Texas Alcoholism Rates, Treatment and Statistics
The prevalence of alcohol use in America has led to some uncertainty about what constitutes having a good time versus having a drinking problem. From a clinical standpoint, some individuals have a mild, moderate, or severe alcohol use disorder.
The Diagnostic and Statistical Manual of Mental Disorders – 5 (DSM-5) is a key diagnostic tools for mental health clinicians, including addiction treatment specialists. The DSM-5 sets forth 11 questions/factors that can guide clinicians in the diagnosis and grade of an alcohol use disorder.1 The number of factors present determines the severity grade of the alcohol use disorder. In 2012, research conducted by the National Institute on Alcohol Abuse and Alcoholism estimated that 17 million Americans in the 18+ age group (7.2 percent overall) had an alcohol use disorder.2
Understanding Blood Alcohol Content
The liver is a key player in the metabolism of alcohol (a depressant). Typically, the liver processes 1 ounce of alcohol per hour. If individuals consume more than 1 ounce of alcohol each hour, the excess alcohol will accumulate in the blood and body tissues until the liver is ready to metabolize it. This is why blood alcohol content rises when drinks are rapidly consumed.
As a rule of thumb, 1 ounce of alcohol translates into one standard drink, which equals a 12-ounce beer, 5 ounces of wine, or 1.5 ounces of hard liquor. Smartphone technology is now available to help estimate one’s blood alcohol content on free or low-cost apps such as iDrinkSmarter, IntelliDrink, and Drink.app.
Alcohol Use Statistics
The National Survey on Drug Use and Health (NSDUH) provides reliable information about alcohol and other drug use patterns across the US. In the 2013 survey, the review included an analysis at rates of current alcohol abuse, heavy drinking, and binge drinking. The 2013 NSDUH made the following findings for the 12+ age group:
- About 52.2 percent of those in this group were current alcohol drinkers.
- Approximately 16.5 million Americans were deemed heavy drinkers.
- In the last month, 60.1 million in this group were binge alcohol users (e.g. consumed five or more drinks on at least one day in a 30-day period).
- Among 12-20 year olds, despite the illegality of alcohol consumption, 8.7 million people were current drinkers.
- Of the underage group of current drinkers, 1.4 million were heavy drinkers and 5.4 million were binge drinkers.3
The national rates on alcohol use disorder and other alcohol use patterns provide a backdrop to better understand the rates in Texas. According to a 2014 survey of various research reports on drug use in Texas, alcohol is the most common drug of abuse.4In 2011-2012, the percentage of the population aged 12 and older who drank in Texas is slightly lower than the national average (48.2 percent versus 51.9 percent).
The 2011-2012 rates were similar to 2008-2009 rates, when 49.6 percent of Texas residents reported in one survey that they had consumed alcohol in the past month. In 2011-2012, among Texas residents aged 12 and older, 6.5 percent were considered to have a history of alcohol dependence (i.e., in the alcohol use disorder diagnostic range) compared to 6.6 percent of the US population overall.5
A review of reports on alcohol consumption among secondary school students in Texas reveals that the majority of students have at least tried alcohol. Highlights of the reports include:
- In 2012, across grades 7-12, 58 percent of students had used alcohol at some point in their lifetime while 25 percent had consumed it in the last month.
- Regarding binge drinking, the 2012 data revealed that 12 percent of secondary school students drank five or more beers at one time while 11 percent binge drank liquor.
- A 2011 report showed that across grades 9-12, 73 percent of students had drank alcohol at some point in their lifetime, 40 percent reported having been drunk in the past month, and 24 percent reported binge drinking in the last month.
- Biological sex is not a major factor in the propensity to binge drink. In 2011, the percent of females and males binge drinking was similar (22 percent of females versus 25 percent of males).6
The 2013 Texas Survey of Substance Abuse Among College Students reveals the prevalence of alcohol use on campuses across the state.7 The survey involved 200 online questions that 11,283 students aged 18-26 answered. The students were matriculated across 45 college campuses in the spring of 2013. According to survey answers, 81 percent of participants had drank alcohol at least once in their lifetime, 75 percent in the last year, and 62 percent in the last month.8 This data reveals that young adults who drank at least once in their lives are likely to be current drinkers as well.
Regarding binge drinking, more than a third of students had engaged in this activity at least once in the past 30 days. Forty-three percent of males and 38 percent of females reported that they consumed at least 4-5 drinks in at least one sitting in the past 30 days.
Fewer reported having engaged in binge drinking numerous times. Fourteen percent of males and 5 percent of females reported that they had at least 4-5 drinks on at least six days in the last 30 days.11
One of the greatest concerns about college drinking is the perception that there is little risk of developing an alcohol use disorder because the practice is largely considered a rite of passage on college campuses.
