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Comment by notch898a | Hacker News Reader

Utopia: We raised the price so people starting using less alcohol!

Reality: We raised the price so people shifted to more black market drugs that didn't show up in this particular study!

That might be plausible if the study was counting alcohol sales, but this is counting deaths.

It seems that counting alcohol sales in addition to deaths could be useful information to show, assuming pricing out the low end was the theoretical model to reduce high volume consumers. I have no idea if any of that's the actual mechanism, or if the study looked at it since the linked article is very sparse.

It is counting alcohol related deaths, not deaths from substitution effect to other intoxicants.

What intoxicants are cheaper than alcohol? The only one that comes to mind is cannabis, and if people are ditching alcohol for cannabis I think that will surely save lives.

Paint, glue, mouthwash. They said they found the difference was most pronounced in the poorest areas so these options are already on the menu.

Do you actually have evidence that alcoholics are switching to paint huffing, or is this just speculation?

Alcoholism is unusual among addictions in that it's (1) largely invisible until its end state and (2) minimally taboo when it occurs in "high-functioning" individuals. Huffing chemicals is neither of those things, nor is swallowing mouthwash (which is more likely to make you sick than drunk at the quantities an average adult would need.)

Deaths are down, not up, so obviously most people aren't switching to such hazardous intoxicants.

Increasing the cost of alcohol not only decreases the relative cost of cheaper substances, it also decreases the relative cost of more expensive substances.

I don't think alcohol abuse is that fungible with other drug abuse. People probably do switch, but it's hard to imagine that every alcoholic who reduces their drinking by so-and-so much increases, say, heroin use by an equivalent amount (in terms of expected mortality).

Do you have any reason to believe that or do you just disbelieve positive results on principle?

I disagree with their phrasing, but I tend to question positive or negative results. That way I can understand the data and how that fits into the overall system.

For example, it seems a lot of this study took place during the pandemic. Seeing the data on a year by year basis and understanding other possible effects of behavior would be good. It's not necessarily to disprove anything, but it could serve to strengthen position.

The way the linked article is written, it's like saying "I have a green marble in this box". You have no reason to doubt me and I have no reason to lie. But you're going to believe me more if I let you look in the box. Who knows, maybe I'm colorblind and it's actually red.

Drug related deaths kept rising after the minimum unit pricing. But they were raising pretty consistently before that though. A quick Google shows that they're finally plateauing now, which is great.

The confidence is pretty high, I find it a bit off putting.

> The methods we’ve used in this study allow us to be confident that the reduction in alcohol health harms we’ve shown is due to the introduction of MUP, rather than some other factor.

It's just too confident of a statement in my eyes. Whenever I read things like this, I'm immediately skeptical and beging questioning the motivations.

On a sidenote, I wonder if these changes made a noticeable difference when it comes to the Glasgow effect[0].

[0] https://en.m.wikipedia.org/wiki/Glasgow_effect

I don't think I've said anything that suggests I disbelieve what the study said about decreased alcohol related deaths. So sure, I believe that positive result.

The https://en.wikipedia.org/wiki/Substitution_effect . Yes nothing else is a perfect substitute for alcohol (some benzos are close though), but other substances are imperfect substitutes to become intoxicated. Substances substitution is a prevalent theme in drug abuse.

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