Is Beer A Drug?

Following the release of their trenchant report Big Beer Duopoly – which documents the impact of megalo-brewers ABInBev and MillerCoors – our colleagues at the Marin Institute have been taken to task by Beer Business Daily for having the audacity to describe beer as a drug:

Or were they meaning drug as in “narcotic”?   If so, I doubt the average voting soccer dad — or President Obama for that matter (who routinely drinks beer on camera) would appreciate his favorite beverage being styled as a narcotic or himself as a drug user, in my opinion.

The BBD report also makes an attempt at innocence-by-association by reference to caffeine.  Caffeine is, indeed, a drug – a mild stimulant.  It can be abused, and, in large doses, have toxic effects.  But it is not implicated in breast cancer (among other cancers), violence, child abuse/neglect, depression, suicide, car crashes, drownings, and risky sexual behaviors (CDC, 2008).

Comparing caffeine to alcohol is like comparing aspirin to hydrocodone.

According to the Merriam-Webster Online Dictionary, a drug is defined as:

3: something and often an illegal substance that causes addiction, habituation, or a marked change in consciousness.

Does alcohol cause addiction, habituation, or a marked change in consciousness?  Of course it does.  Some would argue that alcohol does not “cause” addiction because only a relatively small percentage of users ever become dependent.  But the proportion of alcohol users who ever become dependent (15%) is just under that of cocaine (17%) and more than that of marijuana (9%) (Joy, et al., 1999).

And the harm engendered by alcohol abuse and dependence is far greater than all illicit drugs combined (Mokdad, et al., 2004 ).  Moreover, much of that harm is due to the acute, as well as chronic, effects of alcohol misuse (Rehm, et al., 2006).

Robert Benedetto of the New York State Division of Alcoholic Beverage Control has astutely noted that alcohol outlets are, in effect, single drug pharmacies – but with far less regulation than medicinal pharmacies.

References:

Centers for Disease Control and Prevention (2008).  Quick stats:  General information on alcohol use and health.  Retrieved on October 14, 2009, from http://www.cdc.gov/alcohol/quickstats/general_info.htm.

Joy, J.E., Watson, Jr., S.J., Benson, Jr. J.A. (Eds) (1999). Marijuana and medicine: Assessing the science base. Institute of Medicine.  National Academies Press:  Washington, D.C.

Mokdad, A.H., Marks, J.S., Stroup, D.F., & Gerberding, J.L. (2004).  Actual causes of death in the United States, 2000.  JAMA, 291(10), 1238-1245.

Rehm, J., Giesbrecht, N., Patra, J., & Roerecke, M. (2006).  Estimating chronic disease deaths and hospitalizations due to alcohol use in Canada in 2002: Implications for policy and prevention strategies. Preventing Chronic Disease, 3(4),  http://www.cdc.gov/pcd/issues/2006/oct/05_0009.htm. [free full text]