COVID-19 has brought into sharp focus the alcohol problem in many parts of the world. This is the case also for the United States. Reports suggest alcohol consumption increased in the U.S. during COVID-19, but alcohol use has in fact been rising in the country for some time, COVID-19 only added further fuel to the alcohol epidemic in the country.
Dr. Keith Humphreys, a professor of psychiatry at Stanford who served as a senior policy adviser on drug policy for President Obama points out the following facts which show alcohol is a major burden to society in the United States:
- Alcohol use is the third leading cause of death in the U.S.
- More people die from alcohol every year than from the entire opioid epidemic.
- Alcohol accounts for more crime than all other drugs combined.
Problematic trends of alcohol in the United States
Existing data on alcohol use in the U.S. suggest the following:
- A 2018 government survey found that over a quarter of American adults reported a binge alcohol use episode in the past month.
- About 20 million American adults could be having an alcohol use disorder.
- Over half of Americans consume alcohol every month.
- Alcohol use is still largely a male phenomenon, but more women are consuming alcohol and the gap is narrowing. This is concerning as women are even more vulnerable to alcohol and its related cancers and other harms.
- Alcohol use is higher among older people over 50 years of age. This could lead to more alcohol-related diseases and injuries as the population ages.
- A study of death certificate data between 1999 and 2017 found the number of annual alcohol-related deaths doubled during this time. Death certificate data is usually an underestimation of the extent of the problem.
- An expert panel in 2015 found that alcohol was the most harmful drug in terms of harm to others. Heroin came in second.
Adding to the existing burden, COVID-19 has exacerbated alcohol harm in the U.S.
People are using alcohol as an unhealthy coping mechanism to manage stress and anxiety. Experts have warned the rise in alcohol use is foretelling a tidal wave of substance abuse harm. A recent research report released by the Well Being Trust and the American Academy of Family Physicians predicted the COVID-19 pandemic could accelerate deaths of despair in the country which include deaths from alcohol and other drugs, suicides, and liver disease. Accordingly, COVID-19 could result in an additional 154,037 deaths of despair in the worst case scenario and 27, 644 deaths in the best case scenario. Doctors have called for urgent action to address the growing alcohol harm in the United States during the COVID-19 pandemic.
Costs of pervasive alcohol harm
Between 2006 and 2010, the costs of pervasive alcohol harm in the United States had increased. This trend is likely accelerating, given the rising number of alcohol deaths in the U.S. during the pandemic.
A 2015 study from the Centers for Disease Control and Prevention (CDC) revealed that the costs from alcohol harm drain U.S. economy. In four, years alcohol-related costs to society had climbed fifteen cents per beverage, due to decreased workplace productivity and healthcare costs. Alcohol consumption was the third-leading preventable cause of death in the United States in 2015.
Alcohol harm cost the U.S. economy $249 billion in 2010, or $2.05 per beverage.
This means a significant increase from $223.5 billion, or $1.90 per beverage, in 2006.
Most of these costs are due to:
- Reduced workplace productivity,
- Crime, and
- Cost of treating people for health problems caused by alcohol.
Case study of Baltimore city
A new study, published in the Journal of Urban Health in March 2020, conducted by researchers at the University of North Carolina at Chapel Hill and Boston University estimates that health and safety problems linked to alcohol cost the city of Baltimore about $2.04 per unit of alcohol.
Their study draws the following comprehensive picture about what alcohol harm costs look like to the government and community:
- $61 million in 2013 were spent by the government in direct costs of alcohol such as health care, police, ambulances and special education for children with prenatal alcohol exposure. That year the government had a a $48 million budget deficit.
- Half of adults in Baltimore consume alcohol and 17% out of them engage in binge alcohol consumption.
- In 2013, Baltimore prisons housed 894 persons who committed alcohol attributable crimes, at a cost to the city of $13,331 per day.
- 276 Baltimoreans died from alcohol-attributable causes in 2013. This exceeds death from breast cancer, diabetes and heart disease.
Alcohol control policy in the United States needs to be improved
Alcohol policy in the U.S. is a patchwork of policies which differ from state to state. It is proving insufficient to tackle the growing alcohol burden in the country. The Federal Government is engaging in alcohol policy, not to protect the people and communities but to promote Big Alcohol’s profits.
As the World Health Organization reports, the USA’s restrictions for on/off premise of alcohol and regulations on sponsorship and promotion remain subnational meaning reliant on each state. The country has no regulations on advertising or product placement of alcohol.
Even though excise taxes exist for alcohol, studies have proven they remain insufficient. A study from Boston University School of Public Health published in the Journal of Studies on Alcohol and Drugs found:
Inflation has reduced American alcohol tax rates by 70% since 1933.
Despite this, in December 2019, the United States Congress extended the major tax break for the alcohol industry, losing billions of dollars in government revenue.
- Without the tax breaks the Distilled Spirits Council (DISCUS) would have payed $275 million in higher taxes.
- A beer industry group claims they would have to pay $130 million in higher taxes.
- California wineries alone would have paid $150 million in higher taxes.
All this money is tax revenue for the government being lost which could have been invested in the health and development of people and communities across the country that are seriously affected by rampant alcohol harm.
Added to this the alcohol industry has been swift and aggressive in pushing for the weakening of alcohol laws during the raging pandemic, leading to swift changes in state alcohol laws.
At the current state of alcohol policy, the USA stands to loose more lives to alcohol at a growing cost to the government. Urgent federal action which prioritizes public health over private profit is vital to reduce this alcohol burden.
We know which policies work to reduce these costs. Higher taxes on alcohol could help pay for itself and reduce consumption,” said Dr. David Jernigan, Senior author of the Baltimore study, from the Boston University School of Public Health.
Dr. David Jernigan, Boston University School of Public Health
