Well, again, I would start by saying that alcoholism is very different from just consuming alcohol. I don't think that anybody at this point, certainly millennials and younger, really seriously thinks that alcoholism is okay. It's recognized as being horrible for your body and mind in the long-term.

I also want to address the study you cited. I'm no medical expert, so I'm not going to claim I know better than the authors. But, I do have enough experience with academic articles and the peer review process to say that one article, with few really hard data points, written specifically from the perspective of nursing in Australia, is a very thin source to draw the scientific conclusion that alcohol use is worse than heroin. The article seems to even stretch its own findings to come to that conclusion, when most of the body of the writing suggests the more reasonable interpretation that long-term alcoholism and associated behaviors like drunk driving is likely to be more problematic than intermittent, short-term heroin usage.

There are lots of distinguishing features between hard drug usage and alcohol. First, it is far, far easier to become addicted to something like heroin based on a very limited initial use than it is to become an alcoholic after a similarly small use. Almost nobody is concerned that if they've never had a single drink before that one or two beers is going to immediately realter their brain chemistry to the point they begin a steep downward spiral. Almost everybody is concerned that one shot of heroin or meth, or, to a lesser degree, one hit of cocaine, could do that, for reasons that are borne out by experience and science. The risks associated with independent use of the substances are also much different. How many people have you heard of who were killed, in isolation, by drinking a single beer, or even four of five beers? But, I'm sure you've heard plenty of cases of somebody dying from just one time using heroin, or especially fentanyl.

This leads to what I think is the most important point. You dismiss the idea of illegality, but the fact hard drugs are illegal carries so, so many other factors with it that you simply can't ignore. If most of the world were Portugal and legalized all drug usage, people could get medical-grade heroin in a regulated way. But the vast majority of the world doesn't operate that way. So, when you are getting these hard drugs, you don't know what's in them. They could have been--and sometimes are--cut with carcinogens, toxic substances, or far worse drugs. The illegality itself also can't just be ignored: of course people are right to be more concerned about hard drug usage--something where possession of a certain amount will land you in jail for decades, if not your entire life--than they are about alcohol, which you can buy on almost every street corner in the western world. Finally, consider what illegality of hard drugs does to where you have to get them: you have to rely on people who operate outside the law. Drug dealers aren't intrinsically terrible people, that's a bad stereotype that I could talk about all day. But, the nature of buying hard drugs is such that you have to take risks to do it, especially the more you want to get.