The deadlier drug crises that we don’t consider public health emergencies

Alcohol and tobacco kill far more people than opioids. Should they be considered an “epidemic”?

In 2016, this drug was linked to more deaths than guns, car crashes, or even HIV/AIDS at its peak. Actually, it was associated with more deaths than guns and car crashes combined.

I’m not talking about opioids. I’m talking about alcohol.

According to the Centers for Disease Control and Prevention (CDC), alcohol is linked to 88,000 deaths each year — more than all the 64,000 drug overdose deaths in 2016. That includes all potential alcohol deaths: liver cirrhosis, poisonings, crimes related to alcohol, driving while intoxicated, and so on. But it’s a very high death rate — making alcohol the third leading cause of preventable death in the US.

What’s worse, the 88,000 number may, at this point, be an underestimate. The figure comes from an analysis of deaths between 2006 and 2010. But since then, we’ve seen some signs that alcohol deaths may have gone up: Between 2010 and 2015, the number of alcohol-induced deaths (those that involve direct health complications from alcohol, like liver cirrhosis) rose from nearly 26,000 to more than 33,000.

Alcohol isn’t even the deadliest drug in the US; that would be tobacco. Smoking is linked to, depending on the estimate, 480,000 to 540,000 deaths each year — the leading preventable cause of death in America. (This figure is potentially too high, since it’s based on mortality data from 2005 to 2009, and smoking rates have dropped since then. Still, it’s an extremely high death toll.)

Yet all of these deaths didn’t inspire President Donald Trump or the presidents before him to formally declare a public health emergency over tobacco or alcohol, as Trump finally did for opioids on Thursday. We don’t often call alcohol or tobacco “epidemics,” even as we regularly use that same language for opioids that are linked to a fraction of the deaths from alcohol or tobacco.

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