Alcohol abuse a problem for one in every three Americans

According to the latest study on alcohol abuse, as many as one in three Americans abuse or become dependent on alcohol over the course of their lives, and most of them never receive treatment for the problem.

The survey by National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health, revealed that 17.8 percent of participants said they had abused alcohol at some point over the course of their lives and another 12.5 percent said they were dependent on it at some point.

At the time of the survey 4.7 percent said they had abused alcohol in the past year and 3.8 percent said they were alcohol-dependent in the previous 12 months but the researchers found that under a quarter, 24 percent, are ever treated for it.

Deborah Hasin of Columbia University Medical Center in New York and colleagues say based on their survey of 43,093 people, alcohol use disorders are a widespread and serious personal and public health problem in the United States.

The researchers found from the adults who were questioned in person in 2001 and 2002 that alcohol dependence was significantly more prevalent among men, whites, Native Americans, younger and unmarried adults and those with lower incomes.

They also say the duration of alcohol disorders was often chronic, with an average of nearly four years for alcohol dependence which caused ' significant disability'.

As a rule most abuse started in the early twenties and often led to car crashes, domestic violence, birth defects as well as the economic costs.

The researchers used the definition of alcohol abuse or dependence found in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition which includes having one or more of the following for a year: role impairment (failed work or home obligations), hazardous use (driving while intoxicated), and legal, social or interpersonal problems due to alcohol related to alcohol use.

Alcohol dependence is defined as having three or more of the following for a year:

• tolerance (increased drinking to achieve same effect),
• alcohol withdrawal signs or symptoms,
• drinking more than intended,
• unsuccessful attempts to cut down on use,
• excessive time lost related to alcohol (hangovers etc),
• impaired social or work activities due to alcohol and drinking despite physical or psychological consequences.

The researchers say alcohol abuse is associated with reduced social and role emotional functioning, whereas alcohol dependence is highly associated with mental disability in addition to social and role dysfunction.

The researchers say disability increases steadily with alcohol dependence severity and is greatest among those who do not receive treatment, while mental disability among persons with alcohol dependence is comparable to that among persons with drug abuse, mood, and personality disorders.

According to National Institute on Alcohol Abuse and Alcoholism Director Dr. Ting-Kai Li, M.D. on average a decade is lost before people seek treatment for alcohol abuse and intensive efforts are needed to educate professionals and the public about alcohol abuse.

The U.S. Centers for Disease Control and Prevention estimates that in 2001, 75,000 people died because of excessive alcohol use.

The survey is published in the Archives of General Psychiatry but for more information about NIH and its programs, visit www.nih.gov.