What are drinking problems? How serious is alcohol abuse among young people? What is the trend in drunk driving? What help is available for alcoholism?
- Effectiveness of Brief Intervention for Alcohol Use by Nonphysicians in Primary Care
- Electronic Alcohol Self-Help: More Effective than Alcoholics Anonymous (AA)
- University Promotes Responsible, Safe Alcohol Consumption
- Alcohol and Drug Abuse: A Problem of Choice
- Alcohol Availability and Alcohol-Related Harm
- Alcohol Drinking Trends in the U.S.
What Is Alcohol Abuse
To some college students, heavy drinking that leads to vomiting is not alcohol abuse but simply having a good time and being "one of the gang."
To many whose religion requires abstinence, simply tasting an alcohol beverage is not only alcohol abuse but a sin.
To many activists, a married couple quietly enjoying a drink with their dinner is guilty of abusing alcohol if they happen to be twenty years of age.
To the National Highway Traffic Safety Administration, an accident is alcohol related (and implicitly caused by alcohol abuse) if a driver who has consumed a drink is sitting at a red light and rear-ended by an inattentive teetotaler.
In American Society
Our historical background and multi cultural population have created wide and strong disagreements in American society over what constitutes alcohol abuse.
- Our Colonial tradition taught us that alcohol is the "good gift of God" to be used and enjoyed by all, including small children.
- Our temperance and Prohibition experiences taught us that alcohol is "demon rum," the cause of almost all poverty, crime, violence, and other problems.1 So convinced were they that alcohol was the cause of virtually all crime that, on the eve of Prohibition, some towns went so far as to sell their jails.2 Temperance systematically promoted both fear and hostility toward alcohol beverages, much of which continues to this day.
- Repeal of Prohibition left us with a society in which the majority of people enjoy alcohol beverage in moderation, but a large minority (today about 1/3) of the population abstains. And a substantial proportion of American abstainers favor imposing prohibition again on the entire population. The prohibition impulse has never died and has re-emerged in a different form today.
- Alcohol policy actually results not from science, logic, or evidence, but from a continuing struggle between those who wish to use alcohol beverages and those who don't want them to. Repeatedly throughout our national life, movements have emerged to promote abstinence by persuasion, but failing to succeed, they have then resorted to coercion. The current neo-prohibition movement attempts to reduce consumption in general and to prevent it entirely among targeted groups, such as those under the age of 21.
And Young People
Prohibition for those under the age of 21 currently enjoys wide support in the United States and is imposed by force of law. Often it is enforced with a vengeance. "Carter Loar, a senior at Park View High School in Loudoun County, Virginia was suspended for ten days in February for violating the school's alcohol policy."3 Carter's violation was using mouthwash at school. School officials confiscated the contraband and "He was charged with violating the school's alcohol policy which prohibits the possession or use of alcohol on school property. As part of his ten day suspension, Carter was required to attend a three day Substance Abuse Program sponsored by Loudoun County."4
Mr. Loar was a victim of "zero tolerance," which is now all the rage. But what does such a zealous level of intolerance accomplish and what messages does it send our young people? It probably achieves about as much as the scare tactics characteristic of the temperance movement and is almost certainly counter-productive.
One apparent message is that those who promote such intolerance have lost touch with youth, another is that they are unrealistic and impractical, and another is that their alcohol education messages are naive.
While a continuing barrage of newspaper articles, TV shows, and special interest group reports claim that drinking among young people is a growing epidemic, the fact is quite the contrary. Drinking among young people, like drinking among the larger population, is actually on the decline. For example, look at the statistics on drinking among high school students.
The proportion of high school seniors who have ever consumed alcohol is down (fig 1).5
The proportion of high school seniors who have consumed alcohol within previous year is down (fig 2).6
The proportion of high school seniors who have consumed alcohol within previous 30 days is down (fig 3).7
The proportion of high school seniors who have recently consumed alcohol daily is down (fig 4).8
The proportion of high school seniors who have consumed 5 or more drinks on an occasion within previous two weeks is down (fig 5).9
Drinking among young people continues to drop. For example, the proportion of young people aged 12 through 17 who have consumed any alcohol during the previous month has plummeted from 50% in 1979 to 16% in 2006, according to the federal government's annual National Survey on Drug Use and Health. Thus, while one in two were drinkers in 1979, significantly fewer than one in five were in 2006, the most recent year for which statistics are available.10a
College student drinking attracts much attention in the press. But the proportion of college freshmen who drink continues to decrease. Freshmen entering college in 2006 reported the lowest rates of drinking in the 41-year history of the national college Freshman Survey. The proportion reporting occasional or frequent beer drinking dropped to an historic low, down 43% since 1982.10b
Drunk Driving Fatalities
While we must do even more to reduce drunk driving, we have already accomplished a great deal. Alcohol-related traffic fatalities have dropped steadily.
