National Alcohol Awareness Month: April 2023

Black woman sitting on a couch with a book and a cup of coffee looking to the side

The National Council for Alcoholism and Drug Dependence (NCADD) organized the first annual Alcohol Awareness Month in 1987. Over the following 32 years, the NCADD used the month of April to raise awareness about important topics related to alcohol use, including:

  • The negative effects of alcohol misuse and alcohol use disorder (AUD).
  • The dangers of heavy drinking and binge drinking
  • Treatment options available to people who misuse alcohol or people with AUD
  • Reducing stigma around treatment for AUD and people who seek treatment for AUD

In 2019, the NCADD passed the torch to Partners in Prevention, a New Jersey-based non-profit organization who continues the valuable work started by the NCADD in 1987. They’ve not only continued the work, but expanded the effort to increase awareness about alcohol use, misuse, and disordered use in the U.S.

The problem of alcohol use faded from public awareness over the past several years because of two different public health crises: the opioid crisis and the COVID-19 pandemic. Clearly, the COVID-19 pandemic resulted in a devastating number of fatalities – 1,123,366, according to the latest data from the Centers for Disease Control (CDC) – and the opioid crisis continues to cause harm to individuals, families, and communities across the country.

It’s critical to focus attention and resources where they’re needed most. In 2020 and 2021, we needed to focus on the pandemic. Now, as we return to a new normal – vaccine boosters, variants, and the like – it’s important to recalibrate our efforts and redirect them to issues that existed before the pandemic, such as the opioid crisis and the alcohol use and misuse problem.

That statement begs a question:

Is the alcohol use problem really as bad as the opioid overdose crisis?

We’ll share the latest facts and figures and offer our opinion, of course. However, since the goal of this article is to raise awareness and empower each individual with real facts, we encourage each individual to consider the data answer that question for themselves.

The Harm Caused by Alcohol Use, Misuse, and Disordered Use

First, we need to quality the question we pose above: we’re not setting up a contest between alcohol use and opioid use to find out which one is worse. Excess use, misuse, and disordered use of both can cause pain, suffering, and ultimately, death. That’s the plain and simple truth. What we want to do now is demonstrate the fact that although the opioid crisis receives more attention from the national press, the harm cause by alcohol is also significant – and something we can work to reduce.

Here’s a set of facts many people may not be aware of, as reported by the CDC, the National Institute on Alcohol Abuse and Alcoholism (NIAA), and the National Highway Traffic Safety Administration (NHTSA):

While we typically discuss the harms of alcohol and drug use in human terms, we frequently encounter economic analyses on the financial burden caused by alcohol and drug use. We include this data now because the figures, to put it mildly, are astounding.

The CDC published the latest study on the economic impact of alcohol in 2010.  Here are the top-line results of that study.

Financial Burden of Excess Alcohol Use in U.S.

  • Overall economic impact of alcohol: $249,000,000,000
    • You read that correctly: $249 billion
  • That figure works out to a cost of $2.05 per drink, or $807 person
  • Cost breakdown:
    • 77% of cost attributed to binge drinking
    • 72% of cost attributed to lost workplace productivity
    • 11% of cost attributed to health care expenses
    • 10% of cost attributed to criminal justice expenses
    • 5% of cost attributed automobile crashes

Those facts and figures make a straightforward case for the need for Alcohol Awareness Month: excess alcohol use causes significant harm to people in the U.S. The harms are social, emotional, physical, and economic. The primary harm caused by alcohol, however, is death: after tobacco use and an unhealthy diet and inactive lifestyle, alcohol causes the most preventable deaths in the country.

Now we’ll back up a step and define and discuss the scope of alcohol use, misuse, and disordered use in the U.S.

Problem Alcohol Use: Clinical Definitions

We’ll now offer several basic definitions related to problem drinking, starting with the phrase alcohol use disorder (AUD). Note: AUD is the phrase we now use in place of alcoholism, and a person with an alcohol use disorder is how we now refer to a person diagnosed with AUD, in place of the old, stigmatizing term alcoholic.

Here’s how the National Institute on Alcohol Abuse and Alcoholism (NIAA) defines AUD:

“…a chronic relapsing brain disease characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. AUD can range from mild to severe, and recovery is possible regardless of severity.”

