2 Studies Reveal Why Alcohol Is More Problematic Than Most People Realize

Because alcohol becomes an even bigger part of our socializing during the holiday season than it normally is, now is the perfect time to take a hard look at this substance.

It’s not always a pretty sight.

Two recent large-scale studies will make that point clear, and I’ll get to those in a minute. First, some important context.

Alcohol gets very positive PR.

Because alcohol is so ubiquitous, socially acceptable, intimately associated with good times and celebratory occasions, and yes, legal, we sometimes lose track of how destructive it can be for individuals and society at large.

On the one hand, alcohol products are endlessly glamorized in advertisements and promotions for the “good life.” Thanks to this relentless messaging, alcohol has long been associated with sophistication, attractive people, wealth, sexiness, success, and so on.

On the other hand, beneath that gloss, excessive alcohol use costs the U.S. more than $250 billion a year in lost work productivity, higher healthcare costs, criminal justice expenses, and vehicle accidents.

Excessive alcohol use also kills more than 140,000 people in the U.S. every year. Even the recent spike in opioid overdose deaths doesn’t come near the number of people killed by alcohol annually.

Closer to home, I see the debilitating effects of alcohol on patients every day at our addiction treatment center in Jacksonville, Florida. We accept patients into our center who are battling the entire range of addictive substances, yet we see far more who are battling alcohol addiction than any other challenge.

Yet despite all the destroyed lives and livelihoods and the huge toll that excessive alcohol use takes on the economy and society, alcohol retains its positive patina.

That is dangerous because it lulls individuals and society into thinking there’s nothing to worry about with alcohol. That is simply not true, as two recent studies make clear.

Study 1: Alcohol is killing people in their prime.

The first study just appeared in JAMA in November 2022. It found that 1 in 8 deaths in people aged 20 to 64 can be attributed to excessive alcohol use. When that age range is narrowed to 20 to 49, one in five deaths is from excessive alcohol use. Among 20 to 34-year-olds, 1 in 4 die from excessive alcohol use.

How are people dying in these cases? Mostly from alcoholic liver disease, cancers related to drinking (mouth, throat, esophagus, breast, liver, and colon cancer), heart disease, and from injuries and accidents related to intoxication.

“Alcohol consumption is a leading preventable cause of death in the U.S.,” said the study authors, “and death rates from fully alcohol-attributable causes (i.e., alcoholic liver disease) have increased in the past decade.”

Study 2: We’re not using an available tool to fight alcohol addiction.

One effective way of helping people who have alcohol use disorder (AUD) is with proven medications that decrease cravings or blunt the effect alcohol has on the brain. FDA-approved medications that help with AUD include disulfiram (sold as Antabuse), acamprosate (Campral), and naltrexone (Vivitrol).

None of these is a magic-bullet cure for AUD, but all show a level of effectiveness that has saved countless lives and helped people maintain lifelong sobriety.

Yet despite that, a recent report published in JAMA Psychiatry found that among the 14.1 million people in the U.S. with AUD in 2019, just 1.6 percent of them reported taking medications for their condition.

As the report authors state, “despite the availability of medication with demonstrated efficacy, MAUDs [medications for AUD] are rarely prescribed to and used by adults with AUD.” Furthermore, say the researchers, “our results highlight the urgent need for improving access to and use of MAUDs among adults with AUD.”

The new MAUD on the block

I previously wrote here about a medication called Prazosin that is showing promise in the fight against AUD. Approved years ago by the FDA to treat high blood pressure, Prazosin is proving effective with AUD patients who are early in their recoveries, are feeling a lot of anxiety, and are getting strong alcohol cravings as a way to deal with that elevated anxiety.

Enter Prazosin, an alpha-1 adrenergic receptor antagonist, which can blunt withdrawal-related stress and reduce cravings. In this way, it may help people get through the critical phase of early recovery and get on their way to long-term sobriety.

Final thoughts

For those who have no problems with alcohol, it has a legitimate place at holiday social gatherings. Just please be safe about it. Don’t drink and drive; drink water and eat food while you’re drinking, stick to a reasonable limit, and drink slowly: please, no chugging.

Enjoy the holiday season, but be smart about your intake, and watch out for your family and friends who may be vulnerable.