Alcohol in America Taking Action to Prevent Abuse (1985) / Chapter Skim
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1. Drinking in America
1. Drinking in America
Pages 1-19
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But they are enough to demonstrate an important point: drinking is a pervasive and creep-rooted feature of American life. Alcoholic beverages have been widely consumed throughout American history, despite attempts by the government ant!
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Since about 1960, per capita consumption has again been rising, with a particularly marked acceleration in the 1960s. Today it is about what it was at the beginning of World War I
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They can help produce, in the words of Mark Moore of Harvard University, a society "with fewer drinking problems not zero drinking, not unlimited drinking, but some level of drinking with a much lower profile of harmful consequences than we now experience." To lay the foundation for an examination of prevention policies, this chapter presents a brief history of drinking in America and explores the dimensions of drinking today. It asks the questions, how much do people drink and what are the consequences of that drinking?
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According to Paul Aaron of Brancleis University and David Musto of Yale University, who review the historical research on drinking in America in Alcohol and Public Policy: Beyond the Shadow of Prohibition, "The colonists brought with them from Europe a high regard for alcoholic beverages. Distillecl and fermented liquors were considered important and invigorating foods, whose restorative powers were a natural blessing.
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Moreover, because of alcohol's addictive qualities, even occasional drinkers flirted with danger at the rim of every cup. This view found its institutional voice in the temperance societies of the 1SOOs and early 19OOs.
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A nefarious trade had robbed people of their reason and corrupted domestic and social integrity. The I8th Amendment represented a millennial triumph inaugurating personal self-restraint and national solidarity." Nevertheless, even the temperance societies realized that this transformation would not occur overnight.
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often ambiguous legal code. With 72 separate sections, the Volstead Act was an attempt to synthesize the best features of various state prohibitionist laws, but its contradictions and modifications of normal criminal procedures created enormous administrative and legal problems.
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Earlier views remain strong in certain ways, and alcohol policy in the years after Repeal was heavily shaped by the alcoholic beverage contro! movement, which held that the government should shape the context in which drinking took place to minimize its harmful consequences.
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Definitions and diagnostic criteria vary beyond this core element, but they generally refer to the quantities of alcohol consumed, the recurrence of physical signs such as blackouts, habits such as morning drinking or binge drinking, disruption of life such as job absenteeism or arrest, and tolerance or withdrawal symp
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The common denominator joining the three types of alcoholic beverages beer, wine, and distilled spirits is ethyl alcohol, which is present in quite different concentrations in each type of beverage. Beer is generally 3 to 6 percent alcohol by volume, with "light" beer at the low end and "malt liquor" at the high end; wine is generally 10 to 20 percent alcohol, with table wine low and fortified "dessert" wine high; and spirits are today generally bottled at 40 percent alcohol (80 proof)
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Above 0.30 percent a person can die due to respiratory depression or inhaling vomit while unconscious. Another important measure of drinking, besides the amount consumed in a single drinking episode, is the average amount of alcohol drunk over many drinking episodes.
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For the nation as a DEAlLY COWSLIP on 50 pe8CEuT or D8l~6 _10 —8 1 ~ _4 2 -2 10° FIGURE 1.2 Surveys of the general population indicate that roughly a third of the adult population in the United Stated does not drink, while another third has an average of less than three drinks per week. Such surveys account for only about two thirds of the total amount of alcohol purchased, but they give a fairly good idea of how consumption is distributed across the population.
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The per capita consumption rate actually depends strongly on the drinking patterns of a minority of the population. A third of the adult population drinks 95 percent of all the alcohol consumed, with 5 percent of the population accounting for half of the overall total.
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Furthermore, only half the people who die from cirrhosis would meet the main diagnostic criteria for alcoholism, although most of them are heavy drinkers. In actuarial terms, a person who has three to four drinks daily incurs some additional risk of liver injury.
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Traffic accidents receive the most attention, but as many people die each year from other kinds of accidents- especially falls, fires, and drownings as on the nation's highways. People who ctie in these accidents do not routinely have their blood tested for the presence of alcohol, as is the case with traffic fatalities, so it is more difficult to accurately attribute a percentage of these accidents to drinking.
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clPRHOSI' TRAFFIC ACCIDEN oTHER ACCIDENT HoMlClDE' S0lClDE' _ . 30,000 CZECHS 60,0oo A CoHo,-RELATED, T SELECTED CAUSES OF DEATH U.S., 1975 FIGURE 1.3 The number of fatalities in the United States related to alcohol cannot be precisely determined, because of complicating factors and inadequate reporting networks.
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Adding up all of the fatalities related to excessive drinking, Dean Gerstein of the National Research Council concludes that alcohol may be involved in a maximum of 150,000 deaths per year (see Figure Id. Approximately 2 million people died in 1983 in the United States.
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Over [$60 billion was spent in 1983] on alcohol by people who could have chosen to spend the money on better housing, new clothes, roast beef, or vacations." These expenditures on alcoholic beverages make a substantial contribution to the nation's economy.
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2Ischemic heart disease refers to tissue damage caused by obstruction of the flow of arterial blood to the heart.
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