Most of us know the familiar adage, “Marijuana is a gateway drug.” We are told from elementary school onward that if we smoke even a little pot, it will open doors to other, more dangerous forms of substance experimentation.

Despite Colorado being the first state in the Union to legalize recreational marijuana and other states following our lead, many parents, teachers, members of law enforcement and news commentators continue to push this narrative. But the truth is, substance use and misuse do not begin with weed. Alcohol is the real gateway drug, and you may be shocked to learn that it kills more Americans than opioids each year.   

American Addiction Centers surveyed more than 1,000 Americans on past substance use and found that 65% reported alcohol as the first drug they tried, versus the 18.1% who tried marijuana first. When compared with marijuana, many do not consider the harmful effects of alcohol beyond the Sunday hangover.  

Look closely at the past three years, and you will see a pandemic of alcohol addiction.

During the first year of the COVID-19 pandemic, alcohol-related deaths in the U.S. soared by 25.5%. Liquor stores were deemed essential services during the initial state lockdowns. Not because some needed an escape from our new reality but to spare overburdened emergency rooms from an influx of people suffering from alcohol withdrawal syndrome — the sometimes-fatal consequence of sudden alcohol cessation.

Over the past five years, Colorado has made it easier to access alcohol – more liquor stores, beer and wine in grocery stores, and alcohol delivered right to our doors. Americans, and especially, craft beer-loving Coloradans, celebrate with it and drown our sorrows in empty glasses. It is not perceived as a substance with any risk greater than its reward. But for many, alcohol addiction and other mental health disorders can be hidden and highly stigmatized.    

According to the 2021 National Survey on Drug Use and Health, 44% of people struggling with substance abuse have mental health issues. Often used as a coping mechanism for stress and anxiety, excessive alcohol use costs the U.S. economy $249 billion annually. Alcohol abuse is the third leading cause of preventable deaths in the U.S., killing 140,000 people each year. We can lower those numbers only when we start talking about our relationship with booze and change how we talk about the people who struggle with it.   

Society still considers it acceptable to call people addicts, drunks and drug users in polite conversation. We must begin to change the language we use when talking about addiction.

I cannot think of another illness where we fail to differentiate between the person and the disease. Nobody would ever refer to someone with leukemia as “a cancer,” yet we are quick to call someone an addict. They are not addicts. They are people with substance use disorder, a clinically diagnosable mental health condition. We must remove the stigma associated with addiction if we are ever to expect people to rethink their substance use.   

Each year, hundreds of thousands of people embrace Dry January, the month-long abstinence challenge, to take an honest look at consumption and evaluate their alcohol use. Dry January isn’t some fleeting social media trend. For many people, it has positive, lasting effects: better sleep, money saved, weight loss, improved concentration and more. In fact, many who participate in Dry January find themselves drinking considerably less months later. But not enough of us participate, and perhaps a fear of being labeled or stigmatized factors into that decision.    


As someone who leads an organization that helps people recover from drug and alcohol misuse, I see firsthand the effects of delaying substance use evaluation. Early intervention allows individuals to avoid many serious and life-threatening physical and social consequences of problematic alcohol use. During the initial stages of alcohol use disorder, consequential habits and behaviors are less ingrained. It is far easier to change those behaviors early on than when a person has developed a physical dependence.

Everyone should take 30 days off from alcohol, regardless of the month, and see the results. If the idea of a month dry frightens or distresses you, perhaps you should take a second look at your social habits and relationship with alcohol. But it is just as important that we are open and transparent. We must start conversations with our friends, our families, our loved ones and ourselves. Alcohol use disorder impacts every single family.   

Awareness opens minds, fights stigma and normalizes self-examination of the frequency and quantity of alcohol consumption. If more of us can honestly discuss and scrutinize our alcohol use early, then maybe one day I will be lucky enough to close the doors of my organization with the satisfaction of knowing that our services are no longer needed.  

Shannon Van Deman, of Denver, is CEO of AspenRidge Recovery Center. Previously, she served as vice president of Children’s Hospital Colorado’s Pediatric Mental Health Institute, and co-chaired Gov. Jared Polis’ Behavioral Health Taskforce. 

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Shannon Van Deman

Shannon Van Deman, of Denver, is CEO of AspenRidge Recovery Center. Previously, she served as vice president of Children’s Hospital Colorado’s Pediatric Mental Health Institute, and co-chaired Gov. Jared Polis’ Behavioral Health Taskforce.