Category Archives: Alcoholism
Binge drinking is an increasing concern in the United States. A recent report from the U.S. Centers for Disease Control and Prevention (CDC) finds that one in ten adult deaths is linked to binge drinking through illnesses the binge drinker contracts—such as hepatitis—or accidents that happen to the drinker or that he or she causes—including homicide and domestic abuse. The CDC defines binge drinking as five or more drinks in a row for males and four or more drinks in a row for females.
Binge drinking also remains a concern among young adults. A new report from the Johns Hopkins Bloomberg School of Public Health and the Boston University School of Public Health finds that liquor now trumps beer as the drink of choice for underage (ages 13 to 20) binge drinkers, likely because of increased marketing by alcohol companies.
“Spirit firms have taken a page from the beer playbook in their marketing to young people,” said David Jernigan, PhD, director of the Center on Alcohol Marketing and Youth at Johns Hopkins in a conversation with NewPublicHealth.
The report on youth binge drinking was published in the Journal of Substance Use and found that spirits accounted for 43.8 percent of binge episodes, while beer accounted for less than one-third (31.4 percent) of binge episodes. “The inclusion of some relatively expensive brands in the top twenty-five binge brand list suggests that variables other than price are driving youth brand preferences with respect to binge drinking,” said Jernigan.
“Binge drinking accounts for most of the alcohol consumed by youth in the United States, and is associated with a host of negative consequences, including drunk driving, sexual assaults and suicide,” according to Timothy Naimi, MD, MPH, a lead author of the study and an associate professor at the Boston University School of Public Health.
This week Maryland became one of more than a dozen states to ban sales of grain alcohol, also known as extreme-strength alcohol. The drink, which includes the brand name Everclear, is 95 percent pure alcohol. It has no color, taste or smell and so easily mixes—without detection—into juices, soda and punch, making it an effective date rape tool, according to college health officials. And it’s cheap. A whole bottle can cost $15, which is a price easily shared among college or younger students.
Banning extreme-strength alcohol is among several initiatives a growing number of states are taking to try to reduce college student deaths, injuries and assaults linked to campus alcohol use. A report published in September by The Maryland Collaborative to Reduce College Drinking and Related Problems, which was formed in 2013 to address problems associated with excessive alcohol consumption on ten college campuses across the state, found that alcohol use of any kind on campuses across the country each year results in 1,800 deaths; 600,000 injuries; 700,000 assaults by someone under the influence; and nearly 1 million rapes and sexual assaults.
Many states, including Maryland, have declared college campus drinking to be a public health emergency that goes well beyond the campus because of the noise, vandalism, car crashes and community injuries and deaths linked to campus drinking each year. Banning grain alcohol was the Maryland Collaborative’s first initiative because college students who are binge drinkers—a serious and dangerous issue on campuses, according to the U.S. Centers for Disease Control and Prevention (CDC)—are 36 times more likely to drink grain alcohol than are non-binge drinkers, according to David H. Jernigan, the director of the Center on Alcohol Marketing and Youth at Johns Hopkins' Bloomberg School of Public Health in Baltimore, Md.
But some research shows that banning extreme strength alcohol can actually exacerbate the problem by raising awareness of the drink to students who may not have been aware of it before. This can push students in search of grain alcohol to find other high-octane sources, such as privately made moonshine, which can be even more highly concentrated than commercially available grain alcohol and can contain other contaminants, said Laura Forbes, an associate professor of health education at the University of Alabama/Birmingham and chair of the American College Health Association’s Alcohol, Tobacco and Other Drugs Coalition.
According to Forbes, what is desperately needed is a campus culture change on alcohol just like the culture change that has reduced smoking on campus; many campuses bans tobacco use outright. Forbes said reaching that goal requires collaborations—such as the one in Maryland—that bring together campus administrators, businesses, student leaders, law enforcement, public health and the community.
“The way to change the culture,” she said, “is to start to have a conversation that with students about why they’re drinking and to include administrations, faculty, alumni and others in the talks.”
Forbes said the culture change won’t be a suddenly dry campus. “It will be incremental over time, but each campus has to start the change to where they want to move.”
- The Maryland Collaborative has released a best practices guide for reducing campus drinking that includes both individual and campus-wide interventions.
