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Alcohol or Weed? A Brain Doctor Studied 62,000 Scans to Settle the Debate
Americans have long debated which substance does more damage to the human body. Alcohol flows freely at social gatherings, business dinners, and weekend barbecues. Cannabis, once confined to counterculture circles, now enjoys legal recreational status in 24 states. A whopping 17 percent of Americans admitted to smoking marijuana at some point during 2023, while at least 60 percent of the population drinks alcohol.
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Both substances alter the mind. Both carry health risks. But when it comes to your brain, which one accelerates the aging process more? A psychiatrist with access to one of the largest brain imaging databases in history decided to find out. His findings challenge common assumptions and arrive at a moment when emergency rooms across the country are treating a disturbing new syndrome linked to heavy cannabis use.
Inside Dr. Amen’s Massive Brain Scan Study
Dr. Daniel Amen, founder of Amen Clinics in Costa Mesa, California, led a research team that included scientists from Google, Johns Hopkins University, UCLA, and UC San Francisco. Together, they analyzed 62,454 brain SPECT scans from more than 30,000 individuals. Patient ages ranged from 9 months to 105 years old.
SPECT imaging, or single photon emission computed tomography, measures regional cerebral blood flow throughout the brain. Reduced blood flow in certain regions correlates with various disorders and can indicate premature brain aging. By examining 128 distinct brain regions across tens of thousands of scans, researchers could predict a patient’s chronological age based on their brain’s appearance.
When the scan suggested an older age than the patient’s actual years, researchers interpreted that gap as accelerated aging. A 40-year-old with brain patterns resembling a 45-year-old, for example, would show five years of premature aging.
Dr. Amen and his team examined patients with many psychiatric conditions, including bipolar disorder, schizophrenia, and attention-deficit hyperactivity disorder. They also looked at substance use patterns, specifically alcohol and cannabis abuse.
Cannabis Ages Your Brain Faster Than Alcohol
Results from the study surprised many observers. Schizophrenia showed the most dramatic effect, with patients displaying an average of four years of premature brain aging. Cannabis abuse came second, accelerating brain aging by 2.8 years on average.
Bipolar disorder contributed 1.6 years of accelerated aging, while ADHD added 1.4 years. Alcohol abuse, despite its well-documented health consequences, showed only 0.6 years of accelerated brain aging.
Dr. Amen addressed the implications directly. “The cannabis abuse finding was especially important, as our culture is starting to see marijuana as an innocuous substance. This study should give us pause about it.”
Depression, interestingly, did not show accelerated aging in the study. Researchers hypothesize that different brain pattern types associated with depression may explain why it did not follow the same trajectory as other disorders.
George Perry, Chief Scientist at the Brain Health Consortium from the University of Texas at San Antonio, commented on the significance of population-based imaging research. He noted that such large studies remain essential for understanding how to maintain brain structure and function during aging.
Why Alcohol Still Causes More Real-World Harm
Before anyone rushes to swap their wine glass for a joint, Dr. Amen offered an important disclaimer in his YouTube video discussing the findings.
“Now those of you who follow me know neither one are good for you,” he stated. “And quite frankly there are more deaths every year from alcohol than there are marijuana.”
He continued by noting that alcohol contributes to more domestic violence incidents, more drunk driving accidents, more poor decisions, and more people ending up in jail. Brain aging represents just one metric among many when comparing these substances.
World Health Organization guidelines reinforce concerns about alcohol. According to the WHO, no level of alcohol consumption qualifies as safe because alcohol is a toxic, psychoactive, and dependence-producing substance. Drinking has been linked to at least seven types of cancer, including bowel cancer and breast cancer in women.
Cannabis may age the brain faster, but alcohol’s broader societal toll remains staggering. Any honest comparison must weigh accelerated brain aging against higher mortality rates, increased violence, and greater legal consequences associated with alcohol consumption.
Cannabis Hyperemesis Syndrome Is Sending Chronic Users to Emergency Rooms
While the brain aging study grabbed headlines, another cannabis-related health concern has been growing quietly in emergency departments nationwide. Doctors are treating increasing numbers of patients who arrive with severe abdominal pain and prolonged vomiting. Nearly all of these patients share one common trait. They use cannabis chronically.
Medical professionals call the condition cannabis hyperemesis syndrome, or CHS. Hyperemesis means severe vomiting, and cannabinoids are compounds in the Cannabis sativa plant that bind to receptors throughout your brain, spinal cord, and gastrointestinal tract.
