Alcohol Use and Death

Alcohol is a potent substance, capable of quickly transforming a seemingly respectable and rational individual into a babbling fool. This power can have further consequences, both immediately and over the long term. Rapid drinking of distilled liquor can lead to death in less than 1 hour, sometimes in as little as 30 minutes. Alcohol use has been linked to the genesis of fatal illnesses and irreversible deterioration in nearly every major organ system of the human body. Rarely does a chronic heavy drinker live a full life course and, at best, suffers multiple disabilities. The idea that “alcohol kills” has been a theme in American culture since the early 19th century, surrounded by data that directly confirm this assertion as well as evidence that is deliberately interpreted to support it.

As part of nature, alcohol predates humanity. Ethanol is a natural product of decay of organic material, making its presence known in all human societies and making its total obliteration [Page 28]impossible. Despite many attempts, Prohibition has proven difficult to impose permanently.

Nonetheless, societal alcohol use, relative to risk of premature death, is often seen as playing with fire. Diffusion of information about the potential of damage and death associated with drinking rarely has a significant impact on the targeted drinking behavior. When access to alcohol is forbidden, people go to great lengths to ensure a steady source of supply. Thus, the public policy expert is forced to observe that much pleasure and positive reinforcement accompanies alcohol use. Relief from stress is sought daily by many individuals and groups through the relaxing effects of drink. Social and sexually oriented interactions as well as business transactions among relative strangers flow more easily with the lubrication of alcohol.

Further, in terms of custom and tradition, there are at least two types of events, each sometimes involving death, when groups and communities facilitate disinhibition through alcohol consumption. These are (1) celebration of rites of passage when alcohol may be used to escalate meaning and (2) commemoration of historical events or time passages during which alcohol may be used to invest and deepen the meaning of the occasion.

Public policy rarely showcases alcohol's social benefits or its embeddedness in cultural practices. Indeed, nearly all social policy statements about alcohol are heavily loaded with implications of damage, disease, and death. Beyond well-publicized dangers, the use of beverage alcohol (ethanol) by humans is intimately intertwined with several different types of explanations of death and experiences related to deaths. These relationships are of multiple types and go well beyond common knowledge that it is risky to consume alcohol. This entry offers a review of alcohol, death, and social policy; alcohol and fatalities; ecological perspectives on alcohol and death; and death rituals linked to alcohol.

Alcohol, Death, and Social Policy

The roles of alcohol in death are reflected in the ambivalent attitudes held by Americans, most Western societies, and many other cultures toward alcohol consumption. In addition to the welldocumented experiences in the United States, many other Western countries have experienced periods of national Prohibition of the manufacture and use of alcohol. When and where it has been enacted, nations' rationales for alcohol Prohibition have almost always carried strong themes that alcohol causes premature death among both users and bystanders who may not be users. These bystanders include children, who may be the targets of violence or the victims of neglect; pedestrian and vehicular passengers who are struck by drunken drivers; or members of the public who are simply in the wrong place at the wrong time when alcohol-fueled violence breaks out. Prohibition has always carried a strong death theme that has been difficult for its opponents to challenge.

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