Over the past three decades, reports on rates of alcohol use and consumption in the U.S. and Canada have contained contradictory information. Several large – meaning they include tens of thousands of data points – government-funded surveys show that rates of alcohol use among adolescents have dropped. Age of initiation – meaning the age at which adolescents drink for the first time – has also dropped.
These downward trends began around the year 2000 and continued through 2018.
At the same time, however, rates of alcohol use for people over the age of 18 have increased, with the most significant increase in adults over the age of 26. Along with that increase, there has also been an increase in the number of alcohol-related deaths in the U.S. and Canada.
Two recent studies – one released this summer in Canada, and one released last year in the U.S. – show another disturbing trend related to adult alcohol use: a significant increase in alcohol-related emergency room (ER) visits.
ER Visits: Facts and Figures
The increases are noteworthy because they’re so large.
We’re not talking about one or two percentage points – we’re talking increases measured in tens and hundreds of percentage points.
Here’s the data from the Canadian study, which included analysis of the entire Canadian population between age 10 and 105 – over fifteen million people – between 2003 and 2016:
- Total ER visits (including alcohol):
- Increase for women: 86.5%
- Increase for men: 53.2%
- Alcohol-related ER visits for individuals age 25-29 (alcohol-related only):
- Overall increase: 175%
- Increase for women: 240%
- Increase for men: 145%
Also of note in the data from this study is that rates of alcohol-related ER visits for women age 10-18 were almost double those of men in the same age group.
Next, we offer key points of data from the U.S. study, which analyzed information from 2006-2014 collected by the Nationwide Emergency Department Sample (NEDS), a database that contains records from 945 hospitals across the country:
- Total alcohol-related ER visits:
- Overall increase: 61.4%
- Increase for women: 69.1%
- Increase for men: 57.9%
- Alcohol-related ER visits for individuals age 25-34:
- Overall increase: 50.4%
- Increase for women: 65.7%
- Increase for men: 43.2%
- Alcohol-related ER visits for individuals age 55-64:
- Overall increase: 68.3%
- Increase for women: 80.1%
- Increase for men: 65.7%
Granted, those are different data sets. They cover different time periods and they’re grouped in different age ranges. However, the date and data ranges are similar enough to draw valid conclusions: rates of alcohol-related ER visits are increasing rapidly in Canada and the U.S., especially for adults. In Canada, the increases are the most dramatic for individuals age 25-29, whereas in the U.S., the increases are the most dramatic for individuals age 55-64.
Alcohol-Related ER Visits and the Treatment Gap
While the opioid crisis has the attention of the nation, these stats remind us we need to pay attention to people living with alcohol use disorders as well. They tell us we need to focus on alcohol use in older adults. True – these data sets aren’t about alcohol use disorders, they’re about ER visits.
It’s logical, though, to see the increase in the number of emergency room visits, combined with the increase in the number of alcohol-related deaths, as possible indicators of hidden or untreated alcohol use disorders.
Another fact about alcohol use disorders supports this logic: there’s a significant gap between the number of people – we’re talking about the U.S. only now – who are diagnosed with an alcohol use disorder and the number of people who receive treatment for their alcohol used disorder.
This is known as a treatment gap. Here’s how it looks in the U.S.:
- Adults (18+) with an alcohol use disorder (AUD):
- 11 million total
- 8 million men
- 3 million women
- Adults with an AUD who received treatment for their AUD:
- 1,011,000 total
- 725,000 men
- 286,000 women
- 1,011,000 total
- 11 million total
In percentages, that means only 6.7% of people diagnosed with an AUD get the treatment they need: 7.4% of men, and 5.4% of women.
That leaves over a million people in the U.S. living with an untreated alcohol use disorder.
Which begs the question: is there a relationship between the increase in alcohol-related emergency room visits and the number of people with an untreated alcohol use disorder?
Who to Treat? It’s in the Data
The data in these latest reports do not answer that question, but we can use the knowledge the data gives us to redouble our efforts to help people living with problem drinking. And because of the specificity of the information, we can calibrate our attention, resources, and efforts to include the specific groups of people who appear to need help the most.
In Canada, that means adults over the age of 25 – particularly women. Here in the U.S., that means a group that media and policymakers often overlook in favor of others, when writing articles or making decisions about where and to whom we should allocate addiction treatment resources: adults age 55-64.