change behavior; people need to feel they should do something differently. As I've aged, my metabolism changed, which forced my own relationship with cannabis and alcohol to change. There will always be people who never change — similar to certain legislators in Congress. I once delivered petitions to Dianne Feinstein's office in San Francisco about federal medical cannabis support, and her staffer told us, 'I don't think she's ever going to change her mind — you'll just have to wait for her not to be in Congress anymore.' Some people are comfortable with their discomfort, and that becomes their habit. We don't necessarily need to change every mind — we just need to make things available and appealing, and not assume the cannabis consumer is a monolith, because the messaging that appeals to an 80-year-old who's had two cocktails a night for 50 years is different from what appeals to a 25-year-old figuring out their intoxication regimen. Bryan Fields: Let's dive into the study — can you help our listeners understand what 'substitution' means in this context? Dr. Amanda Reiman: I've always defined substitution as the conscious decision to use one substance instead of another. Across three different studies in two countries with thousands of participants, we get the same three answers for why people substitute: cannabis serves their needs better, whether medical or recreational; they're less concerned about addiction and dependence with cannabis; and cannabis has fewer negative side effects than the other substance. We've found this regarding alcohol, opiates, and methamphetamine in various studies. But it really depends on what someone has access to and what their brain tells them is the best option — someone with physical or psychological dependence may still choose the more dangerous substance out of habit. Substitution is a conscious, mindful decision to use one thing instead of another. Bryan Fields: Is there a safe level of alcohol consumption, or a healthy amount someone can have? Dr. Amanda Reiman: Guidelines vary by person — different for women versus men, for people with pre-existing conditions or not. A recent meta-analysis reviewing all existing alcohol studies concluded there's really no safe level of alcohol consumption — we'd all be better off not using it at all. But we have to meet people where they're at; that's where harm reduction comes in. People are going to drink regardless of what we tell them, so the question becomes how we minimize potential harms — sometimes that's about environment, not the substance itself. When I talk about social consumption lounges for cannabis, people push back, but a bar is essentially a social consumption lounge — a safe consumption space. Bars round their edges so people don't crack their heads open, bolt stools to the floor so they can't be used as weapons, and train servers to recognize over-service. All these measures acknowledge that people will drink and try to make that experience as safe as possible. We're not going to eliminate alcohol from our culture, so we should approach all drug use from a harm reduction perspective, acknowledging these substances will be consumed and working to make consumption safer for everyone involved. Bryan Fields: With harm reduction in mind, most cannabis consumers smoke it, and we know lighting something on fire and inhaling isn't great for health. As consumption lounges proliferate in recreational markets, should they rely solely on beverages and fast-acting nano-emulsions, or is there still a place for smoking lounges despite the harms? Dr. Amanda Reiman: This is a tough question. I was part of studies at UCSF's tobacco department looking at secondhand cannabis smoke, and it's not great — there are small particulates that lodge deep in the lungs. If you're in a lounge for an hour with good ventilation, it probably won't hurt you, but if you're a worker there for eight hours, it's a different story. I worked the Emerald Cup in a large, well-ventilated tent, and after eight hours my throat, lungs, and eyes hurt, and I felt high even without consuming anything. We need to take that seriously — I don't want us in a situation twenty years from now seeing mesothelioma-style lawsuit ads asking, 'Did you work at a consumption lounge between 2025 and 2030?' We need proper ventilation, limits on time spent in lounges for patrons and workers, and use of outdoor spaces — here in Ukiah, our social consumption law allows edibles and drinks indoors, but smoking and vaping must happen in an outdoor portion of the lounge. That said, traditionally social consumption lounges were havens for patients who couldn't consume at home — you can't smoke cannabis in public housing, and many apartment buildings prohibit smoking anything. If someone's preferred, most controllable method of consumption is smoking and they can't do it at home, or they're a tourist in a no-smoking hotel, where do they go? We have to reconcile patient and tourist access with public health concerns, and as nano-emulsified beverages and fast-acting edibles roll out, this may become less of an issue. But we shouldn't assume cannabis smoke is healthy just because you can't smell or see it. Bryan Fields: We usually talk about the pros of cannabis — can you give us a negative aspect that's not commonly understood? Dr. Amanda Reiman: THC tolerance. It's a real