Problem Drinking – A Greater Threat than Recognized

Posted on April 23rd, 2010
Posted in Alcohol Abuse

Alcohol is everywhere in today’s society. You literally can’t drive down the road without seeing billboards touting beer, wine or spirits, let alone watch television, read magazine or newspaper – or even surf the Internet – without being bombarded with advertisements. Drinking alcohol still holds a powerful grip on America’s men, women, and children – despite the tremendous costs of alcohol abuse and dependence. While much attention is devoted to alcoholism and alcohol addiction, the truth is that problem drinking is actually a greater threat than previously recognized.

What is Problem Drinking?

Problem drinking, also known as alcohol abuse, affects many millions of Americans. It can be just as harmful as alcoholism. In fact, a person can abuse alcohol without being an alcoholic. Drinking too much and too often are signs of alcohol abuse and problem drinking.

Problem drinking is insidious as well. What may start out as experimentation or casual drinking may gradually become an everyday occurrence. With the increase in frequency and amount of alcohol consumed comes a related increase in the number of problems related to drinking. Some of these include inability to meet schedules and responsibilities for work, school or family, car crashes and drunk-driving arrests, drinking-related medical conditions, unwanted pregnancies, other drug use, crime, domestic violence, and suicide.

U.S. Drinking Statistics

According to the 2008 National Survey on Drug Use and Health (NSDUH), an estimated 129 million people, more than half (51.6 percent) of Americans aged 12 and older reported being current drinkers of alcohol. This is similar to the 2007 estimate of 126 million (51.1 percent).

Think about slightly more than half of the U.S. population being current drinkers for a moment. Admittedly, not everyone who takes a drink of alcohol is going to experience a problem or become an alcoholic. In fact, most Americans, according to research studies, do drink responsibly. But an increasing number who are not diagnosable as alcoholics do have problems as a result of their alcoholic intake. Let’s look at some more numbers.

Binge drinking – the practice of consuming 5 or more alcoholic drinks on a single occasion – was reported by more than one-fifth of the population aged 12 and older in 2008. That’s about 58.1 million people. Remember this statistic. It will factor into alcohol-related problems to be discussed later.

In 2008, 17.3 million people (6.9 percent) in the same age group (aged 12 and older) reported heavy drinking – which is defined as binge drinking on at least 5 days in the past 30 days. This is similar to what was reported in 2007, but down from the 17.6 million in 2001-2002. By way of historical context, in 1992-1992, the number was 13.8 million. So, a downward trend overall in heavy drinking is good. But that still leaves us with a huge pool of drinkers in America – any one of which could experience alcohol-related problems as a result of continued drinking.

Interestingly, according to research cited by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), of the 17.6 million of alcohol abusers and alcohol dependents in 2001-2001, 4.7 percent or 9.7 million persons were abusers of alcohol, while 3.8 percent or 7.9 million were alcohol dependent. The breakdown for 1991-1992 showed alcohol abusers at 3.0 percent or 5.6 million, versus alcohol-dependent individuals at 4.4 percent or 8.2 million (total for both groups was 7.4 percent or 13.8 million).
Consistent across research studies is the fact that there are more male abusers of alcohol than female. Three times as many men (9.8 million in the 2001-2002 studies) as women (3.9 million) are problem drinkers. And the prevalence is highest for both sexes in the 18 to 29 age group. The prevalence is the lowest among those aged 65 and older.

Some good news is that while binge drinking and heavy drinking among adults aged 18 to 25 was 41.0 percent and 14.5 percent, respectively, in 2008 (and similar to 2007), among underage persons (aged 12 to 20), rates actually declined. Comparing youth drinking and binge drinking in 2002 to 2008 shows the greatest decline: from 28.8 percent in 2002 to 26.4 in 2008 (underage drinking), and past-month binge drinking from 19.3 percent in 2002 to 17.4 percent in 2008.

Alcohol-Related Problems

Numbers of drinkers aside, alcohol-related problems cause numerous consequences for the individual, affected others, and society as a whole. Beside the drinker, an estimated 4 to 6 others are directly impacted.

