Beer has been making the headlines recently. And not in the usual context of sports, like Super Bowl game ads promoting Miller or Budweiser. Nope. In a rather unexpected turn, beer has become a notable discussion point during the ongoing United States Supreme Court hearings. Nominee Brett Kavanaugh’s proclivity for the beverage has been a source of humor for shows like Saturday Night Live where Matt Damon, acting as the judge, sloshed “beer” all over his face during the testimony.
Toasting to beer. Photo credit: Getty images
I realize that the SNL sketch was political satire and meant to generate a laugh. I actually found it quite funny. But all this recent discussion of beer in news media and popular culture has given me pause. Today is the last day of Recovery Month, and as a doctor who specializes in addiction medicine, I tend to see alcohol from a very different perspective.
Nearly half of the patients I care for at my addiction treatment center experience alcohol use disorder. Alcohol nearly destroyed their lives.
Trauma. Photo credit: Getty
Travis, a 38-year-old man from New York, began drinking at 13. When I asked how he was introduced to alcohol at such a young age, he said “I saw my mother murdered in front of me,” tears welling in his eyes. “I’ve had nightmares ever since. Alcohol is the only way I can sleep.”
As a medical student and resident trainee physician, I learned about the pathophysiological aspects of alcohol consumption, like liver disease and cognitive impairment. Other than an increased risk of “drunk driving,” rarely was I exposed to the psychosocial aspects of alcohol experienced by my patient, Travis, who used alcohol to numb his traumatizing pain and suffering.
Trust me, I understand that the vast majority of people who consume alcohol do so in a responsible manner. Alcohol is part of our culture. We have a Heineken during after-work Happy Hours. We celebrate weddings and anniversaries with champagne. We have romantic dinners with wine. But alcohol is also a drug, and at-risk drinking can lead to harmful physical, medical, emotional and social consequences.
So, in light of the cultural phenomenon of boozy beverages as well as Recovery Month, I’d like to share some important details about alcohol.
Alcohol kills more people than opioids. The opioid epidemic is making nearly daily headlines (consequently, I have been speaking nationwide about opioid addiction) – and justifiably so. Opioids such as heroin are ‘fast kills’, and people are actively dying. But alcohol, in fact, kills more people – just slower. According to the Centers for Disease Control and Prevention (CDC), 88,000 people died from alcohol use each year from 2006 to 2010, compared to ~17,000 from opioids in 2010 (sadly, the latter is rapidly rising due to fentanyl). Worldwide, alcohol kills one person every 10 seconds. Hefty financial burden on society. In 2010, the National Institute on Alcoholism and Alcohol Abuse (NIAAA) reported that alcohol misuse cost the U.S. $249 billion. 75% of this cost is related to binge drinking.
Binge drinking. Photo: Getty
Alcohol remains a problem in high school. The CDC’s Youth Risk Behavior Survey revealed that most high school students who drank were binge drinkers (57.8%), with 43% of them consuming 8 or more drinks in a row. Underage drinking cost the U.S. $24.3 billion in 2010. The good news is that the overall prevalence of drinking among high school students has dropped significantly, from 50.8% in 1991 to 32.8% in 2015.
Alcohol and assault. According to a study in the Annual Review of Public Health, 97,000 college students aged 18-24 reported experiencing alcohol-related sexual assault or date rape. Many violent offenders, according to the NIAAA, were drinking at the time of the offense: 86% of homicide offenders, 60% of sexual offenders and 37% of assault offenders.
Alcohol affects EVERY part of the human body. When we think of alcohol-related injury, we tend to think of cirrhosis or liver failure. But alcohol is also associated with cardiomyopathy (i.e. heart failure), brain damage (e.g. memory impairments, blackouts, psychosis induced by thiamine deficiency), mood disorders, pancreatitis, impotence and multiple cancers (breast, esophagus, liver, mouth).
Student with a hangover. Photo: Getty
Treatment exists for people with alcohol use issues/disorder. Most people with substance use disorders (regardless of substance) – once connected to the appropriate treatment and recovery services – GET BETTER. There is no one-size-fits-all solution; what may work for one person may not work for another. That said, the three main treatment types are: medications (naltrexone, acamprosate and disulfiram are FDA-approved, with varying efficacy); behavioral therapies are led by health professionals and can reduce drinking behavior through counseling; and mutual support groups such as Alcoholics Anonymous and other 12-step programs provide peer support and can offer a valuable level of support when combined with counseling.
Alcoholic beverages such as wine, whiskey and beer are a part of our social fabric. But as the current news cycle has reminded us, alcohol can cause significant harm, ranging from long-lasting emotional trauma to death. If you or someone you know is experiencing at-risk drinking, please get help. Talk to your doctor or call 1-800-662-HELP to find the nearest treatment facility near you. Other resources include NIAAA, National Institute on Drug Abuse, American Society of Addiction Medicine and Al-Anon for Family and Friends. Always remember – you are NOT alone.