Daily Archives: 22/02/2015

A comprehensive list of alcohol’s harms and benefits in a cost-benefit diagram

The now defunct Government Cabinet Office Strategy Unit once attempted to capture a comprehensive list of alcohol’s harms and benefits in a cost-benefit diagram

Here it is (click to enlarge)

costs_of_alcohol_m_3167181c

What I find interesting is that there are 17 above the line costs and only 5 below the line benefits.  Feels like a lot of risk for not a great deal of reward wouldn’t you say?

This graph was included in an article in The Telegraph which ran in January and was looking once more at Professor Nutt’s chemical compounds that have been muted as solutions.

He has finally cracked a chemical conundrum, which has allowed him to develop new drugs that could wean people off alcohol, while allowing them to enjoy the feeling of being “tipsy”.

The first drug, which he calls “alcosynth”, is a drink that mimics alcohol. It a non-toxic inebriant that removes the risks of hangovers, liver toxicity, aggression and loss of control. A benzodiazepine derivative, the substance is in the Valium family, but without being addictive or causing withdrawal symptoms, he claims.

The second is a so-called “chaperone”, which would attenuate the effects of alcohol. Take a pill with booze, and it’s impossible to become drunk to the point of incapacitation. The price point would be set quite high, to stop the drug from being abused, but this “sober up pill” could be popped on the way home, reducing drink-driving accidents, and other alcohol-related incidents and crime.

Both drugs would be available in high-end cocktail bars at first, claims Nutt. The alcohol substitute would be marketed as a companion to a regular tipple and relatively cheap to buy.

The overall cost of alcohol misuse is difficult to calculate because of alcohol’s ubiquity. Its combination with fatty food and sedentary activities make the mathematics tricky: estimates for the overall cost of alcohol to the British economy range from £21bn to £55bn per year.

The Prime Minister’s Strategy Unit has pegged the cost to the NHS of “binge Britain” at £3.5bn – higher than smoking at £3.3bn. Add on the £11bn for crime and £7.3bn in lost productivity from hangovers, absenteeism and poor performance and alcohol increasingly appears economically destructive.

Nutt has been working on synthesising his alcohol mitigation drugs for a decade. The effects of alcohol are devilishly hard to mimic because of its complex effect on the human body.

Ethyl alcohol (C2H6O) is unique in the universe of narcotics. Most drugs operate by hijacking one molecular receptor: tetrahydrocannabinol (THC, the active component in marijuana) impersonates our own endocannabinoids. Psilocybin (the chemical contained in magic mushrooms) mimics serotonin. Cocaine messes with the dopamine networks.

Alcohol uniquely masquerades as a number of neurotransmitters. Booze is the ultimate molecular maverick, which explains why so many of us are hooked. “Alcohol is a promiscuous drug,” says Nutt. It is also called the “dirty drug” because of its capacity to invade every cell in the body.

Nutt has applied for patents on 85 new chemical compounds in the alcosynth and chaperone families, which would be licensed to DrugsScience, and the Beckley Foundation, both independent organisations dedicated to research on drugs and drugs policy research.

Getting alcosynths and chaperones to market will not be easy. Licensing such drugs could take between three and five years, Nutt says – if they pass the UK’s stringent drugs laws at all. He has also courted controversy by working with a chemist, known as Dr Z, who was behind the creation of a mephedrone, also known as “miaow miaow”. That drug that was connected to a number of deaths in the UK last year and was subsequently banned.

“Some see him as the ‘new Shulgin’ [the chemist who gave us MDMA, 2-CB, 2-TI and 200 other psychoactive compounds],” says Dr Nutt. “Others see him as evil incarnate. He polarises people.”

The cost of human trials and legal bills for Nutt’s new chemicals will top £1m, he claims. He is hoping to secure a backer from the big pharma world. Danish pharmaceutical company Lundbeck recently launched Selincro, a drug that reduces the craving for alcohol, proving that there is market interest, he says.

The £1m figure doesn’t scrape the surface of the investment required to change our social and cultural relationship with alcohol. Not to mention our economic reliance on the industry, which generated £39bn for the UK, according to Nielson data.

“If alcohol was treated as a toxic compound in the same manner as benzene or other lethal chemicals, the maximum amount you would be permitted to consume would be one wine glass a year,” says Nutt. “But it is exempt from toxic control measures because we like to drink.”

Nutt says the Government must take drastic action to generate results, as all attempts to mitigate alcohol consumption have so far failed.

“We are incapable of killing alcohol’s allure,” he warns. “This is a battle we cannot win.”

This is an interesting premise and has been discussed by me here and here.  As before I’m not sure that replacing alcohol with a benzodiazepine based product is really helpful and the alcohol attenuator sounds just like Selincro, which I wrote about in these posts here.

What do you think?

PS Am now in the process of organising the next Club Soda Social in Cambridge.  The plan is Sunday 22nd March 5-8pm at Brown’s Restaurant and Laura assures me they have a great mocktail selection 😉