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For some months now, I’ve been meaning to write this blog post. The Former CEO of Skybet, and current director of Flutter (the company that currently owns the PokerStars brand, amongst others) wrote this tweet, which finally sparked me to do so:

We have a variety of social debates raging across several parallel fields (alcohol, gambling, and drugs) which have a common thread: they are areas where many people won’t partake (“Abstainers”), many people will partake safely (“Safe Users”), and some people will partake in a way that literally destroys their lives (“Destroyers”). The exact proportions of each group of people varies across the different fields, but in each field, the Abstainers Group is typically bigger than the Safe Users Group, which is in turn typically bigger than the Destroyers Group.

I’m writing this because too often, I see people advocating one-size-fits-all policy prescriptions. The regulatory and community-support needs of a problem gambler are very different to the needs of someone who does not gamble at all.

Limitations of this blog post

Each of these fields raise significant moral issues that are beyond the scope of this short blog post. This is just a discussion of the differing realities of how different groups of our community are affected. I’m not discussing here about the deep and challenging moral issues from a utilitarian, deontological or human flourishing ethical perspective. You’ll have to go elsewhere for that.

Also, as far as the word “drugs” go, I am aware that caffeine and alcohol are drugs. I’m using the word “drugs” in a manner consistent with the UK Home Office’s User Guide to Drug Misuse Statistics. Basically, here, the word “drugs” is used to mean drugs which are illegal in the UK and Isle of Man.

The Parallel Fields

Alcohol

In the UK, around 20% of people abstain from alcohol, with a roughly similar proportion in the USA but it appears that a slightly lower proportion of people in the Isle of Man abstain from drinking.

Of the remaining population, the vast majority of alcohol drinkers are safe users. They may well face some negative consequences (hangovers! stupid behaviour!) but they are largely able to manage and sustain their alcohol consumption – the continuing existence of bars, pubs and off-license alcohol sales is proof of that.

There is, however, a group of people who end up with Destroyed Lives as a result of alcohol. Depending on definitions, it might be as much as 12% of the local population. Serious alcoholism causes a variety of harms, including mental health issues, sexual and fertility problems, and social problems such as unemployment, domestic abuse and homelessness.

These three groups of people require different responses from our community. People who abstain should have their choices be respected; people who are safe users should be able to enjoy their beer, wine or spirits safely and enjoyably, and people who have their lives destroyed need much more active interventions to save their lives.

Gambling

Gambling sees a similar situation: around 57% of people in the UK have not gambled in the last four weeks (Table 1). Of the roughly 43% who did gamble during that time period, around a third of those people were people who played the National Lottery (Table 1 & Table 1a), and the problem gambling rate was estimated at under 1% of the UK population (Table 5).

I wasn’t able to easily find data on what proportion of people who abstain from gambling entirely (only last 4 weeks) but clearly, we can see the broad outline: a lot of people abstain from gambling, another large group of people gamble in a manner which is safe and sustainable, and a small group of people suffer significant problems.

Like with alcohol, these three groups of people require different responses from our community. People who abstain should have their choices be respected; people who are safe users should be able to enjoy their beer, wine or spirits safely and enjoyably, and people who have their lives destroyed need much more active interventions to save their lives.

Drugs

In the UK, around a third of people aged 16 to 59 report having used drugs at some stage in their life, and 9.4% report that they had taken a drug in the last year. This is strong evidence that most people have not used drugs, and a very, very, large majority of people are not currently using drugs.

People’s lives can be destroyed and harmed by drugs to different extents. Obviously, that includes death by overdoses, which is happening at a rate of reportedly 8.5 deaths per 100,000 people from drug misuse between 2013 and 2015 in the Isle of Man. In addition to overdoses, it seems likely that there’s a correlation between drug use and other life disruption and harm:

It also reported that 74% of people entering the prison had tested positive for at least one drug not prescribed by their GP, 45% jailed for burglary or theft were dependent on illicit drugs and 28% of prisoners have a dependency on prescription drugs.

Official report commissioned by health service: Isle of Man’s death rate from drugs higher than England’s

It’s difficult to capture the full harms caused by drugs, but again, we can see the same broad outline: a lot of people abstain from using drugs, another large group of people use in drugs without outwardly identifiable destruction of lives, and a small group of people suffer significant problems (including, but not limited to, dying!).

Like with alcohol and gambling, these three groups of people require different responses from our community. People who abstain should have their choices be respected; we should seek to reduce the risks faced by people who do use drugs, and people who are at significant risk of having their lives destroyed need much more active interventions to save their lives. Any policy proscription needs to address all three groups of people.

If you need help with drugs or alcohol, you can contact Motiv8 on the Isle of Man.