Whiskey or Cocaine: Which Is Worse? What Science Says

Recent statements by Colombian President Gustavo Petro, suggesting that cocaine is “not worse than whiskey”, have ignited a debate about how society classifies the dangers of different drugs. Colombian President Gustavo Petro on purpose polarizes on one side those who note that alcohol is legal despite clear links to health risks, violence and addiction, and on the other side illicit drugs such as cocaine typically carry significant criminal penalties. Where does scientific and medical evidence stand on the comparison between these two substances?

Simplistic Comparison Are Tricky Because There Are Different Forms of “Harm”:
From a purely medical standpoint, both whiskey (alcohol) and cocaine have potential for dependence and can pose serious health hazards. In a 2010 study published in The Lancet, the prestigious medical journal, a team led by British researcher David Nutt assessed multiple ways drugs could harm individuals, and ranked them from the most to the least harmful. Doctors and scientists have warned against the simplistic labeling of any substance as “the worst,” as this approach fails to capture the complexities of drug use, including the role of legal status and broader social factors in shaping risks, and therefore nuanced and prudent approach is necessary.

Left: list of the most dangerous Drugs Ranked. Right: What Do We Mean By “Harmful” ? Evaluation criteria organized by harms to users and harms to others, categorized into physical, psychological, and social effects

But what does “harm” really mean in the drug context ? In this Lancet analysis, the medical researchers looked at many different types of harm, 16 types to be accurate, which can be classified into two main categories: harm to individuals or harm to society.

For example they looked at how deadly a substance is in and of itself (comparing the usual dose to what could kill someone), and how much a drug shortens a person’s life through indirect factors (like accidents or illnesses), not just its own toxicity. They examined direct physical harm such as liver cirrhosis, heart problems, or seizures, and indirect problems, for example, infections spread by shared needles or risky behavior under the influence. They looked at how likely a drug is to hook users despite negative consequences. The researchers split mental harm into specific and related impairment causes such as psychosis from certain stimulants, and depression linked to lifestyle changes. They also considered social fallout, like loss of tangible things such as income, housing, or a job, and loss of relationships with family or friends. Beyond personal harm, they measured the chance of injury” to others when using the drug, through violence or accidents, along with crime rates such as theft, gangs, and so on, they looked at environmental damage such as toxic waste from drug labs or discarded needles, and family adversities such as child neglect, broken homes, lost future prospects. On a wider scale, the study looked at international damage, such as how drug production might destroy local forests or destabilize entire countries. Finally, they assessed the total economic cost including police, health care, and lost work time, and how drug use can degrade community life by undermining trust, safety, and general well-being.

Using this approach, the research placed alcohol, overall, as more harmful to society than any other substance, above even heroin and crack cocaine, primarily because of alcohol’s prevalence and its strong link to violence, accidents, and long-term health complications.

However, one must also add details and nuances in order not to fall for simplistic interpretations, which may convey a wrong and inaccurate meaning. Alcohol, being widely available and socially accepted, often leads to higher consumption and associated harms like drunk driving or chronic diseases. Cocaine, though impacting fewer individuals directly, has severe consequences for users, their communities, and source countries plagued by drug-trade violence. Simplistic comparisons overlook the intricate interplay of these factors.

In the course of this investigation and fact-check, a crucial question arose: what about cocaine consumption among those in power in Algeria? More precisely, what impact does it have on decision-making and the situation Algeria currently finds itself in, in the grip of a rogue junta?

Under the influence of cocaine, Algerian generals and intelligence officers display overestimation of their abilities and increased impulsivity, leading to decisions devoid of any rationality. Cocaine also amplifies paranoia and delusional thinking, leading users to perceive any criticism or opposition as persecution. In response, they may take aggressive action to eliminate or silence any perceived threat. To outside observers unaware of their consumption, this behavior can seem irrational and out of touch with reality. We have devoted a separate article to this subject: “Algeria’s Generals, Judges, and Tebboune’s Circle: Time to Face the Cocaine Test”.

Abderrahmane Fares