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Are You a Risky Drinker?

Alcoholism Only Small Part of U.S. Alcohol Abuse, Experts Say
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WebMD Health News

July 21, 2005 - Alcoholism is only a small part of America's alcohol problem.

Risky drinking affects far more people than alcoholism -- or alcohol dependency, as it's more accurately described. And making things worse is our current way of dealing with alcohol abuse.

That's the consensus of an expert panel convened by the American Medical Association. It was not an exercise in hand wringing. The panel recommends an aggressive plan to enlist doctors and health care plans in identifying and helping people whose drinking puts them and others at risk.

"I believe we are on the cusp of a major shift in how we conceptualize and treat alcohol dependency disorders in the U.S.," said panelist Mark L. Willenbring, MD, director of the division of treatment and recovery research at the National Institute on Alcohol Abuse and Alcoholism.

The plan:

  • Make people and their doctors aware that most risky drinkers are not alcoholics.
  • Identify risky drinkers and educate them about their risks.
  • Help people at all levels of alcohol risk get appropriate treatment.
  • Vastly improve access to treatment.
  • Explore new treatments for risky drinking, alcohol abuse, and alcohol dependence.

Thirty percent of Americans are at least risky drinkers, notes Richard Saitz, MD, MPH, professor of medicine and epidemiology at Boston University Schools of Medicine and Public Health and president-elect of the Association for Medical Education and Research on Substance Abuse.

"The spectrum of use ranges from abstinence, to low-risk alcohol use, to risky or problem drinking, to alcohol abuse, to alcohol dependence," Saitz says. "Risky use and problem drinking are actually much more common than more severe alcohol problems. Four in 100 people have alcohol dependence. Three in 10 are drinking at risky levels."

What Is Risky Drinking?

Saitz puts the definitions in a nutshell:

  • Risky drinking means drinking at levels that put a person at risk of medical or social problems.
  • Problem drinking means drinking too much and having a medical or social consequence.
  • Alcohol abuse means drinking too much too fast.
  • Alcohol dependence is drinking too much too often.

"Risky drinking is not defined by consequences already suffered," Saitz says. "Risky drinking is simply defined by consumption … at levels that put people at risk of future consequence."

For men this means more than 14 drinks per week, or more than four drinks on any occasion. For women this means more than seven drinks per week or more than three drinks on any occasion.

What is a "drink?" It is one 12-ounce beer, or one 5-ounce glass of wine, or 1-1/2 ounces of 80-proof spirits.

Who's counting? Everyone who drinks should, says panelist Marc Schuckit, MD, professor of psychiatry at the University of California, San Diego, and director of the alcohol and drug treatment program and the alcohol research center at the Veterans Affairs San Diego Healthcare System.

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