Alcohol Abuse and Addiction - Prevalence Of Alcohol Abuse Andalcoholism

The Strategic Plan 2001-2005 of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) noted that nearly fourteen million Americans—one in every thirteen adults—have alcohol-abuse or alcohol-dependence problems. As Table 4.3 shows, people ages eighteen to twenty-five are far more likely to engage in alcohol use, binge alcohol use, or heavy alcohol use than those twelve to seventeen or those twenty-six and older. This can be attributed, in part, to the fact that this is a young, social group that—for those over twenty-one years of age—have just reached the age where they may drink legally. What is of particular concern about the data represented on this table is that the rates of binge drinking and heavy TABLE 4.1
Four symptoms of alcoholism
SOURCE: Adapted from Alcoholism: Getting the Facts, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, updated September 2004, http://www.niaaa.nih.gov/publications/booklet.htm (accessed April 3, 2005)

Alcoholism, also known as "alcohol dependence," is a disease that includes four symptoms:

• Craving: A strong need, or compulsion, to drink.

• Loss of control: The inability to limit one's drinking on any given occasion.

• Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, occur when alcohol use is stopped after a period of heavy drinking.

• Tolerance: The need to drink greater amounts of alcohol in order to "get high."

TABLE 4.2
Four symptoms of alcohol abuse
SOURCE: Adapted from Alcoholism: Getting the Facts, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism, updated September 2004, http://www.niaaa.nih.gov/publications/booklet.htm (accessed April 3, 2005)

Alcohol abuse is defined as a pattern of drinking that results in one or more of the following situations within a 12-month period:

• Failure to fulfill major work, school, or home responsibilities;

• Drinking in situations that are physically dangerous, such as while driving a car or operating machinery;

• Having recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk; and

• Continued drinking despite having ongoing relationship problems that are caused or worsened by the drinking.

drinking for eighteen- to twenty-five-year-olds increased steadily from 2000 to 2003—from 37.8% to 41.6% for binge drinking and from 12.8% to 15.1% for heavy alcohol use.

Figure 4.1 shows the trend in binge drinking in adults aged eighteen years and over from 1997 to 2004. These data provide a slightly different picture than those that single out the eighteen- to twenty-five-year-old group. The graph shows that the rate of binge drinking in the overall population over eighteen has decreased somewhat since 1997, from slightly over 21% in 1997 to a bit under 19% in 2004.

Figure 4.2 compares the rates of binge drinking for males and females in four age groups. As shown in Table 4.3, the age group with the highest percentages of binge drinking in 2004 was composed of eighteen- to twenty-four-year-olds; the percentages decline with each subsequent age group. However, in each age group, the rate of binge drinking in males was substantially higher than that of females. The percentage of males aged eighteen to twenty-four who binge drank in the first six months of 2004 was about 42%, while the percentage of females in that age group who binge drank was half that—about 21%. In the twenty-five to TABLE 4.3
Type of alcohol use in past month for three age groups: percentages, 2000-03
SOURCE: Adapted from Results from the 2001 National Household Survey on Drug Abuse: Volume II. Technical Appendices and Selected Data Tables, U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, August 2002, http://oas.samhsa.gov/nhsda/2k1nhsda/vol1/toc.htm (accessed February 21, 2005), and Results from the 2003 National Survey on Drug Use and Health: Detailed Tables, U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, September 2004, http://oas.samhsa.gov/nhsda.htm#NHSDAinfo (accessed February 21, 2005)

	Type of alcohol use
	Any alcohol use				"Binge" alcohol use				Heavy alcohol use
Age group	2000	2001	2002	2003	2000	2001	2002	2003	2000	2001	2002	2003
12 to 17	16.4	17.3	17.6	17.7	10.4	10.6	10.7	10.9	2.6	2.5	2.5	2.6
18 to 25	56.8	58.8	60.5	61.4	37.8	38.7	40.9	21.6	12.8	13.6	14.9	15.1
26 or older	49.0	50.8	53.9	52.4	19.1	18.8	21.4	21.0	4.8	4.8	5.9	5.9
Note: "Binge" alcohol use is defined as drinking five or more drinks on the same occasion on at least 1 day in the past 30 days. By "occasion" is meant at the same time or within a couple of hours of each other. Heavy alcohol use is defined as drinking five or more drinks on the same occasion on each of 5 or more days in the past 30 days; all heavy alcohol users are also "binge" alcohol users.

