As recently as the early 2000s, many Americans viewed cannabis as a dangerous “gateway drug” with little potential for medical use. But over the past two decades, many of these myths have been replaced by hard science, and the general public’s perception of weed has undergone a paradigm shift.

Most Americans now accept the fact that cannabis has proven medical value and less potential for abuse than alcohol, Xanax, or opioids, according to new survey data published in the Addictive Behaviors journal. This survey asked 1,050 adults from across the US to share their views regarding the medical usage and potential risks of a variety of drugs ranging from caffeine to heroin.

Each respondent was presented with a list of drugs including prescription opioids (hydrocodone and oxycodone), anxiolytics (Valium and Xanax), cannabis derivatives (marijuana, hemp, THC, and CBD), illegal drugs (cocaine, heroin, and methamphetamine), and legal drugs like alcohol, coffee and Advil. Every participant was asked to rate the abuse potential of each drug on a scale of 1 to 5. The survey also asked subjects whether they thought each drug had an accepted medical use.

The respondents rated cocaine, heroin, meth, and oxycodone as presenting the highest potential for abuse, and placed alcohol, Xanax, and other prescription drugs in the second-highest risk category. Participants said that they felt all forms of cannabis had less potential for abuse than any of these other drugs. In fact, the only drugs that were considered safer than cannabis were coffee, Advil, and Tylenol.

When rating each drug’s medical potential, subjects chose aspirin and ibuprofen as the drugs with the greatest medical use. Subjects felt that marijuana and CBD were just as medically useful as Xanax or prescription opioids, but rated THC and hemp with a slightly lower medical potential. Coffee, alcohol, coke, meth, and heroin were all seen as drugs with little to no medical use.

This study makes it clear that most Americans are well aware that cannabis has as much medical potential as prescription opioids, but presents fewer risks of addiction. Sadly, the US government still hasn’t gotten the picture. All forms of cannabis are still classified as Schedule I substances, a category reserved for highly addictive drugs that have no accepted medical use. 

“Combined, these results provide evidence that US consumers would not classify any of the cannabis derivatives as Schedule I substances and perceive them as having no greater potential for abuse than cocaine and methamphetamine (Schedule II),” the authors explain. 

The survey also asked subjects whether they used cannabis, and if so, why. About a third of all respondents said that they had indeed used THC or CBD products, and out of this group, as much as half had used cannabis products as a replacement for other medications. In fact, only a quarter of cannabis users said they used THC products recreationally, suggesting that the majority were using THC for medical use. 

These findings support prior research showing that a sizable percentage of cannabis consumers are buying pot for medical reasons, and not solely for recreational use. The present study also backs up other studies finding that cannabis products can serve as effective substitutions for prescription opioids or benzodiazepines.

“Making cannabis more available is likely to reduce demand for over-the-counter drugs and medications taken for anxiety, pain relief, and (to a lesser extent) sleep aid,” the authors concluded. “The study findings suggest that the majority of US Cannabis consumers perceive THC and CBD as viable medical alternatives to pharmaceutical products available on the market even though the medical literature currently does not support their perceptions.”

“The overwhelming majority of Americans have long abandoned the federal government’s ‘Flat Earth’ position that marijuana is [a] highly dangerous substance without any therapeutic efficacy,” said NORML Deputy Director Paul Armentano in a statement. “It is time for Congress to jettison this intellectually dishonest position as well and remove cannabis from the Controlled Substances Act in a manner similar to alcohol — thereby ending the existing state/federal conflict and permitting state governments, not the federal government, to be the primary arbiters of cannabis policy.”