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GreenAXS Capital Newsletter: Cannabis vs Alcohol

11/6/2021

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November, 2021

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                                                                                          The illegality of cannabis is outrageous, an impediment to full utilization of a drug which helps produce the serenity and insight, sensitivity and fellowship so desperately needed in this increasingly mad and dangerous world.
—Carl Sagan (World renowned Scientist and Astronomer)

Alcohol vs. Cannabis and Why Legalization is Happening So Quickly
This month, we decided to put on our scientific research hats and do a deeper dive into the hot topic of alcohol vs. cannabis. A common debate we have with some investors surrounds which one is safer, and if cannabis is as safe or safer than alcohol, shouldn’t it be legalized? With the help of our Chief Medical Advisor, Dr. Benjamin Caplan, we reviewed a significant amount of scientific literature (key references at the end) and here, we want to share some conclusions that have shaped our views.

In a nutshell, our view has always been that cannabis is as safe if not safer than alcohol and has numerous health benefits that alcohol does not – but let’s take a quick tour of the research that gives us such high conviction in this view. Considering that any therapeutic substance, including cannabis, can be abused just like alcohol, it follows that we, as a culture, need to regulate cannabis just like we do for alcohol with age limits, safety checks, and appropriate policing and guidance, etc.
​

Based on the accelerated pace of legalization at the state level, we are seeing, in real- time, the public and government oicials approving of cannabis and these type of studies and combing through the same research that we looked at here, is influencing policy makers and the general public.
It all starts with medical for us
One study we reviewed was completed in Canada, which was one of the first nations to establish a national medical cannabis program. The study surveyed 2032 patients and primary symptoms that were being treated were chronic pain, anxiety, insomnia and stress. The study looked at consumption patterns of cannabis consumers and how those may be impacting consumption of other substances. While these patterns were at the same time striking and unsurprising, we continue to observe a progressive normalization of medical cannabis into modern life. We continue to be amazed at all the medical conditions that are being treated with cannabis including my father in-law quite recently for chronic back pain.
A few notable take-aways from this study:
  1. 69% of the patients cited that they were able to substitute away from prescription drugs (opiates, anti-depressants, pain medications) and 44% substituted away from alcohol.
  2. 74.6% reported daily use with the mean amount consumed at about 1500mg. Daily use by patients is not a major concern as studies have shown that lifetime use of cannabis carries a fairly low risk of dependence (9%) while the lifetime risk of dependence on alcohol is (22.7%) and heroin dependence has been estimated between (23-35%)

    ​
    The data here is encouraging and the ability to treat so many medical conditions, on top of being able to move away from prescription opioids is a big deal, based on the chart below (which is a little dated by today’s standards). When one looks at safety, cannabis is monumentally much safer than opiods, alcohol and even Tylenol, as measured by deaths per year. The literature is fascinating, but these studies really resonate in terms of safety, particularly juxtaposing statistics against alcohol and other drugs from an overall health perspective as well as risk of dependency.

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Will people drink less and is that a good thing?

Studies are, of course, completed in dierent cultural landscapes, with a wide spectrum of idiosyncratic people. It is not uncommon to see that research does not demonstrate consistent patterns across the board (very few do) but several have consistently demonstrated that medical cannabis users drink less than recreational cannabis users and that recreational users generally reduce their drinking alcohol overall. This has been shown in consumption of both CBD and THC as it appears both can reduce drinking and alcohol seeking behavior. All the major data companies confirm this trend in survey data as well. One likely reason is that cannabis increases the feeling of intoxication and therefore fewer drinks are needed to feel happy and the eects from things like Edibles can last over longer periods of time.

Earlier, we established from certain studies that the lifetime risk of dependence for

alcohol (22.7%) is higher than for cannabis (9%) but are there other health benefits from moving away from alcohol?
The health eects of alcohol are clearly better understood than cannabis given there is over half a century of epidemiological research available. In large doses, alcohol can cause fatal overdoses from respiratory depression and alcohol intoxication is a major cause of road accidents, assaults and suicide. Sustained heavy use of alcohol increases risk of liver disease, pancreatitis, cancer and heart disease, among dozens of other morbid, and even mortal, medical concerns.
​

