California Sober: A Marketing Trend or a Real Harm-Reduction Strategy?

"California sober," the practice of replacing alcohol with cannabis, has become a popular wellness trend. But Frank Spinelli, M.D., a health coach at Reframe, said the approach is missing something essential: a clear mechanism for change. Most recovery strategies identify what shifted in the brain, what behavior changed, or what changed in a person's environment. California sober, he said, mainly swaps one substance for another without addressing any of that.

Spinelli compared it to methadone maintenance, a harm-reduction approach built around measurable reductions in specific harms. "California sober is popular, but I don't really see the same kind of structure," he said.

What Are You Really Masking?

For people who feel uneasy about their relationship with alcohol, Spinelli asks a direct question: What are you masking? Depression? Anxiety? Simply substituting cannabis for alcohol does not resolve whatever the drinking was covering up, he said, and he cautions clients against swapping substances without doing the underlying behavioral work.

The Brain's Dopamine Loop

Spinelli described how alcohol triggers the brain's reward center to release dopamine, reinforcing the desire for more. Over time, tolerance builds, requiring more alcohol to produce the same dopamine response, which can lead to dependence.

Sugar: The Most Common Substitute

When people stop drinking, Spinelli said, many develop a transfer addiction, and sugar is by far the most common one. "Alcohol is primarily made up of sugar," he said, so cravings often shift toward desserts and sweets once drinking stops.

Reframe coaches encourage clients to watch for this pattern the same way they would watch for substituting cannabis for alcohol. Left unchecked, a sugar substitution can lead to weight gain.

Watching the Whole Picture

Spinelli said the real test of stepping back from alcohol is staying mindful of everything else happening in a person's life, including sleep, exercise and diet, with particular attention to sugar intake, the most common transfer addiction he sees in practice.