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With all of the justifiable attention to the challenge of opioid (heroin and prescription narcotic) addiction in our state it is easy to lose sight of the harm that results from the unsafe use of alcohol. Here are some facts about alcohol use in our society:

  • 1 in 4 high school students in Maine reports drinking alcohol in the last month and 1 in 6 reports binge drinking.
  • 4 in 10 people aged 18 to 25 report binge drinking in the prior month.
  • In 2013 there were 1203 alcohol related car crashes in Maine.
  • 41% of EMS responses for overdose are related to alcohol.
  • 50% of Americans age 12 and over report being current drinkers (that’s 135,000,000 people using alcohol).
  • There are 60,000,000 Americans who are binge drinkers and there are 17,000,000 heavy drinkers.
  • Only 1 in 6 people with problem drinking talk to their doctor or health care provider about it.

Most people are familiar with many of the complications of heavy alcohol use – intoxication, impaired judgment and accidents from binge drinking. Most of us are aware of the harm to work, family, and social ties that can arise from the chronic regular use of alcohol. Fewer people understand all of the potential health consequences of problem drinking. These include damage to the liver and liver failure (cirrhosis), pancreatitis, gall stones, osteoporosis, high blood pressure, vitamin deficiency, anemia, atrial fibrillation, birth defects, and an increased risk of heart disease, stroke, dementia, kidney disease, depression, suicide and diabetes. Few people realize that alcohol is a carcinogen. Women who drink even modest amounts of alcohol have a higher risk of breast cancer than those who do not drink, and regular use of alcohol increases the risk of cancer of the mouth, esophagus, stomach and colon, cancer of the liver, pancreatic cancer and lung cancer.

Alcoholism (also called Alcohol Use Disorder ) is diagnosed by meeting 2 or more of a list of symptoms or behaviors, which can be found here: http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders The more of these a person has, the more severe the alcohol use disorder, and about 7% of our adult citizens (17 million people) have Alcohol Use Disorder. Alcohol Use Disorder runs in families and there are people who are genetically more at risk. It is also more common in people with other mental health problems.

A much larger number of people (as many as 30% of adults) have what is called “At Risk” use of alcohol – that is they may not have yet experienced social or medical complications of their alcohol use but are at risk for developing those complications. More importantly, with education and support they have a chance to reduce their alcohol use to safer levels. Thus, it becomes important that we find ways of identifying people with “at risk” or problem drinking and offer them the information and resources they need to be safer and healthier. Fortunately there are tools we can use to help in that work. It is likely that primary care providers will be doing more routine screening for “at risk” use of alcohol as part of normal history taking with patients, and each of us can also do our own test, for ourselves, our friends and our family. In adults a very helpful screen is the Alcohol Use Disorders Identification Test (AUDIT). An easy to use version which calculates and helps you to interpret your score can be found here: http://www.markjayalcoholdetox.co.uk/audit.php. This questionnaire asks about your frequency of drinking, the amounts you drink, binge drinking and potential serious consequences of your drinking. It’s quick and easy and if you score greater than 8, your drinking is putting you at risk and by reducing the amount you drink you can reduce those risks. If you score over 20 you are likely already suffering harm from alcohol and should do all that you can to cut back, including talking to your primary care provider. Education, counseling and peer support can help and there are medications which can improve your chances of reducing your alcohol use.

For more information and to learn what is being done here in Maine I suggest the following links:

http://www.lunderdineen.org/alcohol-use-time-ask

http://www.niaaa.nih.gov/alcohol-health

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Noah Nesin, MD

Dr. Nesin, Vice President of Medical Affairs for PCHC, is a family doctor with 30 years of experience.

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