It’s 5:30 on a Friday at the end of a long week, and you’ve just gotten home. Your boss yelled at you, you had to deal with an angry customer, and all you want to do is kick back and blow off some steam with a few drinks. It’s been a long week, and you’ve earned a hard drink or three, right?
This is a pretty classic story in American culture. More than 85 percent of U.S. adults have had a drink at some point in their lives, and more than half have had a drink this month. But American alcohol use isn’t healthy.
America’s History with Alcohol
Alcohol was a part of North America long before Christopher Columbus sailed the ocean blue, but the Europeans' arrival cemented alcohol culture in the Americas.
According to JSTOR, colonists in 1770 drank an average of three and a half gallons of alcohol a year, about double the modern rate. By 1830, that number had doubled, and colonists over the age of 15 drank more than seven gallons of alcohol a year.
Part of this huge alcohol consumption had to do with health, believe it or not. Before water purification measures, beer and other alcohol were safer to drink than water. But for some context, by 1830, the average person was consuming just under 2 bottles of 80-proof liquor every week.
This enormous drinking boom led to moral objections, and in 1919, Prohibition was enacted in the U.S. Alcohol was illegal, at least in name, but underground trade flourished. Organized crime came into its heyday, and speakeasies became a fashion of the day. Prohibition was, by and large, a failure, but it still didn’t get repealed until 1930, just after the Great Depression hit.
After World War II, alcohol started to rise in popularity again. We learned a lot about fetal alcohol syndrome and the risks posed by drunk driving. In 1984, the legal drinking age was raised from 18 to 21, and America came into its modern age of alcohol use.
Problems with Our Alcohol Use
Today, more than 86 percent of U.S. adults over the age of 18 report that they have drunk alcohol at some point. 70 percent said they have had a drink in the last year, and 56 percent have had a drink in the last month. But the American relationship with alcohol is far from healthy.
It's true that American has one of the lowest alcohol use rates per capita of first-world countries, with Belgium, Germany, France, the UK, and Australia coming out ahead of us. But we have a higher rate of alcohol abuse than any of those countries. About 15 million American adults struggle with an alcohol use disorder.
In American culture, alcohol is used for celebration and commiseration alike. It has a sort of therapeutic role in our society; how often have you said after a long day or a stressful situation, “I need a drink”? Too often, we use alcohol in general and drunkenness in particular as a coping mechanism.
This unhealthy relationship gets imparted to us from a young age. College kids are notorious binge drinkers, and this is a culture adults help to perpetuate, accepting that college kids drink heavily. For many alcohol has been taboo up to that point, so when they go away to college and get their hands on it for the first time, they don't understand how to moderate.
Overall, this acceptance leaves Americans with a tremendously unhealthy relationship with alcohol. We learn from an early age to associate heavy drinking with both good times and bad. This leaves us with several excuses a week to get blackout drunk if we want to.
With the American relationship with alcohol being what it is, it’s hardly surprising that so many people suffer from an alcohol use disorder. More than 6 percent of adults in the U.S. have an alcohol use disorder, about 1 in 12 men and 1 in 25 women. An additional 623,000 people between the ages of 12 and 17 have alcohol use disorders.
About 88,000 people die of alcohol-related causes every year in the United States. It’s the third-leading cause of preventable death in the country after tobacco and poor diet and exercise choices. Unfortunately, less than 7 percent of those suffering from an alcohol use disorder seek treatment for the disease.
The Secret Middle Age Crisis
Binge drinking certainly is a problem among high school and college students, but surprisingly, the group most affected by alcohol use disorders are middle-aged adults. In 2015, the CDC estimated that more than three-quarters of the alcohol poisoning deaths across two years were adults between the ages of 35 and 64.
Two Princeton experts suggested that this higher rate of alcohol poisoning death was a result of despair. White adults in that age group have had to deal with the complete transformation of the world they knew in a few short years. Right as they entered adulthood, 9/11, the war in Iraq, the recession, and Hurricane Katrina all hit, shattering their world.
These adults have had to adapt to a world very different than the one their childhoods prepared them for. Far from having career success, economic prosperity, and the golden age their parents conditioned them for, they’re facing an ever-more-divided world where they have to do their best to scratch out a life. Many of them turn to alcohol as a coping mechanism.
When Alcohol Becomes a Problem
Although alcoholism is so prevalent, so is normal alcohol use in our culture. It isn’t uncommon for adults to come home after work and have a drink or two without it becoming a problem. So when does alcohol use become an alcohol use disorder?
One of the quickest ways to find the line between alcohol use and alcoholism is to remember this phrase: alcohol is a problem when it causes problems. In other words, if alcohol starts to cause problems in your life, it may have morphed into an addiction. This can include being late to work because of a hangover, spending more money than you should on alcohol, and straining your relationships with loved ones.
Illness, Not Moral Failing
One of the most important things to know when you or a loved one are dealing with alcohol addiction is that it is a disease. There is a huge stigma surrounding addiction and treatment in our culture because people view it as a moral failing. Addiction has nothing to do with being a bad person or being weak.
Addiction is a chemical process in the brain. When a person with an alcohol addiction stops drinking, there are physiological withdrawal symptoms because of that chemical dependence. When you’re seeking recovery, it’s important to know this.
First of all, there is no reason to be ashamed of seeking help for an alcohol addiction. You wouldn’t feel bad for going to your doctor when you break your arm or get the flu. Addiction recovery should be no different.
And you do need to seek out a program to help you with your recovery. Stopping drinking isn’t as simple as having enough willpower. The symptoms of withdrawal can be dangerous, and you’re combatting a physical addiction, which means trying to handle it on your own would be like trying to recover from a dislocated shoulder through sheer willpower.
Symptoms of Alcoholism
Even if alcohol hasn’t begun to cause significant problems in your life, an addiction still may be present. Alcoholism is a diagnosable illness, and so it comes with a defined set of symptoms. It’s important for you to know these if you believe you or a loved one may have an alcohol use disorder.
You or your loved one may have a hard time controlling how much you drink; one drink turns into three, and three turns into eight. You may also start giving up on your usual social activities or obligations in favor of drinking. When you don’t drink, you might sweat, shake, or become nauseous – these are early symptoms of withdrawal.
There are a number of risk factors that can increase someone’s chance of becoming an alcoholic. You may know people with alcoholic family members who will never touch a drop of alcohol. Alcoholism is a genetically linked disorder, so their risk factor for addiction is higher.
Alcoholism is often comorbid with some other mental health issues, so if you suffer from depression, anxiety, bipolar disorder, or other such conditions, you may be at greater risk for addiction. Starting drinking at an early age, steady drinking over time, and spending time around people who drink are all risk factors, too. And bariatric surgery can increase your risk of developing an alcohol use disorder or relapsing.
Learn More About American Alcohol Use Problems
American alcohol use habits can be seriously unhealthy. We turn to alcohol as a coping mechanism, and over time that coping can turn into a disorder. Make sure you know the signs of alcohol use disorder and think about how healthy your relationship with alcohol is.
If you or a loved one are battling an alcohol use disorder, reach out to us at Caron. We have inpatient and outpatient treatment options, as well as family support for those dealing with addiction. Learn more about our admissions process today.
By Caron Medical Staff
By Joseph Garbely, D.O., DFASAM