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ALCOHOL COSTS: WHO DRINKS WHAT, WHEN, AND WHERE.

Nonetheless, out of the maze of statistics available on how much Americans drink, where they drink it, and with what consequences, some are important to note. It is estimated that over three fourths, or 77%, of men and 60% of women drink alcohol. They comprise 67% of the adult population. Per capita consumption during the 1960s rose 32%. In the 1970s, despite some ups and downs, consumption basically leveled off. However, since 1978, consumption has dropped by 5%. Whether this represents the beginning of a true downward trend or is just another momentary blip will become evident in several years. In 1984 the statistically average American consumed the equivalent of 2.69 gallons of pure ethanol. The average American drinks 2.34 gallons of liquor, 2.77 gallons of wine, and 30.4 gallons of beer. Because the alcohol content of each varies in terms of absolute alcohol, 36% of the alcohol comes from liquor, 14% from wine, and 50% from beer. Not only has there been a decline in total alcohol consumed, there has also been a shift in beverage preference. Since 1978, there has been a drop of about 10% in liquor consumption, with beer and wine becoming more popular.

How does alcohol use in the United States compare to that of other countries? In 1967, the United States had the second highest rate of alcoholism in the world: France was then ranked first. (More recent figures are not available for comparison, because "alcoholics" have given way to "problem drinkers.") Among industrial countries, the United States then ranked eighth in per capita consumption for all categories of alcohol but was second in distilled spirits. Ten years later (1976) the U.S. position had dropped from eighth to fifteenth in a group of twenty-six industrial countries in total alcohol consumption, although it fell to only third for distilled spirits. That change did not reflect a decline in U. S. drinking but represented a more rapid increase in other countries. More recent figures are not available.

A word of caution: all of the above figures describe the statistically average American. However, it is important to realize that the average American is a myth. The typical American does not in fact drink his or her "statistical quota." First of all, recall that approximately one third do not use alcohol at all. Moreover, for the remaining two thirds there is wide variation in alcohol use. Thus 70% of the drinking population consumes only 20% of all the alcohol. The remaining 30% of the drinkers consumes 80% of the alcohol. Most significantly, one third of that heavy-drinking 30%, or less than 7% of the total population, consumes 50% of all alcohol. Picture what that means. Imagine having ten beers to serve to a group of ten people. If you served these to represent the actual consumption pattern described, you'd have the following. Three people would sit there empty handed. Five people would share two beers. That leaves two people to divide up eight beers. Of those two people, one person would take two and the other person would get a whole six-pack!

It is estimated that 10% of the total adult population are problem drinkers (This percentage is derived not from consumption figures but independently determined by the presence of problems attendent to alcohol use. The similarity though between proportion of very heavy drinkers and problem drinkers is striking!). Using 1985 census figures, and applying the usual proportions, 17.6 million persons, age 18 and over, are problem drinkers. It is also estimated that 1 out of 5 adolescents in the 14- to 17-year age range have a serious drinking problem; that is, 2.8 million teenagers. Thus in the United States an estimated 20.4 million people have drinking problems. For every person with an alcohol problem, it is estimated that four family members are directly affected. Thus approximately 81.6 million family members are touched by alcohol problems.

Over the past couple of decades, national public opinion polls have included questions about alcohol problems. An ever-increasing number of those interviewed have indicated an alcohol problem in their immediate family. In 1972, the figure was less than 1 out of every 10 people (12%). In 1978, 1 person in 4 (24%) said that an alcohol problem had adversely affected his or her family life. In 1983, that figure rose to 1 out of every 3. And 1 year later in 1984, the figure reported by a Harris poll was that 38% of all households reported being beset by alcohol problems. Note that these figures do not distinguish among alcoholics and those who are nonalcoholic but abuse alcohol. These nonalcoholic problem drinkers might include the one-time drunken traffic offender who appears in court; or the person who, when drunk for the one and only time in his life, puts his foot through a window and ends up in a hospital emergency room. But we suspect that when reporting "troubles" people are not referring to those who miss work after a particularly festive New Year's Eve.

In the alcoholic population itself only 5% are on skid row. At least 95% of problem drinkers are employed or employable; they are estimated to make up 10% of the nation's work force. Most of them are living with their families. The vast majority live in respectable neighborhoods, are housewives, bankers, physicians, salespeople, farmers, teachers, clergy, and so forth. They try to raise decent children, go to football games, shop for their groceries, go to work, and rake the leaves. The Northeast, the Middle Atlantic, and the Pacific Coast states have the highest percentages of problem drinkers. They are predominantly males. However, the proportion of women with drinking problems is on the rise.

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