Underage Drinking in Texas
In 2013, research shows that on average, a drink costs 78 cents, but in terms of the fallout associated with drinking (healthcare costs, lost work, pain and suffering, etc.), taxpayers pay $3.50 for each drink an underage person consumes (for a total cost of $5.5 billion).
Each year, there are an estimated 1,043,000 underage drinkers in Texas. Underage drinking exposes young Texans to myriad potential troubles, including violence, car accidents, high-risk sex, poisoning, psychosis, fetal alcohol syndrome in children of youth mothers, public crimes, medical treatment, and rehab services. In 2012, underage alcohol use was involved in 73 homicides, 49,400 non-fatal crimes, 80,700 property crimes, and 1,512,000 public order crimes in Texas.
Only a fraction of underage Texans who needed treatment for alcohol use actually received rehab services. In 2012, there were only 465 admissions to alcohol rehab services in the 12-20 age group (4 percent of all admissions for alcohol treatment in Texas).
Source: Underage Drinking in Texas
As the National Institute on Drug Abuse reports, there is a huge gap in America between the annual need for treatment and the annual number of drug rehab center admissions. In 2013, while 22.7 million individuals (8.6 percent of the population) needed rehab treatment for alcohol or other drug abuse, only 2.5 million (0.9 percent of the group in need) received treatment at a dedicated rehab center.12
In Texas, of those individuals who sought treatment at a publicly funded rehab programs in Texas, 28 percent had a primary problem with alcohol.13
The Texas Department of Health Services provides data on alcohol treatment admissions to state-funded programs, including certain characteristics of incoming clients. The most current data available covers 2006. In that year, all admissions to state-funded programs totaled 55,155. Of these admissions, 14,488 involved alcohol as the primary drug of abuse.15 The following is an excerpt of the characteristics of the group that sought treatment primarily for alcohol abuse:
- The average age of first use of alcohol was 16, which was the second youngest age of initiation across all age groups (marijuana was first with an average age of 15).
- The average age as of the date of treatment admission was 39 years old, which was the oldest age of all primary drugs of abuse (the second oldest age was 38, with crack as the primary drug of abuse).
- There was an average of 23 years between first use of alcohol and receiving treatment services in 2006.
- About 42 percent of all persons admitted to rehab centers for alcohol abuse had their first admission in 2006.
- Approximately 66 percent of all clients admitted primarily for alcohol abuse were males.16
A closer look at these treatment statistics on alcohol compared to other primary drugs of abuse reveals that more people sought recovery services for this drug than for any other (alcohol was the only drug with an admissions number in the five digits). In terms of employment rates, with the exception of marijuana (36 percent) the alcohol admissions group had the highest rate (26 percent).
Second only to individuals admitted to state-funded rehabs with downers as their primary drug of abuse ($10,694), the alcohol admissions group had the highest average income ($8,734). Regarding living circumstances, in the alcohol admissions group, 67 percent lived with family while 14 percent were homeless.17 From a consideration of this data on the whole, a profile emerges as to the most likely characteristics of a person who sought treatment in Texas-funded rehab centers in 2006: male, living with family, approximately 39 years of age, and started drinking as a teenager.
Alcohol Abuse Treatment Options
Treatment approaches in rehab centers in Texas and the rest of the world follow two main practices. First, individuals must be detoxed from or gradually weaned off all substances. Second, therapy is a required as part of the abstinence maintenance phase of treatment after detox.
In cases of alcohol withdrawal, the process can go beyond simply uncomfortable and become life-threatening. As a result, it’s essential that those who are addicted to alcohol undergo medical detox. Withdrawal symptoms from alcohol range from milder effects, such as anxiety and/or shakiness, to high-risk complications, such as seizures and/or delirium tremens (DTs). DTs can lead to death in 1-5 percent of cases.18
A supervised medical detox from alcohol dependence can be aided by FDA-approved targeted medications, including disulfiram (Antabuse), naltrexone (oral, non-extended), naltrexone (Vivitrol, an extended-release formulation), and acamprosate (Campral).19 In addition to these targeted medications, the prescription drug topiramate (approved for epilepsy and migraines) has been shown to be effective off-label for alcohol detox assistance. Medications can ease the symptoms associated with withdrawal as well as curb cravings for alcohol.
In addition, supervised medical detox adds a physical layer of protection against relapse. With care workers present and services expressly designed to accommodate the needs of recovering individuals, there is potentially less likelihood that individuals will abandon the recovery process during the detox phase.
