As part of Alcohol Awareness Month, the American Psychology Association has released the following interview with Vivian B. Faden, PhD, director of the National Institute on Alcohol Abuse and Alcoholism Office of Science Policy and Communications (OSPC) and associate director of Behavioral Research, in Bethesda, Md.
Q: Why do young people choose to drink to the point of getting drunk when they know the risks involved?Dr. Faden: Drinking to get drunk is fairly common among adolescents and young adults. According to the 2009 Monitoring the Future survey funded by the National Institute on Drug Abuse, 5.4 percent of eighth graders, 15.5 percent of 10th graders, and 27.4 percent of 12th graders reported being drunk in the past 30 days. In addition, the National Center on Addiction and Substance Abuse at Columbia University reports that one-third of teens who were monthly drinkers said that they typically drank to get drunk.
Although most underage drinkers and young adults understand the potential problems from drinking too much, a general increase in risk-taking occurs during this time of life. Unfortunately, for many, this increased risk-taking involves getting drunk.
People sometimes reach high blood alcohol concentrations because they aren’t fully aware of how alcohol content varies among beverages. A standard drink contains about .50 ounces of alcohol. This is approximately the amount of alcohol in 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces -- one shot-- of 80 proof spirits. Certain mixed drinks and high-alcohol beers and wines can contain as much alcohol as two or more standard drinks. In addition, drinking very quickly and/or on an empty stomach can contribute to high blood alcohol concentration.
Q: What is the relationship of binge drinking and alcohol abuse and dependence?Dr. Faden: Binge drinking refers to consuming a large amount of alcohol in a relatively short period of time, while alcohol abuse and dependence are diagnosable alcohol-use disorders. The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking resulting in intoxication. This typically happens over a period of two hours when men consume five or more drinks and when women consume four or more drinks. Binge drinking is associated with many serious consequences such as car crashes, falls, burns, drowning, gunshot wounds, sexual assault and domestic violence, as well as serious health problems, including alcohol poisoning, sexually transmitted diseases, unintended pregnancy, fetal alcohol spectrum disorders , liver disease, high blood pressure, stroke, and other cardiovascular diseases.
Binge drinking is common among college students. In 2008, about 40 percent of college students reported binge drinking during the past two weeks, compared to 30 percent of individuals the same age but not in college. These rates have remained relatively constant over the past few decades. However, surveys suggest that there may be an increase in very high volume consumption by some college students who binge drink.
Alcohol abuse is diagnosed when a person’s drinking results in a failure to fulfill obligations at work, school or home; repeated alcohol use in physically hazardous situations; significant alcohol-related social or interpersonal problems; or alcohol-related legal problems. Alcohol dependence, or alcoholism, is a more severe disorder that leads to clinically significant impairment or distress. Most people who binge drink, including many college students, are not alcohol dependent.
Q: Are campus-based prevention programs successful?Dr. Faden: Campus-based programs can effectively reduce drinking and related problems among college students using individual and environmental approaches. For example, according to several studies, mandated intervention and/or treatment helped students with alcohol problems reduce their drinking. Further, a number of college campuses are partnering with surrounding communities to implement environmental approaches incorporating a range of specific interventions. For example, the recent Safer California Universities Study of College and Community Alcohol Prevention strategies that compared intervention and control schools found that the implemented programs were effective and that universities with the highest intensity of intervention achieved the greatest reductions. Methods included heavy publicity and highly visible enforcement.
Q: How does the United States compare with other countries in terms of alcohol consumption?Dr. Faden: The United States ranks in the middle for per capita consumption among countries, according to the World Health Organization. The WHO data show approximately 50 percent of people over the age of 15 in United States consume alcohol. In one study of about 60 countries, the WHO reports that one-third had lower percentages of alcohol consumers than the U.S. and two-thirds had higher percentages. Topping the list with more than 90 percent drinkers were Estonia, the Czech Republic, Latvia, Slovakia and Denmark. Mayanmar and Singapore had the fewest drinkers, less than 4 percent of the population. Further, in the United States, 9.3 percent of males and 2 percent of females are heavy episodic drinkers. In another study of about 100 countries, the WHO reports that in 41, episodic heavy drinking was lower for both men and women than in the U.S.; in 37, it was higher for both sexes; and in 20, the results were mixed, with men generally being higher than U.S. men and women lower.
Q: What is psychologyâ€™s role in researching and understanding drinking?Dr. Faden: Psychology continues to play an important role in researching and understanding drinking behavior and in developing behaviorally based interventions. Advances in the treatment of alcoholism mean that patients now have more choices and health professionals have more tools to help. Choices include mutual support groups such as Alcoholics Anonymous, behavioral therapies such as brief motivational interviewing and cognitive behavioral therapy, medications such as naltrexone and acamprosate, and specialized intensive treatment programs. These interventions may be used alone or in combination.
The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 154,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.