On a late-winter Saturday night a few weeks ago, Natalie Penoyer and her girlfriends plunked themselves down at the bar at Clare & Don's, a beachy, island-themed restaurant in Falls Church, Va., and ordered up pomegranate margaritas.
The young Washington, D.C.-area professionals said they were likely to have a few more drinks before the night was over, maybe even make another stop at a karaoke bar nearby. "We'll definitely need social lubrication for that," Penoyer said. But getting plastered wasn't in her plans. "I don't intend to get a DUI at this point in my life. The older you get, the more you think about your actions and your mortality," said Penoyer, 25, who said she goes out for drinks with friends only once every few months.
Like Penoyer, many young adults socialize on weekends and weeknights at bars and parties where cocktails and beers flow, but unlike her, most don't give much thought to their drinking habits, says Mark Willenbring, director of the Division of Treatment and Recovery Research at the National Institute on Alcohol Abuse and Alcoholism (NIAAA). If they did, he says, it's likely that fewer people would develop problems with alcohol abuse later in life.
To that end, he and other experts at NIAAA have developed a "Rethinking Drinking" website (Rethinking Drinking.niaaa.nih.gov) to help people who drink alcoholic beverages determine what type of drinker they are and whether they are at a risk for developing a drinking problem.
'Risk reduction' is the goal
"Not everybody who drinks more than is medically healthy or recommended realizes they are doing it," Willenbring says. About 30% of Americans have too many drinks in one day at least once a year, he says.
The heaviest drinkers are primarily between the ages of 18 and 30, and they are the target population for "Rethinking Drinking," Willenbring says.
"They are a group that drinks more than is healthy, but doesn't have the health problems yet."
Willenbring likens the interactive website to a prevention tool. The approach is similar to how a doctor might focus on groups at risk for heart disease -- those with high blood pressure or cholesterol -- but who haven't had a heart attack yet. "We're really doing risk reduction," he says.
In any given year, about 4% of the population has alcohol dependence, or alcoholism, according to Willen-bring. About 26% are heavy drinkers. "Even if these folks, the heavy drinkers, reduce their drinking, the public health impact is great," he says.
According to NIAAA, each year, alcohol is a player in:
*Approximately 60% of fatal burn injuries, drownings and homicides.
*50% of severe trauma injuries and sexual assaults.
*40% of fatal car crashes.
*40% of suicides and fatal falls.
While many associate heavy drinking with liver problems, it can also increase the risk for heart disease, sleep disorders, depression, stroke and stomach bleeding. Consumed during pregnancy, it can cause fetal brain damage, says Fulton Crews, director of the Bowles Center for Alcohol Studies at the University of North Carolina-Chapel Hill School of Medicine. It's also linked to cancer.
"We know if you're a heavy drinker but not alcohol dependent, your risk of oral cavity cancer and also breast cancer are increased," Crews says.
College binge drinkers
The "Rethinking Drinking" site asks if visitors know what constitutes at-risk drinking. Many might be surprised to learn what does, says alcohol-abuse expert Charles O'Brien, a professor of psychiatry at the University of Pennsylvania.
"A heavy drinking day is a lot less than most people think it is," O'Brien says. "We have in college and universities many who do binge drinking and they don't even realize it. When I told my students the daily limits, they laughed at me. Many said that's barely getting started -- that they have a few drinks in their dorm rooms even before going out drinking for the night."
The site provides illustrations and tables showing the amount of alcohol in a variety of drinks, including beer, wine and liquor. A calculator can help one estimate how much a typical toddy includes. Drinkers who want to make changes can find some helpful tools and resources, too.
The site isn't meant to promote abstinence, Willenbring says. It doesn't demonize alcohol. In fact, it even points out that light to moderate drinking on a regular basis can lower the risk for heart disease for some.
Schoolteacher, soccer mom, athlete, physician, husband -- anyone who cares to find out if drinking habits are risky or not can now do so on their own, Willenbring says.
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