not to mention so can alcohol which is very legal, very marketed, well accepted, and also more deadly and addictive than many so called "dangerous drugs".
Alcohol does a great deal of harm simply because it’s very common and often severely abused. Few drugs are harmless when heavily abuse for decades drives up tolerance levels.
Lifetime ultra heavy pot smokers for example face significant lung cancer risks, though very few people are heavy daily pot smokers for 50+ years at this point.
At the other end, 1 glass of wine every day for 60 years is as far as we can tell on net harmless. Where even light daily pot smoking still causes some lung issues on those timescales. So yes, alcohol in and of it’s self can be deadly but it’s not nearly as bad as these comparisons generally suggest.
In isolation yes it can cause a very small increase in cancer. But it also has other upsides such as reduced cardiovascular issues.
Therefore you need to take net not individual health impacts, which is more complicated. Remember the scale 55% of adult Americans drink at least monthly and those cancers are still rare and also associated with soda consumption etc.
It’s not safe, but a neutral comparison is to compare all users over all timescales. As such an infinitesimal number of alcohol users OD very early on but that’s extraordinarily rare. Chronic use is relatively common, and while not generally deadly for decades has significant issues.
By comparison even clean opioids are more deadly long term. Pot has different Heath effects but is not safe when consumed to excess with extremely heavy users facing mental and physical issues, which can for example result in cancer or traffic related deaths.
Which again isn’t to say alcohol is safe, but rather heavy drug is generally bad independent of drug type.
I’m not arguing otherwise, but the apologetics around alcohol concern me because all too often we hear “oh it’s only a beer”, and “well of course some people have problems but most are ok” used in the same breath as “cannabis causes mental health problems”, utterly disregarding that alcohol does too.
People don’t evaluate alcohol use the same way as they do drug use and they should. When honestly evaluated that way alcohol is right up there in terms of harm.
You can’t put it all down to how common it is, and neither can you write off ‘abuse’ as a separate issue, abuse potential is all part of the harm profile.
My context was someone saying well accepted, and also more deadly and addictive than many so called "dangerous drugs" which is a common argument but as far as I can see biased in the other direction. ~55% of adult Americans drank alcohol in the last month, it’s hard to find illegal drugs that would be safe at that scale and level of use.
Micro dosing LSD for example is likely comparable to some moderate alcohol use. But, if 55% of the population was self administering LSD it wouldn’t be limited to people micro dosing. Many would push thing to much higher levels regularly. That’s really the only thing I meant by separating out people abusing alcohol. It’s part of the spectrum of use, but not the only point of comparison.
> ~55% of adult Americans drank alcohol in the last month, it’s hard to find illegal drugs that would be safe at that scale and level of use.
In that same month about 8000 people in the US died from alcohol-related issues. So I'm losing sight of your point?
Booze just is well established in the literature (AFAICT) as more addictive and more deadly than many/most other recreational drugs. Generally excluding tobacco, opiates, cocaine or methamphetamine, sure, but experts in the field tend to rank it more or less with them. If you don't think the people studying this stuff have taken the widespread nature of alcohol's use into account ... well I think they likely have.
LSD, your example there, is generally considered non (or relatively non) habit-forming, we'd be unlikely ever to see chronic health effects there. At the doses it's commonly used we'd be unlikely to see acute mortalities (though vasoconstriction can be a side-effect), though I imagine some idiots would still take it and get in the car. Result - even if available freely and used widely, it's very likely it would cause fewer deaths and other societal problems than booze.
Remember holistic comparison not just specific areas that support your argument.
Those alcohol related deaths include car accidents. If ~150,000,000 people in the US regularly took LSD you would get a significant increase in such accidents independent of any other health effects. Falls, suicides and other mental Heath related deaths would also increase. LSD related deaths are hard to track as only ~0.1% of adult are active users but from the data we have 8k deaths per month at that scale is roughly within the margin for error.
Now, you can reasonably argue that fewer than 150 million people would take LSD but that’s hardly making it safer for those who would. It’s just arguing Alcohol is popular not that it’s inherently more dangerous.
>> Now, you can reasonably argue that fewer than 150 million people would take LSD but that’s hardly making it safer for those who would.
Of course it is. Wow.