- The CDC recently updated its Alcohol and Public Health website, which now includes new infographics and links to videos, webinars, e-cards and podcasts, as well as a fact sheet on preventing excessive alcohol use, which highlights evidence-based strategies such as those recommended by the Community Preventive Services Task Force.
The January 2014 VitalSigns report, a monthly report from the U.S. Centers for Disease Control and Prevention (CDC) on leading health indicators, looks at the failure of too many health care professionals to counsel patients on the risks of consuming too much alcohol and binge drinking. According to a recent survey cited in the new report, only one in six adults reports counseling by a health care professional during routine visits, and that number drops to one in four for binge drinkers, despite the fact that studies show that counseling could save lives and reduce health care costs.
Research by the CDC finds that having physicians ask patients about alcohol consumption and brief counseling could reduce the amount of alcohol consumed on an occasion by 25 percent. At least 38 million adults drink too much and most are not alcoholics, according to the CDC. Drinking too much includes binge drinking, high weekly use, and any alcohol use by pregnant women or those under age 21. And it causes about 88,000 deaths in the United States each year, costing the economy about $224 billion.
Significantly, alcohol screening and brief alcohol counseling are now covered by many health insurance plans without a copay as a result of the Affordable Care Act.
A review of studies by CDC researchers found that brief (6-15 minutes) intervention sessions were effective in significantly reducing weekly alcohol consumption. A patient survey conducted following brief counseling sessions found that patients reported:
- 3.6 fewer drinks per week for adults
- Binge level drinking was reported by 12 percent fewer participants
- Increased adherence to recommended drinking limits was achieved by 11 percent more participants.
“Drinking too much alcohol has many more health risks than most people realize,” says CDC Director Tom Frieden, MD, MPH. “Alcohol screening and brief counseling can help people set realistic goals for themselves and achieve those goals. Health care workers can provide this service to more patients and involve communities to help people avoid dangerous levels of drinking.”
In a briefing for reporters today, Frieden said that for every one alcoholic in the United States there are about six people who drink too much, and many don’t realize that their drinking is excessive.
The Dietary Guidelines for Americans recommend that adults who drink only do so in moderation, which is defined as up to one drink a day for women and two for men.
The National Institute on Alcoholism and Alcohol Abuse recommends that health professionals discuss alcohol use with all patients and has a screening tool to help determine how much patients drink, assess problems associated with drinking and refer patients for specialized treatment if needed.
- Read a recent NewPublicHealth interview with Lori Butterfield, who produced the recent documentary, Lipstick and Liquor, about hidden drinking by too many women.
- The Guide to Community Preventive Services provides evidence-based strategies for helping to reduce alcohol consumption among individuals and in communities.
Lipstick & Liquor, a recently released documentary, takes a close-up look at a secret that is killing women and harming their families. Excessive alcohol use is the third leading cause of preventable death among women between the ages of 35 and 55. Excessive drinking among women is also a contributing factor in one-third of suicides, one-fourth of accidental deaths and one-half of traffic deaths. Significantly, drinking is more likely to reach advanced stages before it is discovered.
The film, which will launch on iTunes and Amazon.com in December, shares the stories of four women and their struggles with alcoholism. The goal of the film, says Lori Butterfield, the film’s writer and producer as well as a senior vice president of creative content for Home Front Communications, is to help women everywhere shake off the stigma associated with women alcoholics, and to provide understanding and insight into the struggle to stay sober. The documentary includes expert commentary from medical researchers, addiction specialists and authors who shed light on the conditions impacting the increase in alcohol use and abuse among American women.
NewPublicHealth recently spoke with Lori Butterfield about the film.
NPH: How did the documentary come about?
Lori Butterfield: My interest in raising awareness began with a story about a woman named Diane Schuler. In the summer of 2009, Diane made headlines after killing herself and seven other people while driving the wrong way on the Taconic Parkway in Westchester County, New York. The toxicology report showed that Diane had been drinking and yet her husband and other family members came out very publicly and said, “Oh she would never do that, she was a wonderful mother, she was a perfect wife.” And I remember thinking at the time, how could someone hide their alcoholism so well that their own family had no idea? That story really stuck with me.
