Study: 33 million have an 'I-Don't-Have-a-Problem' alcohol problem

Researchers from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) asked 36,000 adults about lifetime drinking habits, including current or within the past year. In the study published June 3 online in JAMA Psychiatry, 14 percent of adults were current or recent problem drinkers, or nearly 33 million nationally. Thirty percent – almost 69 million – had been at some point in their lives.

The study uses a newer classification of alcohol use disorders from the Diagnostic and Statistical Manual (DSM-5) released in 2013. Using the older DSM-IV definition, the rates of problem drinking were still higher: 13 percent for current or recent problem drinking and 44 percent for lifetime prevalence – up from 9 percent and 30 percent in the agency’s 2001-02 survey.

Alcohol abuse and the disease alcoholism (see, Know the Difference) are often untreated, partly due to society's stigma on those with alcohol use disorders, and in part due to denial. According to recovery book Every Silver Lining Has a Cloud, “people with the disease of alcoholism often point to others as having a problem, but they personally don't have one, because it is the only disease that convinces the carrier that he/she doesn't have it.”

The study's author, the NIAAA's Bridget F. Grant, says, “This study highlighted the urgency of educating the public and policy makers about alcohol use disorder and its treatments, destigmatizing the disorder, and encouraging among those who cannot reduce their alcohol consumption on their own, despite substantial harm to themselves and others, to seek treatment.” The numbers may be low, too. In a Nov. 18, 2011 ABC News/Gallup Poll, 67 percent of Americans admitted to having ever abused alcohol. The CDC puts the number at 61.2 percent currently drinking frequently and 14 percent former regular drinkers. Drinking problems were most prevalent among men, whites and Native Americans. Low-income adults, those younger than 30 and those who never married also relatively high rates. Problem drinking also was more common among city dwellers than those in rural areas, while the West and Midwest had higher rates than other regions.

NIAA director, George Koob, said it’s unclear why problem drinking has increased but that many people underestimate the dangers of excessive alcohol. “Many won’t seek help because of stigma and denial, and many don’t realize that medications and behavior treatments can help.” A new alcoholism recovery book,Adding Fire to the Fuel, is being released at the REEL Recovery Film Festival in San Francisco June 13 and addresses the stigma of alcohol use disorders. “It's a disease: Same kind of chronic, progressive, incurable-but-treatable, primary and fatal classification as cancer or diabetes. When we handle people with those other diseases with empathy, and dish out distaste to alcoholics or recovering ones, we create a social and economic problem that's passed its tipping point,” notes the author.

The new book looks at the stigma around alcoholism and alcoholism recovery as a $226 billion annual problem hiding in plain sight. “The story of alcohol and America's affair with it keeps it from being recognized as the problem. Instead, people with the disease of alcoholism are considered the problem. 'Alcoholic' is a pejorative today. That's ripe for change.”

The book includes a graph delineating the differences between alcohol abuse and alcoholism. People interested in evaluating their own alcohol consumption can take any number of self-tests (see related video, Alcoholism Screening Explained). Naturally, the most recommended assessment isn't one done alone, but by a medical or counseling professional. The DSM-5 lists 11 criteria for alcohol use disorders. In the past year, have you:

1. Had times when you ended up drinking more, or longer than you intended?

1. More than once wanted to cut down or stop drinking, or tried to, but couldn’t?

1. Spent a lot of time drinking? Or being sick or getting over the aftereffects?

1. Experienced craving — a strong need, or urge, to drink?

1. Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?

1. Continued to drink even though it was causing trouble with your family or friends?

1. Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?

1. More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?

1. Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?

1. Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?

1. Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

“If you have any of these symptoms, your drinking may already be a cause for concern,” reads the manual, however any two or more of the criteria constitutes an alcohol use disorder as identified in the NIAAA study.

Visit alcohologist.com for a replay of CBS Sports' Power Up Your Health featuring Scott Stevens.  Host Ed Forteau led a discussion on the health risks and myths of health benefits of drinking.  Lucy Pireel's "All That's Written" included a feature on Every Silver Lining Has a Cloud called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud also can be found on www.alcohologist.com, plus an interview with Christoph Fisher Books.  Mr. Fisher is an acclaimed international author from the UK, among his works is the Alzheimer's book "Time to Let Go."  Download the FREE Alcohology app in the Google PlayStore today.