this post was submitted on 20 Dec 2023
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Eleven years ago, two days before Christmas, my 24-year-old brother, who was a university graduate and former law student, died from a self-inflicted gunshot wound. After a decade of hard and continuous drinking interspersed with addiction and mental health treatment, he could not sustain his recovery. His suicide came on the heels of my mother’s death a year before, and just weeks later, my grandfather died in a car accident. My family’s holidays would never be the same.

Like so many others who survived the loss of someone dear from the chaos of severe substance use disorder (SUD), I am too familiar with unspeakable grief. But I have found meaning through it and purpose in passing that on.

I was a medical resident when I dropped my brother off at an addiction treatment facility for the first time. Later, I became an addiction specialist physician, focusing on treating people with SUD and helping them manage their disease and find remission and recovery. My work has taught me something important: To help stop the addiction crisis that has brought so much sorrow to families like mine, policymakers must prioritize prevention at all levels and support evidence-based prevention initiatives — including raising federal excise taxes on alcohol.

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[–] RainfallSonata 66 points 6 months ago* (last edited 6 months ago) (1 children)

"My brother killed himself after self-medicating with alcohol for a decade in order to cope with horrific systemic social ills. So instead of fixing those, we need to make it harder to self-medicate. He probably would have just killed himself sooner. But at least he wouldn't have been a drunk for 10 years!"

[–] [email protected] 10 points 6 months ago (2 children)

Alcohol isn't self medication though...it's a coping mechanism and furthers depression. But yes, this section. Also caught my eye while skimming

[–] hungrycat 19 points 6 months ago (2 children)

I get what you’re saying and don’t disagree with your distinction. But it bears pointing out that it feels like splitting hairs to say self-medication and coping mechanisms aren’t the same when you’re the individual in pain.

[–] [email protected] 3 points 6 months ago

Yeah cope might be the incorrect term here.

[–] [email protected] 11 points 6 months ago

"Self-medication" is a synonym for maladjusted coping mechanisms. It's a euphemism. They used the term correctly.

[–] [email protected] 42 points 6 months ago

Ah yes, Prohibition for the poor.

[–] NightAuthor 29 points 6 months ago* (last edited 6 months ago) (2 children)

Taxes reduce consumption? Id Image people would give up other things before their alcohol, and they’d switch to cheaper alcohol before resorting to reducing.

Gonna to skim the article now

Edit: seems there actually is decent evidence that increasing taxes by 6% caused a 4.7% decrease in [violent] crimes. Or something there about, I skimmed like 3 papers

[–] MicroWave 5 points 6 months ago (2 children)

Looking at Europe, taxing seems to be an effective mechanism:

…A recent analysis on the World Health Organization European Region — which has the highest level of alcohol consumption of all WHO Regions — notes there is strong and compelling evidence in Europe that increasing the price of alcoholic beverages through taxation is one of the most effective (and cost-effective) policies used to lower alcohol-attributable harm…

[–] [email protected] 0 points 6 months ago (1 children)

Let's not compare the average American to the average European please.

[–] [email protected] 3 points 6 months ago

Just want to say, props for actually looking at evidence that would challenge your initial viewpoint and changing your views in response to new information. Not enough people do that.

[–] Thcdenton 20 points 6 months ago

Been sober for years now. No way this works.

[–] hungrycat 20 points 6 months ago* (last edited 6 months ago)

I’ll echo other comments here that simply raising taxes does not seem like a successful long-term intervention strategy in a vacuum—and I don’t think the author intended for it to come across this way, though it kind of did. The availability of mental health services and a number of societal ills are what need to be addressed.

I’ll also add that in the same period when the author discusses a decrease in alcohol-related injury deaths, post-1991, there was an increase in illicit drug use as illustrated in this National Institute on Drug Abuse chart. While the increased trend in the use of any illicit drug is largely driven by marijuana in this chart, you can see there are also moderate increases for other drugs like LSD, cocaine, and later heroin.

Did the sudden availability of certain other drugs plus the higher cost barriers to obtaining alcohol create an environment that led to more drug abuse and other drug-related deaths? I don’t know, I’m not a researcher, but it’s a question.

[–] hOrni 16 points 6 months ago* (last edited 6 months ago) (1 children)

Raise the taxes to lower consumption? That's just stupid. I'm Polish. They tried this here. Beer is around 30 percent more expensive than last year. Vodka around 25. It didn't made me buy less. I have to buy in bulk, what makes me drink even more. Or buy cheaper, lower quality alcohol. Or save money on other things.

[–] SCB 5 points 6 months ago (1 children)

This is called a Pigouvian Tax, and they definitely work.

https://movendi.ngo/news/2022/06/07/alcohol-tax-increase-in-poland-leads-to-falling-alcohol-sales/

I strongly disagree with this opinion piece and find the writer's intentions heavily biased, at best, but Pigouvian taxes as a concept are definitely effective.

[–] Adubya 3 points 6 months ago

Thanks! Wasn't the Tobacco settlement fund used to promote anti-smoking programs, given to communities for anti-smoking ordinances, and enriching other public health initiatives that helped make it so effective?

There has to be a use of the tax effectively to discourage the next generations and help increase treatment otherwise the taxes alone could hit a level where some states might start to ignore regulation & the moonshine stills fire back up.

[–] Alexstarfire 15 points 6 months ago

Yep, treating symptoms instead of causes always works.

[–] [email protected] 7 points 6 months ago

I feel like making things more expensive doesn't address the root issue.

Maybe things like healthcare, food and housing should be cheaper and more available instead.

[–] Fades 5 points 6 months ago

Alcohol is poison, it should be taxed more just like tobacco

[–] [email protected] 2 points 6 months ago

Love this, i think the best thing we could do is ban alcohol advertising, or at least ban it in a lot of places.

[–] [email protected] 2 points 6 months ago* (last edited 6 months ago) (1 children)

Here's a thought, making "sins" more expensive just makes poor people live in greater poverty to keep their sins a part of their life, making them more miserable and increasing their reliance on said sins.

Increasing luxury taxes on sin items only serves to make people feel like they're doing good while getting their *rocks off on punishing bad people.

Focusing on the poverty issue will do more to prevent unnecessary deaths to drugs and alcohol than making them so expensive only the rich can afford them and make the world a truly better place for everyone.

[–] AllonzeeLV 1 points 6 months ago* (last edited 6 months ago)

Yeah, this will end well.

Our "society" sucks. Much of the country lives in subsistence to a few rich assholes.

Clearly the owners won't permit that reality to change, but if you want riots and more mass shootings, by all means, take away your capital battery's means to cope with it, too.