Next, here’s how the NIAA and the Substance Abuse and Mental Health Services Administration (SAMHSA) define moderate alcohol consumption:

  • Women: 1 drink every day
  • Men: 2 drinks every day

Here’s how the NIAA and the Substance Abuse and Mental Health Services Administration (SAMHSA) define binge drinking:

  • NIAAA:
    • Women: 4 drinks in 2 hours
    • Men: 5 drinks in 2 hours
    • Women/Men: 5 or more drinks in one (day/night/event) in the past month

Next, heavy drinking:

  • NIAAA:
    • Women: 3 drinks or more on any day, or more than 7 drinks per week
    • Men: 4 drinks or more on any day, or more than 14 drinks per week
    • Women/Men: 5 or more days in the past month, i.e. binge drinking 5 or more times per month

Both the NIAA and SAMHSA indicate the following:

“Binge drinking and heavy alcohol use can increase an individual’s risk of alcohol use disorder.”

Now let’s look at the latest statistics on problem alcohol use in the U.S.

Problem Alcohol Use: Facts and Figures

The 2021 National Survey on Drug Use and Health (2021 NSDUH) contains the most up-to-date information on alcohol use available. The yearly survey is based on responses from over 70,000 participants across the country. The sample size and consistency of reporting allow us to make population-level generalizations from the data, which give us an accurate picture of the drinking habits of people in the U.S. from all demographic groups.

Here’s the data.

Alcohol Use: Past Month, Binge, and Heavy Drinking, Age 12+

  • Past month use: 133.1 million
  • Binge drinkers: 60.0 million (45.1%)
  • Among binge drinkers:
    • 18-25: 29.2% (9.8 million)
    • 26+: 22.4% (49.3 million)
    • 12-17: 3.8% (995,000)
  • Binge drinking among underage people: 8.3% (3.2 million)
  • Heavy drinkers: 18.3% (16.3 million)
  • Among heavy drinkers:
    • 18-25: 7.1% (2.4 million)
    • 26+: 6.3% (13.9 million)
    • 12-17: 0.4% (103,000)
  • Heavy alcohol use among underage people: 1.6% (613,000)

We’ll observe here that – according to the NIAA and SAMHSA – all binge drinkers and heavy drinkers are at increased risk of developing alcohol use disorder (AUD). Simple math tells us that in the U.S. in 2021, 76.3 million people were at risk of developing AUD, including over three million people under the legal drinking age.

Now let’s look at rates of AUD.

Alcohol Use Disorder: By Age Group

  • 12 + total: 10.6% (29.5 million)
  • 12-17: 3.4% (894,000)
  • 18-25: 15.0% (5.0 million)
  • 26+: 10.7% (23.6 million)

Next, let’s compare that to rates of disordered use of other intoxicants. Note, in the NSDUH, the phrase substance use disorder (SUD) includes people diagnosed with drug use disorders and alcohol use disorders. For the rest of this article, when we use the phrase SUD, we include people with AUD in the related facts and figures.

SUD by Substance in 2021

  • Alcohol use disorder: 29.5 million
  • Illicit drug use disorder: 24.0 million
  • Marijuana use disorder: 16.3 million
  • Pain reliever use disorder: 5.0 million
  • Methamphetamine use disorder: 1.6 million
  • Stimulant use disorder: 1.5 million
  • Cocaine use disorder: 1.4 million

Those facts make it clear that alcohol use disorder is the most common type of substance use disorder in the U.S. This begs another question:

How many people with SUD or AUD – or both – receive the kind of treatment they need?

Let’s look at the data.

Alcohol and Substance Use Disorder in 2021: Needed Treatment and Received Treatment

The NSDUH team defined the term needed SUD treatment in the past year as anyone diagnosed with an alcohol or substance use disorder. They defined received SUD treatment in the past year as anyone who received substance/alcohol use treatment at a specialized facility in the past year.

Needed SUD Treatment in The Past Year By Age (Includes People with AUD)

  • 12+: 15.6% (43.7 million)
  • 12-17: 7.6% (2.0 million)
  • 18-25: 25.1% (8.4 million)
  • 26+: 15.1% (33.3 million)

Received Any SUD Treatment in The Past Year By Age (Includes People Who Received AUD Treatment)

  • 12+: 1.5% (4.1 million)
  • 12-17: 0.3% (82,000)
  • 18-25: 1.3% (438,000)
  • 26+: 1.6% (3.6 million)

Now let’s look at one more set of data: how people with AUD and/or SUD received treatment.

