Thursday, April 6, 2017

Alcohol: America’s elephant in the room

alcohol, health, medicine, alcohol policy, drug policy

America's myopic view on alcohol, its unanimous drug of choice, unravels all efforts to make healthcare affordable. The view creates drug crises, like the opioid one the country is mired in. It shortens life expectancy, smothers productivity, and snuffs out lives.

The very problem originates with the last effort to rid the nation of alcohol harms: The failed American experiment of Prohibition. Once the country was back on the sauce and legit merchants replaced mobsters as the distributors, we gained a taxable commodity. Drunk on alcohol tax revenue and woozy from the Prohibition drama, no politician would throw his neck into the drug policy noose ever again when it comes to this drug. Laissez-faire defines our drug policy when it comes to alcohol.

The closest we came to reframing the view on the toxin was in the Lyndon Johnson administration. President Johnson declared the drug 'America's leading health and economic problem.' Then he went about talking to the paintings in the White House and was voted out. We didn't talk about this elephant in the room again until the U.S. Surgeon General's 2016 Report on Alcohol, Drugs and Health. This was the first time the office ever addressed the $250 billion in annual economic harm caused by alcohol. Not a hard thing to do when your party is getting voted out, but still a landmark moment in U.S. drug policy.

Changing the alcohol dialogue
Where society fears to tread is moving the dialogue beyond car wrecks and the disease of alcoholism. We know these are 'bad,' but generally, the alcohol business and our own experimentation tell us the drug is otherwise safe and it's capitol-F FUN. Reality – in the form of evidence-based science – has a funny way of changing that perspective.

Mothers Against Drunk Driving (MADD) convinced America that alcohol-related car wrecks were going to be our legacy if we continued to pave our roads with the bodies of young motorists and pedestrians. And they were right. Their laudable movement recently reached its maximum potential, reducing alcohol-related road fatalities to 30 percent of all road fatalities. Eliminating the last 30 percent is possible with technology, but politically unacceptable. America loves alcohol. So we're stuck at around 10-11,000 alcohol-related traffic fatalities year in, year out.

There are 89,000 alcohol-related deaths every year. That's the elephant. Drinking and driving carves away on one in eight of those fatalities. Alcoholics die of cirrhosis, right? About 4,000 do. Yep, that's it. So we eliminate the alcoholics and the drunks behind the wheel and there are still more than 70,000 alcohol-related deaths every year because alcohol is 'safe in moderation.'

The numbers game

The numbers say otherwise. Twenty-to-forty percent of general-use hospital beds go to treating alcohol-related complications. Wounds heal more slowly under the influence. Blood pressure increases. Stroke risk doubles. Prediabetes throws blood levels out of whack. Alcohol causes heart disease. Alcohol causes cancer. Eight types to be precise. Drownings. Suicides. Household accidents. All of these consequences stem from even moderate use of the drug.

It's a toxin. Destructive to the point of altering DNA. And you're not alone for not hearing about that: Presently the alcohol industry directs the alcohol dialogue. They can get behind MADD because the product they make just got in the hands of all the wrong people. They can't very well go out and advertise that they are making a toxic drug with no health benefit. Nobody would ask the mom-in-law to come in and help resolve a marital dispute. So don't expect the industry creating the problem to highlight it.

Remember smoking? So glamorous. Some MadMen-era clown even professed smoking was healthy. Smoking used to be a numbers game. In 1964, 72 percent of adult men smoked. Profits tumbled in by the bale. The Surgeon General came out with a report on the health impact of tobacco smoke. Today, 72 percent of adult men don't smoke. What happened in between is that the big numbers of smoking related costs and deaths became more of a priority than tobacco profits. Tobacco companies even tried to dismiss their own data on the health hazards. 

They ran into a tide of education that turned Americans from dumb smoking sheep into informed consumers.

The takeaway here is that tobacco is still profitable today. And fewer people are killing themselves over its drug nicotine, but they still can choose to do so.

Starting from the start
The status quo with this drug has reached unsustainability. The $250 billion is half of U.S. military spending. It's the equivalent of the Gross Domestic Product (GDP) of the 40th largest economy on the globe. The 89,000 deaths rank it third in preventable causes of death. The toxin, even in moderation, is clinically linked to more than 60 diseases. No alcoholic – and there are 20 million of them in the U.S. – ever became alcoholic without first taking a drink.

Reinventing the the alcohol dialogue begins before use. Would anyone take a swig of perfume or down a bottle of cologne? No. Not even the worst parent would model that for their kid. No TV commercial would tell them it's safe. No primary grade teacher would profess it to be ok so long as you didn't get behind the wheel on perfume or get hammered on it.

What's perfume got to do with it? The body breaks down alcohol by metabolizing first into acetaldehyde: A colorless flammable liquid used to manufacture... perfume. Acetaldehyde is too volatile to use straight-up in perfume or cologne so it is mixed with other ingredients in everything from cheap stinks like Hai Karate to whatever high-buck Euroscents the Kardashian clan pimps. Your body turns alcohol into the same rapid-evaporating fragrance carrier the International Agency for Research on Cancer (IARC) lists as a group one carcinogen.

Get the picture? Your body can't not make acetaldehyde from alcohol. Alcohol intoxication just makes you do stupid stuff by lowering inhibitions, intelligence, and rational thought. Acetaldehyde. Damages. Tissue. It permanently alters DNA. You don't see that in a wine commercial, or many classrooms or doctor offices for that matter. When educating about alcohol, we need to get back to the basics on what it is we're drinking and point that out early and often.

Changing alcohol education solves several problems

Whether the approach to alcohol is laissez-faire, or just plain lazy, the vast and unwavering worship of the mind-altering, mood-altering elixir has become the proving ground for what we have in our treatment facilities today. Alcohol is a gateway drug, meaning people get their appetites for other drugs by experimenting with with this drug first. If, culture-wide, we're embracing a gateway drug as socially acceptable and 'safe,' we cannot realistically expect to keep any kid off drugs, especially other depressants like our current crisis-du-jour, opioids.

If we change the dialogue on this drug, do we cease creating more addicts or alcoholics-in-training faster than we create alcoholics-in-recovery? Nothing will stop a person who wants to use a drug from using that drug. Period. So we keep it legal, like tobacco… tax the hell out of it… and educate (or re-educate) America that what causes problems, is one.

Scott Stevens, is the author of four alcohol books including the December 2016 release, I Can’t See The Forest With All These Damn Trees In The Way: The Health Consequences of Alcohol. Buy the new BookLocker title now on Amazon (,, and everywhere books are sold. Stevens also heads up BlogTender LLC, a content marketing firm headquartered in Lake Geneva, Wis. Image by Luis Chumpitaz, used with permission.