Health Council: Alcohol Should Be Made Less Accessible

Is the new recommendation regarding the nation’s number one drug based on sound science or misleading statistics?

In 2023, the World Health Organization tightened its recommendations on alcohol consumption. „No level of alcohol consumption is safe for our health,“ was the pithy, media-friendly statement. Does that mean we should also avoid ripe bananas and other fruits that naturally contain alcohol? And what about medications that contain it?

This is a very complex issue. The 2023 press release already mentioned that alcohol appears to be more harmful to poorer people than to wealthier ones. Could the reported health risks stem not only from the substance itself, but also from lifestyle factors and access to healthcare? Such nuances are easily lost in media reports.

New recommendation

On June 25, the Dutch Health Council issued a new recommendation to the Ministry of Health. According to the recommendation, alcohol should be made less accessible. As with cigarettes, the council proposed price increases, plain packaging, and restricting sales to specialty stores. These measures would also apply to beer and wine. In addition, advertising is to be further restricted.

In short, the ministry is supposed to „denormalize“ alcohol and discourage its consumption among the general public. Since the new report summarizes international studies, it is also of interest to other countries—and for us, it’s a welcome opportunity to take a closer look at so-called public health research.

In Germany, too, there are increasing signs of a crackdown. For example, Federal Drug Commissioner Hendrik Streeck has repeatedly criticized the Youth Protection Act: Section 9, paragraph 2 of the Act allows 14-year-olds to drink beer and wine in public when accompanied by a parent or legal guardian.

Now people are saying that this is inconsistent with new studies on brain development. In my new book, I’ve highlighted how arbitrarily brain growth is invoked in political debates today.

Bans in a neighboring country

In light of these efforts in Germany, it is interesting to take a look at the Netherlands. There, the age limit for purchasing and consuming alcoholic beverages was raised from 16 to 18 as recently as 2013. In 2021, the rules governing advertising were tightened, particularly with regard to discount promotions.

While there is a general trend toward declining alcohol consumption in many countries, around 40 percent of 12- to 16-year-olds in the Netherlands had tried alcohol despite the bans mentioned above. Incidentally, it’s not uncommon for them to get their hands on the „stuff“—from their parents. The National Drug Monitor summarizes it this way: „Schoolchildren are on average 12.9 years old when they first start drinking, and on average 13.8 years old when they start drinking weekly.“ Yet another outstanding result for a drug ban!

On the other hand, there are restrictions: For example, parents cannot buy a bottle of wine to go with dinner while shopping at the supermarket if they have a minor child with them. This is because, when paying at the register, everyone in the group must be of legal drinking age, and those under 25 must also prove it with identification. Of course, teenagers would never think of leaving their underage friends waiting outside.

And in sports clubs, for example, greater care must be taken to ensure that 16- or 17-year-old friends don’t accidentally get a sip alongside the 18-year-olds. Otherwise, this poses a threat to public health, for which the club could be publicly condemned. Even in rural areas, mayors are under pressure to strictly enforce the rules. But they know that if young people’s opportunities to party are restricted, they’ll simply head to the cities in greater numbers.

Given all this effort, one would hope that the scientific evidence regarding the (alleged) threat to public health posed by alcohol is solid. Or is it not? Let’s take a closer look at the new report from the Dutch Health Council.

Science put to the test

Here, too, the World Health Organization’s mantra—in effect since 2023—is reiterated: „There is no safe lower limit for alcohol consumption“ (p. 3). And more specifically: „This means that drinking even a single glass of alcohol carries health risks.“

However, the same page also includes the following qualifying statement: „Alcohol consumption can [my emphasis] have adverse consequences for health and society.“ And on the next page, we find: „At the individual level, these risks are relatively small.“ Aha! Yet the Commission turns these relatively small risks into a major problem because so many people consume alcohol.

This is where the report’s first flaw becomes apparent: The experts act as if it were possible to influence a single risk factor—in this case, alcohol consumption—in isolation. But we must ask ourselves what people do instead when they drink less alcohol, and whether that is healthier overall.

At the same time, we generally observe that the steady decline in alcohol consumption goes hand in hand with a sharp increase in the use of psychopharmacological and hard drugs. For example, prescriptions for so-called antidepressants in Germany have increased elevenfold since the 1980s, reaching 1.8 billion daily doses. That is enough to treat five million people daily. Diagnoses of attention-deficit/hyperactivity disorder (ADHD) have been rising rapidly since the 1990s and have now multiplied among adults, particularly since the COVID pandemic. This is often accompanied by prescriptions for stimulants such as methylphenidate (e.g., in Ritalin) or amphetamine (also known as the street drug „speed“).

Alcohol substitute

Such trends do not in and of themselves prove a causal relationship along the lines of: „Because people are drinking less, they are now taking more psychotropic drugs and other drugs.“ Yet the connection is not entirely implausible. For example, even a regular beer is now considered „toxic“ in some circles. This is also, relatively directly, the message of the highly official recommendations cited above.