Then, in November of that year, I was overseeing a video project for an Ad Council campaign about “Buzzed driving” [see recent Buzzed Driving campaigns from the Ad Council]. That’s when I read a very startling statistic. It said the number of DUI arrests for women had shot up more than 30 percent in the last decade while the rate for men was actually going down. And I also read that binge drinking for women was on the rise, so something was happening, but I wasn’t quite connecting the dots.
>>NewPublicHealth is kicking off a new series to highlight some of the best public health education and outreach campaigns every month. Submit your ideas for Public Health Campaign of the Month to info@newPublichealth.org.
Why limit your good ideas for improving population health to just one country when all the world can be your stage—to share and learn?
That’s the thinking behind Creative for Good, a new website developed by the Ad Council, a non-profit developer of public service advertisements (PSA) in the United States, Ketchum Public Relations and the World Economic Forum. The new site offers more than 60 U.S. and international case studies and well as a primer to help organizations plan and execute their own PSAs.
Creative for Good grew out of the World Economic Forum Summit in Dubai two years ago, with the goal of helping countries around the world increase the quantity and effectiveness of social cause marketing.
PSA examples on the site include:
New funding by the National Institutes of Health (NIH) is aimed at improving treatment for bacterial infections, treating alcohol dependence and determining effective drugs for long-term diabetes treatment.
- Antibiotic Resistance: Duke University has been awarded $2 million by the NIH for a clinical research network focused on antibacterial resistance. Funding could rise to close to $70 million by 2019. According to the NIH, bacterial infections resistant to antibiotic drugs were first reported more than 60 years ago and since then have become more common in both health care and community settings. In some cases, no effective antibiotics exist. The funding will be used to conduct clinical trials on new drugs, optimizing use of existing ones; testing diagnostics and conducting research on best practices for infection control.
- Alcohol Dependence: A new study funded by the NIH and published in the Journal of Addiction Medicine finds that the smoking-cessation drug varenicline (brand name Chantix), significantly reduced alcohol consumption and craving among people who are alcohol-dependent. “Current medications for alcohol dependence are effective for some, but not all, patients. New medications are needed to provide effective therapy to a broader spectrum of alcohol dependent individuals,” said says Kenneth R. Warren, PhD, acting director of the National Institute on Alcohol Abuse and Alcoholism, part of NIH. Participants who took varenicline, compared with those taking a placebo, decreased their heavy drinking days per week by nearly 22 percent.
- Diabetes: The NIH is currently recruiting volunteers for a study to compare the long-term benefits and risks of four widely used diabetes drugs in combination with metformin, the most common first-line medication for treating type 2 diabetes. The study is important because if doctors find that metformin is not effective enough to help manage type 2 diabetes, they often add another drug to lower blood glucose levels. However, there have been no long-term studies on which of the add-on drugs are most effective and have fewest side effects. The study will compare drug effects on glucose levels, adverse effects, diabetes complications and quality of life over an average of nearly five years and will enroll about 5,000 patients at 37 study sites.
The first Vital Signs health indicators report of 2013 from the U.S. Centers for Disease Control (CDC) and Prevention finds that binge drinking is too often not recognized as a women’s health problem. The report found that nearly 14 million U.S. women binge drink about three times a month, and consume an average of six drinks per binge. CDC researchers determined the rate of binge drinking among U.S. women and girls by looking at the drinking behavior of approximately 278,000 U.S. women aged 18 and older for the past 30 days through data collected from the 2011 Behavioral Risk Factor Surveillance System, and for approximately 7,500 U.S. high school girls from the 2011 National Youth Risk Behavior Survey.
For women and girls, binge drinking is defined as consuming four or more drinks on one occasion. Drinking excessively, including binge drinking, causes about 23,000 deaths among women and girls in the United States each year. About 1 in 8 women and 1 in 5 high school girls report binge drinking, with the practice most common among women ages 8-34, high school girls, whites, Hispanics and women with household incomes of $75,000 or more. Half of all high school girls who drink alcohol report binge drinking.
The National Prevention and Health Promotion Strategy is about to celebrate its first anniversary. The Strategy offers a comprehensive plan aimed at increasing the number of Americans who are healthy at every stage of life. A cornerstone of the National Prevention Strategy is that it recognizes that good health comes not just from receiving quality medical care, but also from the conditions we face where we live, learn work and play such as clean water and air, safe worksites and healthy foods. The strategy was developed by the National Prevention Council, which is composed of 17 federal agencies including the Department of Agriculture, the Department of Education, the Department of Housing and Urban Development, the Office of National Drug Control Policy and others.
