A new review published online in the journal Addiction has compiled the best, most up-to-date source of information on alcohol, tobacco, and illicit drug use and the burden of death and disease. It shows that in 2015 alcohol and tobacco use between them cost the human population more than a quarter of a billion disability-adjusted life years. The World Health Organization released many reports in the past fingering alcohol and tobacco as two of the biggest causes of illness and death worldwide–including the developing world.
Because alcohol is legal and often consumed in social settings, alcohol addiction is complicated. But as an addictive agent, it’s remarkably simple–and effective. Alcohol’s withdrawal syndrome is so severe that it can cause death, and its effects on the brain’s reward system cause well-documented and intense craving in heavy drinkers.
Hundreds of millions of people indulge in one of the most dangerous drugs which is sold right over the counter. When it comes to harm done to other people and the users themselves, not heroin, crack cocaine, methamphetamines, marijuana or even tobacco come close to the health and safety hazards caused by alcohol.
Regardless of the mechanism, 17.9 million Americans (7% of the US population) were classified as being addicted to or abusing alcohol in 2010. It acts as a relaxant, causing the user to feel more comfortable in an environment and leading to increased sociability. However, in larger doses alcohol begins to have serious detrimental effects on a person’s health. Addiction to alcohol, as well as being expensive, can lead to serious liver problems, diabetes, cancer and heart problems. Short term effects of alcohol include dehydration, alcohol poisoning and intoxication.
Alcohol, regardless of its type (i.e. beer, wine, liquor, etc) is a class A1 carcinogen which are confirmed human carcinogens. Alcohol consumption has been causally related with breast cancer for some time. Increasing evidence indicates a stronger association with neoplasms, though the risk is elevated for other types of breast cancers too. Regardless of how much alcohol is consumed, it will always be a class A1 carcinogen. That doesn’t mean you will get cancer from drinking a beer or a glass wine, but the classification for the substance is clear.
The exact biological reasons for why alcohol causes cancer remain unclear. One theory is that alcohol can damage DNA, causing harmful mutations. In fact, alcohol is the deadliest drug on an individual level, at least when it comes to the likelihood of a person dying due to consuming a lethal dose.
Binge alcohol consumption during the more vulnerable periods of our lives is clearly able to interfere with critical neural processes and produce significant long-term negative consequences and disease that plants such as cannabis can actually protect us from.
The largest health burden from substance use was attributable to tobacco smoking and the smallest was attributable to illicit drugs. Global estimates suggest that nearly one in seven adults (15.2%) smoke tobacco and one in five adults report at least one occasion of heavy alcohol use in the past month.
Though nicotine doesn’t cause the rush of heroin or crack, it’s biologically similar in a crucial way: it mimics a common neurotransmitter–so well that scientists named one of the acetylcholine receptors after it.
Nicotine is considered one of the most addictive drugs of all time. Although studies vary, it is generally believed that well over 30% of those individuals who use nicotine for a period of time become addicted. That is a high number considering the availability of the product, the manner in which it is marketed towards young people, and the deadly consequences of a lifetime of use. Smoking regularly reduces the number and sensitivity of these “nicotinic” receptors, and requires that the user keep ingesting nicotine just to maintain normal brain function. There are a shocking 50,000,000 nicotine addicts in the US, and one in every five deaths nationwide are the result of smoking.
Compared with the rest of the world, Central, Eastern, and Western Europe recorded consistently higher alcohol consumption per capita (11.61, 11.98 and 11.09 litres, respectively) and a higher percentage of heavy consumption amongst drinkers (50.5%, 48.2%, and 40.2%, respectively). The same European regions also recorded the highest prevalence of tobacco smoking (Eastern Europe 24.2%, Central Europe 23.7%, and Western Europe 20.9%).
In contrast, use of illicit drugs was far less common. Fewer than one in twenty people were estimated to use cannabis in the past year, and much lower estimates were observed for amphetamines, opioids and cocaine. Hotspots included the US, Canada, and Australasia. The US and Canada had one of the highest rates of cannabis, opioid, and cocaine dependence (748.7 [694.8, 812.3], 650.0 [574.5, 727.3], and 301.2 [269.3, 333.7] per 100,000 people, respectively). Australasia (Australia and New Zealand) had the highest prevalence of amphetamine dependence (491.5 per 100,000 people [441.4, 545.5]), as well as high rates of cannabis, opioid and cocaine use dependence (693.7 [648.1, 744.4], 509.9 [453.7, 577.8], and 160.5 [136.4, 187.1] per 100,000 people, respectively).
Some countries and regions (e.g., Africa, Caribbean and Latin America, Asia regions) have little or no data on substance use and associated health burden. These are typically low or middle income countries that frequently have punitive drug policies, and may experience serious political and social unrest. These countries need enhanced monitoring because they are at risk of rapid escalation in substance use and related health burden.
The report, ‘Global Statistics on Alcohol, Tobacco, and Illicit Drug Use: 2017 Status Report’, uses data mainly obtained from the World Health Organization, United Nations Office on Drugs and Crime, and Institute for Health Metrics and Evaluation. The authors note that there are important limitations to the data, especially for illicit drugs, but believe that putting all this information in one place will make it easier for governments and international agencies to develop policies to combat substance use.