Lifestyle choices such as smoking, drinking and risky sex are to blame for much of the chronic disease that occurs in the US. Illness, accidents and crime linked to alcohol abuse cost society more than quarter-trillion dollars per year worldwide.

Approximately 5% of (US) adults are likely to be alcohol abusers or alcohol dependent and another 20% misuse alcohol enough to be considered at increased risk for accidental injuries, medical conditions and psychological problems. Alcohol abuse is on the decline in the United States. In 1993, 18% of American youth aged 12 to 17 said they drank alcohol, down from 25% in 1990, and closing in on the federal government's 'Healthy People 2000' goal of 13%.

According to the researchers, much of this change is due to improvements in public attitudes and the implementation of stricter drunk-driving regulations nationwide. A number of treatment options are available once an individual realizes they have a drinking problem. The study authors point out that psychological treatment and '12-step' programs are effective.

Treating alcoholism costs money. But the investigators note that one recent study found that payers save $1.40 for every $1 spent on even a "brief" anti-alcohol intervention.

American Journal of Health Promotion November/December 1999 14:75-82.