Noah Vinter
Alcohol abuse has been a pervasive issue in society, causing various health, social, and economic problems. The World Health Organization (WHO) estimated that there were 283 million people with alcohol use disorders worldwide as of 2016. The financial costs of alcohol misuse are staggering, with estimates ranging from 1-6% of a country's GDP. Alcohol abuse leads to detrimental health issues such as organ damage, cognitive deficits, mental health problems, and an increased risk of injuries and violence. To combat this issue, various treatment options are available, including medication, behavioral therapy, mutual-aid group counseling, and self-help groups. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides resources and support for those seeking help. The effectiveness of treatment varies, but long-term studies show that treatment works, and most patients are able to reduce their alcohol consumption or achieve abstinence. The terminology used to describe alcohol abuse and its treatment has evolved, with terms like alcohol use disorder and alcohol dependence favored over alcoholism due to its stigmatized connotations.
| Characteristics | Values |
|---|---|
| Term | Alcoholism |
| Definition | The continued drinking of alcohol despite it causing problems. Some definitions require evidence of dependence and withdrawal. |
| Synonyms | Alcohol abuse, alcohol dependence, alcohol addiction |
| Discouraged terminology | Alcoholism is considered stigmatizing and the World Health Organization (WHO) discouraged its use in 1979 due to its inexact meaning. |
| Preferred terminology | Alcohol use disorder, alcohol dependence syndrome |
| Prevalence | The WHO estimated there were 283 million people with alcohol use disorders worldwide as of 2016. |
| Policies to reduce harm | Increasing the legal drinking age, banning or restricting alcohol advertising, taxation, educational campaigns, guidelines for parents |
| Historical efforts | Temperance and Prohibition movements in the US, the Connecticut Society for the Promotion of Good Morals |
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What You'll Learn
Alcohol use disorder (AUD)
The World Health Organization (WHO) estimated that there were 283 million people with AUD worldwide in 2016. In the United States, it is estimated that 14.5 million to 16 million people suffer from AUD, with excessive alcohol use leading to over 95,000 deaths annually. AUD is more common in people with mental health conditions such as depression, post-traumatic stress disorder, and attention deficit hyperactivity disorder. Additionally, people with a history of childhood trauma are more vulnerable to developing AUD.
The diagnosis of AUD is based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. According to the American Psychiatric Association, a person may be diagnosed with AUD if they meet two or more of the 11 criteria within a one-year period. These criteria include consuming alcohol in greater quantities or for longer than intended, unsuccessful attempts to reduce alcohol use, and continued alcohol use despite the negative consequences on social and occupational functioning.
AUD treatment typically involves therapy, support groups, medication, and other activities. Evidence-based treatment approaches such as behavioural therapies, mutual-support groups, and medication have proven effective in helping individuals recover from AUD. It is important to note that the treatment approach may vary depending on the individual, and a combination of therapies may be necessary.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) offers resources and tools to help individuals find the right treatment for their specific needs. The NIAAA Alcohol Treatment Navigator provides a step-by-step process to finding qualified professionals and programs that offer evidence-based methods and address mental health issues associated with AUD.
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Alcohol abuse helplines
The Substance Abuse and Mental Health Services Administration (SAMHSA) runs a National Helpline for Mental Health, Drug, and Alcohol Issues. This service is free, confidential, and available 24/7, 365 days a year. It provides referrals to local treatment facilities, support groups, and community-based organizations. Individuals can call 1-800-662-HELP (4357) or text their zip code to 435748 (HELP4U) to access this service. SAMHSA also offers a booklet for families with answers to questions about substance abuse, its symptoms, treatment options, and recovery.
Other helplines include the DrugAbuse.com hotline, which has Addiction Navigators available 24/7 to answer questions related to drug abuse and offer support. The Al-Anon and Al-a-teen hotline (800-356-9996) provides support and resources to teens and adults affected by alcohol addiction. The National Suicide Prevention helpline (988) supports those in crisis and helps prevent suicide. Boys Town (1-800-448-3000) offers translation services in over 140 languages and provides a telecommunications device for the deaf (TDD) line for the speech and hearing impaired (1-800-448-1833).
If you or a loved one is struggling with alcohol abuse, these helplines are a great place to start. Advisors can provide guidance, support, and information on affordable treatment options.
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Treatment and recovery
Alcohol use disorder (AUD) is a medical condition characterised by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It is a common condition that can happen to anyone and is often influenced by genetics, family history, and mental health conditions. The first step to getting better is recognising that one has a problem.
