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Saturday, January 27, 2024

Alcohol overuse causes 140,000 American deaths annually. Why is it so undertreated?

Melinda Fawcett
Originally posted 28 Nov 23

Here is an excerpt:

How to treat the disorder

In the last decade, the medical community has come to recognize AUD as a disease that (like all others) needs medical treatment through a range of interventions. With new treatments coming out every day, hope exists that in the years to come more and more people will receive the care they need.

For those with the most severe forms of AUD, treatment aims at stopping the individual’s alcohol consumption entirely (while recognizing that having a drink or breaking abstinence isn’t a failure, but an almost inevitable part of the recovery cycle).

“What’s happened in the last probably 50 years or so is there’s a more medicalized understanding,” said Humphreys. “So there’s been the rise of neuroscience that looks at things like how the brain changes with repeated administration of alcohol, how that limits things like self-control, how that increases phenomena like craving.”

And as with any other mental health diagnosis, successful treatment for AUD often boils down to a combination of therapy and medication, the experts Vox spoke to said. Just as depression is treated with medication to balance chemicals in the brain, and therapy to help patients unlearn harmful behaviors, AUD often needs the same combination of treatments, said Disselkoen.

The Federal Drug Administration approved the first medication to treat AUD, disulfiram, in 1951. Disulfiram, whose brand name is Antabuse, is a daily pill that causes someone to fall ill — face redness, headache, nausea, sweating, and more — if they drink even a small amount of alcohol. Disulfiram is safe and effective, but the same characteristic that makes it successful (the way it induces illness) also makes it unpopular among patients, said Nixon.

Key points:
  • Alarming death toll: 140,000 Americans die annually from alcohol overuse, highlighting a major public health crisis.
  • Undertreatment disparity: Unlike other dangerous substances, alcohol issues lack the same attention and treatment resources.
  • Neurological changes: Repeated alcohol misuse alters the brain, making it a serious health condition, not just a social issue.
  • Market forces: The powerful alcohol industry and its growing revenue contribute to lax regulations and limited intervention.
  • Policy gap: Inadequate taxation fails to curb consumption, while other harmful substances face stricter controls.
  • Blind spot in drug policy: Recognizing alcohol as a harmful drug with addiction potential is crucial for tackling the problem.