thing that impacts your endocannabinoid system, which regulates mood, sex, appetite, and sleep. When you constantly bring in external THC, your endocannabinoid system gets lazy — it stops working as hard because the plant is doing its job for it. Over time you build tolerance, and your ECS gets sluggish, which we don't want. I'm especially concerned about chronic use of high-THC vape oil in the 60-80% range. I recommend taking a tolerance break from cannabis at least once a year, ideally once a month — I personally take 48 hours off every month. You'll feel withdrawal symptoms like trouble sleeping, low appetite, and irritability, because your endocannabinoid system suddenly has to take back over. If you push through that first week, your appetite, sleep, and mood come back, and when you return to cannabis, you'll need much less to get the same effect. Kellan Finney: Would you recommend a daily 10-milligram user take those tolerance breaks, and would alcohol be a fair substitute during those two days? Dr. Amanda Reiman: Do what you need to get through, but if you're not normally a drinker, introducing alcohol just because you're off cannabis probably isn't the best idea. From a harm reduction standpoint, you can reduce use gradually instead of stopping cold — if you take four 10mg gummies a day, try two; if you hit a vape pen constantly, put it away for an hour at a time. But stopping completely allows for the real reset. Hemp flower, grown just like regenerative THC cannabis, can substitute for the ritual of smoking a joint, and there are other smokeable herbs and adaptogenic mushrooms that can help with relaxation and sleep during a break. Just know it might not be the most fun few days, and prepare for that. Kellan Finney: Have you seen similar effects with CBD, even though it interacts with a different receptor? Should people taking daily CBD instead of ibuprofen also take breaks? Dr. Amanda Reiman: Probably a good idea. CBD isn't intoxicating, so we don't see the same tolerance or overuse issues, but it's still good practice — just like taking breaks from sugar, caffeine, or NSAIDs — except for specific prescribed medical uses like epilepsy treatment. We're creatures of habit; when we find something we like, we ride it until the wheels come off, so it's healthy to challenge those habits occasionally. Bryan Fields: As someone who provides fact sheets and data to elected officials, is there certain information that really makes their ears perk up? Dr. Amanda Reiman: Money. Elected officials want one thing: to get reelected. Tax revenue resonates with constituents — new schools, repaired roads. Reduction in crime is another — safer neighborhoods. Fortunately, legalization does result in both. On a human level, what really changes their minds is meeting someone whose life has been changed by cannabis — a public declaration of coming around on the issue is almost always paired with 'because I met this person' or 'my mother, sister, neighbor, or friend has this condition and cannabis helped them.' Even with 80% public support and strong economic data, an official might still say, 'I just feel like it's not the right thing to do' — and that's when data can't help; you need that feeling replaced by another feeling, usually through a personal, emotional, first-hand account. Bryan Fields: So we need more anecdotal stories of how cannabis has improved people's lives. Dr. Amanda Reiman: There's a lot of power in individual stories. If you're in a constituency that hasn't been cannabis-forward — I'm looking at you, Indiana, Wisconsin, and Idaho — and you have a personal story about how cannabis helped you, your child, or your parent, share it with the elected officials whose names will actually be on your ballot, since they only care about people who can vote for them. Bonus points if it involves a child, since it's hard for an official to look a parent of a pediatric medical cannabis patient in the eye and say no. A personal email or meeting request can do more than a thousand petitions. Bryan Fields: If you had a magic wand where ethics and money weren't an issue, what research study would you run? Dr. Amanda Reiman: I'd want to understand people who say they use cannabis 'just to get high' — not medically, not therapeutically — I think there's something deeper there worth exploring. I'm also very interested in cannabis as a treatment for addiction; we're seeing promising research on psychedelics for that. I ran a small study years ago where people actively using methamphetamine, trying to stay within self-defined safe boundaries, were given medical cannabis and mindfulness training, and all of them stayed within their boundaries over six weeks even while using cannabis daily. There's a lot of stigma around giving someone with an admitted problem with one drug access to another drug, which makes that research hard to do. I'd also love to see more research on women and cannabis — during menopause, pregnancy, motherhood — but stigma around cannabis use by caretakers makes that nearly untouchable right now. Kellan Finney: That last one could be a massive unlock, though it'd be a challenge to get that study done. Bryan Fields: When you got started in the cannabis space, what did you get right, and what did you get wrong? Dr. Amanda Reiman: I got right the harm reduction nature of cannabis — that people use