NIH Can’t Explain Study Results Showing Steep Increases in Rates of Alcohol-Related ER Visits

Between 2006 and 2014, data collected through the National Institutes of Health (NIH) regarding the prevalence and risks associated with alcohol use and abuse produced some confounding results. Between 2006 and 2014, per capita alcohol consumption in the U.S. increased by a mere two percent. At the same time, researchers discovered a 61 percent annual increase in emergency department admissions resulting from alcohol-related illness or injury. To put this into perspective, the number of emergency department visits for any reason increased by only 8% in the same time period.

These findings came from a nationally representative data set that includes information on about 30 million visits to U.S. hospital-based emergency departments annually, from 945 hospitals in 33 states and Washington, D.C. This study was published in January 2018, in the journal Alcoholism: Clinical and Experimental Research.

Alcohol Abuse Among Men and Women

Increases in ER visits were highest among females, providing additional evidence of narrowing gender gaps in terms of alcohol-related problems in the U.S. And the current evidence suggest that among women, alcohol-related disease, such as pancreatitis and liver disease did not account for the increase of ER visits, even though woman are at greater risk than men for developing these conditions. That leaves binge drinking as the likeliest explanation of the dramatic increase in ER visits. Yet neuroscientist Aaron White, one of the study’s authors, states that the team, all of whom are scientists at the National Institute on Alcohol Abuse and Alcoholism, cannot explain what’s behind the dramatic increase in alcohol-related ER visits. Why? Because the existing data does not show a corresponding increase in binge drinking among U.S. drinkers. On the other hand, binge drinking, especially among teens and young adults is the norm.Ask the Expert

Dr. Bob Brewer, head of the alcohol program at the National Center for Chronic Disease Prevention and Health Promotion at the CDC reports that “ninety percent of people in the U.S. who drink to excess are binge-drinking,” which we know is responsible for the majority of alcohol-related mortality among males age 16 to 24, who represent the cohort that frequently visit the ER.

Why Does this Matter?

Data from the Center for Behavioral Health Statistics and Quality show that two-thirds of Americans over the age of 17 (170 million plus people) reported drinking alcohol at least once in 2014, the last year of the study. In this light, the sheer volume of persons consuming alcohol compared with less than 5 million ER visits in 2014 is a relatively low percentage. However, we cannot ignore the steady increase in alcohol-related illness, injury and mortality, and the economic cost and the immeasurable human suffering associated with alcohol use disorder. Certainly more analysis of these data is needed, but this study does comport with many other risky trends regarding substance use disorder in the U.S.

As the data reveals, alcohol use is high, but it’s not the only psychoactive substance used by most Americans under age 40. To wit, 24 million Americans 12 and older use marijuana, many on a daily basis. So, there are many confounding variables to consider, but the trend towards more use and decreased perception of harm, is likely driving these regrettable data.

White AM, Slater ME, Ng G, Hingson R, Breslow R. Trends in Alcohol-Related Emergency Department Visits in the United States: Results from the Nationwide Emergency Department Sample, 2006 to 2014.Alcohol Clin Exp Res. 2018 Jan 2. doi: 10.1111/acer.13559. [Epub ahead of print]