Alcohol Remains Most Damaging Drug, Experts Call for Funding to Focus on Addiction
Colorado Rep. Jonathan Singer, D-Longmont, worked in child protection and substance abuse counseling before heading to the state legislature. Now a member of the opioid and other substance use disorders interim study committee , Singer said he often has to remind those he speaks with about substance abuse that alcohol is part of the problem as well.
While the opioid epidemic presents unique challenges, including its deadliness, Singer said that alcohol abuse “eclipses all other substances, including opioids,” in terms of prevalence.
Other experts agree that alcohol is one of society’s most damaging drugs. They say that prevention efforts need to focus on the nature of addiction rather than specific substances.
The latest report from the state’s Substance Abuse Trend and Response Task Force shows that treatment admissions in 2016 were by far highest for those abusing alcohol.
More than half — 56.7 percent — of treatment admissions were for alcohol, according to the report. The next highest was for marijuana at 13.9 percent.
The same report also showed that far more people in the population seek treatment for alcohol at about 684 per 100,000 in 2016, while admissions for all other drugs were less than 200 per 100,000 people.
The number of alcohol treatment admissions per 100,000 people has been decreasing since 2014, but the reason for the decline is unclear.
“It probably is the most dangerous substance out there and our biggest problem, but it’s not one that people are willing to talk about because it’s kind of our norm in the U.S. to have a few drinks after work,” said Lindsey Myers, chief of the violence and injury prevention-mental health promotion branch at the Colorado Department of Public Health and Environment.
Alcohol use trends often need their own charts, she said, because the rates are so much higher than other drugs.
Every day in Colorado, there are five alcohol-attributable deaths, according to Kacy Crawford, the alcohol epidemiologist at the department. In addition to overdoses and accidents, excessive drinking over time can contribute to high blood pressure, liver and heart diseases, stroke, depression and some kinds of cancer.
“It’s definitely a problem or a concern worth our state thinking about,” Crawford said.
Rick Jacquemard, 62, has been sober for 10 years now, but struggled with alcohol his whole life, he said. The problem became severe when he worked a job that changed shifts each week, and he began using alcohol to fall asleep.
“When I went to a normal shift, I couldn’t stop,” Jacquemard said.
He lost a marriage, a house and jobs over time to alcohol, he said, and would fall back into addiction each time he got sober.
Jacquemard would get pancreatitis three times over a six-year period before ending the cycle. He was hospitalized for withdrawal symptoms and would tell doctors that he didn’t care if he made it, he said.
“I had to get sober for myself pretty much,” he said.
In the end, what worked for Jacquemard was a combination of a 12-step program and a sober active community, The Phoenix . He has worked as a volunteer to lead bike rides and teach climbing in the group for six years now.
“Helping out new people has really, really added a lot to my sobriety,” he said. ”(...) That’s what I try to tell new people: Try to find something that works for you and keep doing it. Don’t stop doing it because you feel better.”
The Boulder Alano Club is also building a clubhouse to host meetings for 12-step programs. The new venue should be open by late August or September.
A 2010 study estimated that alcohol abuse and alcoholism cost Colorado $5 billion in health care costs, lost productivity, emergency services and more, according to Crawford. The total is almost $100,000 per Colorado resident, she said.
“Alcohol is the most expensive drug in terms of its impact socially,” according to Ann Noonan, director of SUD Center of Excellence at Mental Health Partners, a nonprofit community mental health center in Boulder.
According to Myers, while there has been a recent focus on opioids, the drug hasn’t taken much of their funding away from alcohol because “it hasn’t been well-funded in terms of prevention,” even before the epidemic.
Noonan sees an opportunity with the energy from the opioid epidemic.
“We have the ability now to develop a treatment system that is not for the drug of the year, but is for treatment of any addiction of any substance,” she said.
So far, communities have used grants to pay for treatment solutions, which Noonan compares to using bake sales to raise money.
“We need to have money baked into health insurance,” she said. “Every $1 used for treatment saves $7 in healthcare dollars.”
The highest risk factor for developing an addiction to alcohol, or any other substance, is the age someone begins using.
If someone starts using a drug at 13, their risk goes up to about 70 percent, according to Noonan. If someone doesn’t use drugs before 21, the risk drops down to 4 to 6 percent.
Lori, who declined to give her last name because she is in Alcoholics Anonymous, said she picked her first drink up at 13. Once she was 15, she really started to drink.
Drinking was “all or nothing” for her, she said.
At 21, she was in an accident and a counselor told her she needed to stop. Lori tried that, but eventually picked drinking back up. She hit what she called her bottom at 23, she said, when she quit school, lost friends and started using drugs as well.
“I just knew there must be something better,” she said. “I wanted to live, and I kinda was dying.”
Now 55, the Boulder resident has been sober for 32 years and still attends AA meetings. The disease never goes away, she said, and she sometimes has to remind herself that she doesn’t drink.
“I feel like it’s a disease of body, mind and spirit,” she said.
The state health department uses an “upstream” approach to prevent youth drug abuse, Myers said. Through the Communities that Care program, money goes toward development programs that can connect children with caring adults.
The money isn’t focused on one specific issue, but uses a strategy that has been proven to prevent alcoholism, drug abuse and risk of committing crimes.
While Crawford said they’ve seen youth drinking decrease over the last decade, the data around adult drinking has stayed the same. The state report shows that 25- to 34-year-old Coloradans are most likely to binge drink.
Nationally, most people who binge drink aren’t alcohol dependent, Crawford said, which means there’s an opportunity for prevention before the issue gets worse. She sees a dual need to treat disorders as well as to create healthy communities with limited access to alcohol.
Access is one of the proven ways to prevent alcohol abuse, Crawford said. Regulating the density of alcohol outlets, limiting the days and hours of sale, and making alcohol more expensive with taxes are strategies that are also proven to work.
Crawford said that primary care providers can also screen patients for excessive or binge drinking and then start a conversation about prevention if they screen positive.
However, according to a policy brief from the state task force’s alcohol policy work group, Colorado allows the sale of alcohol up to 19 hours per day, seven days per week. The state also has the third lowest beer tax in the country at one cent for a 12-ounce beer.
Singer, the state representative, said he’s seen research that shows access to alcohol can go both ways, and that decreased access can sometimes prompt people to hoard alcohol. He doubts the rules regarding availability will change, but he supports increasing the tax on alcohol.
Even a penny per pint or glass of wine could help chip away at alcohol abuse, he said.
Last year, the study committee passed four of the five bills it ran. Some were targeted toward the opioid epidemic, like one that limits access to opioid prescriptions, while others were broader, like a bill that raised the budget to ensure more communities have access to addiction counselors.
When it comes to whether policy should address addiction or individual substances, Singer said it should be a yes/and conversation. The committee plans to continue targeting certain drugs when it makes sense, like through the passage of bills that increase access to naloxone, a drug that reverses opioid overdoses.
But, he said, the committee is also mindful that “today it could be opiates, tomorrow it could be meth, the next day it could be cocaine . . . the fundamental issue is you have someone with a substance abuse problem.”
Madeline St. Amour: 303-684-5212, email@example.com