California Sober form of harm reduction

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When people identify as sober, they usually do so in the context of overcoming addiction to alcohol or other substances. Sobriety in the addiction world means that people refrain from all alcohol and drugs. The very loose definition of “California sober” describes people who abstain from all substances except for marijuana. The term “California sober” is a controversial term that has been around for years but picked up wider recognition around 2019, in part due to the media coverage of singer Demi Lovato, who released a documentary series centered around her life in recovery and her choice to be “California sober.”  

This term is often used in an attempt to stop using life-threatening and harmful substances of abuse such as heroin, prescription opioids, cocaine, and alcohol and instead use a “less harmful substance” such as marijuana. While, in theory, it may seem helpful to choose “softer” substances such as marijuana in place of harder ones, all substance use comes with its own set of unique consequences and concerns. 

Is California Sober considered harm reduction?

Some people embrace California sober as a form of harm reduction. Harm reduction is an evidence-based treatment policy used in addiction treatment that focuses on lessening the negative consequences of behaviors. Harm reduction often includes strategies such as offering safe injection sites for those with heroin addiction or methadone clinics for those who are addicted to other opioids. The concept behind harm reduction is “if a person is going to use, they can do so in a safe setting where life-threatening consequences such as overdose and blood-borne infections are highly reduced or eliminated and can also be informed of the resources available to them for addiction treatment.” Harm reduction also focuses on providing addiction treatment resources, education, and community support in the realm of addiction treatment. It is an evidence-based set of practical strategies proven to save lives, prevent infectious diseases, and help people seek addiction treatment. Harm reduction does not attempt to minimize or ignore the real and tragic harm and danger that can be associated with illicit drug use. Under this definition of harm reduction, many addiction professionals agree that California Sober is not a form of harm reduction since this movement is more about replacing one drug with another than about minimizing usage, preventing harm associated with drug use, and educating the public on addiction treatment.

California sober and cross-addiction

One of the arguments against why California sober is not a type of harm reduction is because it is often characterized as a cross addiction. Cross addictions are when people in recovery trade one addiction for another. This can manifest in cases where a person might trade substance misuse with overeating, spending too much time on social media, or playing too many video games. While a person in recovery might no longer use “hard” drugs like meth or cocaine, their brains are wired to seek out drug use. Their brains are still chasing that high and avoiding the uncomfortable symptoms that they will likely face if they submit to total sobriety. If a person chooses to use cannabis in place of a harder drug, they are still replacing one addiction with another.  

Cross-addiction postpones people from receiving the support needed to treat the underlying cause of their addiction. These underlying causes or triggers may be unresolved trauma, poor coping skills, poor self-esteem, or an undiagnosed or untreated mental health disorder. Treatment and sobriety allow a person with an addiction to discover healthier ways of coping with complicated feelings, stress, or triggers. With total abstinence, the underlying problem is addressed instead of avoided. Instead of choosing to smoke cannabis as a way to let go of stress, a person can learn how to manage stressful feelings, urges, and cravings with healthier coping mechanisms centered on cognitive behavior therapy that is taught in addiction treatment.

What are the risks of marijuana use?

Because marijuana is legal in most states but is still considered illegal at a federal level, many people assume that marijuana is safe and comes without any risks or harmful effects. Alcohol is legal in all 50 states and is legal on a federal level and is one of the most dangerous substances when misused, so in reality, legality isn’t always the deciding factor of whether or not substances come with hazardous side effects. One of the critical flaws of the California sober approach is that it’s based on a reputation that it’s harmless, doesn’t hurt your brain, and even has medicinal qualities. 

The fact is, marijuana can damage your brain, especially in young people under 25 whose brains are still developing. Other harmful effects include lung damage from smoking and possible heart damage. If you’re pregnant or breastfeeding, researchers say it can harm your fetus or newborn. Additionally, it should be avoided before driving and by individuals with a personal or family history of psychosis, as it may worsen their condition. Cannabis is also associated with impaired cognition, memory, and psychomotor skills, and different types of cancer.

Marijuana dependence and overdose

Over time, people can be at risk for cannabis dependence. People who use cannabis regularly can struggle with insomnia because they can’t sleep without cannabis or may experience mood swings and depression if they stop using cannabis or try to cut back. The increasing potency of THC in marijuana has resulted in an increase in dependence throughout the years.  

In the 1990s, marijuana’s average THC concentration was about 4 percent. By 2017, the average THC concentration in marijuana in the U.S. had reached more than 20 percent. In 2023, one study of Colorado commercial cannabis found flower THC potency inflated to 35%. These higher levels of potency carry a significant risk of dependency.  

Although cannabis is essentially never an acute cause of death, alcohol, and hard drugs can be, but people can experience cannabis overdose. Weed overdoses, which occur when a person consumes beyond their tolerance of THC, can be very unpleasant and involve extreme anxiety, vomiting, and low blood pressure, but they are not life-threatening.

How does your brain react to being California sober?

Can using another substance in moderation hinder efforts toward addiction recovery? Yes, because of the complex way addiction affects the brain and the dopamine pathways.  

Dopamine is the brain’s primary pleasure hormone. Stimulating conversation, exercise, food, alcohol, sex, or drugs can all lead the brain to release dopamine. The amount of dopamine released depends on the type of pleasurable activity. While a person may experience a small burst of dopamine while drinking a glass of wine or going for a long run, highly addictive substances like opioids and cocaine lead to massive surges of dopamine, hundreds to thousands of times the amount compared to other forms of pleasurable activities.

How does this affect the brain?

Brain imaging research has shown that during intoxication, drugs stimulate large bursts of dopamine, and drug-using behavior is reinforced by this physiological reward.  

If a person has an addiction, these dopamine bursts decrease over time, and they need more of the substance to feel the same desired effects. The circuits in the brain that control urges and cravings are held in check by the prefrontal cortex, an area of the brain responsible for rational, healthy decision-making. Therefore, these pathways are disrupted in the throes of addiction. As a result, it is difficult for a person who is struggling with addiction to resist these urges and cravings. 

For someone adopting the California sober approach, substituting one substance for another will still hit the brain’s dopamine receptors, but the dopamine release will likely be reduced. For someone with a substance use disorder, this could potentially cause a relapse since the brain craves a stronger reward, and healthy decision-making in the prefrontal cortex is impaired.

Seeking addiction treatment at AKUA Mind Body 

A large percentage of people use both alcohol and cannabis and among these people, the frequency of use of one substance is usually associated with the use of the other. If you smoke a joint, you may crave a drink, and people who struggle with addiction may then crave a bump of cocaine, leading down a slippery slope of dangerous substance misuse and reckless behavior. If you adopt a California sober approach and try to replace alcohol or hard drugs with marijuana and you have developed an association between the two, marijuana by itself may increase your cravings for alcohol or hard drugs. Many addiction experts agree that there are better ways to stop abusing alcohol than using weed as a replacement, such as evidence-based approaches like cognitive behavioral therapy or FDA-approved addiction medications like naltrexone. AKUA Mind Body is a full-service addiction treatment company that encourages evidence-based treatments for clients with substance use disorders, mental health disorders, and co-occurring disorders. We offer multiple levels of care depending on the severity of your addiction. Our treatment team is inclusive and works with each client to develop a tailored treatment plan that fits their individual needs.