A search for alcohol-related problems from various sources reveals the following:

• Excessive alcohol consumption is the third leading preventable cause of death in the United States. Injuries are the leading cause of preventable death among persons aged 1 to 44, and alcohol is a leading contributor. Of the 75,000 annual deaths attributed to alcohol, 40,000 are injury deaths.

• More than 9 million children live with a parent who is dependent on alcohol and/or other substance.

• One-quarter of all emergency room admissions, one-third of all suicides, and more than half of all homicides and incidents of domestic violence are alcohol-related.

• Almost half of all traffic fatalities are alcohol-related.

• Between 48 percent and 64 percent of people who die in fires have blood alcohol content (BAC) indicating intoxication.

• Fetal alcohol syndrome (FAS) is the leading known cause of mental retardation.

• Alcohol is at least partly responsible for much juvenile delinquency, illegitimate pregnancies, truancy and fights.

• Alcohol is involved (either the attacker or the victim had been drinking) in forcible rape (41 percent), child beating (67 percent), stabbings (72 percent), felonies (73 percent), wife battery (80 percent), and homicides (83 percent).

Problem Drinking Leaves a Trail of Damage

It’s not just that daddy has a toddy or two too many – and then beats up mommy and the kids. It’s more than the episodes of teens and college students that engage in binge drinking during Spring Break, weekends, holidays or spontaneous parties. Closet drinkers, high-functioning problem drinkers, and newly-initiated drinkers – problem drinking is everywhere.

How can you measure the value of lives lost to problem drinking? Whether the loss of life is due to a motor vehicle accident where the driver or passenger of any of the involved vehicles was drinking, or a domestic violence dispute that escalates to tragedy, an alcohol-fueled crime spree, or any other cause, the loss is still incalculable.

Look at the litter of wrecked families in the wake of problem drinking. As previously mentioned, it’s more than the drinker who’s involved. Everyone in the family suffers as a result of out-of-control or problem drinking by one or more individuals. If both parents drink too much and too often, not only are they setting a bad example for their children, but the likelihood that their offspring will also experience problems with alcohol increases. Children who start drinking before the age of 15 are 6 times more likely to have alcohol-related problems as they get older than children who wait to begin drinking until they are age 21.

Personalities deteriorate among those who are problem drinkers. They may become suspicious, paranoid, display extreme mood swings, become hostile, violent, anxious and depressed.

Suicides increase among those who consistently drink to deal with stress, depression, or anxiety, or who have underlying physiological and/or psychological problems.

Problem drinkers often find their quality of life is significantly reduced – along with that of other family members, close friends, and co-workers.

The impact on a child or spouse from a problem drinker may have lifelong repercussions. Even if the problem drinker receives treatment, the other family members may be unable to recover fully from the problems inflicted upon them.

In terms of human misery, think about the effects of problem drinking on short- and long-term suffering, from disease, injuries as a result of motor vehicle crashes, other accidents and injuries, and psychological consequences.

How to Recognize Problem Drinking

Treatment experts (including the National Institute on Alcohol Abuse and Alcoholism or NIAAA) identify several things to look for that indicate a problem with drinking. Some use the acronym “CAGE” to refer to a basic four-question screening test for problem drinking:

• Have you ever felt you should Cut down on your drinking?
• Have people Annoyed you by criticizing your drinking?
• Have you ever felt bad or Guilty about your drinking?
• Have you ever needed an Eye opener – a drink first thing in the morning – to steady your nerves or to get rid of a hangover?

NIAAA resources say that one “yes” answer suggests a possible problem with alcohol. More than one affirmative answer means it is highly likely you have an alcohol problem. It is important that individuals who suspect or know that they have a problem with alcohol see a doctor or other health care provider as soon as possible. With proper screening, a true diagnosis can be made and a plan of action created to deal with problem drinking.

Information from the Centers for Disease Control and Prevention (CDC) indicates that drinking is a problem if it causes problems in your relationships, in school, social activities, or how you think and feel.

Another screening test for problems with alcohol is the revised Michigan Alcohol Screening Test (MAST), which is available online (//counsellingresource.com/quizzes/alcohol-mast/index.html). This self-test consists of 22 questions that can help you become aware of your use or abuse of alcohol. You can also take the Promises Alcohol Abuse Assessment.

Why Not Just Cut Down?

