Comparative risk assessment of alcohol, tobacco, cannabis and other illicit drugs using the margin of exposure approach PMC

The downside of the probabilistic approach is that the output also is not a single numerical value but rather a likelihood distribution. Nevertheless, using graphical approaches (Figs. 1–3) the results for all drugs under study can be quickly compared. On the other hand, this may be an advantage, as we did not try to establish a single value “to be written in stone”.

The risk of an alcohol use disorder is highest in individuals with intermittent explosive disorder, dysthymia, ODD, bipolar disorder, and social phobia. Alcohol, tobacco, and prescription painkillers are likely deadlier than other drugs because they are legal, so comparing their aggregate effects to illegal drugs is difficult. Some drugs are very harmful to individuals, but they’re so rarely used that they may not be a major public health threat. A few drugs are enormously dangerous in the short-term but not the long-term (heroin), or vice versa (tobacco).

Alcohol consumption by type of alcoholic beverage

Substance use often begins during adolescence, placing youths at risk for fatal overdose and substance use disorders (SUD) in adulthood. A cross-sectional study was conducted among adolescents being assessed for SUD treatment in the United States during 2014–2022, to examine self-reported motivations for using substances and the persons with whom substances were used. These findings suggest that interventions related to reducing stress and addressing mental health concerns might reduce these leading motivations for substance use among adolescents. Education for adolescents about harm reduction strategies, including the danger of using drugs while alone and how to recognize and respond to an overdose, can reduce the risk for fatal overdose.

  • The methodology for comparative quantitative risk assessment was based on a previous study conducted for compounds in alcoholic beverages20 with the exception that probabilistic exposure estimation was conducted65,66,67.
  • British experts evaluated substances including alcohol, cocaine, heroin, ecstasy and marijuana, ranking them based on how destructive they are to the individual who takes them and to society as a whole.
  • All authors have been involved in the drafting of the article and the interpretation of the data and in critical revisions of the content.
  • The BMD approach was first suggested by Crump17, and was later refined by the US EPA for quantitative risk assessment18.
  • The data produced by third parties and made available by Our World in Data is subject to the license terms from the original third-party authors.

He was not linked to the study and co-authored a commentary in the Lancet. Experts said alcohol scored so high because it is so widely used and has devastating consequences not only for drinkers but for those around them. Explore statistics on alcohol-related deaths and emergency visits in the United States. To determine the typical range of individual daily dosage, various textbook and internet sources21,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41 were evaluated (Table 2). As no information about the most likely function for dosage distribution is available, a uniform probability distribution was entered into the calculation in this case (Supplementary Table S1).

Impact on your safety

Alcohol use disorder includes a level of drinking that’s sometimes called alcoholism. The sensitivity analysis data for tolerant users are additionally shown in Figure 1–3 based on the ratio between no-tolerance and high tolerance dosage as shown in Table 227,37,42,43,44,45,46,47,48,49,50,51,52,53,54. Even though the general results remain stable (i.e. especially alcohol at the top position), the ranks between opiates and cocaine change due to the high tolerance to extreme dosages that was reported for opiates. However, as the percentage of tolerant users is generally unknown, the most probable value of MOE would lie in the range between non-tolerant and tolerant users (the gray-marked area in Figures 1–3). Measuring the health impact by mortality alone fails to capture the impact that alcohol use disorders have on an individual’s well-being. The ‘disease burden’ – measured in Disability-Adjusted Life Years (DALYs) – considers mortality and years lived with disability or health burden.

  • He said governments should consider more education programs and raising the price of alcohol so it isn’t as widely available.
  • Alcohol kills by direct neuropharmacological effects on the brainstem when someone drinks too much (i.e., when they overdose).
  • Attempting to quit using alcohol on your own, or “cold-turkey,” is strongly not advised due to the severity of discomfort and health risks.
  • Medications also can help deter drinking during times when individuals may be at greater risk of a return to drinking (e.g., divorce, death of a family member).
  • Alcohol is also commonly used as a coping mechanism for stress, anxiety, or other discomforting emotions and feelings.

Attempting to quit using alcohol on your own, or “cold-turkey,” is strongly not advised due to the severity of discomfort and health risks. It is always best to enter a medically assisted, inpatient detox facility to detox as there is 24/7 medical support, along with clinical support, followed by inpatient treatment. Addiction is not a formal diagnosis, and the term is used in many ways.

What is considered 1 drink?

D.W.L. conceived of the study, conceptualized the data analyses and performed the calculations. Collected the data from WHO and provided additional data for sensitivity analysis. All authors have been involved in the drafting of the article and the interpretation of the data and in critical revisions of the content. All authors have given final approval of the version to be published. Whilst the World Health Organization (WHO) and most national guidelines typically quantify one unit of alcohol as equal to 10 grams of pure alcohol, the metric used as a ‘standard measure’ can vary across countries. However, this can vary, with several adopting 12 or 14 grams per unit.

The map shows DALYs per 100,000 people, which result from alcohol use disorders. In the chart, we see the prevalence of alcohol dependence versus the average per capita alcohol consumption. There is no clear evidence that high overall consumption (particularly in moderate quantities) is connected to the onset of alcohol dependency.

“There’s always choices,” Keith Humphreys, a drug policy expert at Stanford University, explained. Alcohol and marijuana are both intoxicants, but one study from Columbia University researchers estimated that alcohol multiplies the chance of a fatal traffic accident by nearly 14 times, while marijuana nearly doubles the risk. There’s also some divergence within the specific categories of harm.

alcohol vs drugs

An intake of 60 grams of pure alcohol is approximately equal to 6 standard alcoholic drinks. Alcohol has historically, and continues to, hold an important role in social engagement and bonding for many. Social drinking or moderate alcohol consumption for many is pleasurable. Good luck persuading consumers to reduce their alcohol consumption without seeming reactionary. General alcohol consumption increased 39% from February 2020 to November, according to a new study by the nonprofit research institute RTI International and funded by the NIAAA. Withdrawal symptoms, like pain, sleeplessness, anxiety or irritability, occur when a person who is addicted stops drinking.

Add Comment