For years, the War on Drugs has taught Americans to believe that illicit drugs are dangerous and legal drugs are safe. But this dynamic is not that simple. While recreational drug use may certainly lead to devastating health consequences, research has shown that psychedelic drug use can actually decrease the rates of domestic violence. Meanwhile, alcohol, a legal substance, drives up rates of domestic violence.

Alcohol by some measures is one of the most dangerous substances available, despite the fact that it is legal. In 2015, researchers from the UK discovered that binge drinking was responsible for 70 percent of weekend admissions to the emergency room. And in a new Canadian study, published in the journal Medicine, researchers have discovered a neighborhood’s density of bars and alcohol-serving restaurants is tied to the rate that traumatic injuries occur.

"Alcohol is a widely available substance that alters perception, and leads to behaviors that individuals might not otherwise engage in," said study leader Dr. Joel Ray, a physician at St. Michael’s Hospital and researcher in its Li Ka Shing Knowledge Institute, in a press release. "Our study provides novel and comprehensive information about alcohol's availability within on-premise alcohol establishments, within a heavily regulated setting that few others can reproduce.”

By analyzing the number of ambulance calls made in different regions of Ontario, the researchers discovered the risk for traumatic injuries was 7.8 times higher in areas with the highest density of bars and alcohol-serving restaurants, compared to areas with a lower density of these businesses. In the high-density areas, 381 out of every 1,000 ambulance calls were made for traumatic injuries, while low-density areas had only 45 traumatic injury calls for every 1,000 calls.

When sports bars, night clubs, pool halls, and gaming facilities were the most common alcohol-serving establishments in the area, the risk for traumatic injuries rose even higher among young men.

Beyond the presence of bars and restaurants, the researchers also found the rate of ambulance calls increased at certain times of day, as well as certain days of the year, based on the availability of alcohol. For example, ambulance calls for assault-related injuries peaked at 2 a.m., the time of night when Ontario businesses are legally required to stop serving alcohol. Similarly, ambulance calls tripled on days near the end of the month, when paychecks are most often deposited and individuals can afford to drink more alcohol.

"We reiterate that public policies that raise prices of alcohol are an effective means to reduce drinking," Ray said. "Given the province of Ontario's actions to liberally increasing access to alcohol, such as through grocery stores, it is imperative that pricing remains high."

In addition to regulating the price of alcohol, Ray’s paper makes several policy recommendations. These include limiting the number of licensed alcohol establishments that can be opened in an area based on the number of alcohol-serving businesses already operating in the area or how many ambulance calls come from the region.

“It is time to take a more active stance about a substance that is legal, widely available, yet harmful," Ray said.

Although tighter laws on alcohol have led to reduced rates of domestic violence, it’s important to consider the downsides of regulating alcohol. Prohibition has never fared well in the United States, and even if alcohol isn’t totally prohibited, implementing restrictive laws could lead to similar consequences. The simple alternative is to drink responsibly.

Source: Ray JG, et al. On-premise alcohol establishments and ambulance calls for trauma, assault and intoxication. Medicine. 2016.