WHY IT MATTERS: If you are weighing the risks of cannabis versus alcohol for symptom management, understanding that alcohol carries substantially higher risks for organ damage, dependence, and death can help you and your clinician make more informed treatment decisions. CLINICAL OVERVIEW: Comparing the long-term health consequences of alcohol and cannabis is a clinically important discussion, as alcohol carries well-documented risks including liver disease, cardiovascular damage, neurotoxicity, and a strong association with dependence and mortality, while cannabis, though not without risk, has a significantly lower profile for organ damage and fatal overdose. In my clinical experience with over 30,000 patients, cannabis can be problematic for certain populations, particularly adolescents and those predisposed to psychiatric conditions, but the aggregate body burden of chronic alcohol use far exceeds that of regulated cannabis use in adults.