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The One Drug Problem We Keep Excusing

As an addictions counselor, I’m often asked by laypeople, which drug does the most damage? Folks always seem a little embarrassed and uncomfortable when I tell them the truth: alcohol. They will then explain (despite my not asking) how they drink occasionally but that it’s not a problem.

I’m always fascinated by that. If something is not a problem, why do you need to explain that it’s not a problem? Oh, right…because we know it’s unhealthy, has the potential to ruin lives, and that millions of Americans are addicted to it. This of course will never happen and you want to make sure I understand that you’re a responsible drug user.

Did you cringe as you read that?

Good. We have this insane vernacular for alcohol in our society. We distinguish it from all other drugs despite the fact that it is a drug and that it causes serious and chronic problems in our society.

– Alcohol kills more people in our country every year than any other substance – It causes more traffic accidents and fatalities than any other substance. – Alcohol and tobacco products vastly outnumber the health problems caused by all other drugs combined.

Yet, it’s important to drink. It’s not just socially celebrated, it’s expected that adults imbibe at least occasionally. Alcohol is unique in that it’s the only drug that adults both feel socially pressured to partake in and will be asked to explain why they abstain if they so choose.

Why don’t I drink? What a fascinating question! Why don’t you join me for a cigarette? Because that’s unhealthy for you? It’s as simple as this – I enjoy the effects of nicotine and caffeine and I don’t enjoy the effects of alcohol. (Please notice that I’m not explaining or justifying why it’s ok for me to chain smoke and swill Red Bull. It’s incredibly unhealthy and yet I knowingly choose to continue).

I read Scott Gagnon’s blog this morning in which he presents a number of concerns regarding how legalizing marijuana carries the side effect of “normalization of self-medicating with recreational drugs.” Scott presents a fair argument regarding his concerns over self medicating but fails to note that we’ve been doing this with alcohol and other substances for hundreds of years.

A quote from the Drew Carey Show came to mind: “Oh you hate your job? Oh my God, why didn’t you say so? You know there’s a support group for that. It’s called EVERYBODY. They meet at the bar!”

Self medicating is done in countless ways. It’s simply a matter of how you conceptualize it. We use a myriad of substances and experiences to self medicate. We use sex, sugar/food, work, money, caffeine, status, nicotine and adrenaline to alter our mood and perception.

I’m not downplaying anyone’s concerns about other drugs. I’m simply continuously struck by our denial, defensiveness and celebration of alcohol. It’s a drug. Let’s stop pretending that it’s not self medicating with a substance.

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