It’s not just painkillers and heroin. Americans have a growing alcohol problem too.

 

More than 33,000 Americans died due to alcohol-induced causes in 2015.

 

Source: Vox

by German Lopez

Dec 9, 2016

 

A lot of attention has, justifiably, gone to the horrifying opioid painkiller and heroin overdose epidemic over the past few years, as it has killed tens of thousands of people in the US on an annual basis since 2010.

 

But America has another growing drug problem too, one that gets a considerable less amount of attention: alcohol.

 

Since 1999, the number of alcohol-induced deaths – those that measure direct health problems due to alcohol, so not car crashes and homicides but liver cirrhosis and other similar health problems – have steadily increased. In 1999, fewer than 20,000 people died from alcohol-induced deaths. In 2015, more than 33,000 did, according to new data from the Centers for Disease Control and Prevention.

 

The increase is present when you control for population. In 1999, seven per 100,000 people died from alcohol-induced causes. In 2015, 10.3 per 100,000 people did.

 

In comparison, the number of deaths linked to opioid overdoses increased from two per 100,000 people in 1999 to 9.8 per 100,000 people in 2015, as the total number of opioid overdose deaths spiked from fewer than 6,000 to nearly 32,000. That’s a sharper increase than alcohol, but opioid overdoses still appear to kill fewer people overall.

 

The problems are somewhat linked. When taken together, opioids and alcohol worsen each other’s risks. So it’s possible that these numbers are at least partly telling the same story of rising drug abuse in general.

 

But given that there are more alcohol-induced deaths than opioid deaths, that’s likely not the whole story. It seems that a lot of Americans are simply drinking too much – leading to deadly consequences.

 

And if you consider the other kinds of alcohol deaths that aren’t present in this data, such as drunk driving and homicides, the total number of alcohol-related deaths each year goes up by the tens of thousands. The CDC previously estimated, before the recent rise in alcohol-induced deaths, that there are 88,000 alcohol-related deaths a year in the US when accounting for these other types of deaths.

 

So we are dealing with a serious public health problem. But it doesn’t seem to be getting the same kind of attention other kinds of public health crises are.

 

America tends to take a very narrow view on drugs. Typically, Americans don’t even consider the two deadliest drugs – alcohol and tobacco – as drugs at all. Instead, “drugs” generally means illicit substances like heroin, cocaine, meth, and marijuana.

 

But alcohol and tobacco are big problems. Alcohol, as noted above, is linked to 88,000 deaths a year. Tobacco is linked to 480,000 or 540,000 deaths each year, depending on which studies you use – either way, a massive death toll.

 

Heroin, meanwhile, was linked to nearly 13,000 overdose deaths in 2015. And cocaine was linked to nearly 7,000.

 

This isn’t to say that heroin and cocaine aren’t bad. They are very bad – and one of the big reasons there are fewer heroin and cocaine deaths compared to alcohol and tobacco is because alcohol and tobacco are simply much more accessible due to their legality.

 

Instead, the point is that we need to view as all of these drugs in a more holistic way when it comes to public health policy. At the core, they are all linked to the same kinds of issues – overuse, misuse, and abuse. And drug treatment programs, while varying from drug to drug, could help alleviate any of these deaths.

 

Yet policymakers often don’t take a holistic approach. Take the recently passed 21st Century Cures Act: While the $6.3 billion measure included about $1 billion in grant funds to combat the opioid epidemic through public health initiatives, more than half of the funding in the bill, $3.5 billion, is paid for by cutting existing public health programs, including tobacco prevention.

 

It’s true smoking rates have massively dropped over the decades. But tobacco is still linked to hundreds of thousands of deaths annually. That’s a big problem that arguably needs more funding, not less.

 

In terms of other drugs, consider this: According to 2014 federal data, at least 89 percent of people who met the definition for a drug or alcohol abuse disorder didn’t get treatment. Patients with drug abuse disorders also often complain of weeks- or months-long waiting periods for care.

 

This suggests a broader problem with drugs, not just one about opioids. Yet Congress only seems to be reacting to the latest drug epidemic to grab headlines, while taking a step back on at least one other drug that kills a lot of people.

 

Of course, addressing all of this would require a lot more money – or at least better-targeted money. Considering Congress has nearly thrown the country into insolvency over debt fights over the past few years, it doesn’t seem likely that lawmakers will boost funding for anti-drug public health programs any time soon.

 

Some policies can target alcohol in particular

 

The good news in terms of alcohol is there are policies that can help reduce alcohol misuse and abuse without increasing spending. Here are just a few ideas proposed by experts over the years:

 

A higher alcohol tax: A 2010 review of the research in the American Journal of Public Health came out with strong findings: “Our results suggest that doubling the alcohol tax would reduce alcohol-related mortality by an average of 35%, traffic crash deaths by 11%, sexually transmitted disease by 6%, violence by 2%, and crime by 1.4%.”

 

Reducing the number of alcohol outlets: A 2009 review published in the American Journal of Preventive Medicine also found that limiting the number of alcohol outlets in an area through stricter licensing, for example, can limit problematic drinking and its dangers. But it also found that going too far can have negative results – by, for example, causing more car crashes as people take longer drives to outlets and possibly drink before returning home.

 

Revoking alcohol offenders’ right to drink: South Dakota’s 24/7 Sobriety program effectively revokes people’s right to drink if a court deems it necessary after an alcohol-related offense. The program, specifically, monitors offenders through twice-a-day breathalyzer tests or a bracelet that can track blood alcohol level, and jails them for one or two days for each failed test. Studies from the RAND Corporation have linked the program to drops in mortality, DUI arrests, and domestic violence arrests.

 

Put state governments in charge of selling alcohol: A 2014 report from RAND concluded that when state governments monopolize alcohol sales through state-run shops, they can keep prices higher, reduce access to youth, and reduce overall levels of use.

 

These are just a few of the ideas that experts have put out there. There are many more ways to curtail alcohol consumption and abuse without outright banning it – a lesson that could perhaps be applicable in other aspects of drug policy.

 

But for these types of policies to happen, Americans and their lawmakers need to first acknowledge there is a problem.