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Adventures on the Extreme Edge of Heavy Drinking

We're quick to want to take action against new threats, even relatively minor ones. But we grow accustomed to the drip-drip-drip threat posed by, say, drinking.
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One of the joys of being a news junkie is seeing certain types of stories cycle in and cycle out of the public consciousness. Drug-scare stories are a good example, as a new compound (or an old compound Middle America previously wasn’t aware of) gets the full panic treatment—cries of imminent doom from police and politicians, breathless headlines and suspect “trend” articles, corny anthropological looks at the subcultures where the new drugs arose—and then a gradual return to normalcy.

We’re seeing it now with “molly,” the redoubtable club-drug MDMA appearing under a new name and implicated in several recent deaths at electronic-dance music venues, including New York’s Electric Zoo festival, which cancelled its third day following the deaths of two attendees. Raves and EDMs in general are great places for fearful reporting—and fearful doesn’t mean it has no legitimacy—since the Woodstock (three dead, one from drugs) and Lollapalooza generations may find the scene exotic.

Actually, the present reaction to molly has been less hysterical than past experience would suggest—Chuck Schumer marshals his anti-molly legislation with actual facts in his call for “aggressive action,” while Rolling Stone observes, “When it's pure, the drug is significantly safer than, say, cocaine. To get a sense of how rarely MDMA is fatal, in 2011 the BBC reported that there were 500,000 yearly Ecstasy users in the U.K. and just 27 deaths.”

A 2009 paper in The Lancet estimated 3.8 percent of all global deaths can be laid at alcohol's wobbly feet (and this even though most adults in the world abstain).

Whether it’s justified or not, this mania too shall pass. MDMA has been with us a century already, been a party drug for at least three decades, and the mainstream’s focus on it is unlikely to last.

To support this thesis, I offer the example of another intoxicant that has generated numerous panics—think Prohibition—but nowadays pretty much flies under the radar (except maybe for pregnant women). And yet the burden that alcohol places on society is immense; a 2009 paper in The Lancet estimated 3.8 percent of all global deaths can be laid at its wobbly feet (and this even though most adults in the world abstain).

A new study out of Sydney examines the deaths of people who drank themselves to death in that city between 1997 and 2011. Led by Shane Darke of Australia’s National Drug and Alcohol Research Centre, the results published in the Journal of Forensic and Legal Medicine offer a chilling snapshot of why we should pay more attention to things that are already legal in our zeal to reduce all risks to zero.

Keep in mind these were deaths from “acute alcohol toxicity”—an overdose, if you will. The study set a floor for blood alcohol concentration of 0.30 grams of alcohol per milliliter of blood; in the United States the legal point at which you’re considered driving drunk is 0.08, with many states increasing the penalty if you blow over 0.15. So 0.30 is pretty hardcore; most people would have vomited on their friends well before that and then passed out (you don’t want to do it in reverse order). The mean concentration in the decedents was 0.42, “a concentration generally considered fatal,” the authors assure us, no matter how seasoned a drinker you may be. And the high was an eye-popping 0.741.

These deaths were not from car accidents, or heart disease, or cirrhosis of the liver, or suicide, or a reaction with other drugs, or any of a number of other causes of death that might be associated with heavy drinking. Which is not to say that autopsies didn’t find evidence of a host of other maladies were affecting their subjects—almost all had some liver disease and three in four had heart problems. Those benefits of drinking on the heart we hear about? Those protective effects come at low dosages; ramp up the sauce and problems start to accrue.

Australians have been stereotyped as a nation of inveterate pub-goers—“The population of Sydney was divided into two classes, those who sold rum and those who drank it,” historian George Macakness suggested was true at the dawn of the 19th century. And like many stereotypes, there’s some basis for that belief—new research says that while the nation as a whole is drinking less, its heaviest imbibers are drinking more. But this doesn’t mean that the pathologies described by Darke varied much from findings in other tippling countries:

The typical profile in this series was a single, middle-aged male, not in paid employment, with a long history of heavy drinking. More broadly, this profile is similar to the characteristics of cases of toxicity death from other drugs, such as the opioids. ... No case was enrolled in treatment for alcohol dependence at the time of death. These were not young, binge drinkers, and only a single case involved a drinking contest. Indeed, only a single case was aged younger than 25 years. Death typically occurred at home, with spirits most frequently implicated.

And when we say hardcore, we mean it. In 23 percent of the cases where the exact type of booze was specified in post mortems, denatured alcohol—an industrial solvent—was consumed.

The Australian data aren’t completely universal. There, most of the dead were white, while a similar investigation in the U.S. from a decade ago found death rates (although not absolute numbers) were higher for black and Hispanic men. And as in Sydney, an alcohol overdose isn’t usually a college-partying accident: only 2 percent of victims were under 21.

And while OD’ing on alcohol is the most common way to DOA when using only one substance, that’s hardly the most common way to kill yourself (or others) via drinking. Another new study, this one by Alan Wayne Jones and Patrick Harding in Forensic Science International looked at DUI stops in Wisconsin and in Sweden where drivers’ blood alcohol concentrations exceeded 0.40! In both countries the offender was likely to be a man in his mid-40s (although women were nabbed four times as often in Wisconsin and in Sweden). Friday or Saturday nights was the most common time for a bust in Sweden but no more likely for Wisconsinites (and Saturday arrests were the least common). In both countries a large number of arrests occurred between noon and 6 p.m.

None of this is offered as an argument to bring back the 18th Amendment, or to not regulate other drugs, whether molly, meth, or marijuana. But as we paper over the malign effects of tobacco, guns, cars, or even "Satisfries," it’s instructive to see what scares us—and what doesn’t.