- The U.S. has a low traffic fatality rate (drunk, as well as sober) and is a very safe nation in which to drive. And it's been getting safer for decades.20 There are now fewer than one and a half deaths (including the deaths of bicyclists, motorcyclists, pedestrians, auto drivers, and auto passengers) per one hundred million vehicle miles traveled.21 Alcohol-related traffic fatalities have dropped from 60% of all traffic deaths in 1982 down to 39% in 2005 (the most recent year for which such statistics are available).22
- Alcohol-related traffic fatalities per vehicle miles driven has also dropped dramatically -- from 1.64 deaths per 100 million miles traveled in 1982 down to 0.56 in 2005 (the latest year for which such statistics are available).23
- The proportion of alcohol-related crash fatalities has fallen 35% since 1982, but the proportion of traffic deaths NOT associated with alcohol have jumped 53% during the same time. We're winning the battle against alcohol-related traffic fatalities, but losing the fight against traffic deaths that are not alcohol-related.24
The declining proportion of accidents involving intoxication is good news. However, we can do even more to reduce drunk driving deaths. Through our individual actions we can do much right now to protect ourselves and others. [To learn more visit Drinking And Driving]
While the moderate consumption of alcohol is associated with better health and longer life than is abstinence, the heavy consumption of alcohol, especially over a period of many years, can lead to serious health problems and even death.
Fetal Alcohol Syndrome
Fetal Alcohol Syndrome (FAS) is an irreversible condition associated with excessive consumption of alcohol by pregnant women and is, therefore, completely preventable. Each and every case of FAS is a needless tragedy. Victims suffer serious physical deformities and often mental deficiencies. And, they suffer these problems for their entire lives. While most cases occur among alcoholics who consume alcohol heavily throughout their pregnancies (usually in combination with smoking and often illegal drug use), no one knows for certain what level of alcohol consumption is safe for a pregnant woman.
The Royal College of Obstetricians and Gynaecologists recently conducted a study including 400,000 American women, all of whom had consumed alcohol during pregnancy. Not a single case of FAS occurred and no adverse effects on children were found when consumption was under 8.5 drinks per week.15 While it would appear that moderate consumption is safe, the safer choice would be to abstain.
Of course, tobacco and illegal drugs are clearly to be avoided, and a pregnant woman should maintain good nutrition and see her physician on a regular basis throughout her pregnancy.16 [Learn more about Fetal Alcohol Syndrome]
Cirrhosis is probably the most widely recognized medical complication of chronic alcoholism.17 It is a grave and irreversible condition characterized by a progressive replacement of healthy liver tissue with scars, which can lead to liver failure and death.18 Fortunately, the abuse of alcohol is down and so is cirrhosis. [Learn more about Alcohol & Health]
The death rate for cirrhosis has fallen dramatically. During a 22-year period, death from cirrhosis:
- dropped 29.8% among black men
- dropped 15.3% among white men
- dropped 47.9% among black women
- dropped 33.3% among white women19
Help is Available
Moderation Management stresses balance, moderation, self-management, and personal responsibility to eliminate alcohol abuse.
Drink Wise is a brief, confidential educational program for people with mild to moderate alcohol problems who want to eliminate the negative consequences of their drinking.
Habit Smart promotes the reduction of harmful behaviors and harm through habit change and wise choices.
Alcoholics Anonymous (AA) is the oldest and best-known "twelve-step" program of self-help for alcoholics who wish to abstain from drinking alcohol. Founded in 1935 and based on a religious movement of the time, members are expected to follow the Twelve Steps of Alcoholics Anonymous.
Al-anon seeks to help families and friends of alcoholics recover from the effects of living with alcohol abuse. Alateen is the recovery program for young people sponsored by Al-anon members. Both Al-anon and Alateen are adapted from Alcoholics Anonymous and are based on the Twelve Steps.
