Health Hazards, Addiction, and Drunk Driving: The Reality of Alcohol Through Data

Let me start by saying this: this article is not telling you to quit drinking.

I still drink myself. I enjoy my favorite drinks about twice a week, aiming for around 20ml of pure alcohol. I drink without worry at social gatherings.

However, just like with my previous article on tobacco, I believe there is a difference between drinking while informed and drinking while uninformed. That is why I researched this. I am not a scientist, so this is within the realm of inference, but I will write it accurately.

■ First, let's grasp the scale

According to a 2024 report by the WHO (World Health Organization), approximately 2.6 million people worldwide die annually due to alcohol. This accounts for 4.7% of all deaths.

The breakdown is 1.6 million from non-communicable diseases such as cardiovascular disease and cancer, 700,000 from injuries such as traffic accidents and violence, and 300,000 from infectious diseases.

Additionally, approximately 209 million people, or 3.7% of the world's adult population, are considered to have an alcohol use disorder.

Looking at the numbers alone, it is one of the world's largest "legal risks," alongside tobacco.

■ Effects on the body: The link to cancer is deeper than I thought

When people think of alcohol and health damage, they often think of the liver, but that is not the only concern.

The International Agency for Research on Cancer (IARC), under the WHO, classifies alcoholic beverages as "carcinogenic to humans." This is the highest risk classification, the same as tobacco and asbestos.

Cancers linked to alcohol include those of the oral cavity, pharynx, larynx, esophagus, liver, colon, and breast (in women), among others. In 2018, a link to stomach cancer was also recognized.

And—the consensus of the Japanese Cancer Association and the Ministry of Health, Labour and Welfare is that "from the perspective of cancer prevention, there is no safe amount of alcohol consumption."

In other words, the idea that "one drink is fine" is not accurate when it comes to cancer risk.

However, as a supplement, "the risk is not zero" and "if you drink, you will definitely get cancer" are two different things. Research by the National Cancer Center includes data showing a J-shaped or U-shaped relationship where, for men, the risk of death actually decreases with a certain amount of alcohol consumption.

It is not "absolutely bad even in small amounts," nor is it "safe in moderate amounts," but rather "the risk increases as the amount increases, and it is not zero even in small amounts"—this is, I believe, the accurate understanding at this point in time.

■ The problem of causing trouble for others while intoxicated

Apart from the effects on the body, the impact on society is also significant.

When alcohol enters the system, judgment and inhibition are lowered. This is a medical fact, as the prefrontal cortex of the brain (the part responsible for reason) is the first to be affected.

The consequences include verbal abuse, violence, sexual harassment, picking fights, drinking until blacking out, and not remembering what you did the next morning.

I myself have memories of messing up in the past a few times. I won't write the details, but honestly, there are times when I think, 'If only I hadn't been drinking then.'

Alcohol-related domestic violence, workplace trouble, and the breakdown of relationships—the number of cases reported as social issues is not small. 'I was drunk' is no excuse, but it is a fact that alcohol changes people.

■ Drunk Driving—The Figure of a 9x Higher Fatality Rate

Regarding drunk driving, the numbers are clear.

According to National Police Agency data, in 2021, the fatality rate for accidents without alcohol was 0.75%, while the fatality rate for accidents involving alcohol was 6.92%. That is about 9.2 times higher.

This is caused by a decline in judgment, reaction speed, and field of vision due to alcohol. Even if you think you are fine, your brain and body are being affected honestly.

'I only had a little,' 'It's just in the neighborhood'—looking back at my past self, I get a little scared thinking about how many times I made those judgments. Among my fellow blue-collar workers, I have seen several people end their careers due to drunk driving.

■ Alcohol Dependence—It Is Not a 'Lack of Willpower'

In my previous article on cigarettes, I talked about nicotine dependence, and alcohol is also addictive.

I will repost the comparative data on addictiveness.

Strength of physical dependence: Alcohol > Heroin > Nicotine
Difficulty in quitting: Cocaine = Heroin = Alcohol = Nicotine > Caffeine

(Source: Royal College of Physicians, 2000)

Alcohol is rated as having a stronger physical dependence than heroin.

It is estimated that there are over 800,000 people with alcohol dependence in Japan (2003 survey), but it is said that the actual number is much higher.

The important thing is that dependence is not something that happens to 'people with weak willpower.' It is a 'disease' that occurs when the brain's reward circuit changes. Now, I think that the fact that I, who used to drink every day, can still drink normally might just be because I happened not to cross that line.

■ The 'Is Even One Drop Bad?' Problem

I will write this honestly.

Regarding cancer risk specifically, the current medical conclusion is that 'the risk is not zero even with a small amount.'

However, as mentioned above, there are studies showing that all-cause mortality risk actually decreases with small amounts of alcohol. Regarding the impact on cardiovascular disease, there are multiple studies suggesting that moderate amounts may have a protective effect.

There is a saying that alcohol is the 'best of all medicines,' but this is likely only true under specific conditions and in moderate amounts. Currently, the global consensus is shifting toward the view that it 'cannot be said to be entirely good for health.'

In summary, while it is not the case that 'even a single drop is absolutely forbidden,' it is certain that 'the more you drink, the higher the risk.' This is why I am mindful of the guideline of 20ml of pure alcohol.

■ Why is alcohol legal around the world?

This is the part I found most interesting.

Objectively speaking, alcohol is a substance that causes addiction, health damage, and social problems. So why is it that while many other addictive substances are regulated, alcohol alone remains legal?

One answer lies in the lessons of history.

The United States enforced Prohibition from 1920 to 1933. It was a law that completely banned the production, sale, and distribution of alcohol.

What was the result? The mafia took control of bootlegging, poor-quality alcohol without quality control flooded the market, the number of addicts actually increased, and crime skyrocketed. The more you prohibit something, the more it goes underground into the 'black market,' becoming even more dangerous. Some researchers call this the 'iron law of prohibition.'

This historical failure has led to a shift in direction toward 'management rather than prohibition.'

There is also a significant cultural aspect. Alcohol has been deeply intertwined with human history. It has been used in religious rituals, festivals, and social gatherings since ancient times. It is also a massive industry economically. There is the reality that it 'cannot be banned at this point.'

In other words, alcohol is legal not because it is safe, but largely because 'banning it makes things worse' and it is 'deeply rooted in culture and the economy.'

■ What we see when comparing it to drugs

There is a debate about 'why alcohol and tobacco are okay, but marijuana is not.'

When comparing solely based on addiction and health damage, there are indeed cases where alcohol and tobacco are more serious.

However, 'legal or illegal' does not necessarily align with 'safe or dangerous.' It is largely determined by historical, cultural, and social contexts.

What I want to say here is not 'therefore, you should stop drinking,' but rather 'let's make choices while knowing the true nature of what we are consuming.'

■ How should we think about it in the end?

The more I research, the more I realize that alcohol is not a 'substance good for the body.' But that does not lead to the conclusion that 'you should not drink at all.'

The reason I still drink is that I am making the choice to 'enjoy it while understanding the risks and keeping it under control.'

What is the difference between the me of today and the me from back when I drank 365 days a year? I believe it is simply whether or not I can control the amount and the timing.

I kept saying, 'Oh well, I guess I don't need to drink today,' and before I knew it, that's just how it became.

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