FILE - A joint sits in an ashtray next to beer bottles. (Photo by Fabian Sommer/picture alliance via Getty Images)
With Dry January in effect for those looking to cut back on alcohol, there’s another approach to reducing substance use that some refer to as "California sober."
The term is essentially a more-relaxed approach to sobriety, with people cutting out certain addictive substances and replacing them with alternatives that – in theory – are less harmful, according to the Cleveland Clinic.
People who refer to themselves as "California sober" often use marijuana and/or psychedelics in place of alcohol and other hard drugs. Meanwhile, some define it as using both alcohol and marijuana in moderation while avoiding other addictive substances, the Cleveland Clinic said.
What is ‘California Sober’ and where did the term come from?
There’s really no official definition of this approach to substance use, according to Dr. Akhil Anand, a psychiatrist and addiction specialist with the Cleveland Clinic.
"The term is ambiguous and kind of a misnomer," Anand said. "After all, you’re not sober if you’re still using mind-altering substances."
Journalist and author Michelle Lhooq described getting "California sober" by quitting every substance except marijuana and psychedelics in a 2019 Vice article. Lhooq, who writes about drugs, raves and other related topics, noted how, prior to this, she was "doing pretty much any drug handed to me" and said "alcohol was the easiest to quit."
"The truth is that I will always love drugs and raving—and a future without either would be spiritually unfulfilling," Lhooq wrote in the 2019 piece. "Being Cali sober allows me to keep my feet in both subcultures, while its parameters make it easier not to cave to temptation."
The term also gained traction after Demi Lovato, who uses they/them and she/her pronouns, used it in 2021 to describe her approach to sobriety following a near-fatal opioid overdose in 2018. The singer opened up about her lifestyle in the docuseries "Dancing with the Devil."
"I've learned that shutting a door on things makes me want to open the door even more. I've learned that it doesn't work for me to say 'I'm never gonna do this again,'" Lovato said, according to People. Lovato added that they had protocols in place to help prevent them from relapsing on hard drugs like heroin.
"Telling myself I can never have a drink or smoke marijuana is setting myself up for failure because I am such a black-and-white thinker," Lovato said at the time. "I had it drilled into my head for so many years that one drink was equivalent to a crack pipe."
Lovato also released a song called "California Sober" on an album to accompany the docuseries.
But later in 2021, Lovato posted on Instagram that she no longer supported the "California sober" approach.
"Sober sober is the only way to be," Lovato wrote in an Instagram story.
Just last year, bluegrass star Billy Strings also released a song with the same "California Sober" title, featuring country legend and marijuana enthusiast Willie Nelson.
California sober: Is marijuana a safe alternative?
Some who adhere to the California sober lifestyle claim that it helps them cut back on alcohol. However, replacing booze with marijuana isn’t necessarily a safer choice, according to Anand.
"People who replace alcohol with marijuana are more likely to eventually start drinking again, compared to people who give up drinking and don’t use marijuana," Anand said.
The Cleveland Clinic notes how marijuana can also have negative consequences, including causing short-term memory, learning and concentration problems, as well as short-term impairment of judgment and motor coordination, decreased motivation to finish things, and short-term and possibly long-term paranoia and psychosis.
It can also lead to short-term and long-term irritability, depression, anxiety, restlessness and sleep problems, in addition to lung damage and even certain kinds of cancer, according to the Cleveland Clinic.
As the term becomes more popularized, there have been some studies done on the subject of so-called semi-sobriety. One study involving young people ages 15 to 21 recovering from opioid use disorder found no association between marijuana use and opioid use during recovery, suggesting that marijuana didn’t put people at an increased risk of returning to opioid abuse.
Another study found that daily marijuana use was associated with lower odds of opioid use. However, marijuana users in the study did experience side effects, with the most common being slower thought process (26.2%) and lack of motivation (17.3%).
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Health officials seek to downgrade marijuana
The news lit up the world of weed: U.S. health regulators are suggesting that the federal government loosen restrictions on marijuana. Specifically, the federal Health and Human Services Department has recommended taking marijuana out of a category of drugs deemed to have "no currently accepted medical use and a high potential for abuse." The agency advised moving pot from that "Schedule I" group to the less tightly regulated "Schedule III."
Everyone defines ‘moderation’ differently
One issue of being California sober is that "moderation" means different things to different people, the Cleveland Clinic points out.
Heavy drinking for men is defined by the National Institute on Alcohol Abuse and Alcoholism as consuming five or more drinks on any day or 15 or more per week. For women, heavy drinking means four or more on any day or 8 or more drinks per week.
While some can enjoy an occasional beer or cocktail, others have trouble with moderation, and it can be easy to go overboard, Anand noted.
"Some people aren’t able to drink moderately. For them, the consequences of drinking can be dire," Anand said, adding that for those who have an unhealthy relationship with alcohol, it can be more effective to cut it out completely instead of cutting back.
"If you want to drink less, be specific about how much daily alcohol use is acceptable," Anand said. "If you can’t stick to those goals, you might need to seek out addiction support."
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For people who normally drink heavily and might be physiologically dependent on alcohol, quitting abruptly could lead to severe withdrawal and even death. The NIAAA reports at least 850 deaths and 250,000 emergency department visits related to alcohol withdrawal in the United States each year. For more information on alcohol treatment, visit niaaa.nih.gov.
This story was reported from Cincinnati.