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Press Briefing Transcript

Economic Costs of Excessive Alcohol Consumption in the U.S., 2006

Tuesday, October 17, 2011 – 12:00pm ET

Operator: Good morning and thank you all for standing by. All participants will be able to listen only until the question and answer session of today's conference call. Today's call is being recorded. If anyone has any objections, you may disconnect at this time. Now I’ll turn the call over to your speaker for today.  Mr. Tom Skinner, senior public affairs officer at CDC.  Sir, you may begin. 

Tom Skinner: Thank you, Angela, and thank you all for joining us today for this telebriefing on a paper published in the American journal of preventive medicine on the economic costs of excessive alcohol consumption in the United States for the year 2006.  Joining us today is the director of the CDC, Dr. Thomas Frieden, who will be providing some opening remarks, and also available to us today is a Mr. Steven Wing from the Substance Abuse and Mental Health Services Administration, Mr. Ralph Hingson from the National Institute on Alcohol Abuse and Alcoholism, and Dr. Bob Brewer, the Alcohol Program lead here at the CDC.  The three of them will join Dr. Frieden in answering your questions, so at this point, we'll turn it over to Dr. Frieden to provide some opening remarks. 

Tom Frieden: Thank you very much and thank you for your interest in this very important topic.  Excess alcohol consumption is a serious public health problem in this country.  Heavy drinking is defined as drinking more than one alcoholic beverage per day for women and two for men and any drinking by pregnant women or under aged youth, and we estimate that there are about 79,000 deaths in the U.S. each year from excess drinking.  It's also very costly. 

Today we're reporting that the best estimate we have and in fact the most conservative estimate we have is that excess alcohol consumption alone costs the U.S. more than $223 billion in 2006, the most recent year for which we are able to assess. That amounts to almost $750 for every person in the country and about $1.90 per drink. Of that $1.90 per drink, about 80 cents per drink is borne by federal, state and local governments. The economic cost of heavy drinking affects all of us through lost workplace productivity, increased health care costs and costs related to alcohol–attributable crime including the additional burden it places on the criminal justice system.  It's worth noting that fully three–quarters of these costs were due to binge drinking which is a particularly dangerous pattern of alcohol consumption defined as four or five drinks per occasion for women and five or more drinks per occasion for men.  Binge drinking is reported by about one out of seven adults in the U.S. and is by far the most common pattern of alcohol consumption amongst under aged use.  However, most binge drinkers are not alcohol–dependent and there are a number of strategies that can reduce excess drinking including binge drinking.  This is possible both at the community level where the community guide to preventive services outlines what is known to work that communities can choose from to reduce drinking in their area or problem drinking in their area as well as clinical settings where it's possible that doctors, nurses and others can intervene to advise patients in ways that will reduce their risk of progressing to harmful drinking over time. 

Working in collaboration with federal, state and local partners, CDC is helping to strengthen the science base for prevention through improved monitoring and improving community based efforts.  We're also very pleased to be joined today by our partners from the substance abuse and mental health services administration and the national institute of alcohol abuse and alcoholism.  Their participation emphasizes the need for a coordinated and collaborative approach across both government and civil society to reduce excess alcohol use and the huge economic and social burden that it has on our society.  And while we know that excess drinking is not a new public health problem, we recognize that it has been at times easy to lose sight of the enormous impact it has on our lives and on our wallets because binge drinking results in binge spending and not only by the person who drinks, but also for families, communities and society.  There are substantial costs to all of us, not only in health care, but also workplace and criminal justice system. 

The harms of chronic drinking or heavy drinking are very far reaching and include many different aspects of our society.  Chronic health problems such as cirrhosis of the liver, inflammation of the pancreas, cancers including liver, mouth, throat and larynges or voice box, esophageal, high blood pressure, mental health problems injuries such as motor vehicle crashes, falls, drowning, burns and violence including child maltreatment, homicide, suicide and domestic violence, all are substantially contributed to by unhealthy patterns of alcohol intake.  That's also harm to a developing fetus if a woman drinks while pregnant including fetal alcohol effective disorders, sudden infant death syndrome as well as alcohol abuse and dependence. 

