Alcohol Drug of the Month: download
Transcript and Sources
And now it’s time for the Drug of the Week, where we look into the origins, science, history, legal status, and current uses of a different drug each week. For this, our debut episode, the drug of the week is one that is among the most commonly used in our culture, one used in both religious ceremonies and secular celebrations, but also linked with violence, disease, and death. That drug is, of course, alcohol.
Now listeners might be a little confused as to why we’re not looking at a drug like marijuana or cocaine. But while this podcast will extensively cover illegal drugs and the impact of their prohibition, we also think it’s important to talk about legal drugs and the regulations that govern them. I think we need to truly understand that drugs like alcohol or caffeine are, in fact, drugs. While most people know this intellectually, popular phrases like “drugs and alcohol” reveal that we still separate them at some level, which warps our relationships with them and leads us to treat alcohol less seriously, despite it being among the more dangerous drugs from an objective standpoint. Back when I was in SSDP at UConn, I actually discussed this with some University staff and got them to switch official materials from “drugs and alcohol” to “alcohol and other drugs” – some may not think it’s a big difference, but I think being more accurate with the way we talk about alcohol can help people treat it more responsibly and reduce a lot of the problems associated with it.
What exactly is it? Where does it come from in nature, how is it turned into useable form?
But to start off, what exactly is alcohol? From a chemistry standpoint, an alcohol is a class of compounds where there is an oxygen and hydrogen atom bound to a saturated carbon atom, meaning all its other bonds are occupied. But when we talk about alcohol as a drug, we’re talking specifically about ethanol, also known as ethyl alcohol. As beer enthusiasts may already know, ethanol is a byproduct of the metabolic processes of yeast, which are tiny one-celled organisms. This process, called fermentation, only requires carbohydrates, and spits out CO2 and ethanol. Since sugar is a carbohydrate, this means that alcohol can be found in nature wherever there’s both sugar and yeast, such as in overripe fruit. Man-made alcoholic beverages just harness this natural process and turn various kinds of carbohydrates (like sugars or grains) into ethanol, resulting in different drinks – like how wine comes from grapes, rum comes from sugar cane, and beer comes from grains like barley.
What is the science behind how it interacts with the body? What receptors does it influence? What are the medical effects of it, potential side effects?
Alcohol poisoning isn’t common in comparison to the damage indirectly caused by alcohol, it is still pretty substantial. An average of 2,221 Americans die of alcohol poisoning every year – that’s 6 per day. Of those deaths, 75.7% involved adults aged 35–64 years, and 76.4% involved men. Stereotype is of college students or other young people, but it’s mostly middle-aged men who die from alcohol poisoning. This is actually another example of language unique to alcohol that makes it seem separate from illegal drugs – we call deaths from ingesting too much of a drug like heroin “overdoses” while death from too much alcohol is a “poisoning,” even though it’s technically an overdose too.
And compared to other drugs, alcohol is actually pretty easy to overdose on. In the science world, alcohol toxicity is measured by something called the LD-50, which is the lethal dose for 50% of the population – pretty much, if you take the LD-50 amount of a drug, there is a 50% chance you’ll die from it. Then you can just divide it by what people normally consume to see how many doses will kill the average person, what some researchers call the “safety ratio.” For alcohol, this is only 10 – meaning drinking ten times the usual amount can kill you. In comparison, it’s 15 for cocaine, 16 for MDMA, and 38 for ketamine. Heroin is deadlier at a 6, and methamphetamine is the same as alcohol at a 10.
Other long-term effects of heavy drinking include stomach ulcers, liver disease, and a lowered immune system, along with mental health problems like depression. According to the Centers for Disease Control and Prevention, alcohol causes about 88,000 deaths per year in the US. This includes chronic causes like liver disease, which kills more than 15,000 people a year, and acute causes like overdoses and accidents. Drunk driving killed just over 10,000 people in 2013, the latest year for which we have data. While this does sound like a lot, and any preventable death is tragic, this is actually a huge improvement over the past – in the early 80s, it was normal for over 25,000 people to die from drunk driving each year. This reduction in deaths is thanks to improvements in car safety, public education campaigns like encouraging people to use designated drivers, and stricter laws and social attitudes when it comes to drinking and driving.
