What Most People Don't Understand About Alcohol and Drug Use

Every year, countless deaths are attributed to the misuse of drugs and alcohol. When it comes to understanding the risks, though, there are often discrepancies between our perceptions and reality. Research has suggested that we tend to overestimate the prevalence of deaths due to drugs and alcohol but underestimate our personal risk of harm. This post will explore the psychology behind risk perceptions, examining some of the biases we typically experience with respect to both societal and individual levels of risk.

Primary Bias in Risk Perception

The primary bias in risk perception refers to the tendency to overestimate uncommon risks and underestimate common risks. One of the seminal figures in risk research, Paul Slovic, found that we typically overestimate the risk of dying from homicide or natural disaster, but underestimate the likelihood of dying due to diabetes, cancer or stroke.

New research, from myself and colleagues at Northumbria University, surveyed a representative sample of 1,500 UK adults to assess perceptions of risk relevant to different causes of death. We found that, on average, people in the UK overestimated the proportion of avoidable deaths accounted for by drugs and alcohol by 10 percent and underestimated the proportion of deaths accounted for by cancer by 16% and cardiovascular disease by 14 percent.

Previous academic research has suggested that this tendency to overestimate the prevalence of deaths due to drugs and alcohol may be down to the media's sensationalized reporting of high-profile overdoses and binge drinking. An exaggerated media focus may foster the belief that drugs and alcohol are a widespread and imminent societal threat.

Despite the extensive harm caused by drugs and alcohol, the number of deaths is substantially lower than what the public perceives. Overestimating these risks at a societal level can lead to a misplaced focus on moralising addiction and punishing problematic users, instead of providing a more measured public health response. This overestimation can also lead to unnecessary fear and anxiety surrounding drug and alcohol use, which can further contribute to the stigmatization of individuals struggling with addiction.

Personal Risk

Despite overestimating the prevalence of deaths due to drugs and alcohol, we still tend to underestimate our personal level of risk. Participants in our recent study believed that drugs and alcohol were the most prevalent causes of avoidable death in the UK, but were highly unlikely to lead to their own death.

This may be due to the belief that death from drugs and alcohol is something experienced by other people, and the feeling that we are somehow immune to the risks. Drugs and alcohol were also believed to be the most controllable causes of death, suggesting that we generally feel that we can manage the potential risks, but others can’t.

Research on cognitive biases may help to explain the discrepancy between our perceptions of drugs and alcohol at the societal and personal levels of risk. The fundamental attribution error refers to our tendency to attribute the behaviour of others to inherent personality traits, rather than to external circumstances and environmental factors.

Simply put, when someone else does something bad, we assume it’s because they’re a bad person. When we do something bad, we attribute our actions to circumstances outside of our control. When applied to drugs and alcohol, this bias can lead us to view substance misuse as a moral failing or weakness of character, rather than recognizing the complex interplay of genetic, environmental, and psychological factors that shape behaviours.

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Self-Awareness

Research has consistently shown that people tend to underestimate their alcohol consumption: Almost half of the alcohol sold in the UK is unaccounted for, based on the consumption figures given by drinkers. In an international study of drinking habits, the tendency to underestimate personal consumption of alcohol was found to be common in the U.S., Canada and Australia, and highest among UK males.

Some problematic drinkers often look to validate their own habits by pointing to societal norms that are themselves excessive or unhealthy. Others discount the potential harms of heavy consumption through misplaced bravado, or feel that those who warn of the risks of alcohol are trying to stop people from enjoying themselves.

However, it is worth noting that in the U.S., alcohol kills more people than all other drugs combined. Habits may be changing, with recent trends suggesting that Gen Z members are drinking less than people in previous generations. Whether we choose to drink, moderate, or abstain, it is important to reflect and assess our own habits for what they are and for what they contribute to our health.

Cognitive biases, sensationalist media reports, and cultural norms that obsess over the dangerous appeal of drugs and alcohol all come together to drive a wedge between our perceptions and reality. Research suggests that we typically overestimate the prevalence of substance-related deaths.

That said, our tendency to attribute undesirable behaviours to the moral failings of others, whilst blissfully turning a blind eye to our own overindulgence, should prompt us to be more mindful of our habits. Greater self-reflection of the underlying biases that drive our perceptions may help us to make wiser decisions and to avoid the risks of problematic drinking and the increasing tendency to self-medicate.

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