Sometimes we observe a car wreck and rubber neck our way until it is out of our sight. I had that feeling during the hearings for Supreme Court Justice Kavanaugh. As I listened to the testimony, it surfaced repeatedly that the incidents in question revolved around heavy drinking. The presumed assault was not committed by sober individuals: the participants and the victim were blind drunk and many of the details could not be recalled. There were conflicting memories of events and gaps in time. While the politics for whom was wronged were not determined, as a toxicologist the hearings resonated with me.

Research shows that one of the most common toxins we are routinely voluntarily exposed to is alcohol (ethanol to be more precise).  Alcohol is overwhelmingly known to fuel bad behavior, be it events of 30+ years ago for a Supreme Court Justice or yesterday for a college freshman posting the exploits to Instagram. Alcohol also is responsible for the deaths of thousands of individuals in our country every year, whether it’s caused by inebriated drivers on the road or excess consumption from the bottle.

If you review the statistics from the recent National Academies of Science, Engineering and Medicine report, alcohol is the number one cause of traffic fatalities (~1/3rd of the total) and it is also totally preventable. Each day 29 people in the US die from alcohol-related traffic accidents; many of them are passengers, other motorists, or pedestrians. A total of 10,497 people were killed in 2016 alone due to alcohol-related accidents..

Data from 2015 show 27% of people ages 18 and older reported binge drinking in the past month.  According to the 2015 National Survey of Drug Use and Health, 15.1 million adults ages 18 and older have Alcohol Use Disorder (AUD). This includes 9.8 million men (8 % of men in this age group) and 5.3 million women (4% of women in this age group). Approximately 88,000 people (62,000 men and 26,000 women) die from alcohol-related causes annually, making alcohol the third leading preventable cause of death in the United States behind tobacco and poor diet/physical inactivity. You may notice that cannabis is not in the top three causes of preventable death-it doesn’t even make the list.

With respect to sexual assaults, as seen in the Kavanaugh case, 696,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking. Some 97,000 students between the ages of 18 and 24 report experiencing alcohol-related sexual assault or date rape. Roughly 20% of college students meet the criteria for AUD. There are limited reports of a perpetrator’s sole cannabis use leading to sexual assault. As reported by Anthony Floyd, when cannabis use is listed as a causative factor in sexual assault it is in combination with alcohol.

Examining alcohol related deaths is another way to compare the incredible costs of alcohol use to society in comparison with cannabis consumption:

• In 2015, of the 78,529 liver disease related-deaths among individuals ages 12 and older, 47 % involved alcohol.
• Among all cirrhosis deaths in 2013, 48% were alcohol-related. The proportion of alcohol-related cirrhosis was highest (77 %) among deaths of persons ages 25–34.
• In 2009, alcohol-related liver disease was the primary cause of almost 1 in 3 liver transplants in the United States.
• Drinking alcohol increases the risk of cancers of the mouth, esophagus, pharynx, larynx, liver, and breast.
• To date, no death has been directly linked to cannabis consumption.

Toxicologically speaking, researchers have designated cannabis a low risk substance compared to alcohol, a high risk substance (Lachenmeier & Rehm, 2015).  With low abuse potential, low direct and indirect deaths and low disease-causing potential, cannabis not only is a safer alternative to alcohol as a recreational substance, it also offers a plethora of medicinal and therapeutic benefits.  If we look at the pervasiveness of the culture of alcohol consumption in the US-from brunch mimosas, to tailgating beers, to late night cocktails-we can see why so many people end up in bar fights, alcohol-related car accidents or with liver disease.  Consumption of cannabis is the overall better choice as a recreational drug.  Perhaps, in the near future, our country will recognize this difference in health-related outcomes and federally legalize cannabis as a much safer alternative to alcohol.