Most people who drink to get drunk are not alcoholics, a new government report concludes, suggesting that more can be done to help heavy drinkers cut back.
The finding, from a government survey of 138,100 adults, counters the conventional wisdom that every "falling-down drunk" must be addicted to alcohol. Instead, the results from the National Survey on Drug Use and Health show that 9 of 10 people who drink too much are not addicts and can change their behavior with a little — or perhaps a lot of — prompting.
"Many people tend to equate excessive drinking with alcohol dependence," said Dr. Robert D. Brewer, who leads the alcohol program at the Centers for Disease Control and Prevention. "We need to think about other strategies to address these people who are drinking too much but who are not addicted to alcohol."
Excessive drinking is viewed as a major public health problem that results in 88,000 deaths a year, from causes that include not only alcohol poisoning and liver disease but also car crashes and other accidental deaths.
Excessive drinking is defined as drinking too much at one time or over the course of a week. For men, it is having five or more drinks in one sitting, or 15 or more drinks during a week. For women, it is four drinks on one occasion or eight drinks over the course of a week. Under-age drinkers and women who drink any amount while pregnant also fit the definition.
Surprisingly, about 29 percent of the population meets the definition for excessive drinking. But 90 percent of those people do not meet the definition of alcoholism — including impairment, past failed attempts to stop drinking and withdrawal symptoms. That means excessive drinking may be an easier problem to solve than previously believed.
Studies show that simply raising the price of an alcoholic beverage by 10 percent reduces consumption by 7 percent. Zoning laws that reduce the number of establishments that serve alcohol in a given area can also curb excessive drinking. Importantly, a simple intervention by a physician, talking to patients about their alcohol use, has also been shown to help people make better choices.
"I don’t want to minimize the fact that excessive drinking can be a difficult behavior to change even in those people who are not alcohol dependent," Brewer said. "So many of the cues people get about drinking behavior in our society are confusing. People think drinking to get drunk is part of having a good time."