This site has had a great many posts regarding the rate of overdose death in America. That interest is spurred, in part, from the allegations that many illicit drug users may get their introduction to troublesome habits and substances in the course of treatment for medical conditions, accidents, and illness. That is inextricably intertwined with the world of workers' compensation. Over the years, I have heard various stories and anecdotes of individuals "self-medicating" with alcohol as well. 
 
Some samples from the past:
There has been significant coverage of the Opioid epidemic in America, and the havoc wreaked by a massive production and marketing conspiracy over decades. The news has been replete with coverage of the invasion of Fentanyl and its threats and impacts. There is a serious impact from all of these chemicals, and the situation seems to continually deteriorate. Each day there is another news story of a young life destroyed by drugs.
 
To make matters worse, the news feed recently featured a piece by U.S. News (Alcohol Death Toll is Rising, November 2022). The rate of death from alcohol is growing, and significantly. It reports that "The rate of deaths that can be directly attributed to alcohol rose nearly 30% in the U.S. during the first year of the COVID-19 pandemic." Thirty percent. That is not an across-the-board figure, there are communities that are seeing more or less. Averages can be confounding.
 
The "directly attributable" includes various diseases like "alcohol-caused liver or pancreas failure, alcohol poisoning, withdrawal and certain other diseases." The impacts are much more likely to affect men (2.5 times more) than women. The most predominant age group is 55-64, and yet there were increased impacts noted in other age groups. There is no "safe harbor."
 
The article notes the frustration of public health officials, who believe amid the myriad of other challenges, “Alcohol is often overlooked.” And, the scope of challenges extends beyond the "directly" category, according to a JAMA Network Open report mentioned in the article. This broader approach considers also the "linked to drinking" deaths from causes "such as motor vehicle accidents, suicides, falls and cancers."
 
The overall impact is said to be "more than 140,0000 . . . annually." That is a significant population. OF that, the Center for Disease Control says that 82,000 (59%) "are from drinking too much over a long period of time." The remaining 58,000 are "from causes tied to acute intoxication. The statistics are, frankly, sobering.
 
Different people view the allure differently. I strive to never drink and drive, but I persistently drive after appearances and events. Thus, I am known to not drink at conferences, dinners, etc. At one such recent event, a lawyer confided "I know you don't drink, but I cannot understand why." After a brief pause, the other shoe was "what's the point of living if you're not enjoying it?" The implication was essentially that alcohol is a prerequisite, a base necessity, something that cannot be absent from a "real" life. I was taken aback, but have striven to understand the perspective. And, I do drink periodically when there is no necessity of a motor vehicle involved. 
 
The US News article alleges that the situation of social consumption is perhaps of less concern to the researchers. However, they allege "that more than half the alcohol sold in the U.S. is consumed during binge drinking episodes." That is not an indication of "binge" purchasing, though that is perhaps an issue. I buy ice cream only in my weakest moments. If it is not in the house, I am often (OK, sometimes) too lazy to drive a mile to get some. My ice cream habit is clearly one of "binge" purchasing.
 
But, the allegation here is different, and suggests the alcohol is on hand and is consumed in a "binge." Imagine, someone has a drink and then wants another. It is possible, perhaps, that one might even lose inhibitions and judgment with each such drink and thus be less reluctant to have that next one? But, the experts suggest that the path to moderating all this death and destruction is the tax man. Having failed in a Quixotic prohibition a century ago (18th Amend. U.S. Const., 1920), the thought is to instead economically discourage consumption through taxation. 
 
I think back on the unintended consequences of prohibition, the bootlegging, the violence, and the resistence. I reflect on the states rushing to decriminalizing pot in recent years and of those urging Congress to instead actually legalize it. I think of the unintended consequences of the millions of Opioid doses prescribed by both the most well-intentioned and the worst. There were taxes collected on the scripts, but not on the street drugs that followed. 
 
I think of the legion of lives destroyed by crystal meth, prescription drugs, and fentanyl. And, in the end, I sit and wonder if safety and self-preservation can be legislated. Can people be saved from themselves? Can you save people who do not want your help? If it becomes too expensive to sip gin, will people make gin? If gin becomes too difficult or expensive, might one just turn to tax-free dope? If the dope is too . . . Well, who knows where this might lead.
 
Some suggest that there is a need for greater public access to mental health services. Many employers find themselves driven into providing mental health care for their workforce. And, there are those who identify significant coincident between mental health challenges and substance abuse. See AddictionCenter.com. Being a non-expert in both mental health (watch the wisecracks here) and substance abuse, I lack context for any educated answer. But, it is high time we raise the questions. People are dying. Is taxation the answer or merely a diversion? If there is an answer, where does it lie?
 
 
By Judge David Langham
Courtesy of Florida Workers' Comp
 

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    About The Author

    • Judge David Langham

      David Langham is the Deputy Chief Judge of Compensation Claims for the Florida Office of Judges of Compensation Claims at the Division of Administrative Hearings. He has been involved in workers’ compensation for over 25 years as an attorney, an adjudicator, and administrator. He has delivered hundreds of professional lectures, published numerous articles on workers’ compensation in a variety of publications, and is a frequent blogger on Florida Workers’ Compensation Adjudication. David is a founding director of the National Association of Workers’ Compensation Judiciary and the Professional Mediation Institute, and is involved in the Southern Association of Workers’ Compensation Administrators (SAWCA) and the International Association of Industrial Accident Boards and Commissions (IAIABC). He is a vocal advocate of leveraging technology and modernizing the dispute resolution processes of workers’ compensation.

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