Alcohol Does More Harm Than Heroin or Crack

We've all heard about the dangers of “secondhand smoke.”

We might start talking about “secondhand alcohol abuse”—the way alcohol abusers abuse the rest of us.

Alcohol use causes more than 4 percent all deaths worldwide, more than the number caused by HIV/AIDS, violence or tuberculosis, according to a 2011 report by the World Health Organization. It is associated with violence, child neglect and abuse, crime, missing work-days, and of course, traffic accidents. "Yet, despite all these problems, the harmful use of alcohol remains a low priority in public policy, including in health policy,” the authors write. We spend huge sums on fighting a war on illegal drugs and pay little attention to the misuse of a legal one.

If you’re not convinced that alcohol abuse is a global problem: When another group of researchers analyzed the effect of 67 risk factors in 2010 on health around the world, tobacco and alcohol were in the top three factors causing death and disability.

Junkies mainly hurt themselves; alcohol abusers hurt other people. In a study concentrating on Great Britain, a team scored 20 drugs on the harm that they caused in the user and also secondhand. The team included a drug’s role in breaking up families and the costs of related health care, social services, and prison. On a 100-point scale, alcohol got a score of 72, followed by heroin, at 55, and crack cocaine at 54. More than 40 of alcohol’s 72 points came from harm to others. For heroin and crack cocaine, the harm to others came to about 20 points. Tobacco, with a score of 26, got less than 10 points for harming others.

It’s true that most people who drink don’t get themselves into trouble. About 11.5% of drinkers overdrink, the World Organization study reports, although binge drinking is rising among teenagers and young adults. Heavy drinking is largely a male problem: Men outnumber women four to one in weekly episodes of heavy drinking. Around the world alcohol is the leading risk factor for death in males ages 15–59, including death from injuries, violence and cardiovascular diseases. In Russia and neighboring countries, every fifth death among men is caused by overdrinking.

In the United States, we hear a good deal about drunken driving, but less about how alcohol plays into murder, wife beating, robbery and rape. The National Council on Alcoholism and Drug Dependence, an advocacy group, reports that in the United States, some 40 percent of convicted murders and 37 percent of rapes are committed by intoxicated people and that two-thirds of victims who were attacked by a partner say that alcohol was involved.

In heavy-drinking Australia, a country of 21 million, one poll found, more than 10 million people have been harmed by a stranger’s drinking. A report on one Carnival season in Rio de Janeiro, Brazil, found that at least 16,800 people “were reported hurt in…street fights, car crashes and accidents from excessive drinking.”

There are many ways to limit the harm alcohol causes and strategies for individuals short of going dry. People can stay away from drinking games, drink only on certain days or at certain times, always drink with a friend, pour their own drinks, leave their car keys at home or give them to a friend who isn’t drinking when they’re at a bar. If you have a record of drunken driving, sell your car. The main thing is to remember that you’re fully responsible for what happens when you’re intoxicated— even if you can’t remember what you did. If that sounds unfair, consider that a reason not to get drunk.

A version of this story appeared on Your Care Everywhere.