Alcohol Consumption: A Sobering Problem

We know the dangers posed by illicit fentanyl.

We know the dangers posed by xylazine.

We caution people about so many substances, but we often overlook one.

Our relationship with alcohol remains complicated. We acknowledge the dangers that drinking presents — from health effects to underage drinking to drunk driving deaths — but the party keeps rolling. We even glorify alcohol consumption. Anderson Cooper downed a shot of tequila on live television to celebrate the New Year, and it’s possible that few people gave it a second thought.

Cheers to 2024. But it’s good to remind ourselves alcohol consumption carries risk.

The 2022 National Survey on Drug Use and Health (NSDUH) released in November 2023 illustrated a steady increase in the number of people who drink. In 2022, alcohol was the substance most commonly used by people 12 and older.

From 2021 to 2022, the number of people consuming alcohol and the incidence of binge drinking increased. In 2022, 137.4 million people 12 and older said they consumed alcohol in the past month. That was up from 133.1 million in 2021. Binge drinking also increased, from 60 million in 2021 to 61.2 million in 2022.

Today, alcohol use disorder (AUD) is the most common substance use disorder, with approximately 29.5 million people qualifying as having an alcohol use disorder in the past year (meeting two or more of the DSM-5 criteria for AUD).

Yet, treatment for alcohol use disorders remains infrequent.

According to the NSDUH, among the 29.5 million people with an AUD, only 2.1% (or 634,000 people) received medication-assisted treatment (MAT) in the past year for their alcohol use.

For comparison, among the 6.1 million people aged 12 or older with an opioid use disorder in 2022, 18.3% (or 1.1 million people) received MAT in the past year for their opioid use.

Alcohol use disorder requires greater attention.

Promoting MAT for AUD could help many more people with their cravings, but it remains underused. Some drugs, like naltrexone, block the pleasurable effects of alcohol. Others, like topiramate, are awaiting approval from the Food and Drug Administration. Preliminary findings indicate that the diabetes and weight loss medication (seen under the brand names Wegovy or Ozempic) has the unintended effect of curbing alcohol use disorder, though more research is required to determine its efficacy as a treatment for AUD.

In addition to medication options, novel approaches to alcohol use prevention have emerged, including relationship building, protective factors and motivational interviewing techniques outlined by the successful Getting Candid initiative. Researchers at Stanford University tested a text message intervention program that shows promise to reduce alcohol use among young adults. The National Institute on Alcohol Abuse and Alcoholism has created a virtual reality experience, Alcohol and Your Brain, to help people understand the neurological effect of alcohol.

If there is a silver lining, it’s that fewer young people report consuming alcohol as of 2023. Taking advantage of that trend by providing better resources and education about substance use disorders could profoundly improve public health in the future.

Alcohol is pervasive, and drinking is a widely accepted social activity. Because the party won’t stop anytime soon, our work to raise awareness about AUD and the available resources must also continue.

What resources do you recommend to raise awareness about alcohol use disorders? Are there programs for youth and adults that you’ve relied on to raise awareness? I’m also curious to hear about your experience with MAT for AUD — should we take greater advantage of that approach?