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Only 1 in 10 heavy drinkers in U.S. are alcoholics, CDC study finds

REUTERS/Michael Dalder
People who drink excessively but are not alcohol dependent benefit more from policies that reduce people’s access to alcohol, such as raising the tax on alcohol.

Nearly a third of American adults drink excessive amounts of alcohol, but only 10 percent of them are alcoholics, according to a study published late last week by the Centers for Disease Control and Prevention (CDC).

That’s a surprising finding. For the prevailing assumption has been that most people who drink excessively are alcohol dependent.

Signs of alcohol dependency — or alcoholism — include not being able to cut down or stop drinking, continuing to drink even after it causes problems with family or work, and long stretches of time spent drinking each day.

The new CDC finding also has important public-health implications, for it suggests that most excessive drinkers don’t need to be treated for addiction.

People who drink excessively but are not alcohol dependent benefit more, say the CDC researchers, from policies that reduce people’s access to alcohol, such as raising the tax on alcohol, restricting the days and hours during which alcohol can be sold, and holding bars, restaurants and other businesses civilly liable for damages caused by intoxicated patrons.

“This study shows that, contrary to popular opinion, most people who drink too much are not alcohol dependent or alcoholics,” said study co-author Dr. Robert Brewer, who heads the CDC’s alcohol program, in a press statement released with the study. “It also emphasizes the importance of taking a comprehensive approach to reducing excessive drinking that includes evidence-based community strategies, screening and counseling in healthcare settings, and high-quality substance abuse treatment for those who need it.” 

A high cost

The study’s finding does not mean that America’s alcohol problem is any less serious just because most excessive drinkers are not alcoholics. Nor does it mean that individuals who are heavy drinkers aren’t putting their health — and their lives — at risk.

Excessive alcohol  — defined by health officials as having eight or more drinks a week for women or 15 or more drinks a week for men — kills about 88,000 Americans each year, making it a leading cause of premature deaths in the United States. Alcoholic-related causes of death include car crashes, falls and violence, as well as dozens of illnesses, such as liver disease, heart disease and breast cancer.

Half of these deaths are caused by binge drinking, which is defined for women as having four or more drinks and for men as having five or more drinks during a single occasion. Most excessive drinkers are binge drinkers, the CDC study found.

The CDC study notes that excessive drinking is estimated to cost the U.S. economy $223.5 billion in 2006 (the last year for which such an estimate was done). That comes out to about $1.91 per drink. Those economic losses were in workplace productivity, health-care expenses, criminal justice expenses and other costs related to the consequences of alcohol-related behavior (such as property damage).

FYI: Minnesota’s costs were slightly lower than the national average in 2006: $1.65 per drink, or $687 per person. The state’s economic losses related to excessive alcohol consumption that year totalled $3.5 billion.

Other findings

Data for the new CDC study came from 138,100 adults who took part in the National Survey on Drug Use and Health between 2009 and 2011. Here are some of the study’s additional findings:

  • Excessive drinking, binge drinking and alcohol dependence was highest among men, people between the ages of 18 and 24, and those who were unemployed.
  • Among racial and ethnic groups, the highest levels of binge drinking were found among Native Hawaiians/Pacific Islanders (31.8 percent) and non-Hispanic whites (28.6 percent), although the CDC researchers say most differences among such groups were not statistically significant.
  • Binge drinking was significantly higher among people with some college education (30.1 percent) than among those with less education.
  • Binge drinking was significantly higher among people with a family income of $75,000 or more than among lower income groups, while alcohol dependency was significantly higher among those with a family income of $25,000 or less.

The study was published in the CDC journal Preventing Chronic Disease, and can be read in full at the CDC website.

Comments (7)

  1. Submitted by Paul Udstrand on 11/24/2014 - 09:48 am.

    This is very bad news…

    For the addiction and recovery industry.

    However these finding also blow a very necessary hole in a core belief of addiction that the substances being used are “addictive”. This assumption has become more and more controversial in the psychiatric and psychological community over the last couple of decades. The old definitions of “addiction” were largely un-researched declarations from a recovery movement that promoted a model of powerlessness. One had to accept the notion that the substance, not the user, had the power. That model is breaking down in the light of research and observation.

    This doesn’t mean that addiction doesn’t exist, or that some substances aren’t more addictive than others, but it does mean that the substances themselves don’t necessarily create addicts.

