Alcohol overuse causes 140,000 American deaths annually. Why is it so undertreated?

“There is something that kills more Americans every year than drug overdoses, than guns, than car accidents. It’s legal, doesn’t require a background check to buy, is widely advertised, and if you’re 21, you can probably buy it at your corner store. It’s called alcohol.
While cold beers, glasses of wine, and hard liquor cocktails are often treated as end-of-the-workday or weekend indulgences, alcohol is technically a psychoactive, addictive drug, one linked to over 50 fatal conditions, including heart disease; breast, pancreatic, and stomach cancers; liver disease; hypertension; and stroke. It contributes to the death of 140,000 people in the US annually, making it one of the leading causes of preventable death in the country.

More and more research supports the conclusion that even light drinking — that is, less than 15 drinks a week for men or eight drinks a week for women — can contribute to an increased risk for heart disease and cancers. More recent medical recommendations in countries like Canada have increasingly tightened, moving toward the idea that there is no truly safe level of alcohol consumption.

But the dose is the poison, and those who are at the greatest risk are those who consistently binge drink. This group suffers from alcohol use disorder, a condition where someone consumes excessive amounts of alcohol to the point that it impairs their ability to stop or control their use despite negative social, occupational, or health consequences. And that group is larger than you might think: more than one in 12 people in the US have AUD [alcohol use disorder], and it’s likely that figure underestimates the real breadth of the problem.”

” For those with a concurrent diagnosis of AUD and another mental health diagnosis, some form of therapy is often needed to treat both conditions. Mild AUD can be treated with a short mental health screening and intervention in a primary care doctor’s office. Meanwhile, for those with more severe cases of AUD, further treatment — cognitive behavior or motivational enhancement therapy — could help.”

https://www.vox.com/the-highlight/2023/11/6/23931877/alcohol-use-disorder-leading-cause-deaths-medication-therapy

American Distillers Brace for Huge E.U. Tariff Hike

“The E.U. imposed retaliatory tariffs on American whiskey (along with other quintessentially American products like blue jeans and motorcycles) in June 2018 after the Trump administration unilaterally slapped tariffs on all imported steel and aluminum. Trump’s tariffs were sold as an anti-China measure, but covered imports from allies like the E.U. and South Korea as well. The E.U.’s retaliatory tariffs, meanwhile, occurred despite promises from Trump’s top trade adviser that other countries would not respond with tariffs targeting American goods.
Due to those 25 percent tariffs, whiskey exports to Europe fell by about 20 percent between 2018 and 2021, according to the Distilled Spirits Council of the United States (DISCUS), which lobbies on behalf of American booze producers. That decline in foreign sales cost American distilleries over $100 million.

Those tariffs were temporarily suspended in 2022, and exports to Europe rebounded almost immediately, according to DISCUS’ data. Over the past two years, exports to the E.U. increased by 29 percent and exceeded pre-tariff levels.

Now that recent growth is at risk. If no deal is reached by January 1, the E.U. could decide to reimpose the tariffs at 50 percent—double the previous levels—when the temporary reprieve expires.”

“Trump’s been out of office for nearly three years, but the consequences of his half-baked trade wars are still spiraling out of control—in no small part because of Biden’s unwillingness to end them. Another escalation in that conflict now looms over American distillers.”

https://reason.com/2023/12/11/american-distillers-brace-for-huge-e-u-tariff-hike/

Florida’s War on Drag Targets Theater’s Liquor License

“Conservative government scolds in Florida are making good on a Christmas threat against an Orlando performance venue and are trying to revoke its liquor license because it let minors attend a bawdy drag show with their parents.
Florida’s Department of Business and Professional Regulation filed an administrative complaint Friday against the Orlando Philharmonic Plaza Foundation, which operates The Plaza Live theater in Orlando. In December, The Plaza Live hosted A Drag Queen Christmas, a touring stage show of risqué drag performances with holiday themes.”

“For naughty Christmas lyrics, the state is threatening a business’s liquor license. The complaint charges six counts of violating state indecency regulations, all based on allowing children to attend.

The scant photo evidence the state includes in the complaint further substantiates the claim that the war on drag queens is a politically driven moral panic. To the extent that the show is indeed sexual, as with any other form of entertainment with adult content, parents and venues are well-equipped to decide for themselves whether to bring their children. It’s not a role the state should be deciding, and in so many other cases, the state does not.

