Alcoholism isn’t the only alcohol problem: It’s not even the biggest alcohol problem


Alcohol paradox: Alcoholics cause more individual problems but non-alcoholics who binge drink cause more societal problems -- because there are so many more of them


“One in four US teens and young adults binge drink,” blared the headlines in USA Today. And many of those folks are imbibing a lot more than only five drinks in a couple of hours, the definition for binge drinking. The average binge drinker slams eight drinks in a couple of hours.

Wow, what a bunch of alcoholics, you say. But no, they’re not. According to CDC Director Thomas Frieden, 80 percent of binge drinkers are not alcoholics. A lot of them are light to moderate drinkers, maybe like you, who really tie one on every once in awhile. Others are folks who get drunk a lot but aren’t alcohol dependent, like some of your college buddies maybe.

The truth is that non-alcoholics who binge cause the majority of alcohol-related problems, because there are so many more of them. From “Screening and Brief Intervention: Making a public health difference” by JoinTogether:

Research shows that risky drinking causes more total harm than the heavy drinking of alcoholics. Though risky drinkers are individually less likely to cause alcohol-related problems, they make up a much greater portion of the general population than alcoholics, so the most significant amount of damage is caused by those who engage in risky drinking from time to time but are not dependent on alcohol.

Public health researchers have known for a long time that non-alcoholics cause more


Percentages of Persons Aged 12 to 20 and Aged 21 or Older Reporting Past Month Binge Alcohol Use, by Age: 2002 and 2003 -- SAMHSA


alcohol-related problems than alcoholics. But, unfortunately, they never imparted this wisdom to the public. Too bad; the main purpose of social science research should be to help craft sensible public policy. How can we craft sensible alcohol policy if nobody knows who is causing most of the alcohol-related problems?

Anyway, so what if normal drinkers have a few too many once in awhile? Why should we care? Two reasons:

  1. Binge drinking causes a lot of problems – car crashes, domestic violence, fights, shootings, sexual assaults, stabbings, drownings, house fires, falls, injuries, unintended pregnancies, STDs, alcohol poisoning, high blood pressure, heart attacks, etc. All these and more are much more likely to happen around people who are drunk – whether they are hard-core alcoholics or moderate drinkers who drink too much once in awhile.
  2. We need to spend taxpayer dollars on the the right interventions. Treatment for alcoholism isn’t appropriate for most binge drinkers. Right now, we spend a lot more money treating alcoholism than on reducing intoxication. I’m not saying we should spend less on treating alcoholism. In fact, we should spend a lot more. But we also should spend a lot more on prevention methods that are shown to be effective.

In the past few years, screening and brief intervention (SBI) of intoxicated people in emergency rooms and other health care settings has shown to be very effective in reducing dangerous drinking and repeated hospitalizations. SBI should be done in every hospital and primary care setting. But it’s slow getting off the ground. I think the reason is that most people – including most people in the medical establishment – still think that people with alcohol problems are alcoholics, and they don’t see how a brief intervention can help an alcoholic.

There are plenty of other prevention methods that have been shown to be very effective in reducing dangerous drinking, such increasing DUI enforcement, reducing the urban density of bars and liquor stores, enforcing responsible alcohol sales and service laws and raising alcohol taxes. Very little taxpayer money is spent on these interventions.

If the public and policy makers recognize who is causing all these alcohol-related problems like drunk driving and such, then maybe they’ll start implementing policies that reduce the incidence of people getting drunk. That doesn’t mean wagging our finger at moderate drinkers, which would never work. It means implementing policies like SBI and fully enforcing existing alcohol laws to help convince non-alcoholics to drink moderately.

This entry was posted in Alcohol, Alcohol abuse, Binge drinking, Prevention, SBI, Substance abuse, Substance use disorder treatment, Underage drinking and tagged , , , , , , . Bookmark the permalink.

One Response to Alcoholism isn’t the only alcohol problem: It’s not even the biggest alcohol problem

  1. neftwink says:

    “Alcoholism isn’t the only alcohol problem: It’s not even the biggest alcohol problem”

    The biggest alcohol problem is that is itsn’t often enough addressed as a relationship. Alcoholics develop a physical, emotional, and psychological relationship with alcohol that goes beyond any relationship s/he could ever have with another person.

    When an alcohol decides to stop drinking, that isn’t enough. The person has to, not just understand s/he can no longer drink, but s/he needs to REALIZE, that the relationship has to die. Death is involved. And one of the biggest problems is that even when an alcoholic decides to implement the death of their relationship with alcohol – they can still see the shit sitting on the counter at the gas station.

    The psychological challenge to keep the relationship with alcohol completely severed is beyond absurd. Plenty of people manage to walk away from it and not be affected by the site of it. But plenty of those people remember all too well how good three glasses of wine tastes.

    I don”t believe it is possible for an alcoholic to completely annihilate all parts of their attraction to alcohol and drinking. I write about this in my blog under an entry titled The Mosquito Bite.

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