Pot and Alcohol: A Tale of Two Countries

LONDON -- For the moment, anyway, the conversation in the United States about legalizing marijuana appears to have been shut down. Initiatives to legalize some uses of the substance were decisively defeated in three states on Tuesday -- Oregon, South Dakota and, most notably, California. (The drug's legal status in a fourth state, Arizona, still hangs in the balance as of this writing.) But halfway around the world, the Brits began a drug conversation of their own. A report released on Monday argued that alcohol is the most dangerous drug in the U.K. by a wide margin, dominating even heroin and crack cocaine.

The study, which was published online in the prestigious medical journal Lancet, ranked substances including alcohol, cocaine, heroin, ecstasy and marijuana based on how destructive they are to the individual who takes them and to society as a whole. The researchers analyzed how the selected drugs harmed the human body as well as their effects on the environment, families and relationships, and their costs in terms of health care, social services and incarceration.

Overall, alcohol scored 72 -- against 55 for heroin and 54 for crack. Much farther down the scale were crystal meth (33), cocaine (27), tobacco (26), amphetamine/speed (23), and cannabis (marijuana), which only scored 20.

The authors of the study -- including the former government drugs adviser, David Nutt -- contend that this analysis argues definitively for reordering the British government's current drug classification scheme. In their view, alcohol should join the ranks of the most dangerous Class A drugs, such as heroin, whereas ecstasy should be downgraded from Class A to Class C. (A quick glance at this table further illustrates their point: Whereas in 2008, 40 million people used alcohol in the U.K. and 40,000 died from alcohol-related causes, 500,000 people used ecstasy and only 27 died.)

There's no question that alcohol has been taking a rising toll on British society. Although overall consumption is falling, death rates from excessive drinking have been rising steadily. Middle-age women, in particular, are drinking both more frequently and more heavily in Britain, fueling attendant lifestyle illnesses.

Needless to say, the rise in drinking-related health problems has also put an enormous burden on the National Health Service (NHS). Data released two years ago showed that the annual cost to the NHS from drinking topped 2.7 billion pounds (approximately $4.1 billion). This includes more than 1 billion pounds spent on treating people in hospitals due to alcohol, 372 million pounds on ambulance journeys and 646 million pounds on emergency room visits. The total cost has jumped about 1 billion pounds since figures were last compiled in 2003.

At the same time, there are also the social costs that go with increased drinking. There's a strong cross-national correlation between alcoholism and divorce. But alcohol also augments violence and crime. As of this summer, bars and pubs that stay open after 11 p.m. in the U.K. have to pay a "law and order" fee in order to help defray the costs local police here face in tackling anti-social behavior and alcohol-related violence.

This latest study is expected to generate a fresh debate over the potentially damaging effects of legal vs. illegal drugs. Nutt was fired last year after suggesting publicly that marijuana was less dangerous than alcohol. At the time, many interpreted his sacking as motivated more by politics -- the cultural place of alcohol among middle-class Brits as well as the power of the beverage industry -- rather than by science. But there's some reason to believe that the anti-alcohol message he and his colleagues are peddling may resonate more now than it did then.

Although alcohol is far from the social pariah that it is in the U.S., there is a growing awareness of its pernicious effects in the U.K. In this recent memoir, "A Journey," former Prime Minister Tony Blair said that he frequently resorted to alcohol as a drug, bringing booze front and center into the national debate. And newly minted Prime Minister David Cameron has indicated that he would support minimum pricing on alcohol and back local governments that want to ban shops and bars from selling excessively cheap alcoholic drinks.

In writing about the politics of pot just before Tuesday's election, my colleague, Christopher Weber argued that even if the various legislative initiatives to legalize marijuana were to fail in 2010, over the long haul - and largely because of attitudes towards the drug among young voters - this is an issue that's going to stay with us. That is already clear in Oregon, where despite Measure 74's defeat by a margin of 57% against versus 42% in favor - proponents of legalizing medical marijuana are already looking to revisit this issue in 2012.

By the same token - although it cuts in a very different direction - it looks like the Brits are finally opening up a conversation about alcohol.

How refreshing - on both scores - in every sense.

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