Despite making a big deal about supporting parents’ rights in education, Gov. Ron DeSantis does not think parents should have the right to decide what kind of entertainment their children should consume.”

What 2022 Taught Us About Freeing American Alcohol Markets

“In the first two years of the pandemic, American alcohol rules underwent a fundamental shift. States started enacting emergency orders—and then cementing those orders in legislation—that authorized never-before-seen innovations in alcohol policy, such as letting restaurants and bars deliver booze and sell it to go. But if 2020 and 2021 ushered in new hopes of opening up American alcohol markets, 2022 is the year when protectionism struck back.
In the early months of the pandemic, state governments were reacting in real time to unprecedented circumstances. The new environment included stay-at-home orders, social distancing guidelines, and masking mandates. It no longer became viable for most retail businesses to rely solely on an in-person customer base, as the entire economy shifted over to a delivery-centric model. Restaurants, breweries, wineries, and neighborhood liquor stores all faced an existential business crisis.

States reacted by upending a nearly centurylong consensus on alcohol regulations. Before, it was essentially unheard-of to let a pizzeria throw in a margarita with a delivery order. Then states started issuing emergency orders that allowed it. And practices that had been slightly more common—such as allowing alcohol to be included in grocery store deliveries, which numerous states permitted before COVID-19—spread to an unprecedented number of locales.

Unsurprisingly, these changes proved popular. In states where citizens were polled, strong majorities expressed their support for more types of to-go and delivery booze. Lawmakers can read polls, and a wave of states either extended the reforms or made them permanent.

The results were dramatic. When 2020 began, no place in America had a statewide to-go or delivery alcohol law for restaurants. By the fall of 2021, 29 states had such a law on the books. During that time, another seven states passed laws permitting alcohol delivery from off-premise stores, such as grocery or liquor stores, and eight states passed laws expanding the delivery capabilities of breweries, distilleries, and other alcohol producers.

But in 2022, this explosive rate of reform slowed down. The progress didn’t stop altogether: Nine more states passed to-go or delivery alcohol laws for restaurants, and one more state authorized alcohol delivery from off-premise stores. But the pace of change noticeably declined. Worse yet, several reforms suffered high-profile defeats.”

“The opposition has finally had a chance to get organized. And by the opposition, I mean entrenched economic interests. In Colorado, incumbent liquor store owners felt the proposed ballot initiatives would hurt their bottom lines by allowing other types of stores, like grocery or chain stores, to sell and deliver alcohol. . And in California and elsewhere, alcohol wholesalers have become increasingly aggressive in opposing any direct-to-consumer reforms that would let alcohol makers cut out the middleman and ship products directly to their customers.”

Why Should a Drug be Illegal or Legal? Part Three: Costs and Benefits of Implementing Drug Bans: Video Sources

I used to support legalizing all drugs. Then the opioid epidemic happened. German Lopez. 2017 9 12. Vox. https://www.vox.com/policy-and-politics/2017/4/20/15328384/opioid-epidemic-drug-legalization Dopesick Reinforces These Pernicious Misconceptions About Opioids, Addiction, and Pain Treatment Jacob Sullum. 2021 11 17. Reason. Two Courts Debunk Widely Accepted Opioid

Alcohol Delivery Doesn’t Lead To Underage Drinking

“Since the beginning of the pandemic, America has seen a drastic overhaul of alcohol laws. To-go cocktails are legal in most states, ordering a six-pack with your weekly grocery delivery order is now commonplace, and some locales have even started revisiting their open container laws to allow more outside drinking.

While most Americans have cheered these reforms, there has also been pushback. A common concern about alcohol delivery is that it could somehow provide a backdoor route for more underage kids to access alcohol. Although this may sound scary, America has experimented with alcohol delivery before, and new research shows alcohol delivery historically has not led to more underage drinking.

It may be tempting to conjure up scary images of children ordering booze via Mom and Dad’s Instacart account. But any sale of an alcoholic beverage, whether it occurs through a delivery app or at a brick-and-mortar store, provides a point-of-access in which an underage individual could obtain alcohol.”

“Decades of experience with direct-to-consumer wine shipments provide policy makers with a ready historical dataset from which they can analyze the potential impacts of alcohol delivery on underage drinking. Specifically, underage drinking has been tracked for decades by the Centers for Disease Control and Prevention’s (CDC) Youth Risk Behavior Surveillance System survey. The CDC survey asks, among other things, if high school students have had at least one alcoholic beverage in the past 30 days.

