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A new study published in JAMA Psychiatry this month finds that the rate of alcohol use disorder (i.e., alcoholism) rose by 49 percent in the first decade of the 2000s. One in eight American adults, or 12.7 percent of the U.S. population, now meets diagnostic criteria for alcohol use disorder, according to the study.

Here are nine things you should know about the problem of alcohol abuse in America:

1. The most commonly used diagnostic tool to determine alcohol abuse is the DSM-IV-TR, which defines it as a maladaptive pattern of drinking, leading to clinically significant impairment or distress, as manifested by at least one of the following occurring within a 12-month period: (1) Recurrent use of alcohol resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to alcohol use; alcohol-related absences, suspensions, or expulsions from school; neglect of children or household); (2) Recurrent alcohol use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by alcohol use); (3) Recurrent alcohol-related legal problems (e.g., arrests for alcohol-related disorderly conduct); (4) Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol (e.g., arguments with spouse about consequences of intoxication); and (5) Never met criteria for alcohol dependence.

2. The DSM-IV-TR defines alcohol dependence as a maladaptive pattern of drinking, leading to clinically significant impairment or distress, as manifested by three or more of the following occurring at any time in the same 12-month period: (1) Need for markedly increased amounts of alcohol to achieve intoxication or desired effect; or markedly diminished effect with continued use of the same amount of alcohol; (2) The characteristic withdrawal syndrome for alcohol; or drinking (or using a closely related substance) to relieve or avoid withdrawal symptoms; (3) Drinking in larger amounts or over a longer period than intended; (4) Persistent desire or one or more unsuccessful efforts to cut down or control drinking; (5) Important social, occupational, or recreational activities given up or reduced because of drinking; (6) A great deal of time spent in activities necessary to obtain, to use, or to recover from the effects of drinking; (7) Continued drinking despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to be caused or exacerbated by drinking; (8) No duration criterion separately specified, but several dependence criteria must occur repeatedly as specified by duration qualifiers associated with criteria (e.g., “persistent,” “continued”).

3. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL. This typically occurs after four drinks for women and five drinks for men—in about two hours. In 2015, 26.9 percent of people ages 18 or older reported that they engaged in binge drinking in the past month

4. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines heavy alcohol use as binge drinking on five or more days in the past month. In 2015, 7 percent of people ages 18 or older reported that they engaged in heavy alcohol use in the past month

5. Fetal alcohol syndrome is a condition in a child that results from alcohol exposure during the mother’s pregnancy. According to the Mayo Clinic, the problems caused by fetal alcohol syndrome vary from child to child, but defects such as brain damage and growth problems caused by fetal alcohol syndrome are not reversible. The prevalence of fetal alcohol syndrome is estimated to be two to seven cases per 1,000, and the prevalence of fetal alcohol spectrum disorders to be as high as 20 to 50 cases per 1,000. (As the Mayo Clinic notes, there is no amount of alcohol that’s known to be safe to consume during pregnancy. If you drink during pregnancy, you place your baby at risk of fetal alcohol syndrome.)

6. An estimated 88,009 people (approximately 62,000 men and 26,000 women) die from alcohol-related causes annually, making alcohol the fourth-leading preventable cause of death in the United States. Of the 9,967 people who died in alcohol-impaired-driving crashes in 2014, there were 6,391 drivers (64 percent) with BACs of 0.08 g/dL or higher. The remaining fatalities consisted of 2,752 motor vehicle occupants (28 percent) and 824 non-occupants (8 percent).

7. An estimated 623,000 adolescents ages 12 to 17 (2.5 percent of this age group) had alcohol use disorder. This number includes 298,000 males (2.3 percent of males in this age group) and 325,000 females (2.7 percent of females in this age group). An estimated 37,000 adolescents (22,000 males and 15,000 females) received treatment for an alcohol problem in a specialized facility in 2015.

8. In 2015, 33.1 percent of 15-year-olds report that they have had at least one drink in their lives. About 7.7 million people ages 12 to 20 (20.3 percent of this age group) reported drinking alcohol in the past month (19.8 percent of males and 20.8 percent of females). Approximately 5.1 million people (about 13.4 percent) ages 12 to 20 (13.4 percent of males and 13.3 percent of females) reported binge drinking in the past month, and approximately 1.3 million people (about 3.3 percent) ages 12 to 20 (3.6 percent of males and 3.0 percent of females) reported heavy alcohol use in the past month.

