Alcoholics Aren’t the Only Ones with Drinking Problems

Tuesday, November 23rd, 2010

Last week, the NY Daily News published a startling article, “Alcohol-related Emergency Room Visits Skyrocket in New York: 74,000 in 2009.” The scariest part? People who end up in the emergency room because of binge drinking are not normally “alcoholics,” declares Health Commissioner Thomas Farley. Alcohol use poses major problems, even for those without diagnosable alcohol dependence or addiction.

Although 25 million Americans meet criteria for substance abuse or dependence, a whopping 68 million are classified as “harmful drinkers” (those who consume five or more drinks in a sitting). The damage done by this group may be less well-publicized than the damage done by those with full-fledged addiction, but binge drinkers still accrue significant costs and cause harm to themselves, their families, and their communities.

Who are these “harmful drinkers”? They are our friends, family members, colleagues and neighbors—those whose alcohol use has a considerable negative impact on their lives, but who may not yet be dependent on alcohol. This group of drinkers frequently misses work or family dinners due to their heavy drinking, yet they are unprepared to recognize their problem because they still have functioning families lives and jobs.

The costs of their behavior are significant: healthcare costs for “harmful drinkers” are eight times the national average; costs for their non-drinking family members are 5 times the national average. In addition, treatment of chronic medical conditions (diabetes, asthma, hypertension, etc.) is often less effective due to alcohol use, which further augments those costs. Finally, if a heavy drinker is 55 years old, like the transit worker mentioned in the NY Daily News article, it is likely they have been drinking heavily since their 20s—accruing these social, work-related and healthcare costs for over three decades.

“Functional” binge-drinking habits usually emerge in adolescence, within the alcohol-heavy culture of college: 40 percent of college students report being drunk at least once in the past 30 days. According to the SAMHSA 2009 National Survey on Drug Use and Health, 42% of young people between 18 and 25 engaged in binge drinking—and if you’re not addicted to alcohol by age 21, you’re unlikely to become addicted later on. Nevertheless, harmful drinking doesn’t often end with the onset of adulthood; it is a serious problem with the potential to continue indefinitely and to worsen.

Fortunately, there is hope for the future. Healthcare reform, new FDA-approved medications and brief, effective psychosocial interventions will alter what we have to offer for the “problem drinker” population—and these methods won’t necessarily require a “you can never drink again” attitude. In the future, the majority of substance abuse treatment and prevention services will be covered by health insurance, which is expected to triple the number of people receiving substance abuse services nationally.

So take a closer look at your own drinking habits, and the habits of those close to you. How much do those weekend parties affect your Monday mornings? What was the real reason behind that missed recital, ball game, or parent-teacher conference? If alcohol use has a negative effect on someone’s life, it’s time for that person to make a change. You don’t have to be at the end of your rope in order to get help.

Deni Carise, Ph.D.
Chief Clinical Officer
Phoenix House

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  • Awesome post! It’s amazing how there are so many labels given to alcohol abuse ie: “problem drinker” or “harmful drinker” to me it’s like saying you have “annoying cancer” or “problem cancer”. I feel the real statistic is 93% alcohol abusers, not broken into harmful etc. I hope we don’t put to much emphasis on the new magic pill to dealwith it, but education through counseling.

  • It is refreshing to see the discussion expand beyond treating just those with a diagnosable substance use disorder (in this case, alcohol abuse or dependence) to include those who may need to address their harmful drinking. Dr. Carise correctly points to college students as a group of people whose use of this drug, alcohol, may put them at risk, without meeting diagnostic criteria for abuse or dependence. It seems to me that it makes good sense for us as a society to find ways to help people address and change harmful behaviors–without getting quite so caught up in labeling or “diagnosing” them per se. Let’s hope this discussion continues….Thanks, Kevin Doyle, Ed.D., LPC, LSATP (in the interest of full disclosure, a new colleague of Dr. Carise’s at Phoenix House’s latest affiliate, Phoenix Houses of the Mid-Atlantic, formerly Vanguard Services Unlimited)