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(Boston) — Not all heavy consumers of alcohol are addicted to alcohol. Among the 30 percent in the United States who are considered excessive drinkers, about one-third of that group is dependent on alcohol. However, studying those who are addicted to alcohol as well as those who drink excessively has provided significant insight into the societal consequences of alcohol consumption, according to Richard Saitz, medical doctor and professor of medicine and epidemiology at the Boston University Schools of Medicine and Public Health.
“The maximum number of drinks per occasion and typical number of drinks per week that may spark health-related consequences have been identified,” says Saitz, an expert on alcohol use and related consequences whose presentation at a media briefing on alcohol dependence, held today in New York City, was sponsored by the American Medical Association. Saitz is a grant recipient of the National Institute on Alcohol Abuse and Alcoholism.
According to Saitz, adult men age 65 years or younger are at increased risk for health-related problems if they have more than four drinks per occasion and average more than 14 drinks per week. For adult women and people older than 65, the risk is greater if they have more than three drinks per occasion and average more than seven drinks a week.
“Men and women who exceed three to four drinks per occasion are more prone to injuries, including those from auto-related accidents,” Saitz says. “People who frequently exceed the average weekly amounts have detectable medical health consequences, such as high blood pressure, heartburn, some cancers, and cirrhosis.”
In addition, Saitz believes that studies suggesting an occasional drink may actually be good for your health have not yet achieved the full measure of proof needed. Noting that women who are younger than 45 years and men younger than 35 receive no detectable health benefits from light alcohol consumption, Saitz says, “drinking alcohol as a preventive strategy for a number of common diseases such as heart disease requires the highest level of evidence, which we do not have. In studies that find that moderate drinking is associated with health benefits, it is well within the realm of possibility that something else is responsible for better health.”
According to Saitz, each year alcohol kills 85,000 people in the United States and costs society more than $185 billion, a greater cost than heart disease, the nation’s leading killer. Heavy drinking has a range of medical and psychiatric consequences and symptoms, including depression, insomnia, liver damage, heart failure, hemorrhagic stroke, pancreatitis, and gastritis. Use of alcohol is also linked to cancers of the esophagus, larynx, and mouth; to blood conditions such as anemia, low platelet counts, and bleeding; and to a host of social and work-related issues.
“There are a number of terms that describe the spectrum of alcohol abuse, from risky use, problem drinking and alcohol abuse to alcohol dependence,” says Saitz. “The entire range of unhealthy alcohol use requires careful attention.”
In defining circumstances and behaviors corresponding with unhealthy drinking for those 35 years old and younger, Saitz lists the following eight signs or symptoms: driving a car after drinking; suffering a severe hangover that interferes with work or school; becoming sick from drinking; causing trouble at work or school; having problems with boyfriend or girlfriend or relatives because of drinking; neglecting obligations; entering regretful sexual situations; and receiving lower grades than expected.
Saitz says those classified as alcohol-dependent endure more severe problems such as shakiness; an inability to go a day without drinking; losing control of the number of drinks consumed on every occasion; having to drink larger amounts of alcohol to get the desired effect; and an inability to reduce drinking and physical consequences, including falls and other accidents. In some instances, suicide can be a consequence of alcohol-fueled depression.
“A brief intervention is a great way to address excessive drinking,” says Saitz. “It’s well-established that drinking can be decreased when a health care professional counsels an unhealthy drinker for 10 to 15 minutes. This can have a lasting effect on drinking behavior. ”
Boston University, the fourth largest independent university in the nation, has an enrollment of more than 30,000. Its 17 schools and colleges include the Boston University Medical Center. The Boston University Medical Center, located in Boston’s South End, is made up of the Boston University School of Public Health, the Goldman School of Dental Medicine, Boston University School of Medicine, and the Boston Medical Center, a private, not-for-profit teaching hospital.