Excessive Drinking

Excessive Drinking in Pennsylvania

Pennsylvania

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

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

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-related causes increased significantly between 2000 and 2019. An estimated 140,000 people die every year from alcohol-related causes, making it the fourth-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.

According to America’s Health Rankings data, the prevalence of excessive drinking is higher among:

• Men compared with women.
• Adults ages 18-44 compared with older adults. 
• Multiracial, Hispanic, white, American Indian/Alaska Native and Hawaiian/Pacific Islander adults compared with Asian adults. Black adults also have a low prevalence.
• Adults ages 25 and older with an annual household income of $75,000 or more compared with adults with lower incomes. 
• LGBQ+ adults compared with straight adults.
• Adults living in metropolitan areas compared with those in non-metropolitan areas.
• Adults who have not served compared with adults who have served in the U.S. armed forces. 

The Centers for Disease Control and Prevention (CDC) advises that certain individuals abstain from alcohol consumption altogether, including anyone younger than 21 and those who are pregnant. For those who do drink, consuming alcohol in moderation can reduce the risk of adverse health outcomes. More detailed recommendations for moderate drinking are provided by the most recent Dietary Guidelines for Americans.

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

Some evidence-based strategies to reduce excessive drinking and related health and social costs include:

• Increasing alcohol excise taxes.
• Reducing the 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.

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. 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4646044/.

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. 
https://pubmed.ncbi.nlm.nih.gov/12728126/.

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.

U.S. Department of Agriculture and U.S. Department of Health and Human Services. “Dietary Guidelines for Americans, 2020-2025.” 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.

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.