Opiate addiction has been in the spotlight recently. We’ve all seen the statistics. New cases of HIV are popping up daily in seemingly small, sleepy little towns all over the country. While addiction to pain pills and heroin is a life-threatening illness, alcohol misuse is actually more devastating in terms of the number of deaths related to it. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), about 88,000 people die from alcohol related causes yearly. It is the fourth leading preventable cause of death in the US (National Center for Statistics and Analysis, 2015). In 2014, alcohol-impaired driving accounted for 31% of overall driving fatalities (Stahre, M. in Preventing Chronic Disease, 2014). Alcohol misuse takes a toll on health as well. Global statistics reveal that it is the first leading risk factor for premature death in people between 15 and 49. In the 20-35 year age group, 25 percent of total deaths are attributable to alcohol misuse (World Health Organization 2015).
The current diagnostic label for problematic drinking is alcohol use disorder. How do you know whether you have an alcohol use disorder? The bottom line is that if you wonder whether you have a problem, you probably do. There are several screening tools that clinicians use to diagnose problem drinking, and I’ll include one at the end of this blog. However, ask yourself whether anyone has expressed concern about your drinking, whether you need a drink to get going in the morning, whether alcohol has caused you to lose a job or a relationship, or contributed to a health problem. These are all red flags that could indicate that you have a problem.
There are some guidelines about what constitutes moderate and problem drinking. According to NIAAA, moderate alcohol consumption is defined as up to one drink per day for women and 2 drinks per day for men. Binge drinking is defined by the Substance Abuse Mental Health Services Administration (SAMHSA) as drinking 5 or more drinks on the same occasion at least one day out of the last 30 days. SAMHSA defines heavy drinking as drinking 5 or more drinks on the same occasion on each of 5 or more days in the past 30 days. However, in order to really understand these guidelines, it is important to understand how a standard drink is measured. A standard drink is 12 fl. oz. of regular beer, 8-9 oz. of malt liquor, 5 fl. oz. of table wine, or a 1.5 oz. shot of 80 proof spirits (whiskey, gin, vodka, rum, etc.). So if you drink a 24 oz. tall boy, you really have had two standard drinks.
It is true that moderate levels of alcohol have been shown to be beneficial. For example, moderate alcohol consumption decreases risk of heart disease and ischemic stroke (stroke due to blocked arteries and reduced blood flow to brain), and diabetes. But again, these studies are talking about MODERATE drinking as measured by the STANDARD drink.
I mentioned a lot of statistics in the first paragraph. However, I was most surprised by the statistics regarding treatment. Only about 8.9 percent of adults who needed treatment (9.8 percent of men and 7.4 percent of women) received it. This could have been due to refusal to get treatment, lack of available treatment, or lack of financial resources to get treatment. It’s a rather abysmal statistic, however you look at it. There is still stigma about admitting to an alcohol problem. I believe it is decreasing. There are new treatments available that have a better track record as far as treating alcohol use disorder. Talk to your primary care doctor. For more information, check out the following:
Check out the AUDIT. If you score 8 or above, you may be a problem drinker.