Excessive Alcohol Use: The Harm it Causes Others

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by Tom Delegatto, MS, CADC, Executive Director, Recovery Works Merrillville

People who have problems with alcohol often continue drinking because they believe that if their alcohol use harms anyone, it only harms them. They do the drinking, their thinking goes, so, therefore, they experience all the negative consequences. Those include the health risks, the emotional and psychological risks, and the various issues alcohol can cause with family, work, and friends. While it appears that at least part of this is true – the person who drinks is the one who experiences the health consequences – that appearance quickly vanishes when one realizes that when an individual with alcohol-associated health problems falls ill, that illness affects their immediate family, their friends, and anyone involved in their care.

That’s not all.

In fact, it’s barely scratching the surface of the harm excessive alcohol use can cause others. A study published this summer in the Journal of Studies on Alcohol and Drugs found that the negative effects of alcohol on others, which researchers call alcohol’s harm to others (AHTO), take many forms and reach a substantial proportion of the U.S. population.

In the words of the study authors:

“In 2015, nearly one-fifth of all adults in the United States, an estimated 53 million women and men, experienced at least one harm attributable to someone else’s drinking.”

To put those numbers in context, think of them like this: if you’re standing in a line of five people at the grocery store, then data shows it’s likely at least one of them has been harmed by someone else’s drinking. To extend this example, let’s say you saw twenty-five people at the store that day – including employees – it’s likely at least five of them have been harmed by someone else’s drinking.

The point: the harm excess drinking causes others is more significant than most people realize.

Excess Drinking: Types of Harm

As mentioned, people with an alcohol problem often continue drinking because they think they’re not hurting anyone but themselves. It’s easy to expose that illusion – not only with the example we used above, with regards to health problems, but also with regards to the emotional and psychological problems associated with heavy drinking. It’s common knowledge that family members of people who drink excessively experience negative psychological and emotional consequences related to the excess drinking of that family member. That’s why organizations like Al-Anon and Alateen exist: they’re support groups for people with friends or loved ones who live with an alcohol use disorder. They specialize in helping people process the difficult emotions and situations that arise when a loved one struggles with alcohol.

We’ve already identified two ways people who drink excessively may cause harm to others – and that’s without data, statistics, or peer-reviewed journal studies.

Now we’ll expand that list with data from the study above, called “Alcohol’s Secondhand Harms in the United States: New Data on Prevalence and Risk Factors.” The study – which included information collected from close to 10,000 men and women – identifies five types of harm people experience as a result of someone else’s excessive alcohol use. First, we’ll present the general category of harm and the specific ways in which those harms may be experienced.

Excess Alcohol Use: Five Categories of Harm to Others

  1. Harassment and Threats
    • Being called names and/or being insulted
    • Feeling fear as a result of name calling, insults, and harassment
  2. Property Damage and/or Vandalism
    • Clothing or belongings ruined
    • House, car, or property vandalized
  3. Physical Aggression
    • Being hit or pushed
    • Being physically injured
  4. Driving Related
    • Being in a traffic accident
    • Riding with a drunk driver
  5. Family and/or Financial
    • Difficulties with spouses, siblings, parents, and children
    • Money loss: resources spent on alcohol, while under the influence of alcohol, to cover the cost of alcohol-related health problems, to pay for treatment for alcohol use disorder

These five categories of harm are not shocking, in and of themselves. Most of us know – or have peripheral experience – with people whose drinking crosses the line and causes the types of harm we list. Most of us know alcohol can cause people to become insulting and/or physically violent. We all know sometimes people drive drunk – which can harm others. And we also know that in some cases, drinking can lead to financial ruin for families.

Those are all unpleasant facts, but the truth is, they’re not news.

What’s news – what’s both disturbing and shocking – is the number of people in the U.S. who experience these types of harm.

Risk Factors and Prevalence of Alcohol-Related Harm

The study identifies four risk factors for experiencing increased harm related to the alcohol use of another person: gender, sociodemographic variables, personal drinking habits, and the presence of a heavy drinker in the household.