It's my hope that by releasing this information, it will remind us of the public health impact of excess alcohol consumption and challenge us to implement evidence based methods of ensuring that we reduce these very substantial harms in future years.  It's possible that by implementing evidence based policies, we cannot only save money, but also save lives and promote stability in our community.  And at that, I would like to stop and turn it over to Tom Skinner to introduce it for questions. 

Tom Skinner: Angela, I think we're ready to answer questions.  Dr. Frieden will lead the answering session and I would ask each of our participants to state their names prior to answering the question so our listeners know exactly who is responding.  So we're ready for questions, please. 

Operator: If you'd like to ask a question, please press star one on your touch tone phone and record your first and last name so that you may be announced.  Once again, if you'd like to ask a question, please press star one on your touch tone phone and record your first and last name so that you may be announced.  One moment, please.  Our first question will come from Mike Stobbe with the Associated Press. 

Mike Stobbe: Hi, thank you for taking my call.  Dr. Frieden, you said something when discussing that $1.90 estimate, you said 80 cents of that is borne by federal, state and local government.  Could you be more specific, is that Medicaid?  What exactly is –– are those government costs? 

Tom Frieden: I’ll start and then ask Dr. Brewer to continue.  In general, it's a combination of health care costs which are 12% I believe of the total costs as well as societal costs to criminal justice systems and productivity costs to employers.  Dr. Brewer. 

Bob Brewer: Yes, Dr. Breeden is absolutely correct.  We looked at costs across multiple categories as Dr. Frieden said productivity, health care, crime, property damage, many different factors that contribute to the total cost estimate.  And then what we were able to do is to divide up those costs across all these categories and look at how much is being paid by state, local and federal government.  And that's where the breakout that Dr. Frieden alluded to comes from, that is the proportion of the productivity lost, production of health care losses, cost of crime which includes incarceration of individuals who have committed alcohol attributable crimes that could be reasonably assigned to government. 

Tom Skinner: Next question, Angela. 

Operator: Once again if you'd like to ask a question, press star one on your touch tone phone and record your first and last name.  Our next question will come from Dena Bunis, Congressional Quarterly.  Ma'am, your line is open. 

Dena Bunis: Thank you.  I was curious where we could access this study and where the data came from, where the actual dollar figures came from. 

Tom Skinner: This is tom Skinner.  The press release has a link to the study. 

Dena Bunis: Okay, because I haven't gotten that yet. 

Tom Skinner: If you'll e–mail me, tskinner@cdc.gov, I’ll make sure you get that. 

Bob Brewer: And then this is bob brewer.  You had a question about the data sources that were used? 

Dena Bunis: Yeah, I was curious where they came from and why there's such a lag in 2006 data. 

Bob Brewer: Basically we tried to get at proportion of costs from multiple items that could be reasonably attributed to alcohol, so there were actually –– and you'll see it when you look at the report, there were multiple data sources that we used.  One of them is a tool that we developed here called alcohol related disease impact software that looks at the number of deaths and years of potential life lost due to drinking too much.  We used data from the national institute on alcohol abuse and alcoholism represented on this call, they have a large survey that looks at drinking behavior that we were able to use to look at alcohol dependence, drinking patterns of people who are alcohol dependent and costs related to excessive drinking, we also used a large survey from the mental health services administration and then a number of other data bases that allowed us to look at productivity losses and health care expenditures.  So a number of different databases.  And the gist of the study was to try to get at the proportions of costs that could reasonably be attributed to excessive alcohol consumption.  And our estimates are very conservative and yet the number that we're reporting here, $223.5 billion, is huge. 

Dena Bunis: And again, could you tell me why your data had to go so far back, you couldn't go sooner than 2006? 

Bob Brewer: Yeah, we went with the most recent data that we had available.  There is a bit of a lag time with some of these data source in terms of when they're available and 2006 was the most recent data that were available across all of the different data sources that we were using in the study. 

Dena Bunis: Okay.  Thank you. 

Operator: Our next question will come from Timothy Martin, the Wall Street Journal, your line is open. 

