As Movendi International has been covering alcohol use and harm in the U.S. increased with the ongoing COVID-19 pandemic. While the alcohol burden in the U.S. came in to focus with the pandemic, it has been a long standing problem for the country.
A study published by JAMA Network explored deaths caused by alcohol in the U.S. and found that the most at-risk groups were American Indian and Alaska Native people and White middle aged and young people.
Deaths driven by alcohol and other harmful substances and liver disease are called “deaths of despair”. The United States has already been experiencing a rise in these types of deaths for a few years, specifically among young people. The COVID-19 pandemic threatens to increase these deaths even more according to a report released by the Well Being Trust and the American Academy of Family Physicians.
The alcohol and other substance use problem in society is aggravated by serious gaps in the provision of healthcare services. The current level of provision of treatment services for people experiencing alcohol problems is way short of need and is further strained by COVID-19. For example, in 2018, only one in every 13 people who needed substance use treatment in the country received treatment.
The new grants for addiction and mental health distributed by SAMHSA through the American Rescue Plan funds come at a time when the need is at its highest.
Meanwhile, the House of Representatives recently passed another important Act in terms of addiction support, the Family Support Services for Addiction Act (H.R. 433). This Act aims to involve, engage and support families with loved ones struggling with addiction. It is currently awaiting to be passed in to law through the Senate.
Alcohol policy solutions need to be prioritized
Funding addiction services is a necessity but so is investing in alcohol policy solutions. Prioritizing alcohol policy can ensure long-term protection for American citizens from the harm caused by the products and practices of the alcohol industry.
The existing alcohol policy in the U.S. falls short in effectively addressing the heavy alcohol burden. For instance, 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 the alcohol tax rates by 70% since 1933. Despite this, in December 2019, the United States Congress incentivized the alcohol industry by extending the major tax break to the industry, losing billions of dollars in government revenue.
Meanwhile, the alcohol industry has used the pandemic to push for deregulating and weakening alcohol policy protections in several states. According to a Movendi International analysis, the alcohol industry has pushed and succeeded in weakening alcohol laws including on alcohol delivery and alcohol take away in numerous states. These states include Alaska, California, Colorado, the District of Columbia, Kentucky, Maryland, Nebraska, New Jersey, New York, Texas, Vermont or Wisconsin.
But solutions are at hand. The World Health Organization’s (WHO) SAFER package includes five high-impact strategies that can help governments to prevent and reduce alcohol harm and related health, social and economic consequences.
- S – Strengthen restrictions on alcohol availability.
- A – Advance and enforce driving under the influence counter measures.
- F – Facilitate access to screening, brief interventions and treatment.
- E – Enforce bans or comprehensive restrictions on alcohol advertising, sponsorship, and promotion.
- R – Raise prices on alcohol through excise taxes and pricing policies.
Most recently, a comprehensive report from the Organization for Economic Cooperation and Development (OECD) showed that investing in policies to prevent and reduce alcohol harm would save millions of lives. Implementing proven alcohol policy solutions would yield substantial returns on investment and would benefit the health care system, the economy and society overall.
The report entitled “Preventing Harmful Alcohol Use” estimates that for every US$ 1 invested in high-impact alcohol policy solutions, up to US$ 16 is returned in economic benefit.
Alcohol-related diseases and injuries incur a high cost to society. Life expectancy is nearly one year lower than it would be, on average, if alcohol consumption in a population would be lower.
An average of 2.4% of health spending goes to dealing with the harm caused by alcohol consumption – and the figure is much higher in some countries, for example in the U.S. Annual health spending due to alcohol is 3.5% in the United States, much higher than the OECD average.
In addition, poor health due to alcohol consumption has detrimental consequences on labour participation and productivity.
Combined with the impact on labour force productivity, it is estimated that GDP will be 1.6% lower on average in OECD countries annually over the next 30 years.
The OECD report shows that there is a strong economic case for upscaling investment in alcohol policy. So called prevention packages are recommended.
- The Prevention Packages could save 3.5 million life years and US$ PPP 16 billion every year.
- Investing in Minimum Unit Pricing could save US$ 207 billion (adjusted for purchasing power), according to the OECD.
These gains can be achieved through a comprehensive approach to alcohol policy. The OECD calls it the “4P Package”. The 4Ps of the intervention package reflect WHO’s SAFER alcohol policy blue print, and shows the potential of integrated approaches to alcohol policy:
- Pricing – limit the affordability of alcohol, especially by eliminating ultra-cheap alcohol,
- Promotion – ban alcohol advertising, especially to protect children and including online alcohol advertising,
- Policing – improve law enforcement, for instance of driving under the influence counter-measures, and provide better services to victims of alcohol violence, and
- Primary care – invest to support people experiencing alcohol problems and alcohol use disorder. Currently, less than 10% receive the healthcare they need.