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not to mention so can alcohol which is very legal, very marketed, well accepted, and also more deadly and addictive than many so called "dangerous drugs".

Retric 5y ago
Alcohol does a great deal of harm simply because it’s very common and often severely abused. Few drugs are harmless when heavily abuse for decades drives up tolerance levels. Lifetime ultra heavy pot smokers for example face significant lung cancer risks, though very few people are heavy daily pot smokers for 50+ years at this point. At the other end, 1 glass of wine every day for 60 years is as far as we can tell on net harmless. Where even light daily pot smoking still causes some lung issues on those timescales. So yes, alcohol in and of it’s self can be deadly but it’s not nearly as bad as these comparisons generally suggest.
- nine_k 5y ago
  I would say that inhaling smoke, especially tar-rich smoke from burning organic matter, is bad for lungs. The presence of any psychoactive substance in it changes little. There are several other ways to consume THC, though, somehow less destructive. By the same token, drinking alcohol in shots, cold and concentrated, is about the worst way to consume it, because most of it is then spent ruining the liver, and little actually reaches the brain. Sipping a glass of wine does not compare. AFAICT a lot of health problems that even heroin addicts face do not come from overdoses, but from the unsanitary ways of intravenous administration of it, and the wear-off of the veins from constant injection. Comparing drugs by just their chemical properties, and ignoring the ways they are consumed, is not very productive, alas.
  - Retric 5y ago
    > By the same token, drinking alcohol in shots, cold and concentrated, is about the worst way to consume it, because most of it is then spent ruining the liver, and little actually reaches the brain. Sipping a glass of wine does not compare. That really isn’t how alcohol works in the bloodstream. Once it’s through the GI tract there is zero difference in what the source of alcohol is. Further, the liver takes a long time to break down a shot of alcohol or a glass of wine. The only real difference is to the throat, stomach lining where more concentrated alcohol can be a larger irritant. But again once it’s in the blood stream it’s both significantly diluted and rapidly spread throughout the body. Now sipping wine with food does significantly slow absorption, but it’s the same effect if you take a shot in the middle of a meal.
    - xkcd-sucks 5y ago
      https://en.wikipedia.org/wiki/First_pass_effect https://en.wikipedia.org/wiki/First_pass_effect Not sure how this applies to drinking concentrated vs dilute alcohol though
      - Retric 5y ago
        It only plays a role when you are digesting something else. In contrast to the results in the fed state, in humans fasted overnight the concentration of alcohol consumed (4%, 16%, and 40%) had no significant effect on mean AUCs. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1530-0277.1991.tb00589.x https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1530-0277....
- heavyset_go 5y ago
  > At the other end, 1 glass of wine every day for 60 years is as far as we can tell on net harmless. When it comes to mouth, esophageal and stomach cancers, even one drink a day increases your chances of developing them.
  - Retric 5y ago
    In isolation yes it can cause a very small increase in cancer. But it also has other upsides such as reduced cardiovascular issues. Therefore you need to take net not individual health impacts, which is more complicated. Remember the scale 55% of adult Americans drink at least monthly and those cancers are still rare and also associated with soda consumption etc.
- xorfish 5y ago
  > Alcohol does a great deal of harm simply because it’s very common and often severely abused. The body of someone who uses medical heroin every day with clean needles and doesn't drink alcohol will be in a much better state than someone that drinks two liters of beer every day. Of course I don't think that there is a person with a heroin addiction that doesn't also have an alcohol problem. I think it makes sense to look at alcohol as more dangerous than heroin from a personal risk perspective. > At the other end, 1 glass of wine every day for 60 years is as far as we can tell on net harmless. The evidence seems to be that even low levels of alcohol consumption can increase the risk of certain cancers: https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.ht...
  - Retric 5y ago
    Moderate alcohol use is associated with some cancers, but is also associated with cardiovascular benefits. On net it’s as far as we can tell neutral. All opioids build tolerance but not resistance. Overdoing is sadly common in very long term users even of medically sourced and therefore clean drugs. Even clean heroin by itself is vastly more deadly than Alcohol for average users over moderate to long timescales. Which is why you need to compare habitual long term users of drug X to habitual long term users of drug Y.
