text: Photo by Andrew Burton/Getty Images 
   
   An interesting thing happened in my neighborhood recently. A small posse of local busybodies organized as the Shaw Dupont Citizens Alliance proposed a moratorium on new liquor licenses for the increasingly vibrant nightlife corridors on 14th Street and U Street in Washington, D.C. Similar moratoria already constrain longer-established D.C. drinking hubs, and when I heard about the Shaw Dupont proposal, initially I felt despondent. But, in fact, the NIMBYs look set to lose. A guy named Michael Hamilton founded a counter-group called In My Backyard—D.C. to argue for growth-friendly policies. At a neighborhood listening session, moratorium proponents were vastly outnumbered. For now it looks as if Logan Circle and U Street will continue to be safe for entrepreneurs who want to turn vacant storefronts and derelict structures into bars and restaurants. 
   
   Similar fights play out in cities all around the country but not always with the same happy outcome. Almost invariably, these fights give the extreme deference to the concerns of immediate neighbors. But this deference has a cost for everyone else. Cities need to recognize that bars and restaurants are not the ugly stepchildren of the modern urban economy: They are its greatest strength. They spur small-business growth and creation citywide. When cities consider whether to allow them, they should think about the overall benefits to the region, not the particular complaints of near neighbors. 
   
   My neighborhood is hardly the only nightlife cluster in urban America featuring a version of this controversy. Last fall a group of residents of the Lower East Side in New York—some oddly appropriating the “Occupy” brand—tried to bring a halt to the issuance of new liquor licenses. Chicago has areas that have voted to become completely “dry” and moratorium zones where existing businesses stay open but no new liquor licenses can be issued. In California, many whole counties—including all of San Francisco—have gone into moratorium status. 
   
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   Proponents of curtailing licenses typically cite local nuisance effects as the key reason. One of the Lower East Side anti-booze crusaders was quoted as worrying about a “Wild West atmosphere.” In Washington, agitators cite the nightmare of becoming “the next Adams-Morgan”—while the actual Adams-Morgan is itself one of the areas operating under a moratorium. 
   
   These complaints ought to be understood in the larger context of urban economics. Moratorium boosters often seem to think there’s something unnatural about the heavy concentration of booze-serving establishments in a single area. They also think restricting bars and restaurants will cause the kind of thriving local retail they remember from old Jane Jacobs books to magically appear. 
   
   In reality, there’s nothing particularly unusual about similar firms clustering together. Auto companies were all near Detroit for a long time; high-tech firms huddle in the Bay Area; And nightlife hubs arise for similar reasons. Drinking and dining establishments want to be where people are likely to look for them. And people want to go to places where they’ll find options. Complicated interdependencies and complementarities can arise. The late-night pizza joint’s proximity to the dive bar increases the value of both. Alternatively, you might want to meet friends for dinner in a neighborhood where you’re also likely to be able to grab a drink afterwards. Theaters and live-music venues benefit from proximity to other after-hours activities and also drive customers to bars and restaurants. Forcing the cluster to disperse destroys its value. Preventing new firms from entering the cluster fosters high prices and mediocrity, as underperforming bars and restaurants can essentially free-ride on the rest of the cluster. 
   
   Providing these kinds of dense networks of related but independent small undertakings is exactly what cities are good at. 
   
   What they’re not so good at is playing host to modern retailers. Traditional urban neighborhoods feature old buildings with small, often irregularly shaped spaces that are ill-suited to the needs of contemporary retail chains. Refusing to grant liquor licenses won't undo the decades of history that brought us big-box stores.* It just leads to empty storefronts and car rides out to Ikea or Costco. The good news for cities is that lately Amazon has been crushing the big-box sector, and e-commerce levels the shopping playing field between traditional urban neighborhoods and suburban ones. And those smallish and idiosyncratic structures are ideal spaces for bars and restaurants—much better than personality-free malls. Even better is that the Internet isn’t going to put restaurants out of business, for obvious reasons. 
   