Timothy Martin: Thanks for taking my call.  I was wondering if you could help me understand two releases.  One says that the largest percentage of the total cost came from workplace productivity, and then the next came health care experiences at 11%.  Then later on in the release, it says researchers found that about 94.2 billion or 42% of the total economic costs were borne by the federal, state and local governments and the other 40% roughly by the excessive drinkers' family members.  Are those two different studies or is that the same study and you're slicing and dicing the data differently?  I got a little confused. 

Bob Brewer: yeah, this is Dr. Brewer ––

Tom Frieden:  Before I turn it over to bob brewer to answer that specific question, I do want to make something clear which may not be immediately apparent.  This study only looks at excess drinking.  So individuals who drink heavily.  Primarily people who binge drink.  It does not look at or consider any of the costs or potential benefits of light drinking.  So this is only looking at harmful patterns of drinking.  Now I’ll ask bob to further answer that question. 

Bob Brewer: You are correct.  There are no health benefits associated with excessive drinking so we're strictly focusing on excessive alcohol consumption here.  And you're interpreting correctly, that is we looked at costs across multiple categories, productivity being by far the largest source of costs.  There were a couple of components to lost productivity, one was a reduction in wages earned by people who are alcohol dependent which is actually a small piece, very important piece, but a small piece of the overall group of excessive drinkers.  And then we have a large portion of the productivity losses that were sadly due to people dying young typically as a result of alcohol attributable causes.  Somebody who dies at age 21 in an alcohol attributable motor vehicle crash has lost their entire productive life.  So for the purposes of the study, we tried to put a dollar value to that.  The other component is how many of these costs could reasonably be assigned to government as opposed to the individual or other members of society.  So that's the second number that you referred to.  It wasn't a separate study.  It was simply an effort to try and apportion out the total cost estimate to look at how much of it is being paid for by government, how much of it is paid for by the individual, how much of it is being paid for by others in society.  Does that help to clarify it a little bit? 

Timothy Martin: Yes.  If I re–ask the question, what part of the workplace productivity which represents 72% of the total costs are –– can be also related to the federal, state and local government?  It seems like there is overlap there. 

Bob Brewer: Right.  And I think we'd need to take a look at the specific numbers in the study, which we can do and get back to you, about the exact proportion of the productivity piece.  But the general concept here was to try to look at the apportionment of the costs across the different payer sources. 

Tom Frieden: I would think that some of the criminal justice costs are quite substantial and generally borne by the public sector. 

Bob Brewer:  Correct. 

Ralph Hingson: This is Ralph Hingson.  I think it's very important to point out that the excessive drinkers are actually and their families are paying only a minority of the costs.  The majority of the costs are either being borne by government or by other people affected by the drinkers.  But the level of heavy drinking that we're talking about, if I had five drinks over a two hour period on an empty stomach, I’d reach a blood alcohol level of 0.8, so I’d be legally intoxicated in every state in the United States.  And that's why we have our legal limit set at 0.8 because it's a very dangerous amount of alcohol consumption prior to driving.  And many people are affected by drinking drivers.  40% of the people who die in crashes involving drinking drivers are people other than the drinking driver.  So there are a lot of people being affected other than just the heavy drinkers by this pattern of behavior. 

Timothy Martin: Thank you. 

Tom Skinner: Angela, next question. 

Operator: Once again if you'd like to ask a question, please press star one on your touch tone phone and record your first and last name.  One moment, please, sir.  And at this time, there are no further questions, sir. 

Tom Skinner: Okay.  Thank you for joining ––

Tom Frieden: I’d like to thank everyone for their participation this morning and thank our sister agencies, SAMHSA and NIAAA for the terrific work that they do and for their contributions to generating the data and the programs that can help address this.  Bottom line again is that excess alcohol drinking costs a lot of money, costs money for the individual, it costs money for the family and community and government.  For each drink that costs about $1.90, of which about 80 cents is borne by the public sector.  There are evidence based ways that communities can choose from to reduce excess alcohol use and there are important ways that doctors, nurses and other health care professionals can support their patients in reducing heavy alcohol use.  So thanks to you all very much for your interest. 

Tom Skinner: Thank you for joining us.  If you have any follow–up questions, you can call the CDC press office at 404–639–3286.  So thank you for joining us. 

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