By David Sack, M.D. on Psych Central, March 4, 2015

If a person knew nothing about alcohol and turned to YouTube for enlightenment, this is what they’d likely come away with: Drinking is something young and attractive people do, it has little long-term downside beyond a hangover, and it’s hilarious.

That’s the conclusion of a University of Pittsburgh study that examined how alcohol is portrayed on the 70 most popular YouTube videos that depict intoxication. These 70 just scratch the surface of the (literally) millions of such YouTube offerings, which include everything from drinking competitions, to “funny drunk people” compilations, to drunk cooking shows, to wasted bloggers and much, much more.

Of the videos analyzed, the team found that:

• Intoxication videos are hugely popular and tend to earn many more likes than dislikes, particularly if attractive people are shown.
• Hard liquor is shown more than beer or wine, and nearly half the videos involve a brand name reference (but researchers did not determine if any alcohol manufacturers had a hand in creating the videos).
• Most of the videos show active intoxication, but only 7 percent include any reference to alcohol dependence.

Humor and drinking are linked in 79 percent of the videos, and driving is present in 24 percent.

These 70 videos alone had a combined third of a billion viewers, and that’s worrisome. We know from previous studies that portrayals of alcohol in other media, such as movies, ads and social media, have been linked to increased drinking by the young. What messages are these videos sending to those who may be at their most impressionable?

I see a whole other side of alcohol consumption in my work in the addiction field, so allow me to be the buzzkill and go beyond the hilarity seen on YouTube. Here’s what’s viewers don’t see:

Dependence. For many, drinking starts as something you do with friends but leads to something you do alone. Approximately 17 million adults have an alcohol use disorder, according to statistics from the National Institute on Alcohol Abuse and Alcoholism. For those ages 12-17, the number stands at 855,000.

Health problems. The excessive drinking glorified on YouTube can lead to liver disease and has been linked to several types of cancer, including mouth, breast, esophagus, larynx and liver. Drinking in the teen years can damage normal brain development and boost the risk of becoming addicted. And that’s only the long-term health risks. Drinking too much too fast, even a first-time episode, can lead to alcohol poisoning. The Centers for Disease Control and Prevention reports that six people die of alcohol poisoning each day.

Victimization. Being intoxicated or around those who are intoxicated sends the risk of sexual assault soaring. Researchers estimate that, each year, close to 700,000 college-age students are assaulted by someone who has been drinking, and that close to 100,000 will report alcohol-related date rape or sexual assault.

The consequences of risk-taking. Alcohol can make even the most stupid actions seem like a great idea – driving under the influence, unsafe sex, other drug use. And then there’s the more cinematic risk-taking that YouTube loves, such as sliding down a flight of stairs in a plastic box or doing a somersault off the hood of a car. YouTube provides a seemingly endless supply of videos where alcohol-induced risk is celebrated – the crazier, the better. What isn’t shown is the morning after or the trip to the emergency room.

Death. The inability of a drinker to walk a straight line is played for laughs in YouTube videos, but it’s this alcohol-induced loss of coordination that’s a main contributor to injury deaths – and injury deaths, in turn, are the main cause of death for those under 21. For college-age students, those 18-24, alcohol-related unintentional injuries, including motor-vehicle crashes, kill an estimated 1,825 each year.

Fighting Videos With Videos

The research team concluded their study by encouraging health organizations to provide a counterbalance to the YouTube videos by creating videos of their own – ones that link excessive drinking with the real consequences, rather than with pretty people having a good time. Such videos do already exist – check out “100 Reasons to Get Sober” – but many more are needed. True-to-life drinking videos may not earn as many “thumbs up” from the YouTube crowd, but they may well save some lives.

David Sack, MD, is board certified in psychiatry, addiction psychiatry and addiction medicine. He is CEO of Elements Behavioral Health, a network that includes alcohol rehabilitation programs at The Right Step in Texas, Brightwater Landing in Pennsylvania and The Recovery Place in Florida.