The drinking age in NZ is 18. One of the minor parties is wanting to increase the drinking age to 20 and tax alcohol by content. Is this a problem? anecdotally, not as much: I’m middle class with a driving licence. I don’t drink unless I’m going to use a taxi.

But I know there is a lot of alcohol related harm. I see it in the emergency rooms and acute wards where I work.

From the USA is some epidemiology. The rate of drinking, the rate of harmful drinking, and the rate of alcohol use disorder (AUD) has increased in the 2000s.

Between 2001-2002 and 2012-2013, 12-month alcohol use, high-risk drinking, and DSM-IV AUD increased by 11.2%, 29.9%, and 49.4%, respectively, with alcohol use increasing from 65.4% (95% CI, 64.3%-66.6%) to 72.7% (95% CI, 71.4%-73.9%), high-risk drinking increasing from 9.7% (95% CI, 9.3%-10.2%) to 12.6% (95% CI, 12.0%-13.2%), and DSM-IV AUD increasing from 8.5% (95% CI, 8.0%-8.9%) to 12.7% (95% CI, 12.1%-13.3%). With few exceptions, increases in alcohol use, high-risk drinking, and DSM-IV AUD between 2001-2002 and 2012-2013 were also statistically significant across sociodemographic subgroups. Increases in all of these outcomes were greatest among women, older adults, racial/ethnic minorities, and individuals with lower educational level and family income.

Which led to this editorial. If the epidemiology is the shot the chaser is that alcohol regulation is political. It has always been political. New Zealand has a wine export industry. We are developing export craft beers and whiskies. If we regulate, where is the balance?

Because this is an editorial, I will close by editorializing. I feel a personal responsibility to do what I can to support politicians, regardless of whether they are Democrats, Republicans, or Independents, who recognize the benefits of research, understand the health care crises we face, and are willing to do something about it. I believe there are people in the United States who are in situations where it is hard for them to mobilize themselves to work toward avoiding future health-related problems and who do not have the financial resources to pay for their care when they need it. My view is that if we ignore these problems, they will come back to us at much higher costs through emergency department visits, impaired children who are likely to need care for many years for preventable problems, and higher costs for jails and prisons that are the last resort for help for many.

It is easy to measure the economic benefits from the liquor trade. It is much harder to work out the human cost of alcohol abuse and harmful drinking.

But I see the costs, and they are real.