Therapy is a cornerstone of treatment in alcohol abuse recovery programs. As the National Institute on Drug Abuse (NIDA) explains, there are different therapy approaches that have been designed for or adapted to the addiction recovery setting.20 Studies have considered the effectiveness of certain approaches vis-à-vis specific drugs of abuse, such as alcohol. Research on the following therapy approaches has shown that they can be effective in the treatment of alcohol abuse:
- Contingency Management (CM): This treatment is especially useful in the early stages of recovery from alcohol abuse to promote abstinence and treatment retention. CM provides participants with tangible incentives and rewards to reinforce behavior supportive of abstinence. For instance, prizes may increase in value (e.g., from an edible treat to a gym membership) over an ongoing period of positive behaviors, such as continually testing negative on drug tests.21
- Cognitive Behavioral Therapy (CBT): Originally developed to help problem drinking and later adapted to other substances of abuse, this approach seeks to help clients identify and correct the destructive thoughts underlying drug and alcohol use behaviors. In sessions, clients work with therapists on the development of strategies and skills to support greater control over drug use impulses.22
- Motivational Enhancement Therapy (MET): This approach is designed to encourage those newly admitted to recovery to engage in the process. Initial sessions open up a dialogue regarding the alcohol abuse and solicit self-motivating statements from the recovering person. In later sessions, the therapist monitors the recovering person’s progress, reviews the effectiveness of the abstinence maintenance strategies, and continues to encourage recovery.23
- Community Reinforcement Approach, plus vouchers: This is a comprehensive approach that is designed to occur for 24 weeks as part of an outpatient therapy program. The therapy includes attending weekly individual counseling sessions, medication treatment (e.g., Antabuse), urine testing, and tangible rewards/vouchers for pro-abstinence behaviors. A main benefit is longer abstinence periods, which help clients to learn new life skills to sustain sobriety.24
- 12-Step groups: This approach is designed to encourage ongoing and active participation in 12-Step recovery group fellowships, such as Alcoholics Anonymous. Participants first accept that alcohol abuse is a disease. They then surrender to a source of higher power that will play an instrumental role in their 12-Step group work. Active attendance in group recovery meetings can help to support and promote long-term recovery.25
It is established in the field of addiction treatment and research that alcohol abuse is a treatable disease. Although there may not be a cure for alcohol addiction, this condition can be effectively managed and relapse is preventable.
After graduation from a structured treatment program, any number of aftercare services may be engaged, chief among them is Alcoholics Anonymous. Perhaps the most well-known recovery group organization, there are at least 113,000 groups worldwide.26 There may not be a definitive statistic on the success of AA, but the organization reports that the average length of sobriety among members is more than eight years (likely due to a host of contributing factors).27 AA is a longstanding testament to how individuals in long-term recovery can support one another and bolster participants’ efforts to maintain sobriety.
- “Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5.” (July 2015). National Institute on Alcoholism Alcohol Abuse and Alcoholism. Accessed Sept. 27, 2015.
- “Alcohol Facts and Statistics.” (Mar. 2015). National Institute on Alcoholism Alcohol Abuse and Alcoholism. Accessed Sept. 27, 2015.
- “Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings.” (2014). Substance Abuse and Mental Health Services Administration. Accessed Sept. 27, 2015.
- Maxwell, J. (June 2014). “Substance Abuse Trends in Texas: June 2014.” Community Epidemiology Working Group. Accessed Sept. 27, 2015.
- “2013 Texas Survey of Substance Abuse Among College Students.” (Sept. 4, 2013). PPRI, Texas A & M. Accessed Sept. 27, 2015.
- “DrugFacts: Nationwide Trends.” (June 2015). National Institute on Drug Abuse. Accessed Sept. 27, 2015.
- Maxwell, J. “Substance Abuse Trends in Texas: June 2014.”
- “Substance Abuse Statistics Texas Statewide Totals.” (n.d.). Texas Department of State Health Services.Accessed Sept. 27, 2015.
- “Alcohol Withdrawal.” (Feb. 16, 2015). Web MD. Accessed Sept. 27, 2015.
- “Exploring Treatment Options for Alcohol Use Disorders.” (n.d.). National Institute on Alcohol Abuse and Alcoholism. Accessed Sept. 27, 2015.
- “Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Behavioral Therapies.” (Dec. 2012). National Institute on Drug Abuse. Accessed Sept. 27, 2015.
- “Contingency Management Interventions/Motivational Incentives (Alcohol, Stimulants, Opioids, Marijuana, Nicotine).” (Dec. 2012). National Institute on Drug Abuse. Accessed Sept. 27, 2015
- “Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine).” (Dec. 2012). National Institute on Drug Abuse. Accessed Sept. 27, 2015.
- “Motivational Enhancement Therapy (Alcohol, Marijuana, Nicotine).” (Dec. 2012). National Institute on Drug Abuse. Accessed Sept. 27, 2015.
- “Community Reinforcement Approach Plus Vouchers (Alcohol, Cocaine, Opioids).” (Dec. 2012). National Institute on Drug Abuse. Accessed Sept. 27, 2015.
- “12-Step Facilitation Therapy (Alcohol, Stimulants, Opiates).” (Dec. 2012). National Institute on Drug Abuse. Accessed Sept. 27, 2015.
- “AA Facts and History.” (n.d.). Changing Lives Foundation. Accessed Sept. 27, 2015.