One of the great truisms of our culture is that the M card is played often. “Everything in moderation” is a mantra used as an excuse to indulge, but only in moderation. This carries over to drugs too. We are a world of drug consumers, from our morning coffee, an afternoon aspirin, and an evening (or sooner) alcoholic drink. In addition, the most common of moderate motivations involves the brain’s misguided mission to seek out sweets. As the most popular international cuisines, sugar is consumed primarily to satisfy that intense desire called craving, not unlike tobacco or heroin.
Likewise for other drugs, and in addition to those just named, let’s add medical marijuana (cannabis) to our list of substances to discuss. Including sugar, all have a common cause driving their consumption, a shared reason people consume them—pleasure.
The myth, of course, is that moderation is acceptable, even encouraged, and, the real emphasis is that it is not harmful. As we all know, this is not always the case. An example of how devastating moderation can be is the intake of sweets, along with other refined carbohydrates, such as processed flours, which quickly turns to sugar once consumed (with 40 to 50 percent then converting to stored fat). It has significantly contributed to the human species being plunged into a deep unhealthy hollow of sorts, as 75 percent of the world is overfat and growing. While clinicians and scientists may claim the problem is from overconsumption, it can also be stated as too much moderation.
Overfat is a three-decade old term I coined that best describes the obvious physiological state (and we’ve all been there). Obesity is a more politically correct name of the extreme, but merely the miniature tip of the iceberg. Moderation is what got us here, and quite quickly. In a matter of a generation or two, the overfat explosion has taken the earth by storm. (Past global catastrophes may have been much more kind because we recovered from them relatively well.)
Claiming that moderation makes it safe has long been proven wrong. Even following one definition of moderate alcohol intake— the Centers for Disease Control and Prevention lists this as two drinks for men and one for women—has led to untold numbers of tragic consequences. We can reduce the risks significantly by not driving, for example, while following these guidelines.
If moderation is not considered harmful what about a drug like heroin? If it were legal, would moderate amounts be suitable for consumption (but not too much, of course)?
A 2014 Global Drug Survey of almost 80,000 people found that alcohol was the most commonly used drug worldwide, followed by tobacco and cannabis. Close behind was caffeine—not just coffee, but so-called energy drinks containing it, and caffeine capsules. Painkillers ranked high too. (A 2010 study in the journal Lancet showed that alcohol was the most dangerous of all popular drugs to individuals and others, far outranking the next two, heroin and cocaine.)
What do these popular drugs have to do with sugar? They all have the potential for significant harm in moderate doses.
These seven substances are reviewed in the chart below, but first a perspective on some of the key words used.
Of course, the consensus standard for moderation may be lacking (many health professionals accept the CDC’s definition of moderate alcohol intake). Overall, the consensus comes from some social norm we have come to accept, or one dictated by our cravings. Moderate doses of a particular food or drug clearly have the potential for harm when we look at both the effects on the body, and how it can impair our ability to function well (such as alcohol and driving, although sugar, heroin, and cannabis can potentially do the same).
This is also a less well-defined term. One could easily claim all the substances discussed here are potentially addicting, with regular moderate doses of alcohol, heroin, sugar and tobacco being the most obvious examples. Most who consume their moderate morning coffee also know how bad the day can be without it.
We can also look at the substances discussed here from a standpoint of both helping and hurting—or risk-reward. Virtually all drugs have the potential for unhealthy outcomes as a form of harm. Consider the cancer risks associated with moderate alcohol intake, intestinal bleeding from a single aspirin, and the damage from hot smoke (versus eating it) of marijuana. However, these same substances can have therapeutic effects. Well-known examples include the cardiovascular protective properties of alcohol, pain-killing actions of aspirin, and medical marijuana’s growing health benefits. The sole exception is sugar—as a food, the body has no minimum requirement for it like protein, fat and the micronutrients. Its only reward may strictly be pleasure, outweighed by harm.
(Disclaimer: This commentary was conceived under the influence of a glass of red Bordeaux, and the article was written while moderately high on a large cup of my Beyond Bullet-Proof coffee.)