While about 29 percent of the U.S. population meets the criteria for excessive drinking, 90 percent of them do not meet the criteria for alcohol dependence. In keeping with the most recent version of the psychiatric bible, the Diagnostic and Statistical Manual V, researchers now use the term “alcohol use disorder.” This replaces the older “alcohol abuse” and even older “alcoholism,” which has been out of favor among scientists for decades. The new term denotes a spectrum of problem drinking that can range from mild to moderate to severe. The more criteria a person meets on the scale, the more severe the problem. The fewer a person meets, the more likely the person is to be able to modify their drinking by cutting back, says psychologist Reid Hester, director of the research division of Behavior Therapy Associates in Albuquerque and a research associate professor at the University of New Mexico. Hester is a longtime researcher on evidence-based methods of moderating drinking.
Indeed, a large federally funded study published in 2006 found that a brief intervention by a doctor—addressing alcohol use with patients and encouraging them to make healthier choices—is effective in cutting alcohol consumption. That study also found that brief interventions, combined with the use of the opioid blocker naltrexone, was the most effective way in getting patients to reduce their heavy drinking days.
The new report is consistent with a great deal of research that has not yet shifted public thinking about alcohol problems. It is what National Institutes of Alcohol Abuse and Alcoholism reported in 2004: that the prevalence of dependence was declining while that of heavy drinking was increasing.