Alcohol impact

A British assessment of the societal impact of alcohol reaches some sobering conclusions.

The conclusions of a group of British experts concerning the harmful effects of various legal and illegal drugs is a strong reminder of the potential damage attributed to one of the world’s most accepted drugs: alcohol.

The report published online Monday in the medical journal Lancet concluded that, when all its harmful effects are considered, alcohol is more dangerous than illegal drugs like heroin, methamphetamine or crack cocaine. The report was based on the assessment of a group of British drug experts who gathered last June to assess the effects of 20 drugs. The participants ranked the impact of the drugs, both on users and on others, using a range of physical, psychological and social factors.

The online report apparently relies almost entirely on how the individual experts assessed the variables, so an element of subjectivity was involved. It also is done by British experts, but it seems likely that their conclusions have some broad applications in other countries, including the United States.

Perhaps the most interesting finding of the report was that although many illegal drugs were judged to be more harmful than alcohol to their individual users, when the “harm to others” was factored in, alcohol was far and away the top offender. The “harm to others” factors included such issues as crime, injury, loss of relationships, economic costs and cost to the community.

The experts scored alcohol particularly high in terms of economic costs (costs for such things as health care, police, prisons and social services, as well as costs related to lost productivity and absenteeism) and injury, which referred to the chances of the drug’s use causing injury to others, including traffic accidents, fetal harm, domestic violence, etc. Alcohol also was a notable leader in contributing to family adversities, such as family breakdown or child neglect.

The overall conclusion of the experts, therefore, was that, while many illegal drugs have a devastating impact on the individuals who use them, when it comes to the impact on society as a whole, alcohol is by far the most damaging drug.

It is a sobering assessment, but one that makes sense on a number of levels when we consider serious or fatal accidents caused by drunken drivers, workers impaired by alcohol use and the impact individuals’ alcohol use can have on families and children.

Although the British experts didn’t advocate outlawing alcohol, the report concludes “that aggressively targeting alcohol harms is a valid and necessary public health strategy.” Their assessment also raises some interesting questions about why some drugs that cause less societal harm than alcohol are illegal, while alcohol is ingrained and accepted in most global societies.

Because alcohol is legal in the United States, we tend to think of it as harmless. The conclusions of the British report should give us reason to rethink that judgment.