Milwaukee skyline at dusk

Understanding the Problem

Excessive Drinkers Not Alcohol Dependent  Infographic (CDC)Excessive alcohol use is a significant threat to the health, safety, and prosperity of Wisconsin’s residents. Unfortunately, every county in Wisconsin has high rates of excessive alcohol use. Defined as binge, heavy drinking, underage drinking and drinking while pregnant, the impact of excessive alcohol use ripples throughout society and negatively impacts the economy. Wisconsin’s alcohol issues are not just the result of those individuals diagnosed with alcohol use disorders – 9 out of 10 excessive drinkers are not alcohol dependent (see right).

By working together, we can understand the factors that have created the excessive drinking rates. By using research, data and evidence, communities can implement policies and practices that prevent and reduce excessive alcohol use without inconveniencing moderate adult drinkers.

Formed to support communities and decision-makers, the Wisconsin Alcohol Policy Project studies Wisconsin’s trends and supports communities in making positive change by identifying local alcohol-related issues and the policies to address them. Together, we can ensure communities are healthy, safe, thriving and enjoyable to all.

Health Effects of Excessive Alcohol Use

According to the Centers for Disease Control (CDC), excessive drinking is associated with numerous health problems. There are significant short- and long-term health impacts of binge, heavy drinking, underage drinking and drinking while pregnant. Because in Wisconsin every county exceeds the national average of excessive drinking, the Wisconsin Alcohol Policy Project focuses on strategies to reduce excessive alcohol use by working with coalitions and local health departments as well as civic, religious, health care, local government, and state government agencies to make positive change.

Short-term risks of excessive alcohol use include:

  • Memory problems in young adults
  • Alcohol poisoning
  • Unintentional injuries, such as motor-vehicle traffic crashes, falls, drowning, burns, and firearm injuries
  • Violence, such as child maltreatment, sexual assault, suicide and homicide
  • Harm to a developing fetus if a woman drinks while pregnant, such as miscarriages, stillbirth and fetal alcohol spectrum disorders
  • Increased cancer risk in:
    • Breast
    • Head and neck including larynx, mouth and throat
    • Esophagus
    • Liver
    • Colon
    • Rectal

Longer-term impacts include increased risks of:

  • High blood pressure, heart disease, stroke, liver disease, and digestive problems
  • Weakening of the immune system, increasing the chances of getting sick
  • Learning and memory problems, including dementia and poor school performance
  • Mental health problems, including depression and anxiety
  • Social problems, including family problems, job-related problems, and unemployment
  • Alcohol use disorders, or alcohol dependence

Resources

Alcohol Use and Your Health (CDC)
The CDC has excellent resources to understand what excessive alcohol use is and strategies to make changes in the alcohol environment.

Alcohol's Effects on the Body (NIH)
The National Institute on Alcohol Abuse and Alcoholism has an overview of alcohol’s effects on your body.

Excessive Alcohol Use Information & Resources

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Binge Drinking

Why it matters: Data suggest that even one episode of binge drinking can compromise function of the immune system and lead to acute pancreatitis (inflammation of the pancreas) in individuals with underlying pancreatic damage. Alcohol misuse, including repeated episodes of binge drinking, over time contributes to liver and other chronic diseases, as well as increases in the risk of several types of cancer, including head and neck, esophageal, liver, breast, and colorectal cancers.

In addition, crossing the binge threshold increases the risk of acute harm, such as blackouts and overdoses. Binge drinking also increases the likelihood of unsafe sexual behavior and the risk of sexually transmitted infections and unintentional pregnancy. These risks are greater at higher peak levels of consumption. Because of the impairments it produces, binge drinking also increases the likelihood of a host of potentially deadly consequences, including falls, burns, drownings, and car crashes.

Resources

Binge Drinking Fact Sheet (CDC) (PDF)

Binge Drinking: Health Effects, Signs, and Prevention (WebMD)
This site puts information about binge drinking in terms that are relatable to the general public and the myriad of issues that come from binge drinking.

Bringing Down Binge Drinking (PDF)
Infographic from SAMSHA that shows how prevalent the problem of binge drinking is with those who are under the age of 21.

Rethinking Drinking
Learn about drink sizes and amounts and definition of binge drinking from the National Institutes of Health.

The Burden of Binge Drinking in Wisconsin
Wisconsin report for every county on the impact of binge drinking.

Understanding Binge Drinking Fact Sheet (NIH)
Learn what the National Institute on Alcohol Abuse and Alcoholism says about binge drinking rates across the lifespan and health consequences.

Heavy Drinking

Why it matters: Heavy drinking costs society economically and socially. The health impacts on heavy drinkers themselves are well documented. Heavy drinking impacts nearly every tissue in our body. Ten health risks of chronic heavy drinking include: liver disease, pancreatitis, cancer, ulcers and gastrointestinal problems, immune system dysfunction, brain damage, malnourishment and vitamin deficiencies, osteoporosis, heart disease, accidents, and injuries.

In addition to its health risks to the drinkers themselves, heavy drinking also has secondary risks to other people. Secondary effects include injury, property damage, violence, and death; and frequently require the involvement of law enforcement as well as the criminal justice system. Heavy drinkers may also find their work performance impacted by their consumption of alcohol, have lower wages and lost employment opportunities, experience increased medical expenses, and have problems dealing with family issues.

What is heavy drinking? According to the CDC, for men, heavy drinking is typically defined as consuming 15 drinks or more per week. For women, heavy drinking is typically defined as consuming 8 drinks or more per week.

What can we do about it?

  • Increase alcohol taxes
  • Increase the minimum price of alcohol
  • Regulate alcohol outlet density
  • Conduct Place of Last Drink data collections and analysis to determine which businesses overpour alcohol or serve intoxicated customers
  • Electronic screening and brief interventions
  • Enforce laws prohibiting sales to minors

Resources

10 areas governments could work with to reduce the harmful use of alcohol | WHO
World Health Organization recommendations.

Addressing Alcohol-Related Harms: A Population Level Response
American Public Health Association comprehensive statement on reducing heavy drinking.

Underage Drinking

Why it matters: Underage alcohol consumption is a persistent and serious public health challenge, resulting in deaths each year through motor vehicle crashes, violence, suicide, alcohol poisoning, and other causes. Underage drinking is also implicated in sexual assault and other crimes, impaired brain function, school and social problems, decreased academic performance, and the increased risk of developing an alcohol use disorder later in life. And lastly, it can make changes in brain development that may have life-long effects.

Across the nation and in Wisconsin, underage drinking rates have declined in the last ten years, but Wisconsin remains above the national average.

Alcohol is the most commonly used drug among adolescents. To prevent or reduce underage drinking, it’s critical to take a comprehensive approach (see the four types of law below). It’s also important to recognize that underage alcohol use occurs in the context of excessive alcohol use among adults, which continues to be the third leading cause of death in the U.S. (Stahre et al., 2014).

What can be done in Wisconsin? Twenty-six underage drinking prevention policies have been identified as best practices (or as promising practices suitable for ongoing evaluation) and fall into four categories:

  1. Laws addressing minors in possession of alcohol beverages;
  2. Laws targeting underage drinking and driving;
  3. Laws targeting alcohol suppliers; and
  4. Laws affecting alcohol pricing.

Resources

Report to Congress on the Prevention and Reduction of Underage Drinking
Learn about the evidence-based recommendations reported to Congress.

Underage Drinking (Alcohol Rehab Guide)
Learn the consequences to youth who drink.

Underage Drinking (CDC)
Learn more about how alcohol harms underage drinkers.

Alcohol Use Disorder Infographic (NIAAA) (JPG)

Alcohol Use Disorders in US Adolescents Infographic (NIAAA)

In the U.S., underage drinking contributes annually to more than 3,500 deaths among people under 21, about 190,000 emergency department visits by people under 21 for injuries and other conditions linked to alcohol, and about $30 billion in economic costs.

Alcohol Use Disorder (AUD) is a serious diagnosis that some of our youth receive but is just the tip of the iceberg when it comes to excessive alcohol use. Pre-pandemic data shows that 414,000 adolescents ages 12 to 17 had AUD in 2019. More than 90% of the alcohol consumed by those under age 21 is consumed by binge drinkers. In Wisconsin alone, 17.8% of youth ages 15 to 17 admitted drinking alcohol in the last month, and 9.8% admitted binge-drinking in the last month.

Ensuring minimum age laws are enforced and performing biannual alcohol age compliance checks are important ways to reduce the availability of alcohol to our youth.

Drinking While Pregnant

Why it matters: In the United States, exposure of the fetus to alcohol is the most common cause of babies born with birth defects and intellectual disability, effects that could be prevented by not drinking alcohol during pregnancy. Exposure to alcohol during pregnancy causes damage to the fetus’s brain and other vital organs. The range of health effects are grouped together as Fetal Alcohol Spectrum Disorder (FASD). According to the Centers for Disease Control (CDC) and the American College of Obstetrics and Gynecology, pregnant women should not drink any form of alcohol as it has been shown to cause serious and negative effects on the development of the baby (fetus).

While binge drinking and heavy drinking place the fetus at highest risk, even lesser amounts of alcohol can cause damage to the developing brain. During pregnancy, approximately 14.2 % women use alcohol in Wisconsin. This high rate of alcohol use during pregnancy is not healthy since there is no known safe amount of alcohol use during pregnancy or when someone is trying to get pregnant.

In Wisconsin, giving birth to a child with Fetal Alcohol Spectrum Disorder (FASD) also has serious legal consequences. In Wisconsin, if a hospital employee, social worker, or intake worker suspect that an infant has FASD, they must refer the infant to a doctor for an evaluation. If the doctor diagnoses the infant with FASD, the doctor is required to report that diagnosis to the appropriate county department or child welfare agency for a child abuse and neglect investigation, and the mother and infant are referred for services and treatment. Wis. Stat. sec. 146.0257.

What can be done in Wisconsin? According to the CDC, state and local governments can:

  • Work with their Medicaid programs to make sure alcohol screening and counseling services are reimbursable
  • Encourage health insurance plans and provider organizations to support alcohol screening and counseling
  • Monitor how many adults are receiving these services in communities
  • Support proven policies and programs that work to prevent drinking too much

Due to the concerns with alcohol and pregnancy, it is important that communities have alcohol-free spaces and that all gatherings and businesses have plenty of non-alcoholic beverages available to those who may be trying to become pregnant or are pregnant.

Resources

Alcohol: Fetal Alcohol Spectrum Disorders
Alcohol and pregnancy don’t mix.

Drinking Alcohol in Pregnancy (Fetal Alcohol Effects)
In the United States, exposure of alcohol to the fetus is the most common cause of babies born with birth defects.

Fetal Alcohol Exposure Fact Sheet (NIH)
Alcohol can impact the development of the fetus at the greatest risk for problems.

Fetal Alcohol Spectrum Disorders (FASDs) (CDC)
Learn more about Fetal Alcohol Spectrum Disorders (FASDs).

Tracking Alcohol Use In Wisconsin

Learn how alcohol impacts people in Wisconsin. Taxpayers are picking up the tab for the excessive drinking issue in Wisconsin. The tools and resources below present alcohol use rates, binge drinking rates in every county, youth alcohol use rates and alcohol-related injuries and are updated regularly by the Wisconsin Alcohol Policy Project.

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DHS Alcohol Dashboards

Dashboards on alcohol use in Wisconsin by Department of Health Services.

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DHS EPH Tracker

Wisconsin alcohol-related poisoning deaths.

Learn More

Counter Tools Statewide Summary (2021)

In Wisconsin, 75% of retailers display or advertise alcohol beverages at child height; and 55% of retailers alcohol beverages next to non-alcohol beverages.

Understand what types of retailers are selling alcohol, which types of alcohol beverages are being sold, and where they are being placed in stores in your community.

Wisconsin Statewide Summary (PDF)

By county:

The Burden of Binge Drinking in Wisconsin Report (2019)

Wisconsin report for every county on the impact of binge drinking.

Learn More

Excessive Drinking in Wisconsin Annual Report (2017)

Resources about Wisconsin’s health ranking by the well-respected America’s Health Rankings.

Learn More

Wisconsin Youth Risk Behavior Survey Summary Report (2017)

The 2017 Wisconsin Youth Risk Behavior Survey was conducted as part of a national effort by the U.S. Centers for Disease Control and Prevention to monitor health risk behaviors of the nation’s high school students.

View this report (PDF)

Wisconsin Epidemiological Profile on Alcohol and Other Drugs (2016)

This report is a compilation of data from various sources. The indicators cover substance use, misuse, and abuse as well as the resulting consequences. Also included is a review of factors at the community and individual levels that increase the risk for substance use, misuse, and abuse.

View this report (PDF)

The Burden of Excessive Alcohol Use in Wisconsin (2013)

The purpose of this report is to present estimates of the economic cost of excessive alcohol consumption in Wisconsin and its impact on the state.

Burden of Excessive Alcohol Use in Wisconsin Infographic (PDF)
This infographic demonstrates the burden of excessive alcohol use in Wisconsin in 2013. The annual economic cost of excessive alcohol use in Wisconsin was $6.8 billion in 2013. That would be about $8 billion in 2021 dollars, after adjusting for inflation.

View this report (PDF)

Tracking Alcohol Use Nationwide

Learn how Wisconsin compares to the country on alcohol consumption and Surgeon General’s relevant reports.

Wisconsin ranks high in excessive alcohol use compared to the nation. The Milwaukee Journal Sentinel reported that Wisconsin is the only state in the country where every county reported excessive drinking. Excessive alcohol use is responsible for approximately 95,000 deaths in the United States each year and was responsible for $249 billion in economic costs in 2010 alone.

The term “excessive alcohol use” includes:

  • Binge drinking (defined as consuming 4 or more alcoholic beverages per occasion for women or 5 or more drinks per occasion for men)
  • Heavy drinking (defined as consuming 8 or more alcoholic beverages per week for women or 15 or more alcoholic beverages per week for men)
  • Any drinking by pregnant women or those younger than age 21

Explore some of the ways the Wisconsin Alcohol Policy Project recommends making changes for a healthier state. Feel free to use our tools and to contact us.

Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health (PDF)

Special report: The 50 Drunkest Counties in America

Calculating the Alcohol-Related Disease Impact (ARDI)
ARDI is an online application that provides national and state estimates of alcohol-related health impacts, including deaths and years of potential life lost (YPLL).