AUD treatment can take many forms, including medication, therapy, and support groups. It is important to find a treatment approach that works best for the individual. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) Alcohol Treatment Navigator offers a three-step roadmap and a step-by-step process to finding a highly qualified professional treatment provider. The NIAAA also provides research-based information on drinking and its impact.
Medication
The U.S. Food & Drug Administration has approved naltrexone and acamprosate as AUD treatments. Topiramate and gabapentin can also decrease cravings in some people. Doctors can prescribe medications to address withdrawal symptoms and make the process safer and less distressing.
Therapy
Behavioural therapies can help individuals develop skills to avoid and overcome triggers, such as stress, that might lead to drinking. Therapy can also address underlying mental health issues that may be contributing to AUD.
Support Groups
Support groups, such as Alcoholics Anonymous (AA) and other 12-step programs, provide peer support for people quitting or cutting back on their drinking. Combined with treatment led by healthcare providers, mutual-support groups can offer valuable additional support. Studies show that most people with AUD recover, meaning they reduce how much they drink or stop drinking altogether. However, relapse is common, and setbacks are a normal part of the recovery journey.
Family and Friends
Support from friends and family members is important in overcoming AUD. Groups for family and friends, such as Alateen, can help them understand how to best provide support.
Costs
Cost is an important factor when selecting a treatment approach. Evaluating health insurance coverage and exploring sliding-scale fees or payment plans can help make treatment more affordable. SAMHSA's National Helpline also provides free, confidential referrals to local treatment facilities, support groups, and community-based organisations.
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Alcohol policies
One notable alcohol policy is the National Minimum Legal Drinking Age Act of 1984, which raised the legal drinking age from 18 to 21 across all states. This policy intervention has been associated with positive outcomes, including reduced traffic crash deaths, homicides, suicides, and unintentional injuries. Additionally, states have implemented policies to address new products attractive to youth, such as powdered alcohol, by either banning its sale or expanding the definition of alcohol in existing laws.
To further reduce alcohol-related harm, states and communities can employ various strategies. These include setting and enforcing limits on the number of alcohol outlets and their proximity, increasing taxes on alcohol, and restricting the days and hours when alcohol sales are permitted. Enhancing enforcement of laws prohibiting sales to minors is another critical aspect, with compliance checks and penalties for establishments found selling alcohol to underage individuals.
Alcohol-impaired driving policies are also essential. Ignition interlocks, for instance, prevent individuals with a blood alcohol content (BAC) above a certain threshold from operating a vehicle. As of 2013, 28 states had mandated ignition interlocks for individuals convicted of impaired driving, contributing to reduced re-arrest rates and alcohol-related crashes. Updating alcohol-impaired driving policies to address other forms of impairment, such as marijuana or prescription drug use, is also necessary.
Overall, alcohol policies play a crucial role in mitigating the negative consequences of alcohol consumption and fostering healthier communities. By implementing and enforcing these policies at the federal, state, and local levels, it is possible to effectively address alcohol abuse and improve public health and safety.
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Alcohol advertising
The intended audience for alcohol advertising campaigns has evolved over time. While some drinks, like beer, have traditionally been associated with male consumers, brands have increasingly targeted specific demographics, including non-drinkers and younger audiences. This shift has sparked concerns about the influence of alcohol advertising on youth consumption patterns and brain development. Studies have found a correlation between exposure to alcohol advertisements and underage drinking, with some research suggesting that alcohol ads contribute to binge drinking and negative health outcomes among adolescents.
To address these concerns, cities have taken action by banning alcohol advertisements on public transportation. Additionally, organizations like the Federal Trade Commission (FTC) have issued reports and recommendations to reduce underage exposure to alcohol advertising. These include suggestions for improved ad placement and content, such as prohibiting ads with substantial underage appeal and restricting promotional placement of alcohol products in media with mature themes.
Despite these efforts, the regulation of alcohol advertising remains complex due to the interplay between commercial free speech rights and public health concerns. The First Amendment limits the extent to which the government can restrict alcohol advertising, and self-regulation within the alcohol industry has been criticized for code violations. As a result, the ongoing debate surrounding alcohol advertising reflects the challenge of balancing commercial interests with the need to protect vulnerable populations from the potential harms associated with alcohol consumption.
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Frequently asked questions
Temperance.
The Temperance movement aimed to prevent alcohol problems and prohibit the sale of alcohol.
No, the Temperance movement is considered a "bad social policy" and a "ritual invocation of opponents of a variety of sumptuary laws".
