U.S. research offers sobering look at lethal damage caused by alcohol

The liquor cabinets, beer coolers and wine cellars in our homes harbor one of the most pernicious substances  in U.S. households, a leading (but often overlooked) cause of preventable death and debilitation: Yes, alcohol itself. Federal officials estimate that 1 in 8 deaths of Americans ages 20 to 64 results from injuries or illnesses tied to excessive drinking.

And if you look only at the prime ages of 20 to 49, the booze toll is tied to 1 in 5 U.S. deaths, according to a study newly published on the medical JAMA Network.

The study’s authors, researchers with the federal Centers for Disease Control and Prevention, said their startling data likely underestimate of alcohol’s huge economic and health harms on U.S. lives, the New York Times reported, noting:

 “’This is really affecting adults in the prime of their life,’ said Marissa Esser, who leads the CDC’s alcohol program and was a co-author of the study. She said the large share of people dying in their working years meant excess drinking had an outsize effect on economic productivity.”

The study differed from others previously done, as CNN reported:

“Researchers took national and state mortality data from 2015 to 2019 and looked at deaths either fully or partially attributable to excessive drinking. Those causes of death included vehicle accidents, alcohol poisoning, and other health impacts, such as liver disease, Esser said. The data showed that the deaths fully attributable to alcohol have risen in the past decade, Esser added. ‘I’m not surprised at the numbers,’ said David Jernigan, a professor of health law, policy, and management at Boston University. ‘This is a conservative estimate.’ Jernigan was not involved in the study. Esser said there were deaths that alcohol likely contributed to that the study’s researchers could not include in their estimates. Some conditions may have had alcohol as a factor, but researchers were not able to verify for sure the role that drinking played. In other cases, they were not able to determine if someone who died of an illness used to drink excessively but then stopped, Esser added. And people often underreport how much they are drinking, Jernigan said. ‘It doesn’t get anywhere near the attention that it should,’ he said. ‘The bottom line is (researchers) continue to show that excessive alcohol use is a big problem in the US.’”

While researchers have found that alcohol consumption spiked during the coronavirus pandemic, excessive drinking was a problem before — and it continues to be, CNN reported:

The CDC defines moderate drinking as two drinks or less in a day for men or one drink or less in a day for women. Two-thirds of adults report drinking more than moderate amounts at least once a month, the organization added. The CDC also estimates that 1 in 6 adults binge drink — defined as consuming four or more drinks on an occasion for a woman or five or more drinks on an occasion for a man — with a quarter of those doing so at least weekly.”

Even with repeated studies showing alcohol as a menace, and an increasing problem, this substance’s abuse too often gets overlooked, partly because drinking has become ingrained in too many people’s lives, the New York Times reported:

“Alcohol is a leading cause of preventable death in the United States, but it is often overshadowed by tobacco or opiates. And its effects on Americans’ health have been growing. Nearly a decade ago, a similar study found 1 in 10 deaths of working-age people was due to drinking, although researchers have changed the methodology, so a perfect apples-to-apples comparison is not possible. Katherine Keyes, a professor of epidemiology at Columbia University who was not involved in the latest study, said it painted a stark picture of the problem. ‘Where the science needs to go,’ she said, ‘is what do we do about it?’”

The CDC researchers offered quick suggestions to deal with the nation’s excess drinking, concluding their published study, thusly:

“These premature deaths could be reduced through increased implementation of evidence-based alcohol policies (e.g., increasing alcohol taxes, regulating alcohol outlet density), and alcohol screening and brief intervention.”

CNN offered countermeasures, which drinkers could pay special attention to as the holiday season with its many boozy events rolls up:

“Reducing drinking can have a similar effect as dieting — the more you tell yourself you can’t have it, the more you want it, said Natalie Mokari, a registered [Charlotte. N.C.] dietitian nutritionist … She recommends starting with one less drink than you would usually have at each occasion or breaking a daily habit by limiting drinking to certain days. You can also have a sparkling water in between drinks or make weaker cocktails than usual to reduce your alcohol consumption, she said previously. And if you are overcoming a social pressure to drink, remember that people may make you feel bad because they are uncomfortable about their own relationship with drinking, said Annie Grace, author of ‘This Naked Mind: Control Alcohol’ in a prior article. It often helps to have a nonalcoholic drink in your hand at social events, so the offer to have a drink doesn’t even come up, said biological psychologist Aaron White, senior scientific adviser to the director of the National Institute on Alcohol Abuse and Alcoholism.

“Slow down your body’s alcohol intake by eating while drinking, alternate alcoholic and nonalcoholic drinks and planning alcohol-free days, Harvard Medical School in Boston suggests. A tool on the CDC website can help individuals evaluate their drinking and then come up with a plan to make healthier alcohol choices. If you need help or support immediately, the Substance Abuse and Mental Health Services Administration has a free, confidential National Helpline active 24/7/365 to provide information and treatment referrals to local treatment facilities, support groups and community-based organizations: 800-662-HELP (4357) and 800-487-4889 (TTY option).”

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them by dangerous drugs and other harmful substances like alcohol. Booze has been abused for centuries, and modern Americans may think that medical science knows all it needs to help problem drinkers.

The reality is different, as another new CDC study and earlier research affirms. Alcohol, long a significant health and mental health problem for men, has fast become a rising issue for women, too, particularly older women. Women, who typically weigh less than men, may put themselves at higher risk of harms because they may drink at the same levels but experience higher intoxication. Their excessive consumption also heightens the potential they will suffer from cardiovascular diseases, certain cancers, alcohol‐related liver disease, and acute liver failure.

Men, notably older men, face persistent problems with their alcohol consumption, which can prove even more detrimental to their health as they age. Alcohol abuse has become a big part of “deaths of despair,” in which older, less educated white men — believing their economic and social prospects are in sharp decline — engage in behaviors that damage their health and kill them.

Alcohol, of course, also takes a terrible toll on the nation’s roads, as the CDC separately has reported:

“Every day, 29 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver. This is one death every 50 minutes. The annual cost of alcohol-related crashes totals more than $44 billion. In 2016, 10,497 people died in alcohol-impaired driving crashes, accounting for 28% of all traffic-related deaths in the United States. Of the 1,233 traffic deaths among children ages 0 to 14 years in 2016, 214 (17%) involved an alcohol-impaired driver.”

While the nation battles the opioid overdose crisis, we also cannot ignore the mayhem that alcohol can cause. We’ve got a lot of work to do on excessive drinking, and it is good to know that AA can play an important role in helping those with alcohol problems.

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