   Under the circumstances, promoting the development and expansion of nightlife hubs should be a key economic development priority for cities. Or, rather, preventing neighborhood busybodies from stifling them ought to be. That means making decisions about liquor-licensing rules at a higher level, with consideration of the full citywide effects in terms of tax revenue and job creation. And it means attempting to directly address perceived problems with crime and trash. Instead of refusing to issue new liquor licenses, why not send more cops and offer more frequent street cleaning in the hubs? Food service isn’t the sexiest sector in the economy. But it’s one that every city can be strong in. It also provides great opportunities for locally owned businesses, and meaningful opportunities for people with limited formal education to work their way up the ladder and go into business for themselves. Cities need to treat it as a more serious matter than a simple question of neighborhood opinion. ||||| Drinking too much can harm your health. Excessive alcohol use led to approximately 88,000 deaths and 2.5 million years of potential life lost (YPLL) each year in the United States from 2006 – 2010, shortening the lives of those who died by an average of 30 years.1,2 Further, excessive drinking was responsible for 1 in 10 deaths among working-age adults aged 20-64 years. The economic costs of excessive alcohol consumption in 2010 were estimated at $249 billion, or $2.05 a drink.3 Download a PDF of this factsheet in English Cdc-pdf [PDF – 0.9MB] or in Spanish Cdc-pdf [PDF – 1.1MB] 
   
   What is a “drink”? 
   
   In the United States, a standard drink contains 0.6 ounces (14.0 grams or 1.2 tablespoons) of pure alcohol. Generally, this amount of pure alcohol is found in 
   
   12-ounces of beer (5% alcohol content). 
   
   8-ounces of malt liquor (7% alcohol content). 
   
   5-ounces of wine (12% alcohol content). 
   
   1.5-ounces of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey).4 
   
   What is excessive drinking? 
   
   Excessive drinking includes binge drinking, heavy drinking, and any drinking by pregnant women or people younger than age 21. 
   
   Binge drinking, the most common form of excessive drinking, is defined as consuming For women, 4 or more drinks during a single occasion. For men, 5 or more drinks during a single occasion. 
   
   Heavy drinking is defined as consuming For women, 8 or more drinks per week. For men, 15 or more drinks per week. 
   
   
   
   Most people who drink excessively are not alcoholics or alcohol dependent.5 
   
   What is moderate drinking? 
   
   The Dietary Guidelines for Americans defines moderate drinking as up to 1 drink per day for women and up to 2 drinks per day for men.4 In addition, the Dietary Guidelines do not recommend that individuals who do not drink alcohol start drinking for any reason. 
   
   However, there are some people who should not drink any alcohol, including those who are: 
   
   Younger than age 21. 
   
   Pregnant or may be pregnant. 
   
   Driving, planning to drive, or participating in other activities requiring skill, coordination, and alertness. 
   
   Taking certain prescription or over-the-counter medications that can interact with alcohol. 
   
   Suffering from certain medical conditions. 
   
   Recovering from alcoholism or are unable to control the amount they drink. 
   
   By adhering to the Dietary Guidelines, you can reduce the risk of harm to yourself or others. 
   
   Short-Term Health Risks 
   
   Excessive alcohol use has immediate effects that increase the risk of many harmful health conditions. These are most often the result of binge drinking and include the following: 
   
   Injuries, such as motor vehicle crashes, falls, drownings, and burns. 6,7 
   
   Violence, including homicide, suicide, sexual assault, and intimate partner violence. 6-10 
   
   Alcohol poisoning, a medical emergency that results from high blood alcohol levels. 11 
   
   Risky sexual behaviors, including unprotected sex or sex with multiple partners. These behaviors can result in unintended pregnancy or sexually transmitted diseases, including HIV. 12,13 
   
   Miscarriage and stillbirth or fetal alcohol spectrum disorders (FASDs) among pregnant women.6,12,14,15 
   
