Which is worse, heroin or alcohol?

Heroin black tar, Mexican

A few nights ago, I sat at a table where a group of people were drinking large amounts of alcohol while discussing the heroin problem in Northern New Mexico. “That damn drug,” a large and stubbly man said. “Is the Devil’s handtool. We’ve got to get that crap out of our communities.” While I had no doubt of his anger towards heroin, I also had no doubt that the four or five beers he drank fueled his call to action. What really got to me was when several people raised a shot glass in honor of someone who recently died of a heroin overdose. “To Hell with Heroin, but get me another drink!” they seemed to be saying…

Which got me to thinking: Which is worse, Heroin or Alcohol? For starters, I like to teach that nothing in and of itself is good or evil; only its use makes it so. However, I’ve had more clients, friends, family die and suffer from alcohol addiction than I have from heroin addiction. As a matter of fact, I’ve had more success treating heroin and other opiate addictions than I have treating alcohol addiction. So, though I do believe in the neutrality of all substances until their use is examined, I still had to think through the argument of which is worse and I did so through five (5) major points:

  1. Both alcohol and heroin are nervous system depressants; both cause physical and psychological addiction.
  2. Both are associated with criminality and social deviance; several laws exist to measure alcohol intoxication in relation with driving impairment and heroin use is often associated with gang-related activity.
  3. Alcohol is legal and socially acceptable; heroin is neither (which makes alcohol all the more dangerous)
  4. Alcohol is toxic and lethal in high doses; Heroin is also toxic and lethal in high doses (however, alcohol is controlled, heroin is not);
  5. Alcohol withdrawal can be lethal; Heroin withdrawal is not.

After I thought through all five (5) points, I decided that while I do understand the problems that heroin has caused within our communities, I can’t overlook the problems that alcohol has also caused within our communities. And, though I also understand that it’s easy to judge others and ignores our own issues, I can’t help but see hypocrisy when a group of people will speak out in rage against heroin, but drive home after drinking copious amounts of alcohol. To me, there’s no difference between injecting a lethal amount of heroin and killing someone while driving drunk. And while neither alcohol or heroin or evil, in and of themselves, I think that using either is loaded with risks and harm and we shouldn’t be so quick to wipe our drunk asses with the tracked-arms of our acquaintances. So to answer my own question: Which is worse, heroin or alcohol, I say: They are both paths to suffering that should be avoided at all costs.



    1. Not gonna lie: Crack is a very difficult kick. I recommend that someone trying to kick crack does so with a plan and, preferably, a medical detox facility, as there will be emotional and physical impacts that should be professionally monitored.

      I also recommend professional treatment PRIOR TO actually kicking such that the desire to quit and motivation to quit can be codified. Lastly, as of right now, there are no pharmacological interventions for crack/cocaine detox….


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