How others' alcohol use became your business: The Toxin-omics

Drinking is 'The American Way,' 'How We Roll,' 'Harmless Fun,' or just 'None of Your Damn Business.' Just ask a drinker. He or she doesn't even need to have the disease of alcoholism: You attempt to get between a person and the beverage of choice and you'll hear defense. The defense is offensive when you know the economics of the toxin and drug alcohol.

The economic impact of drinking – casual drinking and alcoholic use – tallies an eye-popping $250 billion every single year in the U.S. By way of comparison, smoking costs the economy $173 billion… all other drugs combined cost the economy $130 billion. A 2011 study in the Journal of the National Cancer Institute determined the cost of all cancer care in the U.S. totaled $124.5 billion in 2010 … half as large as the alcohol toll. How big is the we-don't-have-a-problem alcohol problem, by the numbers?

• That's enough to buy a 48 inch HDTV for every man, woman and child in the U.S. And an X-Box. Every year.
• Two-hundred-fifty billion dollars is the same as the annual expenditure on fashion and apparel in the entire U.S.
• The Treasury in 2008 bailed out the banks with a $250 billion “investment” that created critical echoing still heard in the 2016 Presidential campaign and brought hundreds of 99 Percenters camping in Wall Street. That was just a one year expense.
• For the ubersmart Keynesian economists out there, $250 billion is a NEGATIVE GDP (gross domestic product) value of $74 billion. (For those of us less-smart: Alcohol shrinks the economy the way it shrinks libido.)
• For the 216 world economies tracked in the CIA World Factbook, $250 billion is bigger than the 40th largest economy on the planet, and bigger than the output of the bottom one-third of countries COMBINED. 

The costs are in healthcare, lost productivity, legal and corrections costs. Alcoholism is part of the total, but $250 billion is driven by all drinking, even social or moderate use. The CDC readily admits the $250 billion is on the low side, too. The researchers believe that the study still underestimates the cost of excessive drinking because information on alcohol is often underreported or unavailable, and the study did not include other costs, such as pain and suffering due to alcohol-related injuries and diseases.

Alcohol revenue does not cover alcohol economic damage
The monetary consequences are something everyone shares: Drinkers and non-drinkers alike. The numbers get complicated, because the drug Americans enjoy and defend so vigorously, also costs the most in health and hard dollars. Each drink consumed has a median cost of $2.05 in economic harm (lost productivity, health care costs, property damage and criminal justice system expenses). That's according to the Centers for Disease Control and Prevention (CDC). So the drinker pays for that in alcohol tax, right? No. The median paid in tax per drink is less than a nickel a drink. The Tax Policy Center estimates that state and local taxes on alcoholic beverages bring in about $6 billion in revenue nationwide. The overall economic benefit from the manufacture and distribution is less than a quarter per drink.

Industry watchdog, Alcohol Justice, suggests closing the gap between tax revenue and the economic damage, which may also reduce use. According to Alcohol Justice's Charge for Harm Campaign, "Big Alcohol produces, sells, and promotes products that cause harm and incur costs - to both government and its citizens. Appropriately taxing alcohol at state and federal levels will help reduce related harm and provide needed funds. We support state and federal increases in alcohol taxes and fees."
Even if drinkers bore the full $2.05, everyone else still pays in lost productivity. Show up late, never, hungover or just without your A-game and someone has to step in or step up. It doesn't always happen that way. Which costs the company. So the company charges more for its goods or services. Lost productivity, according to the National Institutes of Health (NIH) is more than 70 percent of the $250 billion annual cost of alcohol use in the United States. Every shopper pays… no matter if we shop Walmart or Macy's.

This is the part of the revenue formula pro-alcohol forces leave out of the dialogue when pushing for more beverage licenses, longer hours of service, and absurd ideas like selling alcohol at college sports venues. With greater access to alcohol, the revenue does go up in a bar, store, or restaurant. But so does the economic damage. And never the twain shall meet.

Need a hospital bed? Wait. And pay more.
Here's another way to look at the economic harm. There is an alcohol-related hospital admission every 30 seconds and, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) 20-40 percent of general use (non-specialty) hospital beds are used to tend to alcohol-related complications. Heroin addicts aren't breaking the healthcare system. Aging Baby Boomers aren't pushing it past capacity. Alcohol use is drowning it.

Health care costs related to alcohol use are not limited to the drinker. There are unintended – and sober – victims in traffic crashes you've no doubt heard about from the impaired driving activists, Mothers Against Drunk Driving (MADD). However, children of alcoholics who are admitted to the hospital average 62 percent more hospital days and 29 percent longer stays according to the Children of Alcoholics Foundation.

Nested inside of every major cause of death in the U.S. is the fact that alcohol use is a contributing factor to each of those causes of death or hospitalization. Alcohol is a carcinogen, for example. It is the second-leading cause of oral cancers and is the only dietary connection ever made to an increased risk of breast cancer. The Agency for Healthcare Research and Quality (AHRQ) estimated the price of cancer care for one year of life increased to $207,000 in 2013.

