The Crisis We’re Not Confronting: Alcohol’s Toll on Colorado

Colorado is rightfully alarmed about the opioid epidemic. We’ve mobilized resources, declared emergencies and fundamentally changed how we think about addiction and pain management. Opioids claimed more than 7,000 lives in Colorado in the decade ending in 2024. Along with other drugs, opioids have torn apart families and strained our health-care system to its breaking point. Thankfully, politicians, civil servants, health-care providers and hundreds of nonprofits have moved mountains to try to reduce overdoses in our state.

But while we focus intensely on opioids, we’re overlooking a substance that causes far more harm: alcohol. Alcohol kills 2,200 Coloradans every year — more than twice as many deaths as opioids. And these statistics only capture part of the story.

Opioid deaths are typically acute: an overdose, a sudden loss. Alcohol’s devastation unfolds differently. It operates on multiple timescales and through countless pathways. There are the immediate tragedies: drownings, college students dying from alcohol poisoning, falls.

But far more deaths occur quietly, in hospitals or homes. These deaths occur from chronic diseases: cirrhosis destroying livers over decades, hearts weakening, brains deteriorating. Cancer, too — alcohol is a known cause of at least seven types of cancer, yet we don’t treat it with anything approaching the caution we reserve for other carcinogens. When it comes to nonfatal illnesses, alcohol is even more prevalent: at Denver Health’s emergency department, alcohol causes more than four times as many visits as opioids.

Beyond health care, the secondary effects of alcohol paint an even darker picture. While opioid addiction certainly strains families, alcohol’s ubiquity means its reach extends far wider. Alcohol is involved in roughly half of all intimate partner violence cases. Children growing up in homes with alcohol abuse face higher risks of their own substance abuse, mental health problems and perpetuating cycles of dysfunction. The economic costs — lost productivity, health-care expenses, criminal justice involvement — exceed $250 billion annually.

Consider drunk driving alone: Despite decades of awareness campaigns and increasing penalties for DUI, there are 200+ alcohol-related driving fatalities in our state each year. These aren’t just statistics: they’re teenagers on prom night, parents driving home from work, entire families wiped out by someone else’s decision to drink and drive. The opioid crisis has no equivalent widespread mechanism for killing innocent bystanders.

Why, then, does alcohol receive a fraction of the policy attention devoted to opioids?

The answer is partly cultural. Alcohol is woven into the fabric of American social life in ways opioids never were. It’s celebrated in advertising, served at weddings and funerals, offered at business lunches and religious ceremonies. We’ve normalized a substance that is, by any objective measure, remarkably dangerous.

But normalization doesn’t change biology. Alcohol is toxic to virtually every organ system. It’s highly addictive, with roughly 15 million Americans meeting criteria for alcohol use disorder. And unlike opioids, which require prescriptions or illegal purchases, alcohol is available in almost every grocery store and gas station in Colorado.

The good news is that we know how to reduce alcohol harm; we just haven’t always used the most evidence-based interventions. Moving toward these policies – and funding those that require it – will save lives in Colorado.

• Taxation works. Study after study confirms that increasing alcohol prices through taxation reduces consumption, particularly among heavy drinkers and young people. A modest tax increase could save thousands of lives annually while generating revenue that could fund treatment programs.
• Consistent public information about risk works.  This has been shown most clearly for tobacco use and should apply to alcohol.  We can’t continue to have public information about alcohol be limited to marketing messages from the industry
• Reducing availability works. Limiting outlet density, restricting hours of sale and maintaining the minimum drinking age of 21 all demonstrably reduce harm. States with stricter alcohol policies consistently show better health outcomes.
• Screening and treatment work. Most people with alcohol problems never receive treatment — not because treatment doesn’t exist, but because we don’t prioritize finding and helping them.

The opioid crisis has taught us that we can mobilize resources, change prescribing practices, and save lives when we recognize an emergency. Alcohol has been an emergency for decades. It’s time we treated it like one. What we need is honest acknowledgment that alcohol, like opioids, causes massive harm and deserves a proportional response.

We’ve shown we can confront uncomfortable truths about substances we once thought safe. The question is whether we have the courage to do it again.

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