According to an article published in the influential Journal American Medical Association (Jama), heaving drinking is prevalent at all levels of society in the US. Alcohol abuse kills nearly 100 000 Americans each year. Alcohol abuse has increased over the past ten years after a decrease over the previous period. The authors advocate measures for the US on the grounds of serious medical and social consequences.

The article reports on the first national inquiry on alcohol abuse ever conducted throughout the nation. Alcohol abuse kills nearly 100 000 Americans each year, making it the third most common cause of death in the USA. A randomized cross-section of the over-18 American population was interviewed annually via telephone, among other things regarding alcohol consumption over the past 30 days. Excessive drinking was defined as drinking five or more drinks in at least one episode in the past month. This was extrapolated and calculations showed that the total number of episodes of excessive drinking among the adult population of the USA increased from 1.2 to 1.5 thousand million between 1993 and 2001.

Excessive drinking was most frequent among men (81%). They were usually between 18 and 25 years of age, but 69% of all episodes concerned persons older than 26. Excessive drinkers were 14 times more likely to jump behind the steering wheel while under the influence of alcohol compared with non-excessive drinkers.

Although men drink the most heavily, the effect of heavy drinking among women of child-bearing age is not to be underestimated either, seeing the harmful effects on the foetus, especially during the first four months of pregnancy. Since pregnancies are not confirmed until an average of 5 to 6 weeks after conception, a woman may involuntarily expose her foetus to a high level of alcohol during that period.

The authors suspect that, for various reasons, their figures may still be underestimated. Their research does not include the under-18s; some respondents may have underdeclared their alcohol consumption figures; persons who do not have a telephone may be more-than-average drinkers; the measure of five drinks for a single episode was used as a general criterion for excessive drinking, although the usual criterion for women is only four drinks; finally, students - one of the social sectors where alcohol consumption is most common - were under-represented in the cross-section of the population because they mostly lived in halls of residence, without individual telephone numbers. The concerned authors argue for a campaign throughout the nation to curb problem drinking given the serious medical and social consequences.

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