   Long-Term Health Risks 
   
   Over time, excessive alcohol use can lead to the development of chronic diseases and other serious problems including: 
   
   High blood pressure, heart disease, stroke, liver disease, and digestive problems. 6,16 
   
   Cancer of the breast, mouth, throat, esophagus, liver, and colon. 6,17 
   
   Learning and memory problems, including dementia and poor school performance. 6,18 
   
   Mental health problems, including depression and anxiety. 6,19 
   
   Social problems, including lost productivity, family problems, and unemployment. 6,20,21 
   
   Alcohol dependence, or alcoholism.5 
   
   By not drinking too much, you can reduce the risk of these short- and long-term health risks. 
   
   References ||||| AIMS: 
   
   Substituting cannabis for alcohol may reduce drinking and related problems among alcohol-dependent individuals. Some even recommend prescribing medical cannabis to individuals attempting to reduce drinking. The primary aim of this review is to assess whether cannabis satisfies the seven previously published criteria for substitute medications for alcohol [e.g. 'reduces alcohol-related harms'; 'is safer in overdose than alcohol'; 'should offer significant health economic benefits'; see Chick and Nutt ((2012) Substitution therapy for alcoholism: time for a reappraisal? J Psychopharmacol 26:205-12)]. 
   
   METHODS: 
   
   Literature review. 
   
   RESULTS: 
   
   All criteria appear either satisfied or partially satisfied, though studies relying on medical cannabis patients may be limited by selection bias and/or retrospective designs. Individual-level factors, such as severity of alcohol problems, may also moderate substitution. 
   
   CONCLUSIONS: 
   
   There is no clear pattern of outcomes related to cannabis substitution. Most importantly, the recommendation to prescribe alcohol-dependent individuals cannabis to help reduce drinking is premature. Future studies should use longitudinal data to better understand the consequences of cannabis substitution. ||||| Blogger-pundit Matt Yglesias really wants more bars. First at Think Progress, then at Slate and now at Vox, the commentator has waged a one-man rhetorical war on the country’s urban liquor boards. The current licensing system, in which the number of bars is constrained by city bureaucrats rather than market demand, Yglesias has argued, leaves us with a paucity of public drinking spots where they’re wanted. From New York’s East Village to Adams Morgan in Washington, D.C., license limitations have caused bars to become rare, expensive, crowded and all around worse. 
   
   There’s just one problem with Yglesias’ more-bars plan: alcohol. America has a serious issue with responsible drinking, and increasing the number of sales locations probably won’t help. Alcohol abuse already kills tens of thousands of Americans annually and costs hundreds of billions of dollars a year in lost productivity, health care and property damage. It’s an especially big problem for college students and other young people; Jake New reported for Insider Higher Education that at least eight college freshman died in the first few weeks of school this year, most in alcohol-related accidents or overdoses. “Over the last 10 years, we’ve seen a fairly dramatic increase of alcohol-related hospitalizations in this age group,” George Koob, the director of the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health, told New. More bars would contribute to what’s already a public health crisis. Studies in Los Angeles and Cleveland suggest adding a bar is associated with about three additional violent crimes a year. 
   
   It’s hard to imagine bars without alcohol. Caffeine is popular, but it’s not what economists call a substitute good for booze. Luckily, those aren’t our only options. In a post for Vox, German Lopez suggested that the strongest argument for marijuana legalization might be that people will use it instead of alcohol. Although prohibition has no doubt suppressed use, marijuana’s social costs per user are negligible, especially compared with alcohol’s. A recent National Institutes of Health study suggested that marijuana appears to fit the seven published criteria to be a substitute medication for alcohol, in the same way doctors prescribe methadone for heroin dependence. From a public health perspective, every drink we can replace with a toke is a victory. 
   