  2. Submitted by Tom van der Linden on 11/24/2014 - 10:39 am.

    Excessive drinking definition

    Susan, I would like to see a “second opinion” from the medical community on the CDC’s definition of excessive drinking. While 15 drinks a week is more than I can handle these days, I know a number of senior citizens who lived, or are still living, into their late 80’s, who enjoyed two drinks a day. (Several of them are women). The excessive drinking definition seems arbitrary to me, and while it perhaps makes sense from a public health point of view, I’m not sure it makes sense from a research point of view.

  3. Submitted by Jonathan Ecklund on 11/24/2014 - 12:44 pm.

    The “public health” point-of-view is entirely based on research. Public health decisions are made based on validated research, not on whims or dictionary definitions, so whether or not it seems arbitrary, (when I first learned about the definition of excessive drinking 4-5 years ago, I was similarly skeptical) it’s based on a lot of peer-reviewed research.

    Alcohol is a particularly pernicious drug, one that is entirely socially acceptable and therefore ripe for abuse and overuse. Public health researchers have been working on alcohol policy for a very long time.

    I know a lot of people who, by this definition, drink excessively but couldn’t be called alcoholics. Indeed, Binge drinking, heavy drinking, and excessive drinking are all different categories under alcohol use, but each has been recognized as a public health threat for at least 100 years. Prohibition happened for a reason…

  4. Submitted by Bill Schletzer on 11/24/2014 - 01:18 pm.

    Just keep changing the definition until you get the results…

    …you want. “Everybody” knows somebody who drinks daily and doesn’t seem to have a problem. Doesn’t matter what you call them. My dad drank several drinks every day of his life for decades. Fortunately for him he married a woman with the same drinking habits. He was a daily smoker too. I know for my own sake that these habits were responsible for my mom (not his wife) outliving him by 15 years.

    As Paul above says, “The old definitions of “addiction” were largely un-researched declarations from a recovery movement that promoted a model of powerlessness.” That is true, Paul, but if you haven’t been there you have no perspective to judge. AA has saved millions of lives and everyone that wants to mock it’s “unscientific” beliefs is free to do so. Just remember that model came from the drunks working for free, not from the “recovery industry”; it didn’t start as a profit making model. While everyone who is busy ripping down that model I wait to see an equally effective model. I think you will find that the “shame, shame, shame, just stop it!” model doesn’t really work.

  5. Submitted by Tom van der Linden on 11/24/2014 - 05:08 pm.

    Public health sometimes diverges from research

    Public health is “based on” research, but that doesn’t mean public health campaigns are always optimal. A “campaign” is, by definition, not research. It is an effort to change human behavior.
    Consider the public health campaign to have all women over 40 submit to an annual mammogram. Thanks to more research, and a better understanding of statistical risk, that recommendation is now being changed. Thanks to a overzealous public health campaign, clinics overtreated, and unnecessarily frightened, many women.
    A similar thing occurred with men and PSA tests. Once recommended – “based on research” – now not so.
    The Mayo Clinic defines moderate alcohol consumption as one drink a day for a woman. The public health definition in Susan’s article describes 8 drinks a week for a woman as “excessive” alcohol consumption. One drink a week tips a woman from a “healthy” behavior to an “excessive” behavior. This is what appears arbitrary to me.
    Then, the public health study “Surprises!” health experts when it concludes that the vast majority (90%) of people drinking near the healthful level were not alcoholics. Duh…
    Most doctors agree that excessive drinking is not healthful. But, public health folks should be cautious when launching campaigns that declare millions of Americans as “excessive” drinkers. Such a campaign will surely fail – just as prohibition failed.

    • Submitted by Jonathan Ecklund on 11/25/2014 - 03:16 pm.

      Public vs Private

      You need to dig deeper. The PSA tests you are talking about were advertised by drug companies that developed ans sold the test… and pushed for greater adoption of them. So, it’s a private entity with a profit-motive using public-health language in pushing a test on people who may not have needed it so they could earn money… and PSA tests account for around 30 billion a year in health-care costs.

      Basically, the PSA test example you give doesn’t hold water, as it’s not a public health initiative. I would guess the mammogram thing fits in that category too.

  6. Submitted by Pavel Yankovic on 11/25/2014 - 05:12 am.

    Everyone has…

    their own definition of moderate alcohol consumption and it just happens to be the amount of alcohol that they personally consume.

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