Alcohol in America

Education, Prevention and Regulation

Alcohol is by far the most used drug in this country, with a staggering 138 million Americans reporting current use in the 2015 National Survey on Drug Use and Health (NSDUH). Of those 138 million, almost 67 million Americans reported binge drinking in the previous month and 17 million reported heavy alcohol use (five or more binge episodes in the previous month).

Alcohol is also our deadliest drug. According to the Centers for Disease Control and Prevention (CDC), alcohol kills 88,000 people a year in the United States—making it the fourth-leading cause of preventable death—and is behind one-third of auto fatalities. Alcohol is also involved in more homicides than all other drugs combined, and is especially common in sexual assault and intimate-partner violence.

In addition, a recent analysis of national data showed there are nearly 4 million alcohol-related emergency department visits per year in the United States—a significant increase since 2001. And such visits are increasing at a faster rate than overall emergency department visits, placing a huge burden on our already stressed health care system.

Excessive alcohol use costs our country a $250 billion dollars per year in lost productivity and medical and public safety expenses. It greatly increases the risk of cancers of the mouth, esophagus, pharynx, larynx, liver and breast; is a causal factor in more than 200 other disease and injury conditions; and causes fully one-quarter of all deaths in the 20–39 age range.

Unfortunately, alcohol is ubiquitous in American culture, celebrated more than discouraged. We agree with the CDC that to address excessive drinking, we must address the culture by creating policies, communities and environments that discourage drinking more and promote it less. We feel the policies and practices that have reduced tobacco use by more than 50 percent in the past 50 years offer some guidance on effective approaches.

Specifically, the Hazelden Betty Ford Foundation endorses:

• Alcohol tax increases, which discourage use by raising prices and which provide government dollars that can be used to fund alcohol prevention, treatment and recovery resources
• Regulation of alcohol advertising to limit its reach and to ban it on some mediums
• Bans on alcohol sales and use in some public places, and applause for retailers who voluntarily decide to stop selling alcohol (as pharmacy CVS did with tobacco in 2014)
• Opposition to the approval of new products such as powdered alcohol known as “palcohol”
• Regulation of alcohol outlet density to prevent the concentration of bars and liquor stores in some areas, and opposition to attempts to repeal government control of retail alcohol sales
• Laws that hold alcohol retailers liable for harms caused by illegal service to intoxicated or underage customers
• Initiation or increase of compliance checks at bars, restaurants and liquor stores for laws prohibiting the sale of alcohol to minors
• Maintenance of existing limits on the days and hours that alcohol can legally be sold or served
• Mass media campaigns that encourage drinkers to quit, similar to the CDC’s 2012 anti-smoking campaign, which cost $48 million but persuaded 100,000 people to quit smoking—just $480 for each smoker who quit and $393 per year of life saved
• More routine alcohol abuse screening and counseling interventions in primary care settings