Alcohol ranks at the 9th place among risk factors in the most recent Global Burden of Disease (GBD) analysis. But this does not take into account the social problems, which fall outside the GBD analysis of death and disease.
However, alcohol burdens society beyond the individual effects to the user. Some of the ways in which alcohol burdens societies include:
Australia: This includes an array of negative experiences, including generalized issues such as fear and disruption due to strangers’ drinking, and more specific, concrete harms such as violence, neglect or damage to property. The cost of harms experienced by someone other than the drinker has been estimated at over AU$6 billion per year (Laslett et al. 2010).
Alcohol plays a prominent role in deaths of despair, contributing to overdoses, suicides, and liver disease, as well as to a broad range of other disease states that lead to mortality. Alcohol use is increasing among middle-aged adults in the United States and is more common when people are faced with stressful circumstances, such as job loss, divorce, economic downturns, chronic pain, or psychiatric conditions—all factors related to deaths of despair.
Alcohol use both follows and contributes to mental health conditions that increase the risk of suicide. People with Alcohol Use Disorder (AUD) are
People with AUD are much more likely to contemplate suicide, and alcohol often plays a role in suicide attempts. Estimates suggest that nearly 1 in 4 males and 1 in 5 females are intoxicated—with BAC levels of 0.08% or more—at the time of a suicide.
In addition to overdoses, liver disease, and suicides, alcohol contributes to mortality in other ways that might add to deaths of despair. Alcohol plays a role in roughly 3.5% of all cancer deaths in the United States. For women, the risk of breast cancer increases with less than 1 alcohol unit per day. Compared to women who consumed fewer than 60 units of alcohol in a typical year, those consuming 60–229 units of alcohol (about 0.6 units per day, on average) were 20% more likely to develop breast cancer. Research also has shown that people who consume larger amounts of alcohol have a greater risk of cancers of the mouth, esophagus, larynx, pharynx, liver, colon, and rectum.
Alcohol also is a common factor in deaths from injuries. The U.S. Centers for Disease Control and Prevention (2013) estimates that alcohol contributes to 32% of deaths from falls, 42 percent of deaths from fires, 47% of deaths from homicides, and 34% of deaths from drownings.
Alcohol is not the only factor driving the increase in deaths of despair, but raising awareness of the health risks posed by alcohol and the dangers of using alcohol to cope with challenges in life could help reduce the number of such deaths.
The pounding head. The parched mouth. And, worst of all, the crushing sense of anxiety as you cast your (foggy) mind back to the night before and try to remember if you said or did anything awful.
Most of us have woken up with a hangover at some point and struggled through the day wondering how on earth a few drinks can leave us feeling so wretched ("Can I die from a hangover?" has more than 15 million hits on Google). But the medical definition of a hangover has finally been settled by a German court, which last month ruled it should be classed as an official illness.
Hangover is a proper 'illness' now.
In February, a team of German scientists studying hangovers, writing in the American Journal of Clinical Nutrition, found hangover prevention beliefs such as "beer before wine and you'll feel fine" were scientifically unproven.
"If alcohol was invented today – and treated like a new food additive coming to the market – the recommended safe dose would be about a glass of wine per year. We're very harsh on new food and drink meeting certain criteria, but we have a blind spot towards alcohol because it's so embedded into our culture.
"There's dehydration," says Prof Nutt. "There's inflammation of the brain, which is on a par with a bad cold or flu. The pumping headache is caused by an increase in blood pressure. In fact, incidences of strokes go up on a Sunday and Monday due to weekend alcohol consumption.
"And then there's hangxiety - hang-over anxiety - which is due to something called Gaba (gamma-aminobutyric acid)," explains Prof Nutt. "Alcohol targets the Gaba receptor, which sends messages through the brain and nervous system to inhibit the activity of nerve cells, which calms the brain. Alcohol stimulates Gaba, which is why you begin to unwind and feel happy when you drink."
There's dehydration. There's inflammation of the brain. The pumping headache is caused by an increase in blood pressure.
After the first few drinks, you start blocking glutamate, which causes anxiety, and this leads to the devil-may-care stage that sees you buying another round and missing your last train. However, the body registers these imbalances and begins to bring Gaba levels down and glutamate back up. So, overnight, the happy, carefree you in the pub becomes the anxious, mildly depressed one you see in the bathroom mirror the next morning.
"Then there's sleep," continues Prof Nutt. "After four hours of going to bed, withdrawal kicks in, so you don't sleep particularly well. Water before bed to stave off a hangover, or drinking a lot of beer, means getting up early to go to the lavatory, which affects sleep further. And a lack of sleep makes hangxiety worse."
Glutamate also plays a role in memory, and after around seven drinks the glutamate system is blocked. And if you can't remember what you said in the pub, it further increases hangxiety.
After four hours of going to bed, withdrawal kicks in, so you don't sleep particularly well. And a lack of sleep makes hangxiety worse.
Professor David Nutt, Imperial College London
So do hangovers get worse with age? "There's no evidence they do," says Sally Adams, an assistant professor in health psychology at the University of Bath. "Liver mass reduces with age, so your liver is less effective at metabolising alcohol.
So far today police in Australia would have dealt with on average511 domestic violence matters
There has been a 26 per cent decrease in alcohol-related assaults in the Northern Territory since it introduced the country's first alcohol floor price and rolled out a range of new measures.
A preliminary data assessment published by the People's Alcohol Action Coalition and the Foundation for Alcohol Research and Education (FARE) showed there was also a 21 per cent decrease overall in domestic violence incidences in the NT since the floor price's introduction on October 1, 2018 until July 31, 2019.
The floor price set a minimum amount for which alcohol can be sold at $1.30 per standard drink.
In Alice Springs, where a raft of reforms were introduced following the 2017 release of the Riley review into alcohol policies, there has been a 43 per cent reduction in alcohol-related assaults and a 38 per cent reduction in domestic violence during that same period.
Concurrently, Tennant Creek saw drops of 28 per cent for both alcohol-related assaults and domestic violence.