Here’s what they found:

  • Gender: Women were more likely to experience family and financial harm than men, whereas men were more likely to be assaulted by someone under the influence of alcohol or ride in a car with a drunk driver.
  • Sociodemographic Variables: Individuals with income below the poverty line were more likely to experience any type of AHTO. Also, younger, unmarried individuals (18-35) were more likely to experience any type of AHTO than older, married individuals (36+).
  • Personal Drinking Habits: Heavy drinkers reported higher rates of AHTO than moderate drinkers, and moderate drinkers reported higher rates of AHTO than those who abstain from alcohol. Click here for definitions of heavy and moderate drinking.
  • Presence of a Heavy Drinker in Household: The presence of a heavy drinker in the household increased the likelihood for any type of AHTO.

Now we’ll offer the statistics. These numbers may come as a surprise, because they include a substantial proportion of our population. We’ll group these by sociodemographic characteristics, then include figures, statistics, or probabilities, with the highest level of detail possible for each category.

Alcohol-Related Harms: Prevalence

Gender (By Harm Category):

  • 20.3 million women (16.3%) and 19.4 million men (16.4%) experienced alcohol-related harassment or threats.
  • 5.3 million women (4.2%) and 7.1 million men (6.0%) experienced alcohol-related damage or vandalism to their property.
  • 4.0 million women (3.2%) and 5.5 million men (4.7%) experienced alcohol-related physical aggression.
  • 6.9 million women (5.5%) and 8.3 million men (7.0%) experienced alcohol-related driving harm.
  • 7.0 million women (5.6%) and 3.3 million men (2.8%) experienced alcohol-related family or financial harm.

Sociodemographic Variables (All AHTO categories):

  • Race: White (20%), Black (26.2%), Hispanic (24.5%)
  • Income: Below Poverty Level (25.2%), Above Poverty Level (21.7%)
  • Education: High School Diploma or less (19.7%), 4-year College Degree or more (21.2%)

Personal drinking habits (All AHTO categories):

  • Heavy Drinker: 49.4% (women), 42.7% (men)
  • Moderate Drinker: 21.7% (women), 21% (men)
  • Non-drinker: 13.4% (women), 16.2% (men)

Presence of heavy drinker in the household compared to the absence of a heavy drinker household (Likelihood by Harm Category). Individuals with a heavy drinker in the household are:

  • 6.1 times more likely to experience harassment or threats.
  • 5.7 times more likely to experience property damage or vandalism.
  • 2.3 times more likely to experience physical aggression.
  • 3.9 times more likely to experience driving-related harm.
  • 16 times more likely to experience family or financial harm.

Key Takeaways from the Data

Let’s look at the figures in point number three, above, in case there’s any confusion about how they’re presented, and since they represent the most dramatic differences found in the report. To rephrase: the alcohol-related harm an individual might experience increases with the amount of alcohol they, themselves, consume. About 47% of heavy drinkers reported they experienced alcohol-related harm from others, compared to about 21% of moderate drinkers and about 15% of non-drinkers. That’s worth noting: the rates of harm heavy drinkers experience are double the rates of harm experienced by moderate drinkers, and triple the rates experienced by non-drinkers.

There’s another point about heavy drinkers to tease out of that data. The presence of a heavy drinker in the household significantly increases the likelihood an individual in that household will experience any type of AHTO – and they’re sixteen times more likely to experience family or financial harm.

Public Health Implications

What we can do for the 53 million Americans who experience harm each year as the result of the excess alcohol use of others is raise awareness about the effectiveness of treatment and evidence-based clinical care. Family members and loved ones don’t always know what they can do or how to help. Yet often, they’re the people who make the first phone call seeking treatment, not the person with the alcohol problem. And often, they’re the people – aside from those doing the drinking – who stand to benefit the most from getting their loved one in treatment.