The Most Dangerous Drug You Can Buy at a Grocery Store
In a landmark 2010 Lancet study, David Nutt and colleagues ranked 20 drugs by overall harm. Alcohol ranked first -- more harmful than heroin or methamphetamine when combining harm to users with harm to others. Its widespread availability means population-level damage (car accidents, domestic violence, liver disease, cancer) dwarfs any illicit substance.
This guide applies the same evidence-based harm reduction framework used for illicit drugs to the substance that actually causes the most damage worldwide.
Understanding Standard Drinks
Most people dramatically underestimate how much alcohol they consume because they do not understand standard drink equivalents.
One standard drink contains approximately 14 grams of pure alcohol:
A restaurant wine pour is 6-8 oz, not 5. A craft IPA at 7.5% ABV in a pint glass is nearly 2 standard drinks. A strong cocktail can contain 2-3. When people say they "had two drinks," they often consumed 3-5 standard drink equivalents. BAC and risk scale with actual alcohol consumed, not number of glasses.