it in ways that best suit their own lives, and long-time consumers really know what it's good for and what it's not. What I wouldn't say I got wrong, but understand differently now, is that I used to be someone who believed cannabis had very few risks at all. Early activists leaned that way because we were constantly countering doom-laden messaging claiming cannabis ruined teenage brains, was highly addictive, and led to other drugs — so we were pushed toward the opposite extreme, saying cannabis wasn't addictive and had no risks. In truth, nothing is without risk. People can become dependent, misuse it, overuse it, and some methods of ingestion are more habit-forming than others. That's not a reason to keep cannabis illegal, but if we're building a long-term healthy relationship with this plant as a society, we need to do it with our eyes open rather than treating it as all good or all bad. Bryan Fields: If you distilled your experience into one main takeaway for the next generation, what would it be? Dr. Amanda Reiman: Don't be afraid to pave a path that hasn't been cut yet. It would have been easy for me to stay on the track studying adolescent substance abuse under government grants trying to keep drugs out of kids' hands. Instead, I realized nobody was researching the benefits of cannabis or who consumers really were, so I did it anyway — there was no path, so I cut my own. There are a lot of young people with great ideas the older generations can't even wrap their minds around, and no existing path for them. If you feel passionate, believe it can benefit society, and it's something others have shied away from — cut your own path. Bryan Fields: Prediction time. Shifting widespread consumer behavior across society involves education, research, and potentially generational die-off. Do you envision a world where psychedelics and/or cannabis stigma is completely removed? Dr. Amanda Reiman: Yes. We've done it with other stigmatized things before. It'll be a generational shift — the people still holding onto stigma need to be out of the picture, which could take a few generations. My generation, Gen X, still carries some of that stigma; it was ingrained in us, with uniformed police officers in our classrooms telling us to turn in our parents for using cannabis. Millennials carry some too, since they grew up half in prohibition and half as legalization began. Gen Z is probably the first generation to grow up around legal cannabis, questioning prohibition as bizarre rather than understanding why it existed. When Gen Z becomes the oldest generation, we might see stigma largely disappear — if we don't go backwards. Social policy and behavior move like a pendulum: eras of progressive action followed by conservative swings. We're already seeing early signs of that conservative swing, like the 'trad wife' trend on TikTok, which Gen X would have laughed at but some Gen Z are embracing as a return to traditional values. So we'll have to wait for the generations impacted by propaganda to no longer be around. Kellan Finney: Another guest on the show used the phrase 'generational die-off' too. Cannabis has been legal in Colorado for almost a decade, yet states like the ones you mentioned still haven't budged federally. I think it's going to take more than proving it works — some people in power just won't change their minds. What do you think, Bryan? Bryan Fields: Per the rules of the show, I have to take the other side — I'd say no. There are people today who still hold onto ideas from the past — even things like denying the outcome of the Civil War or the existence of slavery — misinformation that gets passed down generationally, and I think that will keep pockets of stigma alive, reinforced by alcohol, tobacco, and pharmaceutical companies pushing back to protect their interests, until they can find a way to profit from cannabis themselves. Dr. Amanda Reiman: Once tobacco and alcohol companies are sure they can make money off cannabis legalization, it'll be legal — so there is a financial angle to it. A lot also depends on where people get their information. Older generations relied on parents and a few news outlets; now there's so much access to information that people can question what they were told and find other sources. It'll be interesting to see how the information age affects that generational transmission — though it also varies wildly by location, even within the U.S. I grew up in Indiana, and we always joked we were ten years behind the rest of the country. But that pendulum could also swing the other way — two generations from now, people might reject all drugs and intoxicants entirely and go 'straight edge.' We'll have to wait and see. Bryan Fields: Dr. Amanda, for listeners who want to get in touch, learn more, or read your writing, where can they find you? Dr. Amanda Reiman: The easiest way is my email, amanda@mypersonalplants.com, or the website, mypersonalplants.com — I have a free newsletter that comes out every two weeks with great information. And for cannabis businesses looking to acquire new customers and better understand who their consumers are, what they're doing, and what they care about, reach out to us at newfrontierdata.com. Bryan Fields: Awesome, love that. This was a lot of fun — thanks for taking the time. Dr. Amanda Reiman: Oh, my pleasure. Thanks for having me, anytime.