5 ounces of table wine is 12% alcohol which equals 12 ounces of regular beer at 5% alcohol which equals 1.5 ounces of liquor at 24% alcohol.

Alcohol Awareness Month: A Time for Reflection and Action

Alcohol Awareness Month:

A Time for Reflection and Action

By David A. Sleet, PhD, Senior Associate, Bizzell US

April is Alcohol Awareness Month, an opportunity to raise awareness about alcohol harms and take action to prevent them, both at home and in the community.

Data from the World Health Organization found the harmful use of alcohol is a causal factor in more than 200 disease and injury conditions. Worldwide, 3 million deaths every year result from harmful use of alcohol. Overall, 5.1 percent of the global burden of disease and injury is attributable to alcohol, as measured in disability-adjusted life years (DALYs).

According to the Centers for Disease Control and Prevention, excessive alcohol use was responsible for more than 140,000 deaths each year in the United States during 2015–2019, or more than 380 deaths per day. There is clear evidence that heavy drinking, even on a small number of days increases risks to health.

Excessive drinking is also costly, reaching $249 billion in 2010, or about $2.05 per drink. Most (77 percent) of these costs were due to binge drinking, defined as drinking four or more alcoholic beverages per occasion for women or five per occasion for men. Further, two of every five dollars were paid by federal, state, and local governments, demonstrating that we are all paying for excessive alcohol use.

It is well known that alcohol is strongly associated with death from motor vehicle crashes, drowning, falls, workplace injuries, fires, burns, suicide, and violence[1]Chikritzhs, T., & Livingston, M. (2021). Alcohol and Risk of Injury. Nutrients, 13(8), 1-15. https://doi.org/10.3390/nu13082777. Alcohol also has what is regarded as “secondhand harms,” defined as harms to individuals as a result of someone else’s drinking — estimated to affect one in five adults annually[2]Nayak, M., Patterson D., Wilsnack, S., Karriker-Jaffe K., and Greenfield, T. (2019). Alcohol’s Secondhand Harms in the United States: New Data on Prevalence and Risk Factors. Journal of Studies on Alcohol and Drugs, 80(3), 273-281. https://doi.org/10.15288%2Fjsad.2019.80.273.

A recent analysis from the Institute for Health Metrics and Evaluation even suggests that for young adults aged 15-39, there are no health benefits to drinking alcohol, only harms. The harms they are most likely to experience involve injuries. Both males and females under age 40 risked health losses from alcohol use, even when consuming small amounts. For those over age 40, consuming small amounts of alcohol (e.g.,1-2 glasses of wine daily) may provide some health benefits but only among selected groups[3]GBD 2020 Alcohol Collaborators. (2022). Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis from the Global Burden of Disease Study 2020. Lancet, 400(10347), 185–235. https://doi.org/10.1016/S0140-6736(22)00847-9.

We need stronger interventions tailored towards younger individuals to reduce the substantial global health loss attributable to alcohol use. To improve population health, the public should demand greater accountability from those who manufacture, advertise, market, distribute, and sell alcohol.

Actions you can take:

  • Encourage friends and family to make small changes, such as keeping track of how much they drink – daily, weekly, or monthly – and setting safe drinking limits.
  • Find effective ways to talk to your children about the risks of alcohol use and the dangers of underage and binge drinking.
  • Support health care efforts to curb alcohol-related illness and disease by screening patients for alcohol problems, obtaining routine blood alcohol concentrations (BAC) for injured patients, and by strengthening laws that limit the availability of alcohol to underage youth. 
  • Avoid driving after drinking and support state government initiatives to enact per se laws for alcohol impaired driving to 0.05 percent BAC, from current laws at 0.08 percent. 
  • Limit alcohol intake to two drinks or less a day (if you are a man) and one drink or less a day (if you are a woman), on days when alcohol is consumed. 



[1] Chikritzhs, T., & Livingston, M. (2021). Alcohol and Risk of Injury. Nutrients, 13(8), 1-15. https://doi.org/10.3390/nu13082777

[2] Nayak, M., Patterson D., Wilsnack, S., Karriker-Jaffe K., and Greenfield, T. (2019). Alcohol’s Secondhand Harms in the United States: New Data on Prevalence and Risk Factors. Journal of Studies on Alcohol and Drugs, 80(3), 273-281. https://doi.org/10.15288%2Fjsad.2019.80.273

[3] GBD 2020 Alcohol Collaborators. (2022). Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis from the Global Burden of Disease Study 2020. Lancet, 400(10347), 185–235. https://doi.org/10.1016/S0140-6736(22)00847-9

National Alcohol Screening Day

National Alcohol Screening Day (NASD) is an initiative first launched in 1999 by the National Institutes of Health (NIH).  NASD is held annually on the first Thursday of the first full week of April. The purpose of this event is to increase public awareness that alcohol abuse and alcoholism are recognized disorders which can be treated. During this day, members of the public are encouraged to visit screening centers and asked to complete written self-assessments about their alcohol use.