At festivals, some people now prefer to take one ecstasy pill a day. Because of the rising cost of alcoholic beverages, this is often even cheaper. And other designer drugs and cocaine are being used more and more frequently, especially among teenagers and young adults.

For thousands of years, alcohol has been a traditional remedy for mild depression, anxiety, and shyness. When necessary, people would drink to give themselves courage. Like the stimulants mentioned above, alcohol (ethanol) also affects the reward system, which is why consuming it often makes people feel better. For many people, ecstasy in particular creates a stronger sense of connection.

Many of these neurotransmitter systems overlap in the brain. That is why, for example, benzodiazepines—which promote sleep and relieve anxiety—can also be used to treat severe alcohol withdrawal. Like alcohol, they act on the so-called GABA receptors, which calm the nervous system.

So it’s rather short-sighted to focus solely on alcohol consumption, as the Health Council does. One must also consider the broader consequences of these measures. This is especially true when one claims to be acting in the interest of public health.

Burden of disease

Earlier, we already noted an inherent contradiction between, on the one hand, the warning against even a single glass of alcohol and, on the other hand, the relatively low health risks—at least when consumed in moderation. If the mantra that there is no safe lower limit is so central, then hopefully at least that is firmly substantiated!

Here, the Health Council’s report cites numerous studies on increased health risks for seven types of cancer and several other diseases. But the bottom line—believe it or not—is that numerous studies show no difference in mortality rates for moderate to medium alcohol consumption. This is explicitly stated on page 22:

„Among women, daily alcohol consumption of up to 25 grams was not associated with overall mortality compared to lifelong abstainers. Consumption of more than 25 grams of alcohol per day was associated with an increased risk of death. For men, no association with overall mortality was found for daily alcohol consumption of up to 45 grams. An increased risk of death was observed for consumption of 45 grams of alcohol or more per day.“ (Dutch Health Council, June 2026)

It’s important to keep this in mind: Before the World Health Organization’s new initiative in 2023, an average of 10 grams of alcohol per day for women and 20 grams for men was considered „low-risk consumption.“ The figures cited in this report are twice as high and—assuming an alcohol content of 5 percent—equate to 0.6 liters of beer per day for women and 1.1 liters for men!

But how does this square with the mantra that „there is no such thing as risk-free alcohol consumption“ when mortality only increases in a statistically significant way beyond such large quantities? Nevertheless, the Health Council experts asserted: „The Commission concludes that alcohol consumption is incompatible with a healthy lifestyle and is harmful to both public health and societal safety“ (p. 4).

The blurred concept of risk

However, we have left one aspect out of the discussion: The conversation constantly refers to „increased health risks.“ Yet it is rarely specified just how high the risk from alcohol consumption is supposed to be. One could make a similar argument for restricting traffic, since, of course, the risk of a traffic accident also increases with every kilometer traveled by bike or car. Nevertheless, many people get on their bikes or in their cars every day—and, believe it or not, they don’t have an accident!

To make a meaningful assessment, one must always weigh the risks or costs against the benefits. Here, the experts acknowledge that people feel better when they consume alcohol and that this is associated with various positive social experiences. However, the commission simply downplays these positive subjective effects, arguing that „third parties may experience them differently“ (p. 30). I see. And when it comes to social events, they note that it is difficult to separate the potential benefits of alcohol consumption from the characteristics of the setting. Oh. In the 49-page report, the benefits of alcohol are covered in less than half a page.

The scientifically valid conclusion under such circumstances is that it is not yet possible to conduct a cost-benefit analysis. After all, far too little research has been done on the benefits. But that does not concern the Health Council’s commission.

One-sidedness

The report dismisses, just as superficially, studies cited regarding the possible health benefits of alcohol for cardiovascular diseases. These studies are described as „controversial.“ Furthermore: „The favorable associations could [my emphasis] be partly attributable to other factors and behaviors related to alcohol consumption, as well as to the composition of the reference group“ (p. 19).

The same is true in the opposite direction: The negative health effects attributed to alcohol may also be linked to other sociodemographic factors. It is impossible to control for all influencing factors in these broad-scale observational studies. And as we have seen, even the World Health Organization acknowledged the link between illness and poverty among drinkers as early as 2023. Yet virtually no one reports on this.

No matter how you look at it, the Dutch Health Council always reaches the same conclusion: If studies highlight the health risks of alcohol, they are considered credible; but if they show no increased risks—or even reduced risks—then the Commission considers them either irrelevant (e.g., mortality and the positive aspects) or controversial (e.g., cardiovascular disease).

Although these experts themselves admit that the health risks are low, and even though alcohol consumption is declining, they are calling for increasingly strict measures against alcohol consumption. But how logical is that? The less people drink, the more strictly must lawmakers crack down on alcohol?!

That sounds not only one-sided, but also prejudiced—even ideological! In light of this, we should address potential conflicts of interest.

