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Remember the old joke that starts "I've got some good news and some bad news?" Well, I've got some good and bad news about alcohol abuse. No joke.
April is Alcohol Awareness Month. During this month, thousands of public service agencies join with hundreds of thousands of treatment professionals, law enforcement personnel, and volunteers to educate the public and screen individuals for alcohol abuse. On its face, the idea of screening may seem counterintuitive. Don't those who drink too much know it? The U.S. Substance Abuse and Mental Health Services Administration reminds us that alcohol abusers often don't fit our stereotypes. It reports, "People who abuse alcohol can also be college students who binge-drink at local bars, pregnant women who put their babies at risk for fetal alcohol syndrome when they drink, professionals who drink after a long day of work, or senior citizens who drink out of loneliness."
And unfortunately, that's only the beginning of the bad news.
We all know that substance abuse has plagued us throughout recorded history. Few, however, know to what extent. With the National Institute of Health estimating that yearly costs exceed $245 billion, substance abuse is our No. 1 health problem. Dr. George Valiant of Harvard Medical School has stated that one out of every three hospital beds in this country is occupied by someone there due to the direct or indirect effects of alcohol and drug abuse.
Is substance abuse getting significantly worse? Well, no. While certain facets of the epidemiology of addictive illness will periodically wax and wane, the number of people who abuse substances remains about 10 percent of the population. To put this in perspective, consider that one in 10 construction workers, teachers, doctors and pilots has or will contract a substance-abuse disorder during their lifetime.
While we often hear about the scourge of illicit drugs, it is useful to remember that alcohol is, in fact, a drug that we drink. The fact that it's legal should not induce complacency: the cost of alcoholism is much higher and more ubiquitous than that of illegal drug abuse. In the workplace, for example, 83 percent of the $82 billion lost last year to impaired productivity was due to alcohol abuse. Businesses paid additional billions in insurance costs to cover related illnesses of impaired workers.
Ready for some good news? Deaths due to drunk driving have decreased significantly, both in number and as a percentage of fatal accidents. As a nation, alcohol consumption has dropped 20 percent over the last 15 years. The news for Florida is more ominous, however. The National Institute on Alcohol Abuse and Alcoholism reports that, during the same period, usage of beverage alcohol in Florida has increased by 10 percent.
Gov. Jeb Bush created a plan for stemming substance abuse in the state titled Florida's Drug Control Strategy. I am encouraged by the governor's commitment to treatment as a component of drug use reduction: "If we can get treatment to the addicted and to the user of illegal drugs before he or she becomes addicted, we can greatly reduce the harm illegal drugs inflict on Florida." Sounds great. At present, however, treatment is available to only 16 percent of adults and 23 percent of children who really need it. The Florida Legislature must have the fortitude to commit significant resources to change this.
The strategy also substantially addressed the need for drug-free workplaces, stating, "They are best achieved through a combination of private business practices and state incentives and support for businesses that take the initiative." The report continues, "Drug free workplaces do not just occur. They are a product of initiative, entrepreneurship, good management, worker incentives, education, training, support, and availability of diagnostic tools (such as drug testing)."
A good example is the Manatee Chamber of Commerce BAND program, which has provided technical assistance to over 800 workplaces. Manatee County is indeed fortunate to have the infrastructure in place to support businesses with the courage and foresight to implement this vital strategy.
So we've got our work cut out for us. The good news is that treatment works. A landmark 1992 study by the Rand Corp. found that for every dollar spent on treatment, society saves seven dollars due to improved work performance, lower health care costs and reduced crime. The more we begin to see persons with addictive illness not as bad people who need to be good, but as sick people who need to get well, the better the news will get.