According to The Community Guide, there are 2,000 alcohol poisoning deaths in the U.S. each year and alcohol abuse is higher in college students, who do tend to frequently drink in large volumes.  Excessive, fast consumption of alcohol is known as ‘binge drinking’, and this kind of alcohol abuse can lead to many recognized health problems such as anxiety, depression or sexual problems.  The long-term effects of alcohol abuse include an increased risk of developing certain cancers, liver cirrhosis, high blood pressure and heart problems.
National Alcohol Screening Day awareness continues to grow nationally, and the U.S. government is supporting programs and policies to reduce binge drinking and expand access through the Affordable Care Act to new health insurance plans to cover alcohol screening and brief counseling. The National Institute on Drug Abuse (NIDA) has launched two online screening tools that providers can use to assess for substance use disorder (SUD) risk among adolescents 12-17 years old.

Two Screening Options: Providers can select the tool that makes sense for their clinical practice.

CAGE Questionnaire  

The CAGE can identify alcohol problems over the lifetime. Two positive responses are considered a positive test and indicate further assessment is warranted.

The questionnaire takes less than one minute to administer and is often used in the primary care of other general settings as a quick screening tool rather than as an in-depth interview for those who have alcoholism.  The CAGE questionnaire does not have a specific intended population and is meant to find those who drink excessively and need treatment. The CAGE questionnaire is reliable and valid for assessment of alcohol abuse; however, it is not valid for diagnosis of other substance use disorders, although somewhat modified versions of the CAGE questionnaire have been frequently implemented for such a purpose.

AUDIT-C Overview 

The Alcohol Use Disorders Identification Test (AUDIT) can detect alcohol problems experienced in the last year. A score of 8+ on the AUDIT generally indicates harmful or hazardous drinking. Questions 1–8 = 0, 1, 2, 3, or 4 points. Questions 9 and 10 are scored 0, 2, or 4 only. The Audit-C is a 3-item alcohol screen that can help identify persons who are hazardous drinkers or have active alcohol use disorders (including alcohol abuse or dependence). The AUDIT-C is a modified version of the question AUDIT instrument.

Bizzell CEO Appointed to CSAP National Advisory Council

In recognition of his extensive expertise in substance abuse prevention and treatment, Anton Bizzell, M.D., CEO of The Bizzell Group (Bizzell), has been appointed by the Secretary of the U.S. Department of Health and Human Services (HHS) to serve on the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Prevention (CSAP) National Advisory Council. Dr. Bizzell’s appointment is effective through November 2018.

CSAP leads the development of national substance abuse prevention policies and programming, promotes the adoption of proven, science-based substance abuse prevention approaches and helps states and communities build their capacity to implement these approaches. As a member of the CSAP National Advisory Council, Dr. Bizzell will support this mission by making recommendations on agency and center activities and policies, in addition to reviewing grant and cooperative agreement submissions. “It’s a great honor and responsibility to work at a national level to help states and communities find proven and practical ways to prevent substance abuse and reduce the impact this disease has on individuals, families and communities,” said Dr. Bizzell.

Since earning his Doctorate in Medicine from the University of Virginia, Dr. Bizzell has spent the majority of his career working to improve access and quality of care issues for people experiencing substance abuse, mental illness or complicating health issues. He has more than 20 years of combined clinical, research, health services, policy and management experiences with various private and public organizations, including his service as a Medical Officer at both the National Institute on Alcohol Abuse and Alcoholism, NIH, and the Center for Substance Abuse Treatment, SAMHSA. Dr. Bizzell has also provided leadership to projects of national significance including CSAP’s Prevention Fellowship Program, SAMHSA’s Federal Drug Free Workplace Technical Support contract, and SAMHSA’s Prescription Drug Misuse and Abuse project.

Bizzell CEO Appointed to COPE’s Governing Body

The Coalition on Physician Education in Substance Use Disorders’ (COPE) Executive Committee recently announced the appointment of Anton C. Bizzell, M.D., CEO of The Bizzell Group (Bizzell), to COPE’s governing body.  The designation adds to Dr. Bizzell’s rich history in the field of health education as he has served as a Medical Officer with the Substance Abuse and Mental Health Services Administration (SAMHSA), as well as in the Office of Translational Research and Education at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), providing support for research and educational projects addressing physician and other allied health professions’ continuing education.

COPE was formed in 2010 to sustain and expand on the accomplishments of a series of White House Conferences on Medical Education in Substance Abuse, sponsored in 2003, 2006, and 2009 by the Office of National Drug Control Policy in the Executive Office of the President.  The organization’s overarching goal is to improve the education of medical students in the areas of alcohol, tobacco and other drug use disorders – ranging from problematic or risky use to addiction.  Another goal is to help medical students receive appropriate training to develop the skills they need to prevent, screen for, diagnose and manage substance use disorders in their patients, regardless of the location or specialty in which they ultimately practice.

As a member of COPE’s governing body Dr. Bizzell will have a hand in supporting the organization’s current activities including administration of medical school surveys and sponsorship of regional Medical Education Summits which are designed to identify specific needs and respond to opportunities for enhancing teaching about substance use disorders in the undergraduate years.  COPE also produces an e-newsletter, which is distributed to more than 3,000 readers, and maintains a website that offer news and resources to medical educators.

To learn more about COPE visit: www.cope-assn.org.