Rational Recovery is an alternative to the spiritual nature of AA as well as its view that alcoholics are powerless and must submit to God's will in order to recover. Rational Recovery stresses the innate power and strength of individuals themselves to overcome obstacles such as alcohol abuse. It rejects the AA belief that "once an alcoholic, always an alcoholic." Rational Recovery teaches people how to become independent of both alcohol addiction and of organizations dealing with alcohol abuse.
Secular Organizations For Sobriety (SOS), also known as Save Our Selves, stresses the need to place the highest priority on sobriety and uses mutual support to assist members in achieving this goal. The Suggested Guidelines for Sobriety emphasize rational decision-making and are not religious or spiritual in nature.
Self-Management and Recovery Training (SMART Recovery) views alcohol dependence as a bad habit and attempts to use common sense techniques to break the habit.
Women for Sobriety mutual support groups work to enhance the self-esteem of members. Women for Sobriety groups are non-religious and the meetings also differ from those of AA in that they prohibit the use of tobacco, caffeine and sugar.
Bibliography on Alcohol Abuse
- (note: listing does not imply endorsement)
- Aquarius Health Care Media. Alcohol Abuse in Teens. DVD video. Sherborn, MA: Aquarius Health Care Media, 2006.
- Babor, T. F. and Caetano, R. The trouble with alcohol abuse: What are we trying to measure, diagnose, count and prevent? Addiction, 2008, 103(7), 1057-105
- Carlson, Jon and Miller, William R. Drug and Alcohol Abuse. DVD video. Washington, DC: American Psychological Association, 2002.
- Donnellan, Craig. Alcohol Abuse. Cambridge, England: Independence, 2001.
- Goolsby, Erica. Adolescent Alcohol Abuse. Thesis. Carbondale, IL: Southern Illinois University, 2006.
- Hampton, Tracy. Alcohol abuse disorders. JAMA, 2006, 295(4), 2839.
- Johnson, K., et al. Mobilizing church communities to prevent alcohol and drug abuse: A model strategy and its evaluation. Journal of Community Practice, 2000, 25(11), 50-56.
- Lankford, Ronald D. Alcohol Abuse. Detroit, MT: Greenhaven, 2007. (High school readership)
- Marcovitz, Hal. Drug & Alcohol Abuse. Philadelphia. PA: Mason Crest, 2007.(Juvenile readership)
- National Institute on Alcohol Abuse and Alcoholism. Frequently Asked Questions about Alcoholism and Alcohol Abuse. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism, 2001.
- Olson, Steve and Gerstein Dean R. Alcohol in America: Taking Action to Prevent Abuse. Washington, DC: National Academy Press, 1995.
- Park, Jaehong. Korean American Adolescents' Alcohol Abuse. Thesis. Michigan State University, 2008.
- Ringold, Sarah, et al. Alcohol abuse and alcoholism. JAMA, 2006, 295(17), 2100.
- Shoultz, J., et al. Culturally appropriate guidelines for alcohol and drug abuse prevention. The Nurse Practitioner, 2001, 36(13), 1959-1971.
- Veranic, Lea and Pregel, Peter. Alcohol abuse and suicidal behaviour. Psychiatria Danubina, 2008, 20(2), 236-238. (English)
- Winger, Gail, et al. A Handbook on Drug and Alcohol Abuse: The Biomedical Aspects. NY: Oxford University Press, 2004.
- Yoshida, Rin. Trends in Alcohol Abuse and Alcoholism Research. NY: Nova Science, 2007.
- 1. Seldes, George
(compiler). The Great Quotations. New York: Lyle Stuart,
1960, p. 106.
Salvation Army General Evangeline Booth summarized this belief in a poem:
Drink has drained more blood,
Hung more crepe,
Sold more houses,
Plunged more people into bankruptcy,
Armed more villains,
Slain more children,
Snapped more wedding rings.
Defiled more innocence,
Blinded more eyes,
Twisted more limbs,
Dethroned more reason,
Wrecked more manhood,
Dishonored more womanhood,
Broken more hearts,
Blasted more lives,
Driven more to suicide, and
Dug more graves than any other poisoned scourge that ever swept its
waves across the world.
