California Alcoholism Rates, Treatment, and Statistics

Binge Drinking Rates Increasing in California

Binge drinking is when a man drinks more than five drinks in about a two-hour period, or a woman drinks four in the same time period, and the blood alcohol concentration (BAC) is raised above 0.08 g/dL. Heavy drinking is binge drinking (or having five or more drinks in a sitting) five or more times a month.[4] About a quarter of the American adult population binge drank in the month prior to a national survey in 2013, and binge drinking is the most frequent method of excessive alcohol consumption in the nation.[5]^{, [6]} Californians, in 2012, binge drank at rates similar to the national average, although binge drinking does seem to be on the rise within the state.[7]

Traditionally, men may be as much as twice as likely to binge drink than women, and affluent individuals making $75,000 or more annually are more likely to binge drink.[8] It may be becoming more socially acceptable for woman to drink more across the nation in general and in California specifically. Coupling that with the influx of tech jobs and wealthy professionals in the greater Bay Area, it may not be surprising that Santa Clara County, along with San Francisco, Alameda, Santa Cruz, and San Mateo Counties saw increases in binge drinking rates in the 10-year span from 2002 to 2012.[9]

Bars and establishments serving alcohol that are close together may increase binge drinking rates, as may weak alcohol control policies that control how, when, and where alcohol can be sold. Alcohol abuse and binge drinking may also be common in the underprivileged Californian population as well as those more well-off population, perhaps as an escape valve. Whatever the reason, overall, California residents engaging in episodes of binge drinking rose almost 30 percent in 2012 over rates measured in 2002 and may continue to increase.[10]

In California, the rate of residents over the age of 11 who were considered to suffer from an alcohol abuse or dependency in 2012-2013 was slightly higher than the national average at 7.3 percent as compared to 6.7 percent.[11] Approximately 2.3 million California residents, per year between the years 2009 and 2013, battled alcohol use or dependence, or an average of 7.5 percent of the population aged 12 and older.[12]

Alcohol abuse and dependency can create a plethora of social, emotional, physical, legal, and economic problems. In 2006, excessive alcohol use was estimated to cost the state of California close to $32 billion, which was the fifth highest cost per capita among US states.[13] Costs to society count lost workplace production, legal costs, criminal justice expenses, and healthcare costs, meaning that in 2006, one drink cost the California economy $2.44 or $1,165 per capita.[14]

Alcoholism is considered to be a treatable disease. Fortunately, California offers its residents a range of mental health and substance abuse services to choose from.

California’s Substance Abuse Services

Between 2009 and 2013, approximately 186,000 people in California were treated for each year for alcohol dependence or abuse, which was only about 8 percent of those who needed treatment.[15] In 2012, in Los Angeles County, alcohol was the second most commonly cited drug of abuse for individuals admitted to public treatment programs at 23 percent of all admissions behind only marijuana.[16] In general, across California, for the fiscal year (FY) 2009/2010, marijuana jumped ahead of alcohol treatment admissions for the first time, since before 2005 at least. Treatment admissions for both were behind methamphetamine when detox services were excluded.[17]

In the case of detox treatment, alcohol public treatment admissions were second only to heroin for the FY 2009/2010.[18] Drugs and alcohol are commonly mixed, however, and individuals may battle issues with more than one substance at a time. More than 40 percent of those receiving public substance abuse treatment in California in 2013, in a one-day snapshot survey, reported both alcohol and drug issues combined, while only just below 17 percent reported problems with alcohol on its own.[19]

There are two main forms of substance abuse treatment within California: public treatment services that are provided through the California Department of Health Care Services (DHCS) and private treatment options offered by privately funded facilities.[20]

Generally speaking, public programs are funded by the state and provide services to all residents, either for low-cost or free of charge, depending on a person’s economic status. In California, public treatment is provided at a county level, and a County Directory provides telephone numbers of the local offices.[21] Public providers may accept Medi-Cal (which is California’s Medicaid program) recipients, and usually individuals will start the treatment process by first visiting a primary care physician and receiving a referral to a treatment program.[22]

Private programs are typically considered fee-for-service providers and may accept insurance for payment. Private programs may not require a referral first, and generally, an evaluation and assessment are done initially to help families and loved ones choose a program that will best suit their needs. In order to provide substance abuse treatment or recovery services within the state of California, both private and public providers must be licensed through DHCS, and a directory of licensed providers by county can be found here.[23]

Negative Effects of Alcohol and Untreated Addiction

Alcohol was involved in 88,600 deaths in 2010 in America and costs society upwards of $220 billion annually.[29] Data from 2006 suggests that 10 percent of the national alcohol-related fatalities were Californians, as 10,000 people died from alcohol-related causes while another 72,000 were hospitalized.[30]

Like with other drugs, a person can overdose on alcohol. Between 2010 and 2012, six people died in the United States every day from alcohol poisoning, and around 300 people died in California each year as the result of a toxic buildup of alcohol in the body that could not be broken down successfully.[31]^{, [32]} Shallow breathing, vomiting, seizures, trouble remaining conscious, and low body temperatures are all signs of alcohol poisoning, and immediate medical attention should be sought. Alcohol dependency is often the result of repeated patterns of excessive alcohol abuse and may raise the risk for an alcohol poisoning fatality. Alcohol dependence plays a role in about 30 percent of alcohol poisoning deaths.[33]

Excessive or prolonged alcohol abuse can cause a multitude of physical health problems resulting in disease, injury, or even death. Between 2006 and 2009 in California, emergency department (ED) visits involving alcohol were twice as common as those involving drugs, and 280 people per 100,000 were treated in an ED for alcohol-related causes in 2009.[34] Hospitalizations where the principle diagnosis involved alcohol, between 2005 and 2009, were also higher than drug-related hospitalizations at 95.2 per 100,000 as opposed to 79.3 per 100,000.

