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The Enormous Scope of Our National Drinking Problem

A large new study suggests we're in denial regarding this important health issue.
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(Photo: Rawle C. Jackman/Flickr)

(Photo: Rawle C. Jackman/Flickr)

Nearly three out of 10 Americans have shown evidence of a serious alcohol-related problem at some point in their lives, and only one-fifth of those have sought professional help.

Those sobering statistics are found in a study just published in the journal JAMA Psychiatry. It’s the first comprehensive look at the widespread problem of Alcohol Use Disorder, as newly defined by the American Psychiatric Association.

Due to changing criteria, and past studies showing differing results, trends regarding alcohol-related problems are difficult to definitively discern. But just on their own, the latest numbers are staggering.

"Emerging adulthood is becoming an increasingly vulnerable period for Alcohol Use Disorder onset. (The results) suggest an urgent need to develop and implement more effective prevention and intervention efforts."

Based on their behavior over the previous year, nearly 14 percent of Americans fit the new definition of Alcohol Use Disorder, which integrates two previously separate categories, “alcohol abuse” and “alcohol dependence.”

Taking into account their entire lives, that figure increases to 29.1 percent.

What’s more, the problem—if it is even recognized as such—goes untreated in a huge majority of cases. Only 7.7 percent whose 12-month record points to Alcohol Use Disorder sought help for their problem, as did only 19.8 percent of those who have met the criteria at some point in their lives.

The results highlight “the urgency of educating the public and policymakers about Alcohol Use Disorder and its treatments, destigmatizing the disorder, and encouraging (those who cannot stop drinking on their own) to seek treatment,” writes a research team led by Bridget Grant of the National Institute on Alcohol Abuse and Alcoholism.

The data came from face-to-face interviews with 36,309 adult Americans as part of the third National Epidemiologic Survey on Alcohol and Related Conditions, conducted between April 2012 and June 2013. They were asked a series of questions based on guidelines laid out in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (the DSM-5).

The manual lists 11 criteria, and asserts that anyone meeting two or more of them during the previous 12 months qualifies for the diagnosis of Alcohol Use Disorder. These include feeling an intense craving for alcohol; discovering that your drinking interfered with important facets of your life, such as your job or taking care of your family; finding yourself in situations where you engaged in dangerous activities while drunk, such as driving or having unsafe sex; or realizing that you wanted to stop or cut down your drinking, but couldn’t.

Meeting two or three criteria qualify one as suffering from a “mild” disorder, with four or five indicating “moderate,” and six or more “severe.” A “lifetime” diagnosis of Alcohol Use Disorder is given to anyone who has met at least two of the 11 criteria in the course of any year-long period.

The researchers found Alcohol Use Disorder was “generally highest for men (17.6 percent meeting the criteria over the past year, 36 percent lifetime), whites (14 percent and 32.6 percent, respectively) and Native Americans (19.2 percent and 43.4 percent, respectively)."

“Especially striking,” they write, is the fact that among 18- to 29-year-olds, 7.1 percent suffered from severe Alcohol Use Disorder over the past year (meeting at least six of the11 criteria). “This rate is consistent with ... increasing rates of heavy drinking in this age group.”

"Emerging adulthood is becoming an increasingly vulnerable period for Alcohol Use Disorder onset," the researchers conclude. "(The results) suggest an urgent need to develop and implement more effective prevention and intervention efforts."

A good start would be finding ways of getting people to admit they have a problem, and convincing them there is no shame in asking for help.

Findings is a daily column by Pacific Standard staff writer Tom Jacobs, who scours the psychological-research journals to discover new insights into human behavior, ranging from the origins of our political beliefs to the cultivation of creativity.