Conflicts of interest

Here, the Health Council took the easy way out and completely excluded all scientific studies as soon as even one of the researchers had received funding from the alcohol industry. Of course, such collaborations must be viewed critically. However, it is also the sad truth that research funding is scarce and that researchers are sometimes dependent on funding from for-profit groups. Nevertheless, agreements can be reached to ensure independent scientific work.

On top of that, research in this field is usually conducted by consortia of many—sometimes dozens—of scientists worldwide. To completely ignore such studies simply because one person has a potential conflict of interest is an overreaction. This exaggeration further relativizes the report’s conclusion: Even though a large portion of the studies that may be more favorable toward alcohol are excluded, the bottom line is that the results are relatively modest. Yet these results are presented to the public in an exaggerated manner.

If one were to apply the Commission’s own standards to itself, one might as well exclude its report from the discussion. After all, these health research experts are, in a sense, setting the research agenda for themselves and their colleagues. Many of them have already received millions in research funding from the government. And if the government follows their recommendation, funding for further research in the field of public health is likely. In that case, it is precisely these researchers—who are advising the government—who stand a good chance of success.

Since the report only summarizes known studies, it would have been easy to commission experts from a different field who did not have such financial conflicts of interest.

Alternatives

Following this section on conflicts of interest, it is also worth mentioning internal competition within the scientific community: The members of this commission aim to improve public health by reducing relatively small risks among as many people as possible. Measures such as higher prices for alcohol and reduced availability therefore affect everyone. As we have already seen, however, this would probably have no effect on mortality rates.

One might counter: But deaths are still linked to alcohol consumption. Yes—but mainly among heavy drinkers. Those who are already heavily dependent on the substance are unlikely to be deterred by higher prices or less advertising. And those who are vulnerable to substance abuse due to their psychosocial circumstances might then turn to other, perhaps even more dangerous drugs.

The alternative to the perspective on public health research presented here is individual prevention and treatment work. This falls within the realm of addiction medicine and social work. These are, therefore, people who not only write scientific publications and reports for government agencies but actually work with people struggling with substance use.

In times of tight budgets, however, this form of therapeutic and social work is increasingly affected by funding cuts. In my opinion, this is already evident in the growing drug problems—which are particularly visible in large cities. In my assessment, public health research—which has been highly dominant in recent years—will further exacerbate these problems.

Balance sheet

If one looks at media coverage—and, to a large extent, scientific reporting as well—the picture is sobering: To reduce the risks (allegedly) associated with alcohol consumption, there are calls for tougher drug policy measures and, of course, more research funding. Yet these risks are relatively small—or even nonexistent—with moderate alcohol consumption, as studies on mortality and the overall burden of disease have shown. This fact is being withheld from the public.

Furthermore, the debate over potential health benefits remains unresolved. Studies continue to emerge—both for certain types of cancer and for cardiovascular diseases —that link moderate alcohol consumption to lower risks of these conditions. Statisticians are now debating the proper way to define and select comparison groups. To use an analogy: If Elon Musk sits down next to a homeless person on a park bench, then the people on that park bench have, on average, a fortune worth billions. While this isn’t exactly a lie, it does distort reality.

In the scientific debate over the correct conclusion and perspective, some speak of a „trench war„—and the outcome of this debate affects not only funding and careers, but also policy decisions. The new report by the Dutch Health Council is a good example of this. Upon closer examination, it revealed many shortcomings and, above all, an unscientific bias.

Mark Nason, a veteran of alcohol prevention research with over 40 years of experience, is calling for greater honesty with the public. He argues that after downplaying the risks of this popular substance for 20 years, they have now been exaggerating them for the past 20 years. In line with this and with my findings, two nutrition researchers from the University of Lisbon recently wrote: „We conclude that the claim that ‘any amount of alcohol is dangerous’ has no scientific basis.“

A historical perspective

In closing, let’s take a sobering look back at history: A good 100 years ago, the debate over alcohol was just as heated as it is today. Temperance and abstinence societies sprang up everywhere, seeking to protect public health. Today, it’s influencers who generate attention and make money with sensationalist stories.

In the battle for media attention in a highly polarized society, reasonable voices are barely heard anymore. Even in the scientific community, there’s a struggle for media attention. Repeating the recommendation for moderate consumption goes unnoticed. A new, extreme message had to be introduced: Every drop of alcohol is harmful!

A similar extremism a century ago led the US to Prohibition, endangering the state treasury, strengthening organized crime, corrupting law enforcement, and poisoning many poor people. Interestingly, there were exceptions for obtaining alcohol with a prescription. However, one had to be able to afford it. Doctors and pharmacists suddenly didn’t find whiskey so bad anymore when they could profit handsomely from it.

A decade later, in the Northern European countries so concerned with „public health,“ an increasing number of sterilizations were carried out on people deemed to suffer from alcoholism or hereditary diseases. Under the Nazi dictatorship, they could also be stigmatized as „asocials“ by being forced to wear a black triangle and sent to concentration camps. There, they either languished in squalor or were even murdered. Perhaps we will still manage to discuss this topic more sensibly this time around.