One study found that 32.9 percent of self-reported frequent marijuana users who visited an emergency department met the criteria for CHS. With widespread use, increased potency, and legalization spreading across more states, CHS may be becoming increasingly common.
CHS goes beyond typical side effects. Without treatment, it can lead to serious health complications, including severe dehydration, electrolyte imbalances, and damage to the esophagus.
How CHS Develops and Who Faces the Highest Risk
Symptoms of CHS typically appear several years after chronic marijuana use begins. Most patients have used cannabis regularly for about 10 to 12 years before experiencing their first episode. Adults who started using cannabis during their teenage years face a higher risk.
UW Medicine reports that symptoms usually begin within 24 hours of the most recent use and can persist for days. Chronic users may experience episodes three to four times per year, disrupting their lives and sending them repeatedly to emergency rooms.
CHS progresses through three distinct phases. During the prodromal phase, which can last months or years, patients experience morning nausea and abdominal pain. They may fear vomiting, but rarely actually do.
During the hyperemetic phase, which typically lasts 24 to 48 hours, overwhelming nausea and recurrent vomiting take over. Patients may vomit up to five times per hour. Some people experience what emergency room staff have nicknamed “scromiting,” a combination of screaming and vomiting caused by intense pain.
Recovery begins only when patients stop using cannabis entirely. Symptoms gradually lessen over days or months before disappearing completely.
Hot Showers Offer Relief, But Only One Cure Exists
Patients with CHS often discover a peculiar temporary remedy on their own. Hot baths and showers reduce or curb symptoms, at least briefly. Many people with CHS will compulsively shower or bathe, sometimes for hours every day, seeking relief from relentless nausea.
Scientists do not yet fully understand why hot water helps. Leading theories suggest that long-term overstimulation of receptors in the endocannabinoid system may disrupt the body’s natural control of nausea and vomiting. Heat may somehow counteract or distract from these effects.
However, excessive hot bathing carries its own risks. Prolonged exposure to hot water increases dehydration through sweating, potentially worsening the underlying condition. Some patients have suffered scald burns from using extremely hot water to manage their symptoms.
No FDA-approved therapies exist specifically for CHS. Emergency room doctors may provide IV fluids and electrolytes to combat dehydration. Antiemetic medications, typically used to treat nausea in other contexts, often prove ineffective for CHS patients. Some doctors try alternative approaches like capsaicin cream for pain relief.
Complete abstinence from cannabis remains the only proven cure. Most patients who stop using cannabis experience relief within 10 days, though full recovery may take several months.
Medical Marijuana Still Has Legitimate Uses
Any fair assessment of cannabis must acknowledge its medical applications. Several FDA-approved medications derive from marijuana compounds and provide genuine therapeutic benefits.
Epidiolex, a prescription cannabidiol medication, prevents and controls seizures in patients with Lennox-Gastaut syndrome and Dravet syndrome, two rare forms of epilepsy. Dronabinol and nabilone help prevent and treat nausea and vomiting related to chemotherapy. Dronabinol can also address loss of appetite and weight loss in people living with HIV or AIDS.
In states where medical marijuana is legal, healthcare providers may certify its use for chronic pain relief, particularly neuropathic pain. Some patients use medical cannabis to manage multiple sclerosis symptoms like spasticity or to stimulate appetite during illness.
Cleveland Clinic notes that marijuana’s short-term effects vary considerably between individuals. Factors like genetics, age, consumption method, and concurrent medications all influence how someone responds. Different instances of marijuana use can even produce different effects in the same person.
What Brain Science Tells Us About Both Substances
Dr. Amen’s study and the emergence of CHS paint a complicated picture. Neither alcohol nor cannabis qualifies as harmless, despite cultural attitudes that sometimes suggest otherwise.
Cannabis appears to age the brain more rapidly than alcohol, at least based on blood flow patterns visible in SPECT imaging. Yet alcohol causes more deaths, more violence, and more legal problems in society at large. Meanwhile, chronic cannabis users face a condition that sends them to emergency rooms with severe vomiting and abdominal pain.
For individuals weighing these substances, the brain aging data provides new information to consider. A 2.8-year acceleration in brain aging from cannabis abuse versus 0.6 years from alcohol abuse represents a significant difference. Young adults whose brains have not yet fully developed may face particular risks, as marijuana use during adolescence can affect how the brain builds connections for attention, memory, and learning.
Research into both substances continues. Scientists are still studying the long-term effects of cannabis, while the mechanisms behind CHS remain incompletely understood. What seems clear is that the old debate about which substance is worse has no simple answer. Both carry real costs, measured in brain scans, emergency room visits, and lives affected.