Alcohol harm: beyond the body to the body politic

In light of the World Health Organization's declaration that non-dependent drinking contributes more to the global burden of alcohol-related disease than does drinking by those who meet diagnostic criteria for dependence, this paper argues that clinicians, researchers and decision-makers need to consider microsocial and macrosocial impacts of alcohol use, not just addiction and clinical effects on individuals meeting diagnostic criteria at the extreme high end of the alcohol-use spectrum. It suggests some qualitative dimensions to further define social or low-risk drinking and proposes that all drinking beyond that be described as harmful, because of its impacts on personal, community and population health.