FIGURE 4.1
Trends in percentages of adults who had five or more drinks in one day at least once in the past year, 1997-2004
SOURCE: J.S. Schiller, Z. Coriaty Nelson, C. Hao, and P. Barnes, "Figure 9.1. Percent of Adults Aged 18 Years and over Who Had 5 or More Drinks in 1 Day at Least Once in the Past Year: United States, 1997-2004," in Early Release of Selected Estimates Based on Data from the January-June 2004 National Health Interview Survey, Centers for Disease Control and Prevention, National Center for Health Statistics, December 2004, http://www.cdc.gov/nchs/data/nhis/earlyrelease/200412_09.pdf (accessed March 2, 2005)

forty-four age group, the percentage of males who binge drank was nearly 35%, but the percentage of females was about 15%. At forty-five to sixty-four years the gap widens more, with slightly over 21% of males having binged on alcohol, while the percentage of females who binged was not quite 7%. When adults reached age sixty-five years and older, only about 7% of men and 1% of women binge drank.

FIGURE 4.2
Percent of adults who had five or more drinks in one day at least once in the past year, by age group and sex, January–June 2004
SOURCE: J.S. Schiller, Z. Coriaty Nelson, C. Hao, and P. Barnes, "Figure 9.2. Percent of Adults Aged 18 Years and over Who Had 5 or More Drinks in 1 Day at Least Once in the Past Year, by Age Group and Sex: United States, January–June 2004," in Early Release of Selected Estimates Based on Data from the January–June 2004 National Health Interview Survey, Centers for Disease Control and Prevention, National Center for Health Statistics, December 2004, http://www.cdc.gov/nchs/data/nhis/earlyrelease/200412_09.pdf (accessed March 2, 2005)

Figure 4.3 shows that a higher percentage of whites binge drank in the first six months of 2004 (nearly 22%) than did Hispanics (nearly 16%) or African-Americans (over 11%).

Table 4.4 shows trends in the prevalence of alcohol abuse by age, sex, and race/ethnicity by comparing data collected in 1991-1992 with data collected in FIGURE 4.3
Percent of adults who had five or more drinks in one day at least once in the past year, by race/ethnicity, January–June 2004
SOURCE: J.S. Schiller, Z. Coriaty Nelson, C. Hao, and P. Barnes, "Figure 9.3. Age-Sex-Adjusted Percent of Adults Aged 18 Years and over Who Had 5 or More Drinks in 1 Day at Least Once in the Past Year, by Race/Ethnicity: United States, January–June 2004," in Early Release of Selected Estimates Based on Data from the January–June 2004 National Health Interview Survey, Centers for Disease Control and Prevention, National Center for Health Statistics, December 2004, http://www.cdc.gov/nchs/data/nhis/earlyrelease/200412_09.pdf (accessed March 2, 2005) 2001-2002. As one might expect after studying the data in Table 4.3 and Figure 4.2, the eighteen- to twenty-nine-year-old group quite consistently shows the highest percentages of alcohol abuse across races/ethnicities. In general, alcohol abuse rose over the decade between which these two data sets were gathered—quite substantially in some groups. There are exceptions, however. The rate remained somewhat stable in eighteen- to twenty-nine-year-old white males and dropped in this age group in Native American males and females. It also dropped in forty-five- to sixty-four-year-old Asian females. Overall decreases in the prevalence of alcohol abuse over this ten-year period are most notable in Native Americans.

Table 4.5 is similar to Table 4.4 and shows trends in the prevalence of alcohol dependence by age, sex, and race/ethnicity. Alcohol dependence is generally extremely low or nonexistent in the two oldest age groups, and has dropped off in the sixty-five and over age group of Native Americans. Once again, those most likely to be dependent on alcohol within any of the ethnic groups listed are those aged eighteen to twenty-nine.