Heart disease, not cirrhosis, is the leading killer related to drinking. Annually, about one in every six U.S. healthcare dollars is spent on cardiovascular disease. By 2030, annual direct medical costs associated with cardiovascular diseases are projected to rise to more than $818 billion, while lost productivity costs could exceed $275 billion. What is the preventative measure hiding in plain sight? Stopping drinking. About 1 in 3 adults—or approximately 86 million people—have at least one type of cardiovascular disease, which means many more Americans could die from what is often preventable through lifestyle changes or managing medical conditions. There are 1.5 million heart attacks and strokes in the U.S. annually. One in five strokes is alcohol-related. One dollar spent on alcohol education (e.g. abstinence) saves $4 in healthcare costs down the road. (Plus $7 in criminal justice system costs for good measure.)

Bottom line: We ALL pay
The healtcare cost equation under mandated insurance means part of every insurance policy premium is gobbled up to care for alcohol-related problems. An insured person doesn't have an account from which he or she dips. Insurance premiums are pooled. You can be a non-drinker… your own premium will be lower because of your relationship with alcohol… but your premium will still reflect the experience of the insurance pool. With insurance mandatory, and 67 to 70 percent of adults using alcohol in the past year, there is a majority of your insurance dollar used to mitigate the expense of drinking.

Binge drinking alone – four or more drinks per occasion for a woman and five or more drinks for a man – accounts for more than 75 percent of costs related to excessive alcohol use in all states, just under $171 billion. Binge drinking is reported by about 18 percent of adults in America. (Wager that the self-reported binge drinking number is MUCH higher, people aren't typically honest about their answer to the non-of-your-damn-business question.) According to the CDC. binge drinkers and their families paid less than half of the costs associated with high alcohol use (41.5 percent) while federal, state and local governments paid about 42 percent, or more than $94 billion, of the costs.

The government doesn't have a separate checkbook funded by drinkers or beverage companies to pay for this: It uses your checkbook.

Visit www.alcohologist.com for more on the health and economic costs of drinking a toxin and known carcinogen. And order The A-Files: Alcohol A-Z for what alcohol does TO you, not FOR you. I Can't See The Forest With All These Damn Trees In The Way is now available in paperback.

Yahoo! I heard another internet alcohol & health lie!

A ridiculous, and dangerous, piece of fiction emerges from cherry-picking observational studies. In that pursuit, anyone can find support for smoking, alcohol use, or use of any other drug. However, the evidence-based science demonstrates ZERO health benefit to even moderate use of a toxin and known carcinogen. (READ THE DELICIOUS PIECE OF FACT-MANUFACTURING YAHOO! UK IS PEDDLING)

Aside from the fact that daily drinking is one of several indicators of the disease of alcoholism, there is no health benefit to drinking any amount, at any age, for either gender. Spend 52 min. with The A-Filesif you want to find out what this drug does TO you, instead of this fiction of what it does FOR you.

For example, Women... this is the ONLY dietary factor shown to increase risk of breast cancer. Each drink daily (10g of alcohol) increases risk by 11 percent. More than four a day brings the same risk as smoking a pack of cigs a day. It's the #2 cause of oral cancers. Was cancer intentionally left from this article? Probably... because alcohol causes eight types of cancer. “The relationship between alcohol and cancer is not widely appreciated by the public and remains underemphasized even by physicians. When it comes to cancer, there is no safe level of alcohol consumption.” American Journal of Public Health Feb. 2014

The heart health myth was discredited more than a decade ago. It causes pre-diabetes, a precursor to type 2… it doesn’t reduce the risk as observational studies claim. Additionally, one in five strokes is alcohol-related. The risk of stroke is both long-term and short-term. In fact, stroke risk increases instantly and remains elevated for two hours after consuming alcohol. There are also consequences for liver, brain, pancreas. More than 60 diseases are caused by even "moderate" use of alcohol and it is the third-leading cause of preventable death and illness in the U.S. and U.K.. This dandy dietary tip just could kill someone.

The immune system is sacked by even moderate use: That's basic bioscience, not the junk science in this pro-alcohol piece. Sex problems linger even a year after complete abstinence (http://www.examiner.com/article/sex-problems-last-a-year-after-heavy-drinking-stops-according-to-new-study) and an older 2007 study -- evidence-based -- notes a falloff in sex drive with regular moderate use. And life expectancy? Jeez. The CDC notes a reduction of life expectancy 18 months (moderate use) to 20 years (heavy use).

Get evidence-based facts before succombing to Yahoo!'s dangerous and irresponsible article.