The reason alcohol causes so much death and destruction is complicated, but two major factors are that it’s widely available and highly addictive, which actually probably feed into one another. Because of its history and popularity, alcohol is pretty loosely regulated in the US, and even more loosely in some other countries – aside from the few countries that ban it entirely, most of the world has lower drinking ages than the US, and Russia actually didn’t officially classify beer as an alcoholic beverage until 2013. While there are still some dry counties in the US that ban any sale of alcohol, the vast majority either allow it or do so with few restrictions.
Alcohol is also very addictive, moreso than many illegal drugs. Now, measuring addiction is actually far less straightforward than you might think, since addiction is very complicated and the subject of a lot of debate. One measure is just how many people self-report problems with a drug, and a government study in 2007 found that more than 30% of American adults have abused alcohol or suffered from alcoholism at some point in their lives. When we look at those who currently have problems with alcohol, that number is more like 7% of adults. As I said before, this is partly caused by the widespread availability of alcohol – 87% of Americans report having tried alcohol at some point in their life – so we should also look at objective comparisons to other drugs. One group of researchers created a 0 to 3 scale on which to compare drugs’ psychological and physical dependence, and alcohol came in at 1.9, above cannabis at 1.5 and ecstasy at 1.1, but below tobacco at 2.2 and heroin at 3.0. And in certain ways, alcohol is even worse than heroin, as it can cause more severe withdrawals that really heavy users can even die from.
But this isn’t to say alcohol is all bad. There have also been studies indicating that in low doses, we’re talking one drink per day, alcohol can actually contribute to a healthy heart and lower your risk of a stroke or diabetes. And when used responsibly, alcohol can help you relax and socialize, contributing to mental health and wellness.
Recent news and trends. Where are things going?
So, we’re always going to end our Drug of the Week segment with some recent news and trends. Since alcohol has been around for so long and is pretty well-established in its use and legality, it doesn’t have the same kind of exciting legal changes as we’re seeing with marijuana, or the kind of media frenzy seen with more taboo drugs like ecstasy or cocaine. But that doesn’t mean that the world of alcohol isn’t constantly changing!
Here in the US, one of the biggest developments in alcohol in recent years has been the huge growth in the popularity of craft beer. The Brewers Association says that their share of the beer market got into the double digits for the first time last year, with craft beer making up 11% of beer sold nationwide. This is up from only 5% in 2010, so who knows where it will peak. There’s also been a big surge in the popularity of home brewing, with tons of companies selling kits to beer geeks who want to try their hand at it.
There have also been some stories lately about a few new ways to consume alcohol: inhaling it through vaporization, and buying powdered alcohol to mix your own drinks. With the surge in popularity of nicotine e-cigs and marijuana vaporizers, there has been a lot of reporting on alcohol vaping, in which alcohol is turned into a vapor and then inhaled. This makes it get into your bloodstream a lot faster, which could theoretically help with titration but could also be very dangerous since if you have too much, vomiting isn’t an option for your body to get rid of some of the excess. Right now, alcohol vaporizers are pretty bulky – tabletop units instead of handheld vape pens – and most of the reviews online make it sound pretty unpleasant, so I don’t think it will be supplanting plain old drinking any time soon.
Powdered alcohol, registered under the brand name Palcohol, was approved for sale this year, leading to a bunch of fear mongering articles warning that teens would start snorting it and being able to hide their alcohol use from their parents more easily. Some elected officials are even trying to ban it before it hits the market, and the Arizona legislature passed a bill to do so that was then vetoed by the governor. But it’s not intended to be snorted, and its creator says it would be awful to try that – the idea is that you can mix it with water to create a drink on the go. Sounds like it could be great for backpackers and people traveling through TSA check points, but I don’t see it catching on much beyond that.
And finally, there’s one very promising trend when it comes to plain old liquid alcohol: use by young people is at historic lows. This is from the Monitoring the Future Study, an annual survey of American students about their drug use. Since 1991, the percentage of high schoolers who have ever used alcohol dropped from 80.1% to 46.4%, and the percentage who had drank in the past 30 days dropped from 39.8% to 22.6%. This is great news, and hopefully a trend that continues over the coming years – and it’s also a decent bit of evidence that age restrictions and public education campaigns can be much more successful at decreasing teen drug use, since over the same time period, illegal drug use has actually increased a few percentage points.