From Lanny Swerdlow, RN:  

I imagine you have seen the recent study showing that beer consumption has decreased in states with legal mj. Anecdotally that shouldn’t really be a surprise but there really haven’t been many studies to confirm that. I know that in summer 2003 edition of O’Shaughnessy’s, Dr. Mikuriya published a study of 92 mmj patients who had used mj to get off alcohol. Are you aware of any study published before Dr. Mikuriya’s study about cannabis as a substitute for alcohol? I can’t find any.

I would think that this was a fairly controversial position and was wondering if Dr. Mikuriya tried to get the study published in a peer-reviewed medical journal and got turned down. I have a pdf of the study, but it doesn’t list any publication info —not even O’Shaughnessy’s.

I have been writing for years that as a nurse I always considered the most important medical use of cannabis was as an alcohol substitute. Yeah, good for insomnia, cancer, depression, pain and on and on and on, but when I was working I don’t think I ever had a single shift where at least one of the patients I was taking care of was in that hospital bed at least partially due to their use of alcohol.

Retro Message from Fred Gardner:

 Tod had written a case report published* in 1970 by Medical Times, about a 43-year-old woman who had been getting drunk to overcome disinhibition in social situations —until she discovered that marijuana produced the desired effect and began using it to cut back on booze. This was the first statement of his “cannabis-vs-ETOH” theory. He was planning to aggregate similar case reports for a journal he had in mind for the newly formed “California Cannabis Research Medical Group” (now the SCC). By the end of the ’90s he was fed up with the psychiatric establishment and the Addiction Specialists, understood the ravages of alcoholism, and urgently wanted to share his important observations with colleagues and patients (and the public). He hired a research associate, Jerry Mandel, to assemble the relevant cases from his files. The launch of the CCRMG journal was delayed when I went to work for Terence Hallinan at SFDA in 2000. 

Ethan Russo launched the Journal of Cannabis Therapeutics in 2001 and Tod was on the editorial advisory board. He submitted “Cannabis as a Substitute for Alcohol” for publication in J-CANT with the proviso —no problem for Russo— that the paper could also appear in the CCRMG journal. And so it was published twice in 2003. Or once, if you exclude O’Shaughnessy’s. 

* To “publish,” in the jargon of academics and professionals, doesn’t mean getting an article written, illustrated, laid out, printed and distributed to readers. It means getting approved by the clique of decision-makers whose  journals constitute “the literature” in a given field of science or medicine. (How arrogant of the academics to appropriate the words publish and literature, as if they owned the language itself.) 

It’s hard to imagine anything more accurate and insightful than Mkuriya’s “Cannabis as a Substitute for Alcohol” being written on the subject. The word is way overused, but it really is a landmark paper. 

When Tod quit the Addiction Medicine societies, O’S published his letter(s) of resignation.

Cancel My Denial

To: California Society of Addiction Medicine 74 New Montgomery Street, Suite 230 San Francisco, CA 94105

American Society of Addiction Medicine 4601 North Park Avenue Suite 101 Chevy Chase, MD 20815


As I contemplated whether or not to renew this year with the not unsubstantial dues, I asked myself “Why should I?” Over the years since I joined the organization I have tried to raise the possibility of a harm-reduction option for the treatment of alcoholism. Notwithstanding my repeated and persistent entreaties, I have been repeatedly denied any opportunity for a collegial and professional forum. I have even offered to make my patients available for questioning and review. Nothing. Lame excuses -not ready yet.

Forays into spiritualism with self-styled practitioners responding to the “spiritual needs” of addicts was particularly disturbing. Somehow I don’t remember any training in medical school in theological studies. The blurring of boundaries and confusion of identity diminishes, attenuates medical leadership, and reduces professional credibility to cultism. Medical Review Officers conducting forensic examinations are not engaged in a medical activity. Endorsing their enforcement of corporate authority diminishes medical leadership and reduces ASAM/CSAM to shills and trough feeders. The societies support the federal government’s irrational drug-war policy while prominent addiction specialists seek to maximize their share of court referrals.

I officially give up on ASAM/CSAM and any possibility of a magical ethical transformation. I have been denied the opportunity to present a viable, effective, and medically appropriate intervention: cannabis as a substitute for alcohol and other addictive substances. Retrospectively, I wonder why I waited so long to quit. I can no longer maintain my wishful thinking that somehow ASAM/CSAM could be fair, objective, professionally and medically correct.

I shall not be renewing my membership.

Tod H. Mikuriya, M.D.

Member since 1974 Certified by ASAM 1986 MRO Certified by ASAM 1992