- Nursie 5y ago
  > alcohol in and of it’s self can be deadly but it’s not nearly as bad as these comparisons generally suggest. This is such a weird view. Alcohol is addictive, causes a huge variety of mental health issues and can kill through both chronic and acute exposure. It's not just that use is widespread, and if it is abused, that's part of the issue, that people are prone to abuse it!
  - Retric 5y ago
    It’s not safe, but a neutral comparison is to compare all users over all timescales. As such an infinitesimal number of alcohol users OD very early on but that’s extraordinarily rare. Chronic use is relatively common, and while not generally deadly for decades has significant issues. By comparison even clean opioids are more deadly long term. Pot has different Heath effects but is not safe when consumed to excess with extremely heavy users facing mental and physical issues, which can for example result in cancer or traffic related deaths. Which again isn’t to say alcohol is safe, but rather heavy drug is generally bad independent of drug type.
    - Nursie 5y ago
      I’m not arguing otherwise, but the apologetics around alcohol concern me because all too often we hear “oh it’s only a beer”, and “well of course some people have problems but most are ok” used in the same breath as “cannabis causes mental health problems”, utterly disregarding that alcohol does too. People don’t evaluate alcohol use the same way as they do drug use and they should. When honestly evaluated that way alcohol is right up there in terms of harm. You can’t put it all down to how common it is, and neither can you write off ‘abuse’ as a separate issue, abuse potential is all part of the harm profile.
      - Retric 5y ago
        You’re correct. My context was someone saying well accepted, and also more deadly and addictive than many so called "dangerous drugs" which is a common argument but as far as I can see biased in the other direction. ~55% of adult Americans drank alcohol in the last month, it’s hard to find illegal drugs that would be safe at that scale and level of use. Micro dosing LSD for example is likely comparable to some moderate alcohol use. But, if 55% of the population was self administering LSD it wouldn’t be limited to people micro dosing. Many would push thing to much higher levels regularly. That’s really the only thing I meant by separating out people abusing alcohol. It’s part of the spectrum of use, but not the only point of comparison.

Retric 5y ago

Alcohol does a great deal of harm simply because it’s very common and often severely abused. Few drugs are harmless when heavily abuse for decades drives up tolerance levels. Lifetime ultra heavy pot smokers for example face significant lung cancer risks, though very few people are heavy daily pot smokers for 50+ years at this point. At the other end, 1 glass of wine every day for 60 years is as far as we can tell on net harmless. Where even light daily pot smoking still causes some lung issues on those timescales. So yes, alcohol in and of it’s self can be deadly but it’s not nearly as bad as these comparisons generally suggest.

nine_k 5y ago
I would say that inhaling smoke, especially tar-rich smoke from burning organic matter, is bad for lungs. The presence of any psychoactive substance in it changes little. There are several other ways to consume THC, though, somehow less destructive. By the same token, drinking alcohol in shots, cold and concentrated, is about the worst way to consume it, because most of it is then spent ruining the liver, and little actually reaches the brain. Sipping a glass of wine does not compare. AFAICT a lot of health problems that even heroin addicts face do not come from overdoses, but from the unsanitary ways of intravenous administration of it, and the wear-off of the veins from constant injection. Comparing drugs by just their chemical properties, and ignoring the ways they are consumed, is not very productive, alas.
- Retric 5y ago
  > By the same token, drinking alcohol in shots, cold and concentrated, is about the worst way to consume it, because most of it is then spent ruining the liver, and little actually reaches the brain. Sipping a glass of wine does not compare. That really isn’t how alcohol works in the bloodstream. Once it’s through the GI tract there is zero difference in what the source of alcohol is. Further, the liver takes a long time to break down a shot of alcohol or a glass of wine. The only real difference is to the throat, stomach lining where more concentrated alcohol can be a larger irritant. But again once it’s in the blood stream it’s both significantly diluted and rapidly spread throughout the body. Now sipping wine with food does significantly slow absorption, but it’s the same effect if you take a shot in the middle of a meal.
