Kentucky bourbon raking in money doesn't mean we can ignore alcohol's risks
Brian Edwards' op-ed ('Kentucky's bourbon business is vital to our economy. Don't let DC dry it up") seems wrongheaded. If there is a near-prohibition lobby as he claims, I, too, would disagree and think them Menken's Puritans. While I will make the argument for consumption here, doing so on economic grounds for a substance that the National Institutes for Health estimates costs the nation $249 billion and results in 178,000 annual deaths according to the Center for Disease Control seems antithetical.
To start, the science is clear: 'We cannot talk about a so-called safe level of alcohol use. It doesn't matter how much you drink – the risk to the drinker's health starts from the first drop of any alcoholic beverage. The only thing that we can say for sure is that the more you drink, the more harmful it is … the less you drink, the safer it is' (Dr. Carina Ferreira-Borges, World Health Organization, 2022).
Further, the purported health benefits of alcohol use have been repudiated. From JAMA ('Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease', March 2022): 'Observational studies have repeatedly demonstrated a lower risk of cardiovascular disease with light to moderate alcohol intake compared with either abstinence or heavy consumption, suggesting J- or U-shaped epidemiologic associations. However, the observed cardiac benefits of alcohol have been hypothesized to be the product of residual confounding (variables) because of favorable lifestyle, socioeconomic and behavioral factors that tend to coincide with modest alcohol intake.'
In sum, there is no safe use and no cardiovascular benefit of alcohol.
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However, there is evidence of human use of alcohol from 900,000 years ago, and alcohol is a well-established part of life in America. The National Academies notes that many alcohol-containing beverages provide flavors and sensations that people enjoy, and the effect on how we act and respond in social situations are two of several reasons for widespread alcohol use in our culture.
Concerning responsible drinking, the data are split. The United States Census Bureau estimates that there are 258.3 million adult Americans. The National Institutes for Health estimates that 63% use alcohol at least on occasion, or 177 million Americans imbibe. Among these, the Centers for Disease Control estimates 29.6% of young adults and over 10% of seniors binge drink by consuming toxic amounts in one sitting. The CDC estimates that there are, separately, 15 million heavy drinkers who drink beyond moderation every week.
The NIH estimates that there are 54 million Americans who need treatment for Substance Use Disorder. Let's use some rough, back of the envelope math, allowing that the groups defined above overlap, let us say that we have at least 100 million Americans who drink responsibly but very many who do not.
The Centers for Disease Control (CDC) defines moderate drinking as two drinks per day and seven per week for men and one drink per day and four a week for women (alcohol is on the whole metabolized differently by gender). A standard drink is 12 ounces of beer at 5% alcohol by volume (ABV), 5 ounces of wine at 12% ABV, or 1.5 ounces of spirits at 40% ABV.
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Concerning risk, it is also true that Americans take similar and more severe risks than alcohol use on a regular basis. For instance, Driving Test America estimates that in 2021 Americans drove cars and light trucks 3 trillion miles. These drivers are guided by rules of the road and formal laws that guide their driving behavior, and the manufacture of automobiles is very regulated for safety purposes. Nonetheless, there were 6.1 million vehicular crashes, resulting in 1.7 million injuries and 39.3 thousand deaths in 2021. This analogy falls apart at some point, as all do, but the point is made that alcohol use is not the only widely popular, risk-taking behavior in America.
Applause to Mr. Edwards for contributing to the public debate. We would agree about a near-prohibition agenda if, as he says, such exists. America and most of Europe have tried prohibition. We know how that ends. Further, regulating the amount of consumption would be a regulatory nightmare.
However, holding up the economic benefit as a reason to ignore the science is not the way to go. Better for the alcoholic beverage industry to recognize and promote responsible use and take those steps within their ken to reduce heavy and binge drinking. A market of 100 million American adults should suffice. For the nation as a whole, increasing access to treatment would be a far better use of our time and treasure.
Agree or disagree? Submit a letter to the editor.
Gene Gilchrist is the chief executive officer for Stay Clean, a cloud-based addiction treatment and recovery community.
This article originally appeared on Louisville Courier Journal: Kentucky shouldn't ignore alcohol's health risks for profit | Opinion
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