Many problem drinkers – and those who care about them – think that they can just cut down on their alcoholic intake and eliminate the problem. If only it were so easy. Unfortunately, it may or may not succeed. If a person has been diagnosed as an alcoholic, simply cutting down rarely succeeds. For alcoholics, true abstinence – cutting out all alcohol – is generally the best course for recovery. For those who are problem drinkers, however, it may be possible for them to limit the amount they drink – and reduce the alcohol-related problems. If they continue drinking and experience problems as a result of such drinking, they need to completely stop drinking.

Trying to cut down on your problem drinking – or know someone who should? The NIAAA has a helpful publication, How To Cut Down On Your Drinking, available on their website (//pubs.niaaa.nih.gov/publications/handout.htm).

Getting Help for Problem Drinking

Finding and getting help for problem drinking is easier than you think. There are many national and local resources available. The National Drug and Alcohol Treatment Referral Routing Service has a toll-free number – 1-800-662-HELP (1-800-662-4357) where you can speak with a representative concerning substance abuse treatment or to request printed material on alcohol or drug use, or get local substance abuse treatment referral in your state.

The Substance Abuse and Mental Health Services Administration (SAMHSA), of the U.S. Department of Health and Human Services, provides a substance abuse treatment facility locator (//findtreatment.samhsa.gov/) showing the location of facilities around the country that treat alcoholism, alcohol abuse, and drug abuse problems. SAMHSA also lists Promises Treatment Centers as a choice for treatment in California.

Other resources for more information include:

• Alcoholics Anonymous – (//www.aa.org/?Media=PlayFlash)
• Adult Children of Alcoholics – (//adultchildren.org/)
• Al-Anon/Alateen – (//www.al-anon.alateen.org/english.html)
• National Clearinghouse for Alcohol and Drug Information (NCADI) – (//ncadi.samhsa.gov/)
• National Association for Children of Alcoholics (NACOA) – (//www.nacoa.org/)

Adding It All Up

When you combine the personal, familial, and societal costs of problem drinking, the resulting totals stagger the imagination. And, there’s no uniformly agreed-upon statistic that you can point to. Suffice to say that the real dollars’ economic cost is in the multi-billions of dollars annually – for health care, lost productivity.

Again, this doesn’t even begin to take into account the cost of lives lost – since you can’t put a dollar value on a human life.

Even one life lost due to problem drinking is too much.

Think back to the number of binge drinkers on any given night, week-end, or during holiday periods. Picture those binge drinkers – who may otherwise not touch a drop of alcohol again until the next bingeing episode – getting behind the wheel. The results are tragically predictable, especially among younger individuals, mostly male.

What about the ruination of lives, the incalculable loss of potential as those who are directly impacted by problem drinking fail to achieve their dreams, or give up, or have them taken away as a result of being imprisoned? What of the children born to mothers who drink during pregnancy? How do their lives suffer as a result?

Although help is available for those who are problem drinkers or become dependent on alcohol, the sad truth is that few actually seek it. According to the 2008 NSDUH, of the 19.0 million people in 2008 who needed treatment for an alcohol use problem, only 1.6 million (8.2 percent) received treatment at a specialized facility. That left 17.4 million who needed treatment for alcohol use but didn’t receive it at a specialized facility. That same year there were 1.2 million youths aged 12 to 17 who needed treatment for alcohol use. Only 77,000 (6.2 percent of those needing treatment) received it, leaving almost 1.2 million youths needing treatment but not getting it. Talk about a huge problem. The statistics speak for themselves.

Bottom line: the sheer volume of problem drinkers versus alcoholics means the magnitude of the threat of problem drinking is greater than recognized. These aren’t the stumbling down alcoholics or winos or the crazed DT-suffering chronic drinker. These are men, women and children that live in our own homes, next door, down the street, work next to us or sit beside us at school, on the train, or drive alongside us on the highway. In short, it could be any of us.

We are all potential problem drinkers – some of us are able to pick up on the signs and dangers of drinking too much, too often. Many of us are either not able to, are in denial, or know it and refuse to take responsibility.

In any case, the issue of problem drinking needs to be addressed. It’s not cool, not healthy, and certainly not conducive to a high quality of life to be a problem drinker.

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