While the relationship between excessive alcohol use and motor vehicle crashes is well known, many people don't realize the many other negative effects are associated with binge drinking.
The Centers for Disease Control and Prevention recently alerted the public to the specific dangers of binge drinking by women and girls. The CDC estimates that excess alcohol use causes about 23,000 U.S. deaths among this group each year.
Women who exceed three drinks on occasion and/or drink more than seven drinks a week are at increased risk for breast cancer and heart and liver disease as well as sexually transmitted diseases, unintended pregnancy and miscarriage. Alcohol use during pregnancy is especially dangerous as it is known to cause life-long learning and behavioral problems in children. Although these birth defects are 100 percent preventable, more than half of pregnancies are unintended, so women may expose their unborn child before they even realize they are pregnant.
As the problem of binge drinking receives national attention, here in Wine Country we need to take special notice. According to the most recent California Healthy Kids Survey findings, excessive alcohol often begins with our youth. More than a quarter of 11th-graders in Sonoma County (27 percent) reported drinking five or more drinks in a row within the past month. Meanwhile, in 2010, Sonoma County women had one of the highest rates of binge drinking in the three months before pregnancy and alcohol use during pregnancy. Multiple approaches have been shown to be effective to reduce risky drinking. Our county has focused on reducing underage drinking by enacting social host ordinances and preventing underage sales. These are important steps, yet more can be done to help change the culture of heavy alcohol use among legal drinkers.
Experts recommend that medical settings are an ideal place to screen and educate adults about risky drinking. The goal is to reach the quarter of adults who have developed a pattern of harmful and unhealthy alcohol use. By asking all patients one or more questions, health care providers can identify individuals at risk and help them to reduce their use to a safe level. The evidence suggests that clear medical advice can be very effective at changing behavior.
This is not about abstinence or trying to reach the 3 or 4 percent of people with an addiction problem. It is about safe levels of alcohol consumption.
The benefit of this approach couldn't be more compelling than with women who may soon become pregnant. During the past 15 months, our group of physicians, nurses, social workers, treatment providers and prevention specialists have come together to prevent alcohol-exposed pregnancies. Sonoma County was selected as one of six communities nationally to participate in a collaborative effort funded by the Centers for Disease Control to find innovative ways to make this a routine part of care for women.
We are instituting a brief questionnaire that asks women about their alcohol use and also screens for intimate partner violence, depression and other substance-use disorders. These problems can be interrelated and helping women access resources can turn their lives around for the better and lead to healthier pregnancies.
For women who are not interested in making changes in their drinking or substance use, practitioners are advocating highly effective birth control methods to prevent unintended pregnancies. Currently, three local health centers are using the questionnaire with good results. We hope this type of care will soon be standard in Sonoma County so that local women and families become the healthiest they can be.
Dr. Marie Mulligan is medical director of the Santa Rosa Community Health Center.
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