America’s Hidden Substance Abuse Epidemic

For decades now, America has been on the verge of an opioid epidemic. As public health officials have drawn attention to the problem, more and more resources have become available toward funding solutions and addressing the crisis head on. At the same time, a larger and more expansive substance abuse issue has been expanding at a rapid rate.

According to a 2017 study, alcohol abuse has increased by 50 percent since the start of the century. Today, an estimated one in eight Americans abuses alcohol.

This is nothing new, of course. Substance abuse, and in particular alcohol abuse, has been an almost constant since the beginning of human civilization. But quantifying the costs, personally, socially, and fiscally, is something that has only been taken seriously in recent years.

This study, which was published in JAMA Psychiatry, is one of the first of its kind to quantify these costs. According to their research, alcohol is responsible for one in 10 deaths among working-age Americans, from accidents as a result of alcohol use as well as illnesses developed among those who partake in excessive drinking. There are 90,000 alcohol-related fatalities each year. Excessive drinking cost Americans over $250 billion a year in lost productivity at work, health care costs, and other related expenses. The emotional toll this takes on individuals and their families is impossible to measure, but clearly affects a large number of people.

This is due, in part, to the hesitancy for many to label alcoholism or substance use disorders as an illness. Many societal attitudes in the United States label addiction as an individual and personal failure, and neglect to realize that the after effects of drug or alcohol dependency drastically alter your brain chemistry. In many cases, these individuals require the help of professional addiction counselors and organizations dedicated to treating the root cause of addiction.

The higher rate of addiction, one Bloomberg Opinion column posits, lies with the reluctance to use tools that have been known to deter people from drinking to excess in the first place: restrictions on advertising and higher taxes on wine, beer, and spirits.

“The federal tax on spirits (about 21 cents per ounce of alcohol; taxes on beer and wine are less than half that) has not changed since 1991, and over the past few decades the inflation-adjusted cost of drinking as fallen considerably,” the column says. “Many states have likewise neglected to index their alcohol taxes to inflation.”

Without upending the mental health care system in the United States to make accessing health care treatment for addictions more easily accessible, adjusting taxation on “sin products” such as alcohol is one of the more simple ways to deter people from drinking to excess.

“Some states levy excise taxes on “sin products,” such as cigarettes and alcohol, with the goal of deterring undesirable behavior in addition to raising revenue,” note the experts at Villanova University’s Taxation program. “While Alaska, Delaware, New Hampshire and Oregon have no sales tax, these states levy excise taxes on alcohol and other goods.”

It’s a thought that bears consideration, given that the government spends nearly $100 billion per year on the economic costs of alcohol consumption, but state and federal alcohol taxes bring in a mere $15 billion. This means that the taxpayers are paying a significant amount regardless of their amount of alcohol consumption.

There are other ways to address the issue. In Scotland, for example, a law was passed that would set a 65 cent minimum price for every unit a drink contains, putting the onus on the drinker rather than the taxpayer.

Other solutions might fall to the Centers for Disease Control to raise awareness, which might give Americans the push for a national response when it comes to policy making.

“In the terrible days of rapidly increasing HIV infections and AIDS deaths in the 1980’s, CDC used its Morbidity and Mortality Weekly Report (MMWR) to create an almost real-time tracking of the disease,” writes John P. Walters. “This created a common understanding of the epidemic, a sustained awareness of the need for action, and guidance for a national response.”

Regardless of the response taken, its important that the issue be addressed by lawmakers and mental health experts alike. If we continue to ignore these problems, they will come at a much higher cost later on.

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