  - xkcd-sucks 5y ago
    https://en.wikipedia.org/wiki/First_pass_effect https://en.wikipedia.org/wiki/First_pass_effect Not sure how this applies to drinking concentrated vs dilute alcohol though
    - Retric 5y ago
      It only plays a role when you are digesting something else. In contrast to the results in the fed state, in humans fasted overnight the concentration of alcohol consumed (4%, 16%, and 40%) had no significant effect on mean AUCs. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1530-0277.1991.tb00589.x https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1530-0277....
heavyset_go 5y ago
> At the other end, 1 glass of wine every day for 60 years is as far as we can tell on net harmless. When it comes to mouth, esophageal and stomach cancers, even one drink a day increases your chances of developing them.
- Retric 5y ago
  In isolation yes it can cause a very small increase in cancer. But it also has other upsides such as reduced cardiovascular issues. Therefore you need to take net not individual health impacts, which is more complicated. Remember the scale 55% of adult Americans drink at least monthly and those cancers are still rare and also associated with soda consumption etc.
xorfish 5y ago
> Alcohol does a great deal of harm simply because it’s very common and often severely abused. The body of someone who uses medical heroin every day with clean needles and doesn't drink alcohol will be in a much better state than someone that drinks two liters of beer every day. Of course I don't think that there is a person with a heroin addiction that doesn't also have an alcohol problem. I think it makes sense to look at alcohol as more dangerous than heroin from a personal risk perspective. > At the other end, 1 glass of wine every day for 60 years is as far as we can tell on net harmless. The evidence seems to be that even low levels of alcohol consumption can increase the risk of certain cancers: https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.ht...
- Retric 5y ago
  Moderate alcohol use is associated with some cancers, but is also associated with cardiovascular benefits. On net it’s as far as we can tell neutral. All opioids build tolerance but not resistance. Overdoing is sadly common in very long term users even of medically sourced and therefore clean drugs. Even clean heroin by itself is vastly more deadly than Alcohol for average users over moderate to long timescales. Which is why you need to compare habitual long term users of drug X to habitual long term users of drug Y.
Nursie 5y ago
> alcohol in and of it’s self can be deadly but it’s not nearly as bad as these comparisons generally suggest. This is such a weird view. Alcohol is addictive, causes a huge variety of mental health issues and can kill through both chronic and acute exposure. It's not just that use is widespread, and if it is abused, that's part of the issue, that people are prone to abuse it!
- Retric 5y ago
  It’s not safe, but a neutral comparison is to compare all users over all timescales. As such an infinitesimal number of alcohol users OD very early on but that’s extraordinarily rare. Chronic use is relatively common, and while not generally deadly for decades has significant issues. By comparison even clean opioids are more deadly long term. Pot has different Heath effects but is not safe when consumed to excess with extremely heavy users facing mental and physical issues, which can for example result in cancer or traffic related deaths. Which again isn’t to say alcohol is safe, but rather heavy drug is generally bad independent of drug type.
  - Nursie 5y ago
    I’m not arguing otherwise, but the apologetics around alcohol concern me because all too often we hear “oh it’s only a beer”, and “well of course some people have problems but most are ok” used in the same breath as “cannabis causes mental health problems”, utterly disregarding that alcohol does too. People don’t evaluate alcohol use the same way as they do drug use and they should. When honestly evaluated that way alcohol is right up there in terms of harm. You can’t put it all down to how common it is, and neither can you write off ‘abuse’ as a separate issue, abuse potential is all part of the harm profile.
    - Retric 5y ago
      You’re correct. My context was someone saying well accepted, and also more deadly and addictive than many so called "dangerous drugs" which is a common argument but as far as I can see biased in the other direction. ~55% of adult Americans drank alcohol in the last month, it’s hard to find illegal drugs that would be safe at that scale and level of use. Micro dosing LSD for example is likely comparable to some moderate alcohol use. But, if 55% of the population was self administering LSD it wouldn’t be limited to people micro dosing. Many would push thing to much higher levels regularly. That’s really the only thing I meant by separating out people abusing alcohol. It’s part of the spectrum of use, but not the only point of comparison.