How People Received SUD Treatment in The Past Year

  • Self-help group like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA): 2.0 million
  • Virtual support: 1.9 million
  • Outpatient AUD/SUD center: 1.8 million
  • Outpatient mental health center: 1.5 million
  • Inpatient AUD/SUD center: 1.3 million
  • Hospital inpatient: 1.1 million
  • Emergency room: 571,000

Those three sets of bullet points reveal something we often discuss in our articles: the treatment gap. The treatment gap is the difference between the number of people who need AUD/SUD treatment and the number of people who receive AUD/SUD treatment. We can see how many people received treatment and where and how they received treatment: unfortunately, the engagement with professional support – i.e. the treatment gap –  is unsatisfactory.

Here’s what this data tells us about the treatment gap in 2021.

The Treatment Gap: 2021

  • Overall, 12+: 90% of people 12+ who needed treatment did not get treatment
  • 12-17: 96% of people 12-17 who needed treatment did not get treatment
  • 18-25: 95% of people 18-25 who needed treatment did not get treatment
  • 26+: 89% of people 26+ who needed treatment did not get treatment

Those gaps are far too large. This data tells us we need to increase our overall efforts in the following areas: awareness, education, advocacy, and access. To learn more about the treatment gap and how to address this problem, please navigate to the blog section of our website and read this article:

Recovery Communities Help Close the Treatment Gap

In order to close the treatment gap, we need to inform people about the need for treatment, teach them what treatment is and what it entails, encourage them to seek help when needed, and work to reduce barriers to care for people who want and need professional support for AUD or SUD.

To close, we’ll return to the focus of this article: National Alcohol Awareness Month.

How to Participate in National Alcohol Awareness Month

The first thing to do is learn.

Anyone reading this article right now is learning about the scope of the alcohol problem in the U.S. – and realizing the problem is greater than most of use think. One thing we want people to learn from this article is that there’s a common misconception in our culture that one or two drinks a day is not bad for our health. In fact, for decades most of us heard that two glasses of red wine with dinner in the evening – or the equivalent – was beneficial for our health.

By the standards established by the NIAA and SAMHSA, that’s moderate drinking.

That means it’s safe, right?

Unfortunately, no.

In the 2020-2025 Dietary Guidelines for Americans, experts from the CDC state the following:

“Emerging evidence suggests that even drinking within the recommended limits may increase the overall risk of death from various causes, such as from several types of cancer and some forms of cardiovascular disease. Alcohol has been found to increase risk for cancer, and for some types of cancer, the risk increases even at low levels of alcohol consumption (less than 1 drink in a day).”

In addition, a study published in 2022 called “Binge Drinking and Alcohol Problems Among Moderate Average-Level Drinkers” that examined the long-term health outcomes of moderate drinking showed:

  • Moderate drinkers accounted for 85% of alcohol-related problems 9 years after an initial interview on drinking habits.
    • Men:
      • Moderate drinkers accounted for 85% of alcohol-related problems at 9-year follow-up
    • Women:
      • Moderate drinkers accounted for 64% of alcohol-related problems at 9-year follow-up.
    • Binge drinking among moderate drinkers was associated alcohol-related problems more powerfully than binge drinking among heavy drinkers.
    • Moderate drinking + binge drinking at baseline increased risk of multiple alcohol-related problems at 9-year follow-up by 439%

That’s right: researchers obtained baseline drinking data, then followed up 9 years later, and found that moderate drinking – which most of us would consider safe – was associated with a majority of alcohol-related health problems at follow-up.

In a phrase, that’s eye-opening. And once you see those facts, you can’t unsee them. That’s why, this year, the way anyone reading this article can participate in Alcohol Awareness Month is by sharing this information with friends and loved ones. It may change their behavior, and – if they’re at risk of developing AUD – it might just change their lives for the better.

The materials provided on the Pinnacle Blog are for information and educational purposes only. No behavioral health or any other professional services are provided through the Blog and the information obtained through the Blog is not a substitute for consultation with a qualified health professional. If you are in need of medical or behavioral health treatment, please contact a qualified health professional directly, and if you are in need of emergency help, please go to your nearest emergency room or dial 911.