What entails categorizing a substance as the most dangerous drug in the world? One would likely think of exotic poisons such as the venom of the black mamba, or botulinum toxin. The real answer to that question is quite startling it's alcohol.
According to a new report from the Centers for Disease Control and Prevention, approximately 88,000 Americans died each year from excessive alcohol use between 2006 and 2010, and these figures are rising. In 2010, the economic cost associated with this problem was an estimated $249 billion.
According to a paper in the Lancet, the legal status of a drug has little to do with its harms. Alcohol is accessible and easily obtained with respect to other drugs of abuse, and its sheer impact can be weighed by the vast number of people it will affect.
In an effort to understand drug harms, the authors of the paper assessed 20 different drugs and scored them on 16 criteria nine related to harm to individual, and seven related to harm to others and the drugs were scored on a 100-point scale.
Working with members of the Independent Scientific Committee on Drugs, including two specialists, researchers found that overall, alcohol was the most harmful drug, based on it receiving a 72, the highest score.
From a standpoint of alcohol's direct impact, it's a causative factor for a number of diseases that can affect any major system in the body. Meanwhile, the indirect consequences of alcohol consumption are widespread, with the economic impact of infections/illness, violence, accidents and lost days of work, being staggering and almost unquantifiable.
Much attention has been paid lately to the skyrocketing number of deaths from opiate and heroin overdoses linked to the epidemic of prescription pain killer abuse. While 47,000 deaths were attributable to this devastating problem, it is just over half of the number of deaths related to alcohol.
Unhealthy alcohol use ranges from consumption that puts people at risk of health consequences, to that which is responsible for multiple medical and/or behavioral problems meeting DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) diagnostic criteria for alcohol use disorder.
The U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA) has estimated consumption amounts of alcohol that increase health risks, as follows:
Men under age 65:
- More than 14 standard drinks per week on average
- More than 4 drinks on any day
Women and adults 65 years and older:
- More than 7 standard drinks per week on average
- More than 3 drinks on any day
These numbers, it should be noted, are not based on any exact science, rather they are based on epidemiological evidence as a basis for estimates. What constitutes a standard drink is defined as 12 grams of ethanol, five ounces of wine, 12 ounces of beer, or 1.5 ounces of 80 proof spirits.
It's easy to overlook the danger of alcohol simply because it is not a controlled substance. This is exactly why it is such a monumental public health problem.
Especially during the holidays, many of us will be celebrating with a drink, or two. While doing so, we ought to reflect that we are cradling in our hands the most dangerous drug in the world.