From the outset, it’s clear that underage drinking has been in a near free-fall over the past few decades. In 1991, over 50 percent of high schoolers drank alcohol, whereas only 29 percent do so today.

But even more interesting for the purpose of alcohol delivery, the data reveals that states that have continuously allowed direct-to-consumer wine delivery over the past few decades have actually seen a larger decline in underage alcohol consumption than states that prohibited wine shipments. Namely, states that allowed direct wine shipments from 2003 to 2019 saw a 44.3 percent decline in underage drinking compared to a 43 percent decline in states that forbid it during that entire timespan.

Furthermore, states that engaged in the most robust forms of direct-to-consumer wine delivery reforms between 2003 to 2019—by going from no direct wine delivery at all to full-fledged wine delivery—saw a larger decline in underage drinking than states that engaged in more modest reforms.

In other words, the more permissible states were with direct-to-consumer wine shipments, the more their underage drinking rates fell. This does not prove that direct wine shipments actually cause less underage drinking, but it does demonstrate that alcohol delivery is not correlated with more underage drinking.”

A better way to legalize marijuana

“Marijuana is nowhere as dangerous as alcohol. You can quite literally drink yourself to death; the same doesn’t apply to marijuana. So it’s almost certain that legalizing marijuana the same way won’t lead to all the same bad outcomes.

Still, there are some risks. A thorough review of the research, by the National Academies of Sciences, Engineering, and Medicine, found that marijuana poses a variety of possible downsides, which can include a higher risk of respiratory problems (if smoked), an increased risk of developing schizophrenia and other psychoses, an increased likelihood of car crashes, a general decrease in social achievement, and, potentially, some harm to fetuses in the womb.

There’s also the real risk of addiction and overuse. As Stanford’s Keith Humphreys put it to the Atlantic, “In large national surveys, about one in 10 people who smoke [marijuana] say they have a lot of problems. They say things like, ‘I have trouble quitting. I think a lot about quitting and I can’t do it. I smoked more than I intended to. I neglect responsibilities.’ … People will say, ‘Oh, that’s just you fuddy-duddy doctors.’ Actually, no. It’s millions of people who use the drug who say that it causes problems.”

None of that is to make the argument for prohibition, which produces its own problems”

“An obvious question is: If the standard commercial model works for alcohol, why can’t it work for a newly legal drug like cannabis, too?

But this model doesn’t work well for alcohol. The nation’s second-most popular drug (after caffeine) is linked to nearly 100,000 deaths a year in the US — about the same as all overdose deaths, and more than the combined death tolls of car crashes and murders.

A different model could help. Previous research, for example, found that states that maintained a government-operated monopoly for alcohol kept prices higher, reduced access to youth, and cut overall levels of use”

When Forced To Choose, Some New Mexico Gas Station Liquor Stores Will Now Just Sell Liquor

“When New Mexico lawmakers make its owners choose between selling gas or selling liquor.

Some gas stations in a rural New Mexico county are being forced by an inane new law to choose between selling gas or selling liquor and wine. Some have chosen to close their pumps in protest and sell alcohol instead of gas.

The new ban is part of a larger package of changes to the state’s liquor laws—one its chief sponsor, Sen. Daniel Ivey-Soto (D–Albuquerque), calls “the biggest reform of liquor laws in 60 years in our state.” The new law contains several key elements in addition to the gas station liquor ban. Many of those changes are steps in the right direction. In fact, the “original intention” of the alcohol bill was deregulatory in nature. Among other things, it lifts a ban on home delivery of alcohol, introduces a new, less expensive liquor license for restaurants, and allows alcohol to be sold longer hours on Sundays (on par with allowable sales hours on other days).

The bad parts of the law are, well, bad. Ask the owners of Kokoman Fine Wines in Pojoaque, which was forced to try to offload $65,000 worth of nip bottles—those little liquor bottles commonly found lurking in a hotel mini-fridge—after the new law banned their sale across the state.

And then there’s the ban on gas station sales in McKinley County, where three out of four county residents are Native American. Sen. George Muñoz (D–Gallup), who introduced the gas-station amendment to the new law, says he did so because “people die in McKinley County because of alcoholism.”

While I have no doubt that some people in McKinley County who abuse alcohol die from that abuse, compelling gas stations that sell alcohol to become alcohol stores that don’t sell gas probably won’t save many (or even any) lives, and may do just the opposite. The ban is also likely unconstitutional. That’s why one chain of gas stations has sued the state to overturn it.”