As the Strategy is rolled out, NewPublicHealth will be speaking with Cabinet Secretaries, Agency directors and their designees to the Prevention Council about the initiatives being introduced to help Americans work toward the goal of long and healthy lives.
This week, NewPublicHealth spoke with Mary Engle, Director of the Federal Trade Commission's (FTC) Division of Advertising Practices, and National Prevention Council designee.
NewPublicHealth: Why is health a priority for the FTC? Why was it important for FTC to be involved in the development of the National Prevention Strategy?
Mary Engle: When you think about our mission, which is to protect consumers and maintain competition in the marketplace, health is such an important part of that. We want to make sure consumers aren’t misled about health services and products marketed to them and that they don’t pay more than they need to.
Initiatives that are a priority for us include combating deceptive advertising of fraudulent cure-all claims for dietary supplements and weight loss products; monitoring and reporting on the marketing of food to children as well as alcohol and tobacco marketing practices; and developing consumer education materials designed to empower consumers to make informed health care decisions and to avoid fraud.
NPH: What FTC initiatives support the National Prevention Strategy?
The January 2012 issue of Vital Signs, the monthly health indicator report from the Centers for Disease Control and Prevention (CDC), finds that more than 38 million U.S. adults binge drink an average of four times a month and the most drinks they consume, on average, is eight.
Binge drinking is defined as consuming four or more drinks for women and five or more drinks for men. Excessive alcohol consumption, including binge drinking, causes more than 80,000 deaths in the U.S. each year.
The Vital Signs report is based on the Behavioral Risk Factor Surveillance Survey (BRFSS), which includes self-reporting about binge drinking within the last thirty days. The report includes data on 458,000 U.S. adults aged 18 years and older. The numbers are higher than for the year before because, for the first time, the information includes cell phone users. Researchers have found higher rates of binge drinking among cell phone users because they tend to be disproportionately younger males.
The report has some startling numbers:
- Binge drinking is more common among young adults ages 18 to 34, but people age 65 and older who report binge drinking, do so more often—an average of five to six times a month.
- Binge drinking is more common among those with household incomes of $75,000 or more, but the number of drinks consumed per binge drinking occasion is significantly higher among those with household incomes of less than $25,000—a whopping eight to nine drinks.
Dafna Kanny, PhD, an author of the report, who is an epidemiologist in the division of Adult and Community Health at CDC’s National Center for Chronic Disease Prevention and Health Promotion, told NewPublicHealth that much of the binge drinking problem in the U.S. stems from the fact that “alcohol is relatively cheap, widely available, heavily promoted and too often not seen as a public health problem, which makes it a behavior of choice.”
Kanny says strong local and state alcohol polices, such as fewer outlets and hours for alcohol sales, and stricter penalties for selling alcohol to minors, can help reduce binge drinking. Kanny says the Alcohol Policy Information System, a resource from the National Institutes of Health, is an excellent source of ideas on alcohol policies that local and state governments can implement.
The silver bullet, says Kanny, would be policies that affect the most people with the least amount of efforts, such as alcohol-related policies from CDC’s Guide to Community Preventive Services.
Alcohol consumption is also impacted by liquor firms’ efforts in social media. The Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health has recently released a four-part YouTube movie that looks at the industry’s push into digital marketing and a new brochure that looks at underage youth exposure to alcohol marketing in magazines, on radio and television and on social marketing platforms. For example, ten leading alcohol brands have more than 16.5 million people "liking" their Facebook brand pages.
“[Alcohol] brands are now taking their messages… to social media platforms such as YouTube, Flickr, Twitter and Facebook,” said David Jernigan, director of the Center. “As teens are early adopters of social media and there are viral elements of this media, parents need to be more aware of this marketing and educate their children about the real harms of underage drinking in spite of the industry’s message of glamour and allure.”
The Center on Alcohol Marketing and Youth was launched in 2002 at Georgetown University with funding from The Pew Charitable Trusts and the Robert Wood Johnson Foundation. The Center moved to the Johns Hopkins Bloomberg School of Public Health in 2008 and is currently funded by the CDC.