Don't you mean that it's quite good? It's easily more than an order of magnitude for many people (not sure about chronic alcoholics with high tolerance). How many medications can you 5x your dose and not have some risk of ending up in the hospital?
Well given "therapeutic index" I had said "medication" as opposed to "commonly abused substances". I think your list skews heavily due to psychedelics tending not to be acutely toxic to the same extent as other chemical species.
Statins for example are probably 10x to 20x (quick napkin math based on an animal study I found). Tylenol is 10x and is OTC.
Personally I consider alcohol to be much safer than many other substances given the form it typically takes. Utterly irresponsible binge drinking aside, most people will suffer serious adverse effects long before they're in danger. Compare that with pills or injections where an OD can be entirely inadvertent even when observing basic common sense.
7-Up contained lithium citrate until 1950. The soda jerks were literally treating manic depression during WWII. There were advertising signs for it at crosswalks on city streets. Make 7-Up Yours, Baby!
Any product that contains ethanol but is not intended for consumption will be adulterated with ingredients that make it really unpleasant to consume. Any drug, OTC or sometimes even prescription, that has a risk of abuse, will be combined with another drug that makes it impractical or dangerous to use it recreationally, or isolate it for manufacturing.
So the next time you wonder why all your cough medicine has to come with guaifenesin, or you need a psychiatrist to prescribe your lithium carbonate, you can blame all the addicts and Walter Whites out there who ruined it for honest people.
By the way, Wikipedia attempts to contradict the claim about 7Up containing lithium citrate and says it was never an ingredient. There is no source supporting this claim. An unreliable source, by "Bill Lockhart and Bob Brown" never makes any claim about 7Up's ingredients, but focuses on weirdly-long names that had never been used by the company.
On the contrary, multiple sources insist that lithium citrate was in 7Up for decades, and in fact that the FDA had banned this usage in 1948, and that is why it was removed! If it was never in 7Up to begin with, it seems odd to ban a thing that wasn't going on!
> the FDA had banned this usage in 1948, and that is why it was removed! If it was never in 7Up to begin with, it seems odd to ban a thing that wasn't going on!
7 Up says that 7 Up was using it. The primary marketing campaign of 7 Up from its inception was its lithiated benefit. Soda jerks were the baristas who sold carbonated beverages at drug-store counters. The soda pop, tonic beverage, patent medicine, and pharmaceutical industries were intertwined from the beginning.
Lithiated beverages were all the rage in the 1930s and 1940s. It was equivalent to the coca beverages, which included coca wine, coca tonic, coca teas. There was lithia beer, lithia spring water (because there were natural springs containing some amount of dissolved lithium salts) and 7Up Lithiated Lemon Soda was a market leader. The "Lithiated" quality was on the bottle caps and it was in their advertisements.
The FDA first banned lithium citrate in 1948. There were over a dozen deaths related to lithium toxicity. It is unclear which products caused these deaths. The FDA doesn't have to say which ones: they were identifying a controlled substance, not issuing a recall.
There was yet another FDA ban in 1949. You see, doctors had begun recommending low-sodium diets to people with CVD and related illnesses. So people cut out table salt from their diets. But lithium chloride was commonly available in the same medium. So your wife and restaurant chefs cooked with a teaspoon of lithium chloride; your dinner table at home had a shaker of lithium chloride; people "salted to taste" with this marvelous salt substitute. But the lithiated effects were, again, lethal, and this secondary ban put the last nail in the coffin for the next 20 years before anyone started playing around with manic-depressive patients.
