Using new definition in DSM-5, study finds 3 in 10 Americans have drinking problem sometime in their lives, June 3, 2015

AlcoholismNearly 30 percent of Americans have a problem with alcohol at some point in their lives, ranging from binge drinking to full-blown alcoholism, but less than 20 percent are ever treated, a new study found.

Alcohol use disorders are among the most common mental health problems worldwide and result in disability, illness and death, researchers from the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA) said.

“The problem of alcohol abuse is bigger than people thought,” said NIAAA Director George Koob. “Alcohol disorders cost the United States $224 billion a year.

“Seventy percent of Americans drink and most don’t have a problem, but there is a significant group that do have a problem,” he added.

One of the biggest concerns, Koob said, is that less than 20 percent of those who have a drinking problem get help.

Koob thinks people avoid treatment for a variety of reasons. First, there is a stigma to admitting you have a drinking problem. Many people still believe that alcohol disorders are a matter of choice, he said.

BarPeople might think “it’s a matter of morality or that people with alcohol problems are just bad people,” he said.

“Alcoholics can be in denial about their problem,” Koop added. “That can go on for years until it’s too late.”

Also, Koob said that many people are not aware that effective treatments are available.

“Historically, it has been hard to find treatment,” he said. “But with the Affordable Care Act, hopefully, these things are going to change.” (The Affordable Care Act is the health insurance reform law signed by President Barack Obama in 2010.)

“Treatments range from Alcoholics Anonymous to behavioral therapy and medications,” Koob said. “These medications have been out there for a long time. Unfortunately, they (Naltrexone and Acamprosate) are not prescribed that much,” he said.

The report was published online June 3 in JAMA Psychiatry.

Researchers also found that:

  • White and Native American men had the highest rates of lifetime drinking problems — 33 percent and 43 percent, respectively.
  • Thirty-seven percent of people aged 18 to 29, and 34 percent of those between 30 and 44 years had lifetime alcohol disorders.
  • People previously married or who were never married had high rates of lifetime alcohol problems — 27 percent and 35.5 percent, respectively.
  • Alcohol abuse was associated with other problems, including major depressive and bipolar disorders, and antisocial and borderline personality disorders.

For the study, a research team led by Bridget Grant used data from a 2012-2013 national survey of more than 36,000 adults.

LFrederiksen.AlcoholHijacksBrainThe researchers relied on a new way of compiling data on alcohol abuse based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), a manual used by psychiatrists. The changes included eliminating separate categories for alcohol abuse and alcohol dependence. They were combined into a single “alcohol use disorder” diagnosis. This increased the number of people diagnosed with a drinking problem, Koob said.

Dr. James Garbutt, a professor of psychiatry at the University of North Carolina School of Medicine in Chapel Hill, said the U.S. health care system hasn’t paid enough attention to drinking problems.

alcohol-abuse1“The other thing is that individuals with drinking issues oftentimes don’t want to get help — they want to keep drinking,” he said.

Garbutt said that more education about the risks of drinking is needed, including the risks to health and the possibility of addiction. He also thinks that primary care doctors need to play a bigger role in helping people who have drinking problems to get help.

Koob also thinks primary care physicians have a role to play. Doctors should ask their patients how much they drink and be aware of the medications available to treat drinking problems, he said.

“We could alleviate a lot of human suffering and medical costs if we would address the problem of excessive alcohol use,” Koob suggested. “It’s not something that’s going away on its own, so we really need to be proactive,” he said.