Alcohol is the worst drug (when Americans drink it)

By the time my former boyfriend’s little brother, E., hung himself, it made sense to my ex. “His kidneys were failing,” he said, matter-of-factly. His younger brother was in his mid-thirties.

E’s family had worried he’d overdose on heroin. Instead, it was the alcohol they should’ve been worried about. In a last bid to save his life, his aunt and uncle decided to take him in. They knew he couldn’t quit drinking cold turkey so they limited his intake to ten beers a day. He died by suicide on April fools day of all days. “He never lost his sense of humor,” people said.

Research shows that alcohol is the deadliest drug out there. While drugs like fentanyl cause more direct harm to the user, alcohol causes a slew of harms to the user and their community. Drunk driving, intimate partner violence, and other kinds of fighting and harmful behavior are more associated with alcohol than opioids. America’s puritanical rigidity and hedonistic excess creates a uniquely nasty type of drinking culture.

Like all drugs, it’s not all bad. First, the good parts. I like alcohol. It’s fun. It greases social interactions. It makes us feel good. A few years back, The Atlantic fleshed out a theory of why humans continued drinking once we’d figured out healthier ways to purify water (tea, etc). The theory posits that when people drink together it builds social ties, which are key to human innovation and progress.

“A little alcohol can boost creativity and strengthen social ties,” the Atlantic notes. “But there’s nothing moderate, or convivial, about the way many Americans drink today.” The Atlantic article concludes with a caveat about the social perks of booze. “This rosy story about how alcohol made more friendships and advanced civilization comes with two enormous asterisks: All of that was before the advent of liquor, and before humans started regularly drinking alone.”

I think it’s instructive to look at which countries have a culture of doing shots. Shots are about getting as wasted as possible in the fastest way possible. The big countries that do shots are America and Russia. I don’t know much about Russian drinking culture—just that life is very hard and that people, men especially, drink a lot of vodka. Also, my mother was a tour guide in Bulgaria in the 1970s and some of her Russian clients had a habit of spreading shoe polish on bread and eating it to get fucked up.

In the United States, for people most likely to drink to excess—upper-middle class and wealthy white people—life is, relatively speaking, not that hard. Yet in the US, binge drinking culture is a perfect manifestation of the historic tension between puritanism and excess. In the US, if you give a 16-year-old a glass of wine, as many European parents do, you’d be a monster. Yet, among certain demographics (well-off ones), at the arbitrary age of 18, kids get shuffled off to college where virtually everyone is drunk (And come on, the cool kids figured out how to get illicit booze before then).

But when you have to do something illicitly, you build unhealthy habits around it. Hence, taking shots. The drinking age is 21, so even in the free-for-all of party schools you’ll probably pregame with shots; quickly ingesting a potent dose. The iron law of prohibition strikes again here: The more a substance is policed—whether literally or socially—the more dangerous the behaviors around consuming it. Our puritanical urge to repress alcohol consumption manifests in its opposite extreme: keg stands and shots, shots, shots, and Girls Gone Wild style debauchery, leading to accidents and alcohol poisoning, which is frankly only possible with hastily consumed liquor. It’s not possible to drink enough beer fast enough to die, though you might wish you were dead the next morning. America is “rosé all day” culture or “In parts of Pennsylvania, the only way to get a six pack is to buy from a bar and they of course jack up the price.” Land of contradictions!

The flip side of excess is the total abstinence model presented by Alcoholics Anonymous.