Excessive Drinking

Excessive Drinking in Nebraska

Nebraska

Excessive drinking comes with short- and long-term risks. Short-term risks include:

• Unintentional injuries such as falls, drownings, burns and motor vehicle accidents.
• Violence such as homicide, suicide and sexual assault.
• Alcohol poisoning.
• Poor decision-making and engagement in risky behaviors like unprotected sex.

Long-term risks include:

• Hypertension, heart disease, stroke and liver disease.
• Cancer of the breasts, mouth, throat, esophagus, liver or colon.
• Alcohol dependence.
• Memory and learning problems.

Death rates from alcohol-involved causes increased significantly between 2000 and 2019. An estimated 95,000 people die every year from alcohol-attributable causes, making it the third-leading preventable cause of death in the United States, behind tobacco and poor diet/physical inactivity. Excessive drinking is responsible for an average of 261 deaths per day, which is equal to 2.8 million years of potential life lost per year. Excessive alcohol use cost the U.S. a total of $249 billion in 2010.

The prevalence of excessive drinking is higher among:

• Men compared with women.
• Adults ages 18-44 compared with adults ages 45 and older. 
• Hawaiian/Pacific Islanders, followed by Hispanic, multiracial, American Indian/Alaska Native and white adults, compared with Black and Asian adults.
• Adults ages 25 and older with an annual household income of $75,000 or higher compared with adults with lower income levels.

The Centers for Disease Control and Prevention (CDC) recommends that some people not drink at all, including anyone younger than 21 and those who are pregnant. For those who do drink, using moderation when consuming alcohol can reduce the risk of adverse health outcomes. More detailed recommendations for moderate drinking are provided by the 2020-2025 Dietary Guidelines for Americans.

The U.S. Preventive Services Task Force recommends that clinicians screen adults ages 18 and older for unhealthy alcohol use and provide those with unhealthy alcohol use with brief behavioral counseling interventions. The CDC provides a free, evidence-based Alcohol Screening Tool to identify individual barriers to and motivators for drinking less.

A variety of evidence-based strategies have been shown to effectively reduce excessive drinking and related health and social costs:

• Increasing alcohol excise taxes.
• Reducing density of alcohol outlets.
• Reducing the days and hours of alcohol sales.
• Holding alcohol retailers liable for injuries or damage done by their intoxicated or underage customers.

Healthy People 2030 has multiple alcohol-related goals, including:

• Reducing the proportion of adults over 21 who engaged in binge drinking in the past month.
• Reducing the proportion of people who had alcohol use disorder in the past year.
• Reducing the proportion of motor vehicle crash deaths that involve a drunk driver.

“2020-2025 Dietary Guidelines for Americans.” Washington, D.C.: U.S. Department of Agriculture and U.S. Department of Health and Human Services, December 2020. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf.

Esser, Marissa B., Sarra L. Hedden, Dafna Kanny, Robert D. Brewer, Joseph C. Gfroerer, and Timothy S. Naimi. “Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009–2011.” Preventing Chronic Disease 11 (November 20, 2014): 140329. https://doi.org/10.5888/pcd11.140329.

Esser, Marissa B., Adam Sherk, Yong Liu, Timothy S. Naimi, Timothy Stockwell, Mandy Stahre, Dafna Kanny, Michael Landen, Richard Saitz, and Robert D. Brewer. “Deaths and Years of Potential Life Lost From Excessive Alcohol Use — United States, 2011–2015.” MMWR. Morbidity and Mortality Weekly Report 69, no. 39 (October 2, 2020): 1428–33. https://doi.org/10.15585/mmwr.mm6939a6.

Kanny, Dafna, Robert D. Brewer, Jessica B. Mesnick, Leonard J. Paulozzi, Timothy S. Naimi, and Hua Lu. “Vital Signs: Alcohol Poisoning Deaths - United States, 2010-2012.” MMWR. Morbidity and Mortality Weekly Report 63, no. 53 (January 9, 2015): 1238–42.

Naimi, Timothy S., Leslie E. Lipscomb, Robert D. Brewer, and Brenda Colley Gilbert. “Binge Drinking in the Preconception Period and the Risk of Unintended Pregnancy: Implications for Women and Their Children.” Pediatrics 111, no. 5 Pt 2 (May 2003): 1136–41.

Planalp, Colin, Caroline M. Au-Yeung, and Tyler N. A. Winkelman. “Escalating Alcohol-Involved Death Rates: Trends and Variation across the Nation and in the States from 2006 to 2019.” State Health Access Data Assistance Center (SHADAC), April 2021. https://www.shadac.org/sites/default/files/publications/Alcohol-Involved-Deaths/AID-4.21-SHADAC-Brief.pdf.

World Health Organization. “Global Status Report on Alcohol and Health 2018.” Geneva, Switzerland: World Health Organization, September 27, 2018. https://www.who.int/publications/i/item/9789241565639.