If you follow the news, you might think that the opioid overdose epidemic is our only drug-related public health crisis.
To be sure, it is a serious problem that claims more than one life a day in Maine, affects nearly every community and demands a much bolder coordinated response than what we have seen so far.
But it is not the only one, and it may not even be the deadliest. Alcohol, available at corner stores and gas stations everywhere, is killing Mainers and ruining lives right under our noses.
A new World Health Organization study blames alcohol for 3 million deaths a year, accounting for one in 20 deaths globally.
Unlike many diseases tracked by the WHO, alcohol use disorders are most common in the richest countries such as those in Europe and the Americas. With Maine, along with the rest of New England, among the heaviest drinking states, a better public health approach should be at the forefront of state policy, aimed at preventing dangerous drinking with education and providing treatment for people who need to stop. But alcohol is so prevalent it can hide in plain sight and does not get the attention it demands.
Part of the problem is that alcohol is used safely on a daily basis by millions of adults. While a recent study found that there was no absolutely safe dose, it measured very small levels of risk for light drinkers.
But the minority of drinkers who engage in dangerous behavior like binge drinking (five or more drinks in two hours for a man, four for a woman) or exceed the daily recommendations (no more than two drinks a day for a man and one for a woman) are putting their physical and mental health at risk, causing unnecessary suffering for themselves and their families.
According to the researchers, 28 percent of the deaths were due to injuries, including traffic crashes, suicide and violence; 21 percent die from liver disease, pancreatitis and other digestive disorders; 19 percent die of cardiovascular diseases, and the remainder due to infectious diseases, cancers, mental disorders and other health conditions.
No one is calling for a return to Prohibition, but there are steps policymakers could take to alleviate the problem.
Duke University professor Philip J. Cook has long argued that raising the federal excise taxes on alcohol should be part of the response.
About 60 percent of the population, who don’t drink at all, would pay nothing. Light to moderate drinkers would pay only a little more, but heavy drinkers, who are incurring the biggest health care and law enforcement costs, would pay the bulk of the tax, and those people who spend every cent they have on booze would have less to spend.
Other WHO recommendations are policies that are already in place, regarding limits on advertising and the places where it’s legal to drink. They could be tightened up and combined with the kind of public health information effort that changed attitudes about cigarette smoking.
Complacency is the biggest obstacle. As the WHO report shows, minimizing alcohol’s threat to public health would be bad policy.
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