   Individual states, moved by a combination of hard evidence and shifting public opinion, are advancing with plans to legalize recreational marijuana use. So far, only Colorado and Washington have gone all the way to legalization, but the whole country is headed quickly in that direction. Despite all the new regulatory architectures for growing, distributing and using marijuana without violating the law, no states have been willing to propose what responsible common use in public could look like. Not one Amsterdam-style coffee shop has managed to keep its doors open. Still, there’s a demand for marijuana bars or weed cafes or whatever we end up calling them, a demand that’s being suppressed far more strongly than the demand for more alcohol bars. ||||| BACKGROUND: 
   
   Excessive alcohol consumption causes premature death (average of 79,000 deaths annually); increased disease and injury; property damage from fire and motor vehicle crashes; alcohol-related crime; and lost productivity. However, its economic cost has not been assessed for the U.S. since 1998. 
   
   PURPOSE: 
   
   To update prior national estimates of the economic costs of excessive drinking. 
   
   METHODS: 
   
   This study (conducted 2009-2010) followed U.S. Public Health Service Guidelines to assess the economic cost of excessive alcohol consumption in 2006. Costs for health care, productivity losses, and other effects (e.g., property damage) in 2006 were obtained from national databases. Alcohol-attributable fractions were obtained from multiple sources and used to assess the proportion of costs that could be attributed to excessive alcohol consumption. 
   
   RESULTS: 
   
   The estimated economic cost of excessive drinking was $223.5 billion in 2006 (72.2% from lost productivity, 11.0% from healthcare costs, 9.4% from criminal justice costs, and 7.5% from other effects) or approximately $1.90 per alcoholic drink. Binge drinking resulted in costs of $170.7 billion (76.4% of the total); underage drinking $24.6 [corrected] billion; and drinking during pregnancy $5.2 billion. The cost of alcohol-attributable crime was $73.3 billion. The cost to government was $94.2 billion (42.1% of the total cost), which corresponds to about $0.80 per alcoholic drink consumed in 2006 (categories are not mutually exclusive and may overlap). 
   
   CONCLUSIONS: 
   
   On a per capita basis, the economic impact of excessive alcohol consumption in the U.S. is approximately $746 per person, most of which is attributable to binge drinking. Evidence-based strategies for reducing excessive drinking should be widely implemented. 
   
   Copyright © 2011 American Journal of Preventive Medicine. All rights reserved.
target: – Malcolm Harris doesn't have a problem with more bars—he just thinks those bars should sell pot, not alcohol. In an opinion piece for Al-Jazeera America, Harris offers his take on how marijuana bars would give Americans more palatable gathering spaces with fewer health risks, creating an "urban-planning win-win" and possibly even saving lives. Some highlights: Harris points out the 88,000 deaths annually from excessive alcohol use as noted by the CDC and the "hundreds of billions of dollars a year in lost productivity, health care, and property damage" that the National Institutes of Health has researched. Citing another NIH study, Harris says that pot would serve as an acceptable "substitute medication" for booze: "From a public health perspective, every drink we can replace with a toke is a victory." There are few places these days that resemble the famous bar from Cheers. "Fewer and fewer people have a third place (not work or home) where everyone knows their name," Harris writes. Because so many people have migrated to the suburbs and holed up with their cable TV and Internet, not as many people are heading out to congregate. "These spaces [would] promote community integration, friendship, and extrafamilial networks of support," Harris notes. Although he's optimistic that "eventually Americans will have public places to go and get high with their friends," Harris thinks government should ease up on strict regulations. "Not one Amsterdam-style coffee shop has managed to keep its doors open," he writes. "Though owners seem willing to conform to whatever guidelines they're given, so far, no locality wants to be the first to host an American marijuana bar." Harris also acknowledges some of the logistical hurdles that businesses may have to overcome. "One problem with weed bars is employees' right to a smoke-free workplace; even if cops allowed indoor marijuana smoking, no one would be allowed to work there," he writes. Click for his full piece.