The most common hospital discharge diagnosis involving alcohol was alcohol-related psychosis followed by alcohol dependence and alcoholic liver disease.[35] Alcohol-related psychosis is often the result of alcohol withdrawal, which can be life-threatening and should be considered a medical emergency. Long-term alcohol abuse and alcoholism left untreated can wreak havoc on a person’s brain and body and may be a contributing factor to developing liver disease, heart or cardiovascular problems, cancer, diabetes, gastrointestinal problems, sexually transmitted diseases, gout, dementia, and more.

The Impact of Alcohol on Crime Rates

Alcohol decreases a person’s inhibitions and impulse control functions, as well as impairs a person’s decision-making abilities, reaction time, and motor coordination, which may result in injury or in being in a hazardous or criminal situation. In 2007, approximately 14,555 Californians were treated in an ED for a non-fatal motor vehicle crash in which alcohol was a contributing factor. In 2009, there were 1,263 alcohol-involved car crash fatalities in California.[36]  Males between the ages of 26 and 34 were involved and treated in EDs most often in the automobile accidents involving alcohol and impaired driving in California in 2007.

In 2013, there were 160,388 arrests for driving under the influence, or DUI, with the average arrestee having a BAC of twice the legal limit at the time of their arrest.[37] Almost a quarter of these arrests were in Los Angeles County, and close to half of all the DUI arrests in California occurred within the counties of Orange, San Diego, Los Angeles, and San Bernardino in 2013.[38]

When people are suspected of driving under the influence in California, they may be asked to take a chemical test by an arresting officer. If the test is refused, it will result in a one-year suspension of their driver’s license. If the person is 21 or older and fails the test, their license will be suspended for at least four months for the first offense. Multiple offenders may be looking at a minimum of a year’s suspension and those under the legal drinking age may as well.[39] A DUI conviction may also result in jail time, fines, or additional criminal penalties.

The majority of alcohol arrests in California (based on 2009 data) are for DUI, public intoxication, or a liquor law violation, and all are considered misdemeanors.[40] Alcohol may also contribute to the perpetuation of other crimes or violent acts that may have stricter penalties and be more serious offenses. Sexual assault, homicide, spousal abuse, child neglect or abuse, and other violent acts may be escalated and their risk factors increased by the presence of alcohol. It is estimated that in between 32 and 50 percent of all homicides the person was drinking before committing the act, and two-thirds of those who fall victim to intimate violence report that the perpetrator was drinking at the time.[41] It is estimated that around 40 percent of women in California will be involved in physical intimate partner violence at some point in their lifetime, and three-quarters of those who do are likely to have minor children living at home at the time. In 2012 there were close to 160,000 calls to law enforcement agencies for domestic violence in California.[42]

Alcoholism and Mental Health

Alcohol is a psychoactive substance that may temporarily dull emotional pain and memory of trauma, and increase pleasure. Over time, alcohol abuse can change the brain’s chemical makeup, and it may become harder for an individual dependent on alcohol to feel pleasure without drinking. The individual may even become depressed and irritable when without alcohol.

Alcohol abuse may be the result of an attempt to self-medicate troubling emotions or mental illness symptoms, but may actually result in making them worse in the long run. It is estimated that mental illness and alcohol abuse or dependence co-occur around a third of the time.[43] This may increase the risk for suicidal behaviors or thoughts. In California between 2009 and 2013, around 1 million adults aged 18 or older had serious thoughts of suicide each year.[44] In 2009, approximately 3,760 Californians committed suicide, and 16,554 suffered from a self-inflicted injury that was nonfatal.[45]

Californians seem to suffer from mental illness and depression at rates similar to the average American, which may be exacerbated by the abuse or dependence of alcohol.[46] When an individual battles both depression, or any mental illness, and substance abuse, the optimal treatment program will be an integration between both medical and mental health resources. Programs that focus on the treatment of co-occurring disorders may be highly beneficial.

Local Substance Abuse and Mental Health Resources

An estimated 63.5 percent of Californians aged 18 or older needing treatment or counseling for mental health concerns did not receive what they needed between 2009 and 2013. More than 70 percent of the 1.8 million each year who did receive public mental health services reported that it helped them and improved their ability to function.[47]

There is often a treatment gap between those needing services and those receiving them. There may be many perceived barriers to treatment, such as cost, accessibility, knowledge of treatment options, and lack of healthcare coverage. There is a wealth of public and private organizations in California that strive to close this treatment gap by providing information and services to residents for mental health concerns, substance abuse, or both.

Each individual county in California has region-specific resources available to help families and loved ones struggling with alcohol abuse and/or mental illness as well. Nonprofit and community organizations may provide preventative and educational measures as well as information on local treatment options.

Alcoholism and mental health can both be improved with treatment. There are numerous substance abuse and behavioral health services of all types within the state of California for residents to choose from. Families are sure to find one that will fit all of their specific needs to provide a healthy foundation for a lasting recovery.

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