Feb. 4, 2024  – Notions of what constitutes sobriety and problematic substance use have grown more flexible in recent years as younger Americans have shunned alcohol in increasing numbers while embracing cannabis and psychedelics — a phenomenon that alarms some addiction experts.

Not long ago, sobriety was broadly understood to mean abstaining from all intoxicating substances, and the term was often associated with people who had overcome severe forms of addiction. These days, it is used more expansively, including by people who have quit drinking alcohol but consume what they deem moderate amounts of other substances, including marijuana and mushrooms.

“Just because someone has a drinking problem doesn’t mean they have a problem with every single thing,” Mr. Reed said. 

As some drugs come to be viewed as wellness boosters by those who use them, adherence to the full abstinence model favored by organizations like Alcoholics Anonymous is shifting. Some people call themselves “California sober,” a term popularized in a 2021 song by the pop star Demi Lovato, who later disavowed the idea, saying on social media that “sober sober is the only way to be.”

Approaches that might have once seemed ludicrous — like treating opioid addiction with psychedelics — have gained broader enthusiasm among doctors as drug overdoses kill tens of thousands of Americans each year.