Over the past decade, the prevalence of high-risk drinking, alcohol abuse, alcohol use disorders, and subsequent deaths have continued to rise to the point where alcoholism has become a health issue of epidemic proportions and one of the leading causes of preventable death. In recognition of April being Alcohol Awareness Month, we are looking into America’s long (and sometimes complicated) relationship with alcohol to better understand where we fall on the global scale and how we got to this point in the first place.  

A Brief Look at America’s History With Alcohol and Attitude Towards Drinking

Rates of U.S. alcohol consumption have fluctuated along with changes in religious beliefs, cultural trends, and politics. The early settlers drank far more than we do now. Colonists were consuming alcohol with every meal and at a much earlier age. They drank about 3.5 gallons per person, per year (the Puritans did not oppose alcohol itself, but drunkenness). The drinking rate later jumped to over 7 gallons per year after the American Revolution, with children as young as 15 partaking in alcoholic beverages during the day’s numerous drinking breaks. 

Alcohol’s heyday in the United States took a sharp blow due to the Temperance movement of the 1830s when nearly half of the population abstained from drinking. This belief that alcohol was to blame for the violence and immorality that were corrupting American culture paved the way for Prohibition to be passed as the 18th amendment in 1919. American alcohol consumption was the lowest in recorded history until its repeal in 1933.

Levels of alcohol consumption have continued to change with minor ebbs and surges over the century. However, the past three decades have seen a continuous, gradual increase in how much Americans are drinking. 

A Toxic Relationship With Our Toxin Of Choice

A study by JAMA Psychiatry found that cases of alcoholism rose by 49% in the early 2000s and currently 12.7% of the population meets the criteria. These figures are alarmingly high in their own right, but are representative of an even greater problem: a lack of public awareness towards the seriousness of alcohol misuse. Nowadays, there always seems to be some mention of the opioid or prescription painkiller crisis. But alcoholism kills almost double that of those drugs and is significantly less talked about. These statistics highlight a complacency towards alcoholism and related deaths, that has long been fostered by our casual relationship to alcohol. 

Alcohol Abuse Statistics

  • Excessive alcohol use is responsible for over 95,000 U.S. deaths each year
  • 85.6% of Americans drink alcohol; 25.8% reported binge drinking and 6.3% reported heavy alcohol use in the past month
  • Nearly 15 million Americans ages 12 and older have or had alcohol use disorder; 414,000 those between 12-17 years old
  • Only 7.2% of those 12 and older received treatment
  • Alcohol is involved in 18.5% of emergency room visits
  • 7.5 million U.S. children (approximately 10.5%) live with a parent with an alcohol drinking disorder

Nearly half of all alcohol-related deaths are caused by health issues directly attributed to excessive consumption (liver disease, heart disease, various types of cancer, etc.). The other half are caused by short-term ailments such as overdosing, suicide, or motor vehicle accidents. 

How Do American Drinking Habits Compare With the Rest of the World?

The figures about American drinking habits seem dismal, but to have a proper scope of whether our relationship with alcohol is as dysfunctional as it seems requires perspective. So how do we stack up against international drinking cultures? A comparison of our drinking habits to our global peers is even more sobering (pun not intended). 

In terms of overall alcohol consumption, the United States ranks 34th out of 59 alcohol-drinking countries. Compared to other first-world nations, many where alcohol is similarly integrated with their culture, again Americans are found to drink considerably less than our industrialized peers. Yet despite this (and the United States having one of the highest legal drinking ages in the world), we have significantly higher rates of alcohol use disorder than similar countries. Why? 

Wet vs Dry Cultures

One possible explanation for this disparity is the concept of wet and dry cultures. Wet cultures are those like the Mediterranean: alcohol is widely integrated into daily life and activities, frequently consumed with meals, and rates of abstinence are low. Dry cultures are those where alcohol is less prevalent in everyday activities, abstinence is more common, access to alcohol is more restricted, and notably, consumption is more likely to result in intoxication than their “wet” counterparts. These types of cultures include Scandinavian countries, Canada, and the United States.

France and Portugal are wet cultures whose countries have much higher alcohol consumption rates than the United States (ranking 9th and 12th respectively), but remarkably lower rates of alcohol use disorder (1.42% and 1.26%). This disparity shows that it is not so much the quantity (or lack thereof) of alcohol consumed, but rather the intention behind alcohol consumtion.

Global Alcohol Use Statistics

  • 107 million worldwide are estimated to have alcohol use disorder; about 1.4% of the global population compared to the 2% of the entire U.S. population
  • Alcohol is responsible for an estimated 5.3% (3 million) of deaths among the world population. Of those, nearly a third were due to accidents, and over half due to long-term health issues caused by alcohol
  • Alcohol is the 7th-leading risk factor of premature death compared to number three in America

The Importance of Moderation

Alcohol is a fixture in American culture; It accompanies all our favorite pastimes and is firmly rooted in our social rites, both good and bad. But just as ingrained as alcohol is to our cultural norms, so is a reluctance to admit when a person’s lost control over their drinking habits. When combined with cultural stigmas towards addiction and mental illness, America is a breeding ground for the development of alcohol abuse and alcoholism, the like of which often goes undetected and unchecked until the situation is dire. 

Can such a circumstance be prevented? Of course. Drinking in moderation and understanding standard drink size could go a long way in minimizing the short and long-term detriments of alcohol consumption. As the rates of AUDs in other countries have shown, it’s quite possible to drink without doing so to such a debilitating degree. Much of Americans’ attitudes towards drinking is the same mentality of ‘excess’ that we also apply to our portion sizes and shopping habits. Not terribly surprising as the origin country of such sayings as “work hard, play hard” and “go big or go home”. 

Still, our relationship with alcohol isn’t just unhealthy, it’s killing us at rates disproportionate to the amount that we drink. Not only must Americans learn what moderation is and how to apply it to our recreational behaviors; but also to change how we view alcohol (i.e. as a coping mechanism) and to alter our intentions behind our indulgence from intoxication to appreciation.

Source: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics