Over short of doing a mental shift here from our previous hour discussing culture and football. Into something that in this area in particular of very important discussion. Do you ever wonder if you're drinking too much or have you ever thought to yourself. -- only drink on weekends but it's 45 or six drinks maybe in the first couple of hours. 38 million Americans drink too much and most of them are not alcohol X. How much is too much and what exactly is binge drinking. The Centers for Disease Control has just come out with a new report that addresses all of those questions. And that's what we're going to discuss for the next hour with the lead author of the report doctor Lila mic night -- And with Lindsay -- director of prevention services for the council on alcohol and drug addiction here in New Orleans. And in thirty minutes were going to be joined by doctor Bob brewer who was head of the alcohol op program at the CDC. But I wanna thank both of you first of all for joining us now. Doctor Elaine. Let's start with. Would you define drinking too much 38 million Americans from this report are drinking too much. Yes thank you for having share for drinking. And it is really important issues. Country and I can't be defined in several different ways to meet several different. Patterns of troops. But -- that. It's called binge drinking. And after the top four adopted as the show progresses but binge drinking means. For a moment for our drinks and occasionally -- -- -- two hours. And forty man. That at that time -- Drinking too much includes. You know portrait and a weak form and are more parliament. In -- out on used by pregnant women or those who at age between. So pregnant women run any drink is too much. Any alcohol you Patrick what is considered drinking too much yet. When you say an eight drinks per week for a woman her for a man right. That's really. Well and drink a day and then maybe 21 Saturday. I bet about it allotments and challenging days for me and the US dietary guidelines side. That people who drink more than. Are at increased risk for certain health outcomes. And I think people actor I can yell back at. Level a lot of people think Patrick and -- -- -- -- motor vehicle crash. And but even drinking above those daily weekly limits that -- of hurt and it. My heart disease breast cancer diabetes and other chronic diseases. I have detail and among those who was very surprised by the -- because I don't drink every day here -- have they had a drink and now. It doesn't seem like much to think that all of a sudden -- over drinking we're gonna go back to that but I'm I'm very interested in why you'll decide to do that stuff. Sure. -- the -- and it was about health care and health care providers occasion with their patients opt out alcohol use. And the reason why is that indicated drinking too much is associated with a number held out. From a chronic disease. Two. -- that excite people alcohol syndrome. Two injuries and back. -- -- For decades. That. Actor doing -- -- a screening every Saturday -- -- pocket and take it victory today. And Indians recount -- can't be effective in helping a patient's injury collect. We do you know how much of the Harry. So we wanted to find out. -- responded to AP survey. If there providers -- -- them. Okay I have many of the questions for you but we do have a caller -- -- All of it and that this is better off or -- this Gator cute quote where -- got it from the all years ago they're disparity there and it indicated that. All alcohol as the bulk -- -- especially like -- course specifically Italy and -- church here in salt. Or for whatever reason was much lower and as cultures actually. -- use alcohol at a relatively early age for like your children Arabs want a bigger -- -- eight. Are you where does that in -- leisure -- on back. Your questions -- -- That the that your record what I can act. We know that wanted to read US industrial complex here about 4% of US adults who actually that are alcoholic out all that did it. So that you are people who drink and I. -- I. Think they're really important that the screening I am referring to people like Ali. You're saying. Too much and. One entry into play. That was estimated that they're only 4% of the US population. Was quite an alcoholic or dependent upon how -- would not able to stop -- -- -- yeah you're more. Pop out just wondered why the researchers are -- little more specific from Paris for border -- depending on your side can affect you differently like. Has there been any indication as -- Ago. Like blood alcohol level you know if you reach is is. Considered healthy he got the -- deliberate restriction consistently point 08. But I mean in character certain people to the Arctic Jeter right here in. In direct the point she eligible options so -- kind of our return it. Well I think the bigger -- That. The way it people I have a lot alcohol and that that hurt it in the back. Your gender of your aid the -- -- to stop talking about is. The impact of alcohol -- your -- If you don't have our priorities -- alcohol. Impact illnesses. Let it yet that alcohol use you know lower levels we can't find people. Had issues and then -- it even -- -- -- well so. Recommendations made from -- We did an army to. Create what is considered. For the general population. That -- that they really need to talk to help providers so they get better as it. For themselves and -- an earlier. In other countries there how would let all over the world -- as bad. Economy -- now believed -- -- the problem. With alcohol and other part of the -- that absolutely not true and it kind. -- -- -- -- -- -- -- They would admit that it Petrie. In. Today I really appreciate your help. Everybody stay with this -- gonna take a quick break we're going to be back and we're going to be talking about this new CDC study. On alcohol is -- end the difference. But people who just drink too much -- activist I'm Angela on WWL while the Centers for Disease Control and Prevention has come out with a new. Study and it's about alcohol and are drinking habits and showing that. 38000. Americans drink too much. We -- talking with doctor Lila McKnight Italy and also in studio is Lindsay -- -- is with Kate and are going to be getting to Lindsay is well. I wanted to go back to doctor McKnight Heatley though. How did you do distant. OK and yes to go back. Thirty million. To. 30000 in arguing. That. What it -- a question you want it. CC annual. Survey. Call behavioral risk factors that they fit that survey unit that telephone -- eight of US adults eighteen years of age and older. And again I really. Are there health care provider talking to them about apple argued. Show. We asked them a single question about de -- have -- back burner -- professional ever talk to you about alcohol use. And the people who say yet. -- asked when that talker. So we weren't able to collect data from over a hundred CC 8000 that the it 44 states in EC and we sat down and only about one thing or 18%. But boy that they ever head a communication under discussion with their doctor or other health professional about alcohol you. And you just felt that this the study needed to be done. Because the doctors are perhaps the link to part of the solution. We get help for that. He can find the solution what happened there and recommendations from eight -- it -- That you accident services task force that -- clinical recommendations to providers. Most recently -- 2013. And -- is being policy changes that well we're now really -- end. So how are -- -- -- intervention brief council has come up. Are a lot differently as we get it now hop it was being. With The -- studio is Lindsay pre those who's the director of prevention services for the council on alcohol and drug addiction. Here in New Orleans and you've been listening to doctor McKnight -- And just sort of your thoughts on the -- Well. Doctor McKnight -- I was wondering I mean I if you like the article is aimed at their report is aimed at both patients and doctors encouraging patients to. You know be open and honest about their alcohol use with their positions. But -- you know patients are likely to walk into the that medical office and say I wanna talk about my drinking -- You know unless their -- and if they are asked him they they might respond candidly but. What specifically beyond releasing this report. Is being done to. Encourage or perhaps in short that health care professionals like doctors nurses. And social workers you know anyone that would be talking about health would be to implement a pre screening. And that's a great question and I think you'd hit a really important. They have -- relationship between health care in -- and that dialogue go both ways there are people who are concerned about their work pop up -- particularly if they all those questions. Are going to be equity. Are coming equipment and particularly. Health conditions to be out of it. I think that we wanna change that it has how teams practice Eckert. Similar to wait let the smoking weed -- expect to be asked about looking. Good professional if you are concerned about that you would talk about it. You operate and other questions it. Yeah it did it take lax system level changes made it apart routines here. And I indicated your policies are able -- -- here. Cover without cocaine alcohol reading your recount. And at the federal level. There are efforts to work. -- better. Health center with Medicaid. Which is better for Medicaid and they're. Can integrate. Apple counseling. It could be a critical that it also make -- cover insurance. Their efforts. Cary Grant program to implement alcohol screenings counseling. For example in New York department of health and integrated it that way. Screening every everything has been integrated. Into several clinics kind of permanent -- in -- in California. -- really be a huge. Shift where doctors at a perfect effort educated about it and medical school as well as -- residency. Hi how to do it. And it important that is emphasized that has to be consistent level change it and we're health care insurance companies are considering that -- there. It just seems like in many ways it's a very delicate subject I agree with what you're saying nobody hesitates now about smoking. -- the smoking questions but with alcohol it's it's it's a little different I think and I think for a doctor. You're right -- going to have to be trained to say. Interim we've. Your drinking. Habits with perhaps these health issues you're facing. Right and me and there's decades -- -- show it affected. There -- Way to cap and work. Between the case. You know that hate to achieve them easily read articles. That explain. You know. I think it's important. You decade. Showed that the work and it and that people are receptive. I was -- ask Lindsay what you thought of the figures that we talked about earlier in the program about. Drinking too much would be eight or more drinks per week for a woman or fifteen or more drinks per week for man. Yeah it I mean I agree with Hewitt on paper it doesn't seem like that much but at the same time I think. It's it's you know alcohol is inherently it's the toxin you know it's -- -- poison that week you know healthy adults can consume in small quantities with relatively low risk but. But when it was still takes a told the body. Odd body has to work hard the liver has sort heart the heart the stomach. Kidneys -- to process -- and that takes its told the bodies on. It you know when I think about it -- context on a weekly levels subjecting your body to repeated. You know especially it's four more drinks in one sitting him like two to three hours in he'd do that as a regular routine it can take its hold on your body -- if you are paying attention how much you Kensing. I would hope that anybody is listening who wants to call either talk to any of these people we'd love to hear from you about your thoughts on. On the study on drinking on alcoholism. If you know somebody who is an alcoholic and needs help. You know how do you have approach that. I'm agreeing with you -- we live in party central here and there are we are permanently cheering and let's celebrate -- center center and done I think perhaps and I'm just surmise and that's on very unscientific. But in this area. That we would be shocked at just G-8 drink some drinking too much. Right right yeah I mean and you know most people you know think of binge drinking ads. You know. Keg stands are using a bottling drinking games like frat parties things like that while that is of course binge drinking. It doesn't have to be delivered in some sort of party. Apparatus sixteen to simply be. You can sitting at home to run drinks in our for a couple hours. And and and again that. That takes its hole and your health and if you have a condition that's affected by alcohol or you take any number of medications that most certainly interact negatively with alcohol or magnify backs. I can be a big problem. And one and it went to stay with this again give us a call 2601870. If you like to join this conversation. We're gonna take a break in go to the newsroom with Chris Miller but when we come back doctor -- CDC will join us we've been talking about. Alcoholism and not just alcoholism more importantly a CDC study -- showing. 38 million Americans. Are drinking too much and there is a definite difference between the drinking too much and alcoholism but. The report is very very interesting. We have the lead. Author on that doctor -- McKnight -- really talking to us now we're joined by doctor Bob brewer. Who is not the lead in the alcohol program and doctor Brian appreciate you joining us as well. My pleasure. My understanding injure -- quite the authority on binge drinking and I have to say that I had. Actually never heard the term binge drinking to about fifteen years ago. And it was a college professor. In another state not talking snow we're starting to see issues on campus with binge drinking and I remembered saying. What is that does Willis drinking a whole bunch of drinks quickly. Could you elaborate on really -- isn't hasn't always been around. Well I'm afraid we've always been dealing with people who drink too much -- venture -- time basically drinking to get round. And that essentially what we're talking about with binge drinking. I think. Binge drinking started to get a lot of attention and perhaps twenty or thirty years ago. Based on some studies that were down and looking at binge drinking among college students. And just to define binge drinking you may have discussed this a little bit before that probably doesn't hurt to repeated. We're talking about for a woman in the consumption of four or more drinks within a short period of time on occasion and that's. To be more precise typically defined as an institution three hour period and for a man it would be the consumption of five or more drinks. But ensure their time against two or three hour period. And majority noted -- we estimate there about 38 million adults in the United States that. Engage in binge drinking one or more times to a thirty day time window and in fact actually based in some some studies that we've done and and results published. On average people who report drinking at that level. Do so about four times a month and consume on the order he drinks and against other concerning a lot more than that. At 45 threshold that I just mentioned. -- you bring up the very good point for for anybody listening. I think the question would be you know I only do that on Saturday night her on a football. Thing on Sunday were right now that your defining binge drinking maybe that's what I do but what's the big deal I'm not drinking during the week. Yelled and and you know that's that's a common than what we would call pattern of alcohol consumption. In contrast to some other country's most people who drink in the United States and we're talking you know maybe. A little more than half of all the US adults depending on the service that you look at report drinking at all suggested to put it in sort of a broader context there's a large portion of -- the general population doesn't drink at all. But among those who do most people tend to drink relatively infrequently maybe ten days or less per month. And that's why when we talk about people drinking too much. Binge drinking really looms large as a pattern of alcohol consumption because not to get into trouble doing exactly what you just described which is. Drinking too much on occasions that we can classically although not necessarily just on the weekend. And to what's the big deal about that well -- actually it's quite a big deal. Again just stated to take. A wide angle look at this and we estimate overall there about 80000 deaths and states that are due to people drinking too much partly defined. And over half of those -- to binge drinking in particular. And because. A lot of binge drinkers are younger than them explicitly -- of the -- big problem throughout the lifespan. But because we have a lot of again people who've been shrink. A large portion of what we would call the the years of life lost due to. Drinking too much is. Is due to binge drinking about about two thirds of the years of life slot and then after expenses -- conflicts. So we estimating and try one other number big number -- an entry for billion dollars in economic costs. Due to excessive drinking and about 35% of the concert to binge drinking so that the numbers are large and what does that mean for the individual what it would -- it's an individual is that by drinking too much there. Putting himself and potentially others at risk of but the whole host of health problems from the obvious ones would be alcohol impaired driving around drunk driving and motor vehicle crashes related to that. Some people and they drink too much also -- aggressive. So you -- a strong relationship between drinking too much specifically binge drinking and and violence. I'm directed toward other people and frankly also sometimes directed toward the individual themselves. People don't tend to make wise choices about sexuality when they're dropped. And so -- you see higher rates unintended pregnancy and sexually transmitted diseases related to binge drinking and then there are whole host of health problems that can. Manifest themselves over time so things like high blood pressure. Even heart attacks have been associated with -- binge drinking strokes. And there's a growing body of literature showing that alcohol consumed per -- higher levels and over time. Is -- really important risk factor for cancer one that your listeners may not think about it breast cancer. And it turns out that about 15% of breast cancer death United States. Are what we would call attributable to alcohol and binge drinking certainly plays a part in in that overall. The risk of very health outcomes including the chronic conditions that I just mentioned so. Actually people may not think it's such a big deal to get drunk on the weekends that. In fact after the overtime an awful lot more problems than people think. Please stay with this we're gonna continue our discussion on the -- CDC report. Right after this I'm Angela under the don't do well. We're talking about the new CDC study on drinking too much too many Americans drinking too much what is too much. And and more importantly. It as as doctor McKnight Elise said the goal of this was really also -- to setup a program where doctors. Global talked to their patients about drinking and and it's certainly very very important before we get back to that doctor Bob brewer who was head of the alcohol group but the CDC. I wanted to ask you sir about is there an alcohol jeans. And is there does this run in families. Well I don't think that that the research mission is that there is any single genes for. Alcoholism alcohol dependence I think that there have been numbers that is shown. For example the sirens. Men who are alcohol dependence -- perhaps greater risk of developing -- the tendency throughout their lives. But you know I think we're talking about it condition that is affected by many different factors. Genetics. Is it perhaps part of the picture force some people are there differences in the ways that. People metabolize alcohol and there's some differences across racial and ethnic groups and in that regard. But what I think the science has chemical solution honest is that alcohol consumption similar to smoking similar to eating is. Very strongly influenced by the environment that we live again. And by and large across the country. Not not just in New Orleans or in particular cities. We find that alcohol tends to be pretty inexpensive it tends to be quite readily available and it tends to be quite heavily Africa. And we know that those factors really do make a difference in terms of people's. Likely to drink and how much they drink when they do and so I. -- the the difference between. Drinking too much and being an alcoholic we with sort of discuss but if one is a binge drinker let's end. Or two people one is have been binge drinker and it never kicks and alcoholism. But somebody else is binge drinking and within a few years they are dependent. What is the difference. But it can't talk to hard to tease that apart. Why one person becomes. -- addicted now caller alcohol dependence and another does not. We do know a good bit about some of the important risk factors for development and alcohol dependence and in fact. Binge drinking is itself a risk factor for developing alcohol dependence. There's been a lot of cities independently looking at the each when people start drinking and that seems to be quite strong evidence that if people start drinking at an earlier age. Their likelihood of developing now called the ten minutes later and life goes out. But unit consisting. Angela. Even though there are important differences in the drinking patterns of people and and perhaps between those were dependent does not. Actually is some of the same factors that we've been talking about in the environments. Can influence the drinking behavior people were dependent and and not dependent as well. And certainly back to a New York talking about in the first half hour. I think. Either way there's companies is now dependent or not. I think it emphasizes the importance just given huge magnitude of the public health problem argument here's the number of illnesses caught all the -- are you about before. About the importance. They're being a conversation about drinking taking place in in clinical settings I think that's but that's very important part of what we need to do in general. To try to reduce excessive drinking and -- -- in particular. Regardless the -- companies is now dependent. What you all are everyone is saying both you and doctor McKnight -- and Lindsay is that the importance of that relationship with the doctor. Can in fact have an effect on how much you're drinking. Absolutely and there is as I'm sure doctor and the anti elite soldiers there very strong body of scientific evidence. Shelling that that. Discussions between a doctor or other health professional patient about -- drinking behavior. Really can make a difference in reducing how much they drink. And I think when that is combined with. Some changes in the environment that the put -- what I would regard at least -- the science would suggest are reasonable controls. On the pricing availability of alcohol how would advertise particularly young people. I think we really can make a significant difference in in reducing excessive drinking and you know those -- the same kind of prevention strategies. That have worked so effectively and smoking. I know that is the topic our discussion today but I I have to mention issue may be aware that this is actually the fiftieth anniversary of the release of the surgeon general's report on smoking. That really started down the road that we've been traveling here for that period of time has resulted in just dramatic reductions in -- smoking behavior. Yeah and we did a store a show on that yesterday and it wasn't just. That it came around so this is what's happening it was the next twenty years of policy changes. Right and and I think. Really and these are these are conversations of course that have to take place within communities in states mean it's not. He's p.'s role to tell states or communities what they ought to be doing in terms of their prevention activities. But I think that there are a lot of parallels between smoking and excessive drinking and certainly the science tells you this on the same kind of things that have worked very effectively. To reduce smoking. Through a combination of policy change -- and measures that can happen in clinical settings. Can really make a huge difference and in helping to create an environment that encourages people make healthier choices. About smoking and that is not to talk at all but with respect to drinking to get people to drink in ways that are are lower risk. Yeah we had dietary guidelines and that's it for some time that define what we mean by low risk drinking and I know this is often confusing for people. But you -- Either I'm gonna have to interrupt you again -- -- -- -- the break but we're gonna talk about those guidelines Friday after that we're talking about the CDC study and done. Doctor brew or you're going to tell us the guidelines. Yes but there are they're actually dietary guidelines so their alcoholic addressed along with. Other. Food items actually these guidelines in the recommendations by the dietary guidelines are that he woman's drink no more than one drink a day to -- to wonder get a and a man up to two. And this is not based on averages this is based on the total amount consumed today. And dietary guidelines also specify that there are some people who shouldn't drink at all and doesn't include. Young people under age 21. Of course pregnant women as well and really anyone who has medical problems that could be made worse by the drinking. And there are up actually a lot of people that fall into that category people with liver disease. Chronic hepatitis for example. And variety of other medical problems that they -- I'm an -- only because I'm listening to the person out on the street sank. Well I don't have a drink on Tuesday can -- two on Wednesday. Well again it's not an average and that's where the -- guidelines are a little bit different. It's saying that this is really the maximum amount that you ought to have in today and that may sound very -- people that there actually is strong. Scientific evidence that we get above that level of consumption in the -- -- bad things happening -- -- -- ago. I cannot thank you enough doctor Bob brewer doctor Lee McKnight -- -- and Lindsay pre post from Kate thank you so Eric stay with -- were going to be talking. -- after that.