Cannabis Is part of Recovery for Some People: Why Does That Make People So Angry?

Is shame more toxic than cannabis?

I’ve been abstinent from all forms of intoxication for nearly thirty years. It is one of the best decisions I’ve ever made. Sobriety gave me a career, meaningful relationships, peace of mind, and a life that would have been impossible had I continued drinking.

So when I say that cannabis can be a legitimate part of recovery for some people, I’m not saying it because I’m looking for permission to get high. I’m saying it because after three decades in recovery and a career in mental health, I’ve met too many people whose lives improved dramatically through pathways that didn’t look exactly like mine.

That idea makes some people deeply uncomfortable.

For decades, the addiction field has operated from the assumption that recovery means complete abstinence from all psychoactive substances. For many people, that approach works beautifully. But somewhere along the way, a treatment philosophy became a moral certainty. What started as “this worked for me” evolved into “this must work for everyone.”

The result is a strange form of recovery fundamentalism.

Like religious zealots, recovery zealots are often convinced their path is the only legitimate path. If you don’t follow their oath, they predict the same grim future: relapse, jail, institutions, misery, or death. The certainty is remarkable. They speak with the confidence of people who believe they have exclusive access to the truth.

The irony is that Alcoholics Anonymous itself is often more humble than some of its loudest followers. AA reminds us that it claims spiritual progress rather than spiritual perfection. It does not claim a monopoly on recovery. Yet some people behave as though they have been appointed Secretary of Recovery and charged with determining whose recovery counts and whose does not.

What gets lost in these debates is a simple question:

What if someone’s life is actually getting better?

One of the most influential researchers in this area is Dr. Amanda Reiman, whose work on what she calls the “substitution effect” examined people who intentionally replaced alcohol, illicit drugs, or prescription medications with cannabis. Her findings showed that many participants reported fewer negative consequences, better symptom management, and an overall improvement in quality of life after making that substitution.

That doesn’t prove cannabis is harmless. It doesn’t mean everyone should use it. It simply suggests that for some people, cannabis creates fewer problems than the substances it replaces.

For some people, cannabis is not a gateway drug. It’s an exit ramp.

That distinction matters because the stereotype of the cannabis user often bears little resemblance to reality. My own eighty-two-year-old mother has experienced significant relief from arthritis pain through cannabis. She’s not exactly hanging out with Willie Nelson and Snoop Dogg. She’s an elderly woman whose knees hurt less than they used to.

To the best of my knowledge, Nonni is not bringing a bong to bridge.

The point isn’t that cannabis is good. The point is that people use cannabis for different reasons. Some are managing chronic pain. Some are trying to sleep through the night. Some are dealing with PTSD. Some are trying to reduce or eliminate their dependence on alcohol or opioids.

Pennsylvania, for example, includes opioid use disorder among the conditions that may qualify a patient for medical cannabis treatment. Whether you agree with that policy or not, it demonstrates that physicians, policymakers, and public health officials are already wrestling with questions that many recovery communities still refuse to consider.

The question becomes even more complicated when we look at specific people rather than abstract principles.

Imagine a combat veteran with severe PTSD. He isn’t drinking himself unconscious. He isn’t misusing opioids. He isn’t getting arrested or destroying his marriage. He uses cannabis occasionally to reduce nightmares and improve sleep, and as a result he remains employed, connected to his family, and engaged in life.

Is abstinence necessarily the best outcome for that person?

Maybe.

Maybe not.

What I know is that the answer isn’t as obvious as many people pretend.

Too often, recovery culture evaluates success through a single lens: did you consume a substance? Clinicians should be asking broader questions. Is the person healthier? Are they sleeping? Are they working? Are they treating people better? Are they participating in their community? Are they less miserable than they were before?

Human flourishing is more complicated than a urine screen.

That brings me to another question I rarely hear discussed.

Why is recovery shaming still acceptable?

We’ve largely accepted that fat shaming is harmful. We’ve recognized that shaming people for mental illness is ineffective and cruel. We understand that public humiliation is rarely a pathway to meaningful change. Yet recovery shaming remains alive and well.

People are routinely told that their progress doesn’t count. That they aren’t “really” in recovery. That they are fooling themselves. That disaster is inevitable.

I sometimes wonder whether the shame itself creates more damage than the cannabis.

Not because cannabis is harmless. It isn’t.

But neither is shame.

Shame isolates people. It encourages secrecy. It pushes people away from treatment, away from community, and away from honest conversations about what is and isn’t working in their lives. I’ve watched people make remarkable improvements only to be told that none of it matters because they failed someone else’s purity test.

That strikes me as less like medicine and more like theology.

None of this is an argument against abstinence. Abstinence remains a powerful and effective pathway for millions of people. It has certainly been the right pathway for me.

What I’m arguing for is humility.

The goal of recovery should not be moral compliance. The goal should be reducing suffering and helping people build lives worth living. For some people, that life includes complete abstinence. For others, it may include medication, harm reduction strategies, or medical cannabis.

The question isn’t whether their recovery looks exactly like mine.

The question is whether their life is getting better.

If it is, perhaps we should spend less time policing recovery and more time celebrating progress.