Excessive alcohol consumption, which is responsible for 88,000 deaths annually in the US, is commonly assumed to occur in people who are alcohol-dependent. However, of these deaths only 3,700 were due to alcohol dependence. A study published yesterday found that in 9 out 10 cases, adults who drink too much alcohol are not alcoholics or alcohol-dependent.
Excessive drinking includes having multiple alcoholic drinks on one occasion (binge drinking: four drinks for women, five for men); high weekly alcohol intake (≥8 drinks a week for women, ≥15 drinks a week for men); alcohol use by pregnant women; alcohol use before the minimum legal drinking age of 21 years.
Whereas excessive drinking can be a one-off or infrequent occurrence for an individual, alcohol dependence is a chronic medical condition. It typically presents as routine excessive drinking, a strong craving for alcohol, continued alcohol use despite repeated problems, and an inability to control alcohol consumption.
Deaths from excessive alcohol use arise from conditions caused by drinking too much over time, such as breast cancer, liver disease, and heart disease; and from consequences of drinking too much in a short period of time, such as violence, alcohol poisoning, and motor vehicle crashes.
The study analyzed data from 138,100 US adults aged ≥18 years who participated in the National Survey on Drug Use and Health in 2009, 2010, or 2011. The survey includes a wide range of questions on substance use, including current drinking, binge drinking, average alcohol consumption, and symptoms of alcohol dependence.
The results showed that 1 in 3 adults drank excessively, with most of them binge drinking on multiple occasions. Alcohol dependence had developed in about 1 in 30 adults and was most common among those drinking greater quantities of alcohol. It affected 10% of binge drinkers, and 30% of regular (≥10 times a month) binge drinkers.
Dr Robert Brewer, Alcohol Program Lead at CDC, commented that the study:
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.
Several evidence-based strategies to reduce excessive drinking have been proposed, including increasing alcohol taxes, regulating the number of alcohol retail outlets, and holding alcohol retailers liable for harms resulting from illegal sales to minors or intoxicated patrons. Screening and counseling for excessive drinking is recommended for all adult patients.