LSD is not habit forming. That's the point. This is so frustrating and you keep ignoring it. LSD does not present the same danger to the individual as alcohol because people are not drawn to keep using it in the same way. This in itself reduces the dangers of chronic problems, because lifetime exposure is reduced. It also reduces the liklihood of acute problems, because the frequency of use is reduced. This includes both physical and mental health issues, and consequences of intoxication like car crashes.
>> It’s just arguing Alcohol is popular not that it’s inherently more dangerous.
No, it isn't.
Alcohol is addictive. More so than most other drugs.
"Alcohol is addictive. More so than most other drugs."
Alcohol withdrawal can be nasty. But it takes years and dedication (usually) to build up an alcohol habit that threatens serious withdrawal symptoms; for the most part, "withdrawal" is simply a hangover.
Contrast with a minor tranq such as diazepam: you can easily acquire a habit from which withdrawal is potentially life-threatening, in as little as a month.
Addictiveness isn’t the primary issue with drugs. Caffeine is quite addictive (61) almost as much as Alcohol (81) though notably less than Nicotine (100), it also has withdrawal symptoms, and occasionally people even OD, but it’s a also much safer because it doesn’t have significant health impacts or impare driving.
LSD is mildly addictive (18) slightly less than MDMA (20) or Marijuana (21). But MDMA is inherently much more harmful. That said, when LSD was legal it was quickly becoming popular and caused users a lot of issues. As such the more addictive nature of alcohol (81) is just one property and not enough on it’s own to compare it to other drugs.
Research by John Hastings. Relative rankings are definite, numbers given are (+/-)1%
While addictiveness is not the same as habit forming, it does link to overall useage.
"LSD, your example there, is generally considered non (or relatively non) habit-forming"
It's literally impossible to acquire an LSD habit. After 3 or 4 days of continuous LSD use, no amount of LSD will have much effect on you. You need to lay off it for a few weeks to re-sensitise.
> Alcohol does a great deal of harm simply because it’s very common and often severely abused.
The body of someone who uses medical heroin every day with clean needles and doesn't drink alcohol will be in a much better state than someone that drinks two liters of beer every day. Of course I don't think that there is a person with a heroin addiction that doesn't also have an alcohol problem.
I think it makes sense to look at alcohol as more dangerous than heroin from a personal risk perspective.
> At the other end, 1 glass of wine every day for 60 years is as far as we can tell on net harmless.
The evidence seems to be that even low levels of alcohol consumption can increase the risk of certain cancers:
Moderate alcohol use is associated with some cancers, but is also associated with cardiovascular benefits. On net it’s as far as we can tell neutral.
All opioids build tolerance but not resistance. Overdoing is sadly common in very long term users even of medically sourced and therefore clean drugs. Even clean heroin by itself is vastly more deadly than Alcohol for average users over moderate to long timescales.
Which is why you need to compare habitual long term users of drug X to habitual long term users of drug Y.
I would say that inhaling smoke, especially tar-rich smoke from burning organic matter, is bad for lungs. The presence of any psychoactive substance in it changes little. There are several other ways to consume THC, though, somehow less destructive.
By the same token, drinking alcohol in shots, cold and concentrated, is about the worst way to consume it, because most of it is then spent ruining the liver, and little actually reaches the brain. Sipping a glass of wine does not compare.
AFAICT a lot of health problems that even heroin addicts face do not come from overdoses, but from the unsanitary ways of intravenous administration of it, and the wear-off of the veins from constant injection.
Comparing drugs by just their chemical properties, and ignoring the ways they are consumed, is not very productive, alas.
> By the same token, drinking alcohol in shots, cold and concentrated, is about the worst way to consume it, because most of it is then spent ruining the liver, and little actually reaches the brain. Sipping a glass of wine does not compare.
That really isn’t how alcohol works in the bloodstream. Once it’s through the GI tract there is zero difference in what the source of alcohol is. Further, the liver takes a long time to break down a shot of alcohol or a glass of wine. The only real difference is to the throat, stomach lining where more concentrated alcohol can be a larger irritant. But again once it’s in the blood stream it’s both significantly diluted and rapidly spread throughout the body.
Now sipping wine with food does significantly slow absorption, but it’s the same effect if you take a shot in the middle of a meal.
