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Alcohol and opioids are different kinds of risk

FROMA HARROP

Is alcohol really “the most dangerous drug”? That’s what Governing magazine said on a cover, adding, “Cheap, legal and more deadly than opioids.”

This assertion is problematic. One could say that biking is quite dangerous if you ride 5,200 miles a year at night along poorly lit busy roads. If you ride 800 miles a year on dedicated bike paths, the risk is obviously lower.

This story, of course, looks at population-wide numbers. It compares total deaths attributed to alcohol with deaths attributed to opioids.

But even here the conclusions seem shaky.

We hear that opioids claimed 42,000 lives in 2016, whereas alcohol took 88,000 lives.

Even if those numbers are accurate, one must ask: How many Americans drink, versus how many take opioids?

About 175 million Americans age 12 or older said they consumed alcohol in 2016, according to the National Survey on Drug Use and Health. Almost 104 million said they took opioids (and about 88 percent had prescriptions). So we are comparing the number of deaths in one group (drinkers) with the number of deaths in another group (opioid users) that’s about 70 million people smaller.

Further, the count leaves out users of cocaine and other illicit drugs. Including them would vastly raise the loss of life from drugs.

What turns someone into an addict is a complex subject. Most friends and I have been prescribed opioids for pain, and as far as I know, none of us is addicted. We took a few of the pills before switching to over-the-counter Tylenol. The remaining opioids got tossed.

The headline number for alcohol-related deaths is traffic fatalities. Certainly, stricter rules against driving under the influence have contributed to a 50-plus percent drop in alcohol-related traffic deaths since 1982.

Nationally, the blood alcohol content limit for drivers is now 0.08 percent. Utah is about to go lower with a 0.05 limit. What difference that will make is debatable.

Consider: In 2017, some 10,874 people died in crashes involving a driver with a BAC exceeding 0.08, the National Highway Traffic Safety Administration reported. But 68 percent of alcohol-impaired drivers in that group had a BAC of 0.15 (nearly twice 0.08) or higher. These were not couple-of-glasses social drinkers but serious drunks. Note also that in 65 percent of the fatal crashes, no alcohol was found in the drivers’ blood.

About half the alcohol-related deaths are tied to health problems such as cirrhosis, cancer and heart disease.

It seems pointless to raise alcohol taxes to dissuade drinking. An addict will get his fix. Many states have expanded the permitted hours and places for selling alcohol, but that probably hasn’t changed drinking habits much. Anyone who has attended meetings of Al-Anon — which helps people living with alcoholics — knows that the addict stashes booze in places someone else would never dream of.

As for who gets hooked, very often the alcoholic and drug addict are one and the same person. Alcoholics Anonymous sardonically refers to them as “double winners.” The terrible crisis of pregnant women harming their fetuses by ingesting one or both of these substances deserves its own conversation.

Be that as it may, a residual temperance movement tries to tag alcohol as an evil for all, not a pleasurable relaxant when taken in moderation. A study using federal data found that only 10 percent of drinkers account for over half(!) of the alcohol consumed.

So it’s misleading to lump the two-glass wine drinker with the fall-down drunk. Or he who takes just a couple of opioid pills after surgery with a drug addict. Or A with B. For society as a whole, these substances provoke serious concern, but on the level of the individual, every story is different.

Editor’s note: Follow Froma Harrop on Twitter @FromaHarrop. She can be reached at fharrop@gmail.com. To find out more about Froma Harrop and read features by other Creators writers and cartoonists, visit the Creators webpage at www.creators.com.

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