The entire 26 episode HD The A-Files: Alcohol A-Z series is available on disc, along with fact sheets, for helping professions. Visit alcohologist.com for a replay of CBS Sports' Power Up Your Health featuring Scott Stevens.  Another interview is on Alcohol Awareness.  Syndicated radio program Savvy Central Radio did this interview, too. Lucy Pireel's "All That's Written" included a feature called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud and the first for Adding Fire to the Fuel also can be found on www.alcohologist.com. Download the FREE Alcohology app in the Google PlayStore today. Stevens also is the public relations officer with AddictedMinds.com 

Selling care: Patient brokering in addiction treatment

Ambulance-chasing. Society generally looks on with disgust at the attorney who markets directly to the accident victim in the hours after the ink on the police blotter dries. The practice isn't illegal, but it brings up the subject of ethics. A similar practice has smoldered silently in the addiction care business for the last decade and will be leading to more scrutiny – and crackdown – over the second half of 2016.

Treatment centers provide a service (detox, intensive outpatient, inpatient, partial hospitalization, or some combination of elements) for a fee, which is charged to the client or the client's insurer. It's America. Lawyers charge a fee in a time of need. Mutual fund companies charge a fee to manage the retirement money upon which you'll develop a need. Lawyers are regulated. Fund companies and their sales reps are regulated and supervised. The practice is largely unregulated in the treatment industry.

The ambulance chaser in the addiction care business solicits business in 12-step meetings and detox facilities and even emergency rooms. There are reputable recovery coaches and other addiction paraprofessionals in the service of those struggling with substance abuse who also attend to those venues and offer suggestions. When they are paid by a treatment entity to deliver those struggling heads to the facility's beds is the point in which the practice becomes predatory.

Take for example, Alcoholic Joe. Joe turns up in the emergency department, unconscious due to acute intoxication. (e.g., he's beyond drunk) A responsive ER staff will inquire about what he's had, how much, and how frequently. Maybe even a social worker or staff associate will address the possibility that Joe has a substance use disorder and suggest courses of action beyond the hospital's capability. Other resources may be given to Joe, if he inquires. He takes it to heart (or his wife does) and Joe goes to a 12-step meeting.

So far, so good. When Joe bumps into a counselor, a self-styled recovery guru or a fellow at the meeting, the conversation sometimes turns to treatment. If the person steering the conversation toward a facility is getting paid $1,000 or $5,000 a head to steer Joe toward that facility – and never discloses he or she is on the dole – is where the industry is getting its latest black eye.

It's not unfamiliar territory for the healthcare biz. Rewind the tape back to the early 90's when physicians were accepting elaborate junkets from pharmaceutical companies and medical device makers. The public bristled when the kickback exposed that the patient might not be getting the best medication or device for his condition, just possibly the medication or device offered by the company with the sweetest “conference” destination. In the early 2000's a similar practice in the mutual fund business was discontinued when fund companies were found to have influence over brokers who might not be offering the most suitable investment for the client, just the funds that landed on the “preferred list” because of the extras offered the broker or brokerage firm.

As the opioid epidemic continues to grow within the shadow of the alcohol pandemic, more treatment centers are opening. Which can only be considered a good thing if they are treating the patient and not the one who provided the patient. As start-up facilities – and some established ones – struggle to keep cashflow manageable, a pay-per-client (heads-in-beds) can be an attractive alternative to shelling out for a marketer's salary and benefits. A captive marketer is going to work for one facility or group of facilities. He or she may not have a component of their compensation based on the census of the facility (e.g. percentage of beds filled at a given time). But they are, in theory, still driven by getting the right fit between the client and the facility. Many even network with other centers' marketing staff and refer business to the right fit based on the cost, insurance and most importantly the client's needs. When a consultant makes a referral without accountability to the facility or for the outcome of the treatment for that client, but for what it appears to be the financial gain of a $5,000 payday over a $1,000 payday, the treatment industry's self-policing has a weakness.

There is no inference that every per-client marketer or treatment facility that employs the tactic is sketchy. As with any enterprise, there are scrupulous and unscrupulous sales people. This industry is no exception even though it is commonly referred to as a helping profession which comes in contact with families and clients during a real and human and emotionally charged crisis.

In the early part of this decade, healthcare officials as well as federal agencies have had the practice show up on their radars. In some cases, the fit between the client and facility or program was so poor, litigation ensued. In extreme cases, people have relapsed and/or died while in the care of a program. Not that the relapse is uncommon with the disease of addiction to alcohol or other drugs… it's not a welcome outcome in or shortly after treatment.

For now, the status quo is under greatest scrutiny in California and Florida, two treatment industry hotbeds. However the status quo remains as a practice that is not illegal – like ambulance chasing – just potentially unethical until greater oversight and guidance is provided. For the time being, it pays to ask a question if and how a person is being compensated for making a recommendation of one facility over another.

The entire 26 episode HD The A-Files: Alcohol A-Z series is available on disc, along with fact sheets, for helping professions. Visit alcohologist.com for a replay of CBS Sports' Power Up Your Health featuring Scott Stevens.  Another interview is on Alcohol Awareness.  Syndicated radio program Savvy Central Radio did this interview, too. Lucy Pireel's "All That's Written" included a feature called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud and the first for Adding Fire to the Fuel also can be found on www.alcohologist.com. Download the FREE Alcohology app in the Google PlayStore today. Stevens also is the public relations officer with AddictedMinds.com