In contrast, the known adverse eects of cannabis appear consistently modest based on most studies, consistent with Dr Caplan’s unique clinical perspective. Cannabis is not known to cause fatal overdoses because it doesn’t have respiratory depressant eects like alcohol and opioids. Epidemiological studies, when looking at being under the influence of alcohol vs. cannabis and driving accidents, have been consistently inconsistent (thus “inconclusive”) regarding cannabis use (due to coping strategies that are still available) while unanimity exists that alcohol use increases crash risk.
Below is an interesting chart that was produced by the New Zealand Medical Journal comparing the health risks of cannabis vs. alcohol.
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While cannabis seems safer than alcohol, we still strongly believe it needs to be regulated federally to provide more universal safeguards for the public than are alreadyinplacetoday,atastatelevel,particularlyforadolescents. However,an interesting study was done with adolescents that had alcohol use disorder (AUD) vs. those that had cannabis use disorder (CUD) and the results showed much less impairment for the cannabis users. For many, any degree of risk to adolescents is concerning, and we all surely agree that protecting our children is of paramount importance, but nevertheless, many are surprised to consider that cannabis need not be viewed as worse than alcohol for any age group, and in many respects appears to be much safer. Still, like alcohol, cannabis ought to be consumed responsibly and regulated properly at the federal level.

Conclusion:
While many of us enjoy a glass of wine or beer as a normal part of modern life, our cannabis journey has pointed us to the multitude of risks and dangers brought on by alcohol consumption, and we just don’t see the same level of risks in the cannabis research. More importantly, we keep seeing more and more medical applications for cannabis. Wehavemanyculturesgloballythatincorporatecannabisintotheirdaily use, with both reduced harm and notable benefits that are driving the global movement towards legalization. And as our advisor, Dr Caplan, has pointed out to me, the epidemiological data for alcohol is much worse than cannabis across the board. This doesn’t mean that we all have to stop drinking tomorrow– it just signals that cannabis legalization is the healthy direction for humankind to be pursuing. It is quite possible that with a steady reduction in alcohol consumption commensurate with a slow replacement with cannabis, the general public will come to know improved health and wellness, overall.

References:

https://journal.nzma.org.nz/journal-articles/alcohol-is-more-harmful-than-cannabis

https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-019- 0278-6

https://pubmed.ncbi.nlm.nih.gov/32299790/#:~:text=During%20Instrumental%20Le arning-,Alcohol%20Use%20Disorder%2C%20But%20Not%20Cannabis%20Use%20D isorder%2C%20Symptomatology%20in,(6)%3A610%2D618.

https://www.researchgate.net/publication/347790447_Investigating_Relationships_ Between_Alcohol_and_Cannabis_Use_in_an_Online_Survey_of_Cannabis_Users_A _Focus_on_Cannabinoid_Content_and_Cannabis_for_Medical_Purposes
​

https://www.tandfonline.com/doi/abs/10.3109/16066359.2012.733465


DISCLAIMER
The views expressed here are those of the individual personnel quoted and are not the views of GreenAxs Capital, LLC (“GAC”) or its respective ailiates. Certain information contained in here has been obtained from third-party sources, including from portfolio companies of funds managed by GAC. While taken from sources believed to be reliable, GAC has not independently verified such information and makes no representations about the enduring accuracy of the information or its appropriateness for a given situation. In addition, this content may include third-party advertisements; GAC has not reviewed such advertisements and does not endorse any advertising content contained therein.
This content is provided for informational purposes only, and should not be relied upon as legal, business, investment, or tax advice. You should consult your own advisers as to those matters. References to any securities or digital assets are for illustrative purposes only, and do not constitute an investment recommendation or oer to provide investment advisory services. Furthermore, this content is not directed at nor intended for use by any investors or prospective investors, and may not under any circumstances be relied upon when making a decision to invest in any fund managed by GAC. (An oering to invest in a GAC fund will be made only by the private placement memorandum, subscription agreement, and other relevant documentation of any such fund and should be read in their entirety.) Any investments or portfolio companies mentioned, referred to, or described are not representative of all investments in vehicles managed by GAC, and there can be no assurance that the investments will be profitable or that other investments made in the future will have similar characteristics or results.
Charts and graphs provided within are for informational purposes solely and should not be relied upon when making any investment decision. Past performance is not indicative of future results. The content speaks only as of the date indicated. Any projections, estimates, forecasts, targets, prospects, and/or opinions expressed in these materials are subject to change without notice and may dier or be contrary to opinions expressed by others.
No part of this report may be reproduced without the express written permission of GAC.
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