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SAN DIEGO — Californians do a lot of things differently from other Americans, so why not sobriety?

The concept of “California sober” — or “Cali sober” if you want to make that a thing — takes a swing at that idea. Its adherents generally abstain from alcohol and “hard” drugs but still smoke cannabis. Some proponents, like the author of a 2019 Vice article that’s often cited as popularizing the term online, also take certain psychedelics.

Proponents say that by choosing some drugs over others, they’ve been able to relax and expand their mind without suffering the pitfalls of addiction and other problems associated with substance abuse.

Popstar Demi Lovato was perhaps the most high-profile advocate — they even wrote a song about it — but later said that “sober sober” was the only lifestyle that worked for their long-term recovery.

So in weed-friendly California, is this kind of selective sobriety a path forward for folks who want to change some, but not all, of their habits?

Dr. Brian Couey, the director of outpatient services at the Betty Ford Center, discussed the concept with in a phone interview this week. Couey emphasized multiple times that every individual, their relationship with drugs and their recovery process is unique. His advice is also more targeted toward people who struggle with substance abuse than occasional recreational users.

In 15 years of work in the fields of mental health and addiction treatment, the clinical psychologist has seen many people try half-measures at sobriety only to find entirely swearing off drugs was the best path forward for their health.

“For people who truly have addiction, complete abstinence tends to work the best,” Couey said. “‘California sober’ or using in moderation may not produce the results that a person is looking for.”

Couey said different drugs and other compulsive behaviors play on the same parts of our brains, and we often rely on them for the same reasons, like dealing with stress or numbing ourselves to sadness and anxiety.

“Addiction does not have as much to do with which substances people use as it does with the person’s biology, their psychology and genetics,” he said. “It’s more about how a person’s brain reacts to chemicals … than it is about a specific chemical that they ingest.”

In short: “Addiction is really about people, it’s not about any particular drug.”

Research shows that “non-chemical,” or behavioral, addictions (think gambling, food, pornography or video games) involve the same brain structures as those that play into drug use, Couey said. While each person is different, those that struggle with one addiction are statistically more likely to struggle with another.

You’re also not entirely allowing your brain to heal if you continue to use one drug while abstaining from another that you’re trying to quit, Couey said.

“If you have actual addiction — a substance-use disorder — and you continue to alter your brain chemistry through chemical misuse, the addictive neural pathways in your brain are not going to be allowed to heal and recover,” he said. “If you continuously raise your dopamine levels artificially through chemical misuse, whatever the chemical is, you’re likely to fall into problematic behaviors.”

Again: It’s about more than the drug itself.

“Addiction is also about habits and rituals that reinforce behavior. When much of your life is about drinking or using to feel normal, whatever substance you’re using, you may struggle to facilitate the growth and recovery that comes with adaptively coping with things using your own internal abilities.”

A final consideration from Couey: The marijuana you buy at legal dispensaries today and the ways you get high from it have changed from 30 years ago, but our attitudes about how “serious” of a drug it can be have not.

Couey said the average THC content found in available cannabis products has significantly increased, especially with vapes and “dabbing” rigs for wax and other hash oil concentrates. That can increase its potential for misuse and for some of the psychological issues associated with substance abuse, including anxiety and depression.

“There’s no hard-and-fast rule,” Couey said, again emphasizing that each case he encounters is different.

But generally, the psychologist has a litany of suggestions for those looking to address their addiction to alcohol or another drug — and they don’t revolve around replacing it with cannabis.

“Decades of research support evidence-based practices, FDA-approved medications, feedback-informed treatment, 12-step programs, cognitive therapy,” he said, ticking down the list.

You can learn more about treatment options on the Hazelden Betty Ford Foundation’s website. California locations include San Diego, Los Angeles and the Palm Springs area.