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Massachusetts Medical Society's
Physician Focus

June 2011

Alcoholism and Alcohol Abuse

PROGRAM HIGHLIGHTS:

  • Nearly 18 million people in the United States abuse alcohol or are alcohol dependent.

  • Each year, excessive alcohol use contributes to some 79,000 deaths, 1.6 million hospitalizations, and 4 million emergency room visits.

  • Alcohol is the most commonly used and abused drug among youth under 21 in the U.S. according to the Centers for Disease Control.

  • Alcohol leads to nearly 4 percent of deaths worldwide, and is a causal factor in 60 types of diseases and injuries, according to the World Health Organization.

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 ADDITIONAL RESOURCES

National Institute on Alcohol Abuse and Alcoholism

Substance Abuse and Mental Health Services Administration

Alcoholics Anonymous

Centers for Disease Control

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Alcoholism PSA

From left: John Fromson, M.D., John Renner Jr., M.D.
hi-res photo
promo slide

Alcohol has become a major part of our culture, a fact reflected in how we socialize with each other, the advertising we see in the media, and even the sponsorships of major events. Most Americans take it for granted that they will drink – more than 90 percent of us do - and some start very early – at 14 or 15 years of age. 

“We’ve really got a job to do to educate parents and adolescents that this is dangerous and that they may be setting a pattern that’s going to cause enormous problems for them in the future,” said John Renner Jr., M.D., Associate Chief of Psychiatry at VA Boston Healthcare System and Associate Professor of Psychiatry at Boston University School of Medicine. As a guest on the June edition of Physician Focus with the Massachusetts Medical Society, Dr. Renner engaged in a wide-ranging discussion on alcoholism and alcohol abuse, their causes and effects, and how the conditions are treated, with program host John Fromson, M.D.

“People need to look at the consequences of their drinking and how many parts of their life are affected by it,” says Dr. Renner, who is also Director of the BU Medical Center Addiction Psychiatry Residency Program and the Chair of the American Psychiatric Association Council on Addiction Psychiatry.

Dr. Renner was clear about the effects of excessive drinking: It can lead to a host of health problems, affecting the liver, heart, and brain. It’s associated with dementia and gastrointestinal cancer, and in many cases, occurs along with psychiatric disorders such as bipolar disease, depression, or attention deficit disorder. Besides health concerns, excessive drinkers also experience more divorce, problems in relationships, and trouble with work and holding a job. And with drinkers there’s a high rate of smoking, along with a “mixing in” of other drugs such as painkillers or stimulants.

While recent research has indicated that alcohol has some healthful effects, Dr. Renner cautions that the benefits of moderate drinking – one to two drinks daily - apply only to healthy people who have no medical conditions and are not on medications.

The ill effects of drinking are clear and well documented, but is alcoholism a disease? Yes, it is. “The old view,” says Dr. Renner, “is that this is bad behavior, but we now have abundant evidence that alcoholism is a biological condition, that it’s inherited and runs in families.”

That’s why, he says, it’s particularly important that if alcohol problems are present in a family, that the family be open about them, and that young people be told that they have a high risk for alcoholism.

Dr. Renner acknowledges that it’s hard for people to hold a mirror up to themselves and to be honest about how difficult the problem is. “It takes time for people to accept the fact they have a problem, time to decide they should get help, and even more time for treatment,” he says. “The sad part of it all is that treatment works and people don’t know that. They often avoid or delay treatment because they think it won’t work.”

“Alcoholism is the most common addiction in our culture," Dr. Renner says, "and we need to pay attention to that. The earlier you get someone engaged in treatment, the more likely it will be successful.”

Watch the accompanying video for the complete conversation, which includes discussion on binge drinking, what it means to “hit bottom,” how to approach someone with a drinking problem, and treatments for the condition.

Text:
MMS/Richard Gulla