It is Time for a Serious Conversation… About Alcohol

This may not be a terribly popular topic, but somebody needs to talk about it.

We hear and read a lot of rhetoric about the marijuana/cannabis legalization debate, though in my opinion, it is mostly political in nature. There are complaints and a few stories about meth problems in some areas of the country, not so much in others. We hear a great deal about the opioid epidemic in the United States, and we should, it’s important.

According to the Center for Disease Control (CDC), there were just over 77,000 opioid-related deaths in 2017 in the US. Clearly, something must be done. There are Presidential committees, and pharma industry regulation changes, and Congressional hearings. News stories abound.

Good, I am glad that the opioid problem is getting the attention it deserves.  So why is everyone ignoring the white elephant in the room? Alcohol.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA), puts the number of alcohol-related deaths at 88,000, but we hear… crickets. A number that large makes alcohol the third leading cause of preventable death in the United States, behind tobacco and “poor diet and inactivity”. On a global scale, “in the age group 20–39 years, approximately 25 percent of the total deaths are alcohol attributable.” Let me rephrase that, and repeat it: 25% of all the deaths, amongst the 20-39 crowd in the entire world, are caused by alcohol use.

When I have talked with people about this, the answer always seems to be some variant of “Nobody talks about this because alcohol is such a big part of the culture.” Clearly, there is some truth to that. Though it seems to me that smoking was a “part of the culture” at one point. Hell, in the sixties and seventies, Walter Cronkite used to chain smoke while he read the news live on national television. But that didn’t stop the movement to make smoking unpopular and for drastic changes in ‘that culture’. So, why the crickets, where alcohol is concerned?

Hear me, I am not asking for government intervention, that is rarely the answer to anything. They tried that, Prohibition during the 1920s and early 1930s was a disaster, causing law-abiding citizens to become criminals to satiate themselves and the criminal syndicates to find a massive revenue stream. Besides, if you have ever been to a congressional dinner or fundraiser and have seen the consumption by our ‘leaders’, government action seems highly unlikely.

But I would like to see a national conversation aimed at changing the culture of mind-altering substances. Why is it that people need to reach altered states to ‘have fun’? Why is it that such a large percentage of our population put themselves at risk for such a fleeting benefit?

What risk, you ask? There are, of course, the obvious issues: Hangovers, poor decisions, bar fights, DUIs, etc. I stated earlier that Alcohol was the number three cause of preventable deaths in the U.S; behind Tobacco and “poor diet & inactivity”. There have been numerous studies showing an increase in smoking while drinking, both the onset of smoking and the frequency of smoking. Alcohol is clearly a factor in the number one cause of preventable death. Number two, “poor diet & inactivity” also has alcohol as a factor. The excess empty calories in alcohol are certainly a contributor, with very little positive impact on health (except perhaps for a modest amount of wine’s oxidative benefits). There has been a national conversation about obesity, but rarely is the alcohol connection mentioned, except nutritionist’s calorie counting lists.

For more study data:

So, alcohol is number three and has an impact on the number one and two causes of preventable deaths… still no conversation. So, let’s keep going. There is a lot of talk about drug use, specifically meth, opioids, heroin, and marijuana. I don’t have data, but anyone who has dealt with addiction and/or excessive drug use can see the link with alcohol as likely for a high percentage of first use, the gateway if you will. Suicide has been a national conversation, especially amongst teens and/or veterans, but rarely is a connection to alcohol mentioned. In the U.S. the ‘victims’ blood toxicity results show that more than one-third of all completed suicides had alcohol in their system at the time of death. Not only that but adult alcoholics are 120 times more likely to commit suicide than the general population.

Still not ready to have that conversation? The National Cancer Institute has positively linked alcohol use to increased risk of 6 types of cancer, with several other types having tentative links. Most people understand the link between alcohol and cirrhosis of the liver, but it is also the number one factor in liver cancer.

People who drink regularly also have a 2-3 times greater risk of head and neck cancer, even more, if you drink and smoke.

Drinking contributes to esophageal cancer, too.  The NIAAA states, “Alcohol consumption is a major risk factor for a particular type of esophageal cancer called esophageal squamous cell carcinoma. In addition, people who inherit a deficiency in an enzyme that metabolizes alcohol have been found to have substantially increased risks of alcohol-related esophageal squamous cell carcinoma.”

Ladies, even with all the walks and pink ribbons, are you aware that drinking even as little as one drink per day has been shown to cause a 12% increase in your chances of getting breast cancer? It is true.

So, as a whole, this seems to be a fairly compelling argument to begin to address alcohol use; and I haven’t even discussed alcoholics (except in the suicide numbers), broken homes, destroyed families, affected children and spouses of alcoholics. I will save that for another day.

White elephants in the room tend to get ignored, nobody wants to acknowledge it and risk a cultural backlash. It’s a shame.

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