Alcohol causes the most overall harm to the Australian community, surpassing crystal methamphetamine (ice) and heroin, a new national study suggests. The Australia-first study, funded by St Vincent’s Hospital in Melbourne, examined 22 drugs and measured the risk to an individual and the damage to society as a whole. As part of the study, 25 drug-harm experts – including frontline emergency service workers, police, addiction specialists, doctors and those working in the welfare and homeless sectors – ranked the drugs on a score of zero to 100, based on the damage they caused to users, including illness, injury and death. They also examined the effects drugs have on users' families and the wider community, such as through violence, crime, unemployment, economic costs and relationship breakdowns. Alcohol was ranked by far the most damaging drug to the Australian community, scoring 77 out of 100, followed by crystal meth (66), heroin (58) and fentanyls (51).

As well as consuming about 23 standards drinks a day, Mr Reichmann would smoke cannabis and regularly use crystal meth and heroin. But alcohol was always the easiest drug to get. Thousands die from alcohol-related harm each year. Credit:Nic Walker “Over the years, it destroyed relationships with people I loved," he said. "It stopped me from having employment because I was completely unreliable." Lead researcher Associate Professor Yvonne Bonomo said almost 6000 Australians die from alcohol-related harm each year. "That’s about one person every 90 minutes," she said. "Yet up to half a million Australians are unable to access the help they need from alcohol and other drug treatment services, with the largest unmet demand being for alcohol dependence."

Associate Professor Bonomo said while there was no doubt crystal meth and heroin were causing profound challenges, the dangerous effects of alcohol cannot be ignored. The costs of alcohol to the Australian community is estimated to be $6.8 billion annually, compared with methamphetamine at $5 billion, the Australian Drug Harms Ranking Study, published in the Journal of Psychopharmacology,found. Crystal meth was ranked behind alcohol in the study. Alcohol was linked to 60 physical illnesses including seven forms of cancer and scored high rates of depression, anxiety and brain injury. "Once people are really in the grips of alcohol dependence they start to lose what we call the tangibles like loss of job, loss of house," Professor Bonomo said. "For the first time, we examined all those harms to the drinker and those around them."

Women were most at risk of being assaulted by intimate partners under the influence of alcohol, while men were most likely to be injured by strangers, friends and colleagues, researchers said. Children exposed to parents who drink excessively were also left with long-lasting trauma including effects on their development and mental health. The study ranked fentanyls, a family of highly addictive synthetic opioids, as the most dangerous drug to users based on the risk of death, followed closely by heroin and crystal meth. Researchers stressed that the prevalence of fentanyls in Australia remained low compared with epidemic rates seen in countries such as the US, but it was important to monitor as there were fears their use could soar in future.

Dr Matthew Frei, clinical director of drug and alcohol service Turning Point, said alcohol was a legally regulated drug that was entrenched in Australian culture, which meant people often underestimated its risks. "Alcohol is used in almost all social situations by most Australians, whereas drugs like methamphetamine and heroin aren’t," he said. "It's understandable then that when people think of dangerous drugs they'll go straight to one that they've seen on the TV news report ... or that image of drugs like crystal meth making people erratic and violent." But he said awareness of the dangers of drinking had grown steadily in the past 20 years. "There's been increasing acknowledgement of alcohol's role in aggression," he said.

Mr Reichmann said he hit rock bottom when he couldn’t attend his daughter’s wedding in 2015. “I was so ashamed that I couldn’t get myself together to be there for my daughter’s special day," he said. “I still really struggle with that." About a year later, he checked himself into drug and alcohol rehabilitation service Windana in St Kilda East. He hasn't touched drugs or alcohol since December 2016 and attends recovery programs every week. "For me it's about having that connection with like-minded people and getting regular support," Mr Reichmann said. Now he works as a recovery group leader mentoring others to break the cycle of addiction.