30 Percent of Americans Have Had an Alcohol-Use Disorder

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Nearly one in seven adults have struggled with an alcohol problem in the last year. Across people’s entire lives, nearly one-third have suffered an alcohol-use disorder. Zachary Fagenson / REUTERS

America has a drinking problem, and it’s getting worse. A new study shows that 32 million Americans, nearly one in seven adults, have struggled with a serious alcohol problem in the last year alone. It gets worse if you look at numbers across people’s entire lives: In that case, nearly one-third have suffered an “alcohol-use disorder.”

In a study published today in the journal JAMA Psychiatry, researchers surveyed more than 36,000 Americans and asked them about their drinking habits. They found that a growing number of Americans have alcohol-use disorder, a relatively new classification which the National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines as “problem drinking that becomes severe.”

In addition, binge drinking is becoming more common and intense, the study found. “There has been this cultural shift—people are drinking more when they drink,” says George Koob, director of the NIAAA, who wasn’t directly involved in the study.

He said he was concerned that the study also found that 20 percent of those with an alcohol-use disorder seek treatment. For those who’ve had such a diagnosis in the past year, that figure is just under 8 percent.

Koob says the numbers may be this low because there is still a stigma attached to seeking treatment, and many are in denial about having a problem.

The diagnosis of alcohol-use disorder has been around for more than a decade, and covers a wider variety of problems than connoted by the term alcoholism, which doesn’t have a precise medical definition. Alcoholism would be equivalent to an alcohol-use disorder that is “moderate to severe,” however, and often involves compulsive drinking and an inability to stop imbibing, he says. 

Here are some questions physicians ask when trying to diagnose alcohol-use disorder: Have you had times when you ended up drinking more, or longer than you intended? Do you spend a lot of time drinking, or being sick or getting over the aftereffects? Have you experienced a strong need—or urge—to drink? If the answer to any of these questions (or others on a list furnished by the NIAAA), you may already have a problem, according to the institute.

“There are various degrees of this disorder,” Koob says. “It could be somebody who’s gotten several DUIs. It could be that you just wake up hungover a lot. If you plan to binge over the weekend and miss some classes because of it, then maybe you already have a problem.”

To be sure, many people grow out of this kind of behavior. But most people with a real problem need help, and many of them aren’t seeking it out or getting it, he says.

If the disorder is bad, people can end up drinking alcohol to fix the problem that alcohol created. (Or as Homer Simpson might put it: “To Alcohol! The cause of—and solution to—all of life's problems.”) “When you're at that stage, I'd considered it a disease, and you need help,” Koob says.

The study also found that 36 percent of men and 43 percent of Native Americans had struggled with problem drinking in their lives; young and unmarried people also have higher rates of the disorder than those who are older and wedded.

All of this excessive drinking “costs us a great deal,” Koob says—a total of $224 billion each year (in accidents, DUIs and medical bills for diseases caused by alcohol), according to the Centers for Disease Control and Prevention.

“We could save a lot if we addressed alcohol-use disorders and treated them,” he says.