Alcoholism

How Much Does Alcohol Harm People Besides the Drinker?

Two new studies reveal alarming details of the "secondhand harms" of drinking.

Posted Aug 01, 2019

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Fun? Maybe...maybe not.
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Have you ever been harmed by someone who was drinking alcohol?  If the answer is yes, you have a lot of company. 

Two new studies, one from the U.S. and one from England, examine the degree to which alcohol misuse is harming people other than the drinker within a given year.  Just as exposure to “secondhand smoke” from burning or exhaled tobacco products can cause serious health problems for children and adults in the smoking environment, so exposure to alcohol overuse can result in a variety of dangers to those in the drinking environment.

Before describing those dangers, let’s take a quick look at “firsthand drinking” and review the harms of alcohol to the drinkers themselves. 

Alcohol’s Harm to the Drinker

Binge drinking, heavy drinking, and alcohol use disorder (a.k.a. alcoholism) can have disastrous effects on the life and health of those who over-drink.  For example:

  • Alcohol is the third leading cause of preventable death in the U.S. (after smoking and obesity).
  • About 88,000 people in the U.S. die of alcohol-related causes each year (about 62,000 men, 26,000 women).
  • Almost half of liver disease deaths in the U.S. involve alcohol.
  • Drinking alcohol also places the individual at risk of numerous other diseases, including cancers of the mouth, esophagus, pharynx, larynx, liver, and breast.
  • Alcohol use during the teenage years can interfere with normal brain development.
  • Widespread alcohol use and abuse in college has both short and long-term effects on mental and physical health, as I write here.

That overuse of alcohol can be harmful is no surprise. What’s important about the two studies discussed below is that they cast the spotlight on a relatively neglected area—the specific harms of drinking to family members, colleagues, friends, and the society as a whole. 

Alcohol’s Harms to Others

What percentage of adults in the U.S. are harmed by someone else’s drinking? 

According to a recent study in The Journal of Studies on Alcohol and Drugs, the answer is: About 20% of the U.S. population in a 12-month period. That amounts to approximately 53 million adults (26 million women, 27 million men) estimated to experience at least one type of harm from someone else’s drinking.

Using telephone surveys, researchers interviewed a random sample of 8,750 U.S. adults ages 18 and older. The respondents included both men and women and were representative of the general population. Abstainers, moderate drinkers, and heavy drinkers were all included in the interviews as well.

Adopting a framework from previous surveys, researchers inquired about 10 harms that might have resulted from the drinking habits of another person. The harms were: “(a) being harassed, bothered, called names, or otherwise insulted; (b) feeling threatened or afraid; (c) having clothing or belongings ruined; (d) having house, car, or other property vandalized; (e) being pushed, hit, or assaulted; (f) being physically harmed; (g) being in a traffic accident; (h) being a passenger in a vehicle with a drunk driver; (i) having family problems or marriage difficulties; and (j) having financial trouble.” 

A few interesting findings from the U.S. study:

  • Two major factors elevating the risk of harms were: 1. Having a heavy drinker in the household and 2. A family history of alcohol problems. 
  • The most prevalent type of harm was harassment/threats.
  • Compared with women who abstained from alcohol, heavy-drinking women were at seven times the risk for physical aggression.
  • Men were more likely to experience belongings ruined, property vandalized, or physical aggression; women were more likely to experience family/financial harm (one example: money spent on alcohol rather than necessary household expenses).        

A similar study from England of those aged 16 and older likewise found that one in five people were harmed by others’ drinking over the past year. In addition, nearly one in 20 of those experienced physical or sexual aggression from a drinker.  This survey used a sample size of 5,000 individuals, making it the largest survey of its kind in the United Kingdom and the first in England itself.

This survey included questions about 18 possible harms, ranging from “actual or threatened physical violence, through emotional hurt or neglect or having to care for someone whose drinking had resulted in illness/disability, to being kept awake at night because of associated noise and disruption.” 

A few other interesting findings from the English study:

  • Hazardous drinkers were at high risk of being harmed by other drinkers. (Think bar fights or sexual assault, to name two possibilities.)
  • Those aged 16-24 had a higher probability of harm from hazardous drinkers.
  • Retired people had a lower probability of harm from excess drinking.
  • People with disabilities are more likely to be harmed.
  • Single people were at higher risk of harm than those with families.

The study authors note that alcohol is implicated in over half of violent crimes in England and in 10,000 traffic accidents. 

Both these studies focused mostly on adults, with the U.S. study interviewing those 18 and older and the English study those who were 16 and older.  Therefore the studies may actually underestimate the harms of alcohol overuse, as they do not include young children.  From counseling experience with those aged 16 and younger, I can personally attest to the variety of harms endured by this age group.  In addition to the possibility of abuse, neglect, and accidents, life in a household with an alcoholic can be chaotic and unpredictable. As one client poignantly recalled, "I never knew when or if I would be picked up from daycare."

(For an interesting perspective on the harms of alcohol versus heroin or cocaine, see this excellent blog post from 2015 by PT blogger Temma Ehrenfeld.)

Preventing Harms

This latest research tells us that the effects and burden of dangerous drinking are much more widespread than many people realize. What can be done? The authors of the English study summarize the public health task this way: "Policies that focus on alcohol must take into consideration the impact of drinking on those other than the drinker."

The CDC's fact sheet describes a variety of possible prevention strategies.  A few of the ideas:

  • Additional taxation on alcoholic beverages. 
  • Restricted advertising. (Can you watch a sports event on TV without a barrage of ads touting the joys of alcohol consumption? I think not.)
  • Routine screening for alcohol misuse and harms to others in medical settings.
  • Screening of pregnant women and their partners.
  • Talking to children and teens about responsible drinking and, I would add, advising them to avoid settings such as college fraternity parties where hazardous situations are likely to occur. 

Other prevention and harm-reduction ideas from a variety of sources might include these:   

  • Publicize and expand such programs as “Dry January,” a.k.a. "Sober January."  While research is somewhat scant, abstaining from alcohol for one month seems to reduce harmful drinking episodes in the following months.  Colleges, make this "a thing!"
  • Publicize recovery programs of various types (including AA and Al-Anon) as well as counseling opportunities for those affected by alcohol misuse.
  • Develop Public Service Announcements (PSAs) on the dangers of alcohol to others that are inspiring and motivating. 

Summing Up

Studies like the two recent ones not only provide valuable educational material.  They also provide us with a baseline of alcohol-related harms to others that can help public health officials test out and evaluate various interventions that might make alcohol less of a burden to our society.

© Meg Selig, 2019. 

Note of gratitude:  The two studies discussed are available in their entirety for free online. Thanks to the authors and journals for making this possible and for contributing to our public health knowledge base! Click the links at #1 and #2 below to see each study.

References

1. Nayak, M.B. et al, "Alcohol’s Secondhand Harms in the United States: New Data on Prevalence and Risk Factors." Journal of Studies on Alcohol and Drugs: Vol 80, No 3, 2019. 

2. Beynon, C. et al, "Alcohol-related harm to others in England: a cross-sectional analysis of national survey data." BMJ Journals, Vol. 9, Issue 5, 2019.

3. “Alcohol Facts and Statistics,” National Institute on Alcohol Abuse and Alcoholism=