- 2. Anti-Saloon League of America. Anti-Saloon League of America Yearbook. Westerville, Ohio: American Issue Press, 1920, p. 28. Cited by Mulford, Harold A. Alcohol and Alcoholism in Iowa, 1965. Iowa City, IA: University of Iowa, 1965, p. 9.
- 3. Campus Report. A pox on mouthwash. Campus Report, 1995 (April), 10, p. 2.
- 4. Ibid; for a similar example of zero tolerance, see Brooke, James. School spreads alcohol policy to wine sips in Paris. New York Times, May 31, 1998, p. NE12.
- 5. Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2011). Monitoring the Future National Survey Results on Drug Use, 1975–2010: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan. Table 4-1a.
- 6. Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2011). Monitoring the Future National Survey Results on Drug Use, 1975–2010: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan. Table 4-1b.
- 7. Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2011). Monitoring the Future National Survey Results on Drug Use, 1975–2010: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan. Table 4-1c.
- 8. Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2011). Monitoring the Future National Survey Results on Drug Use, 1975–2010: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan. Table 4-1d.
- 9. Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2011). Monitoring the Future National Survey Results on Drug Use, 1975–2010: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan. Table 4-1d.
- 10a. Office of Applied Studies. Results from the 2006 National Survey on Drug Use and Health: National Findings. Rockville, MD: Department of Health and Human Services, Suibstance Abuse and Mental Health Services Administration, 2007. NSDUH Series H-32, DHHS Publication No. SMA 07-4293.
- 10b. Higher Education Research Institute. The American Freshman: National Norms for Fall 2006. Los Angeles, CA: Higher Education Research Institute, 2007.
- 11. Williams, G. D., Stinson, F. S., Stewzrt, S. L., and Dufour, M. C. Apparent Per Capita Alcohol Consumption: National, State, and Regional Trends, 1977-92. Surveillance Report No. 35. Rockville, MD: National Institute of Alcohol Abuse and Alcoholism, Division of Biometry and Epidemiology, Alcohol Epidemiology Data System, 1995. Midanik, L. T., and Clark, W. B. Demographic distribution of US drinking patterns in 1990: Description and trends from 1984. American Journal of Public Health, 1994, 84 (8), 1218-1222.
- 15. Drinking in pregnancy permissible. AIM, 1997, 6(1), 13. For additional information, contact Administration Department, The Royal College of Obstetricians and Gynaecologists, 275 Sussex Place, London, NW1 4RG, UK.
- 16. Stratton, Kathleen, Howe, Cynthia, and Battaglia, Frederick (eds.) Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: National Academy Press, 1996.
- 17. Fallon, Harold J., and Lesesne, Henry R. Medical Complications of Excessive Drinking. In: Ewing, John A., and Rouse, Beatrice A. (eds.) Drinking: Alcohol in American Society - Issues and Current Research, Chicago, Illinois: Nelson-Hall, 1978, Pp. 63-69, p. 67.
- 18. U. S. Department of Health and Human Services. Ninth Special Report to the U. S. Congress on Alcohol and Health from the Secretary of Health and Human Services. Washington: U. S. Department of Health and Human Services, 1997, p. 11.
- 19. DeBakey, Stinson, F. S., Grant, B. F., and Dufour, M. C. Liver Cirrhosis Mortality in the United States, 1970-1992. Surveillance Report No. 37. Rockville, MD: National Institute on Alcohol Abuse and Alcoholism, Division of Biometry and Epidemiology, Alcohol Epidemiology Data System, 1995.
- 20. Table 2. 2005 Traffic Safety Facts Annual Report. Washington, DC: NHTSA, 2007. DOT-HS-810-631.
- 21. Table 2. 2005 Traffic Safety Facts Annual Report. Washington, DC: NHTSA, 2007. DOT-HS-810-631.
- 22. 2005 Traffic Safety Facts Annual Report. Washington, DC: NHTSA, 2007. DOT-HS-810-631
- 23. Subramanian, R. Summary. Alcohol-Related Fatalities and Fatality Rates by State, 2004-2005. Washington, DC: NHTSA, 2006. DOT HS 810 686.
- 24. Table 13. 2005 Traffic Safety Facts Annual Report. Washington, DC: NHTSA, 2007. DOT HS 810 631.
filed under: Alcohol Abuse