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Problem drinking  - Alcohol's 'neglected majority' need help reducing intake

by Victor Greto, South Florida Sun-Sentinel, Fort Lauderdale, Fla., 10/15/2002. Minor reformatting: 7/1/2004. []

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Your name is
(fill in the blank) and you are not an alcoholic. 

Alcohol-related vehicle crashes cost the country more than $15 billion a year, while the criminal justice system spends more than $6 billion on alcohol-related crime. 

Addressing the need to change
Those statistics might be sharply reduced if mass mailings of educational materials would be sent to problem drinkers, says Sobell. 

The Sobells' study was published in the June issue of Alcoholism: Clinical and Experimental Research, the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. 
"A lot of people have the wherewithal to change," says Mark Sobell, who also co-directs NSU's Guided Self-Change Clinic in Davie, Fla., which helps people who want to stop or moderate their behavior, including drinking. 
"What the literature shows is that the only thing that matters is the person's choice. The earlier you catch it, the better the prognosis." 

If anything, it's the "alcoholic" label that scares off many problem drinkers who want to get help, says Mark Kern, who is on the board of directors of Moderation Management, a New York-based organization founded in 1993 to help problem drinkers. 

"Some people really do need to stop, but a lot of people are not getting help that could reduce the amount (of alcohol they drink) because we all give them the either/or message," Kern says. "And that's naive." 

Problem drinkers don't fit the stereotype of the traditional alcoholic, Sobell says. "Of people who are problem drinkers, 80 percent are employed, most still have relationships with significant others, many will be married," Sobell says. "Sometimes it goes out of control, and many times it doesn't." 

Teresa Herzog Mourad, coordinator of DrinkWise, an organization created to help self-motivated problem drinkers, says, "the primary factor is self-motivation. Those who come to us on their own ... listen sooner and act sooner." 

Herzog Mourad, whose program is associated with the University of Michigan, says she got a call from a Florida resident seeking help - an "older, educated professional with a degree, but he had no idea what a drink was." He claimed he drank three whiskeys a day, she says. But once Herzog Mourad told him what was considered a "drink" - 12 ounces of beer, 5 ounces of wine or a 1.5-ounce shot of liquor - he realized he was drinking 15 drinks of whiskey daily. 

"It is amazing how little the average citizen knows what is healthy and what is not healthy drinking," says Kern. 
Both he and Herzog Mourad say they were excited at both the Sobells' findings and the idea of mailing educational materials to problem drinkers. 

One of his study's surprising findings, Sobell says, was that there was no meaningful difference in the drinking-reduction results between those who just read generic materials and those who were given personalized information. "Just filling out the assessment material may have been enough for someone to say, 'Hmmm, now that I look at this, I should cut it down,"' Sobell says. 

But you may be a problem drinker and still in need of help. 
Experts say problem drinkers have become the "neglected majority" of alcohol abusers. Because of their sheer numbers, they're at the heart of the country's alcohol-related social and economic troubles, from drinking while driving to lost work productivity. 

"For every alcoholic, there are four problem drinkers," says Mark Sobell, a professor at the center for psychological studies at Nova Southeastern University, Fort Lauderdale, Fla. He estimates there are 12 million problem drinkers in the United States. 

Alcoholism, considered a disease by the American Medical Association, occurs when one becomes physically dependent upon alcohol. 

Problem or excessive drinkers average 12 or more drinks per week or binge at least five times a year. Bingeing is defined as consuming five or more drinks at a time. 

Sobell and his wife, Linda, also an NSU psychology professor, conducted a yearlong study of 825 problem drinkers who wanted to cut back. They discovered participants who received generic educational pamphlets cut down their weekly intake on average by 15 percent to 33 percent.
The costs of alcohol abuse to human lives and the economy are enormous. 
According to the latest reports gathered by the National Institute on Alcohol Abuse and Alcoholism, each year alcohol abuse in the United States is responsible for $134 billion in lost productivity, including $87 billion in losses from alcohol-related illness, $36 billion in premature death and $10 billion in crime. 

Yearly health-care expenses for treating alcohol-related illnesses includes more than $7 billion spent in direct treatment and $19 billion spent on the treatment of medical consequences. 

(Published: October 15, 2002) 

How do you know if you drink too much?
According to the National Institute on Alcohol Abuse and Alcoholism - - if you answer yes to any of the following six questions, you may have a drinking problem: 

1. Do you drink alone when you feel angry or sad? 
2. Does your drinking ever make you late for work? 
3. Does your drinking worry your family? 
4. Do you ever drink after telling yourself you won't? 
5. Do you ever forget what you did while you were drinking? 
6. Do you get headaches or have a hangover after you have been drinking?

For more information:
Moderation Management: Go to its Web site at  or call 212-871-0974. 
DrinkWise: Go to its Web site at  or call 1-800-222-5145. 
Mark and Linda Sobell are co-directors of Nova Southeastern University's Guided Self-Change Clinic in Fort Lauderdale, which "offers professional guidance for individuals who are not severely dependent on alcohol and drugs and who want to take major responsibility for guiding their own change." To contact the clinic, go to its Web site at  or call 954-262-5968. 



Dr. DeLuca's Addiction, Pain, and Public Health Website

Alexander DeLuca, M.D., FASAM.

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Originally posted:  10/17/2002

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