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One of my favorite scenes in the Lord of the Rings movies appears early in the Fellowship of the Rings when Frodo and company first encounter Aragorn. Frodo and his adventure mates were putting the happy in happy hour at the Prancing Pony Inn, frolicking, tipping mugs of ale, and generally making a public hash of themselves—foolhardy behavior for a party of hobbits and dwarves embarking on a dangerous clandestine mission. Frodo slipped the ring on his finger and instantly became invisible, took it off, and reappeared to an astonished audience of merrymakers. Aragorn appeared from a dark corner of the pub, grabbed him by the collar and slung him into a side room as if he were a side of beef. “Are you frightened?” Aragorn asked the wide-eyed hobbit. Frodo answered a breathless, “Yes.” Aragorn’s counter line is unforgettable, “Not frightened enough. I know what hunts you.”

Ringwraiths. That’s what hunted Frodo. The evil emissaries of the dark lord Sauron were searching meticulously for the ring bearer; they wanted to destroy him and capture the one ring that ruled them all. Indeed, Aragorn was spot-on: the naïve little hobbit did not know what hunted him. And his naïveté was anything but humorous: the future of Middle Earth hung in the balance.

That scene came to mind Thursday night as I watched the sad news about Los Angeles Angels of Anaheim outfielder Josh Hamilton scroll across the screen: Relapsed, again. Drugs and alcohol, again. The sin that has hunted Hamilton since he was a teenager found him, again. I whispered a prayer under my breath: “Father, lavish your mercy on Josh Hamilton and his family. And have mercy on us. Let us never forget what hunts us.” I’m a big fan of our national pastime. I’m a big fan of Josh Hamilton. And like Josh Hamilton and Frodo Baggins, I, too, am hunted. I’m well aware that something hunts me, something deadly, an enemy I can only shake by unilateral grace: sin.

All-World Talent

Hamilton’s story is deeply compelling. At 18 years old, he was an all-world talent with a powerful bat that reminded some of Mickey Mantle and a howitzer arm that conjured memories of Roberto Clemente. He was the top overall pick in the 1999 draft, chosen out of high school in Raleigh, North Carolina, but Hamilton’s path to greatness was blocked by the twin demons of alcohol and drug addiction. Twice he failed drug tests, and on another occasion he was arrested after smashing the windshield of a friend’s car. Major League Baseball suspended him for most of three seasons from 2003 to 2005. His star appeared to have fallen.

But the effectual grace of God found Hamilton after this tumultuous period. God gave Hamilton new life through the death and resurrection of Jesus Christ. His conversion also breathed new life into his baseball career. Hamilton made his Major League debut in 2007 with my beloved Cincinnati Reds. He was an instant star. During the past seven years he has become what scouts expected him to be from the beginning: one of the best players in the game. He led the perennially mediocre Texas Rangers to consecutive World Series appearances in 2010 and 2011 and was named American League MVP in 2010. There were hiccups along the way, like a time in 2009 when he was photographed in a bar in a compromising position. And there was a seemingly small slipup 2012 when he admitted to drinking three beers. But Hamilton has mostly kept a strong witness for Christ. His family has helped build an orphanage in Uganda and established an outreach called Triple Play Ministries. Hamilton chronicled his fall and redemption in a 2008 book, Beyond Belief: Finding the Strength to Come Back (FaithWords).

Hamilton has kept accountability partners constantly at his side while away from home. He travels with only a small amount of cash and carries no credit cards. His wife, Katie, shuttles him to and from the ballpark during home games. After the Rangers won the American League pennant in 2010, Hamilton celebrated with ginger ale rather than champagne. I once heard Hamilton quote the apostle Paul, saying that he does not want sin to have mastery over him. No follower of Christ does.

Core Disease

Despite all that, sin continues to want to rule over Josh Hamilton. It wants to rule over us all. As a follower of Christ, Hamilton no doubt knows and agrees. Paul Tripp puts it memorably:

Sin is every human being’s core disease. It is completely beyond the power of any human being to escape it. It separates you from God, for whom you were created. It damages every aspect of your personhood. It makes it impossible for you to be what God created you to be and to do what God designed you to do. It robs you of inner contentment and peace, and it puts you at war with other human beings. It renders you blind, weak, self-oriented, and rebellious. It reduces all of us to fools, and ultimately it leads to death. Sin is an unmitigated, almost incalculable disaster. You can run from a certain situation, you can get yourself out of a relationship, and you can move to another location and choose not to go back again. But you and I have no ability whatsoever to escape from the hold that sin has on us. It is the moral Vise-Grip that has held the heart of every person who has ever lived.

Hamilton’s story could be my story or your story. The world, the flesh, the Devil is an unholy trinity that hunts us all. His story is in the news because of his profession; ours is not. What should we take home from Josh Hamilton’s sad brush with sin?

  • Life between the times is brutal war. We face enemies within and without that relentlessly wage battle against us. We will not defeat them fully in this life, but in the next. Thankfully, Christ has defeated them for us. My own pastor, Tom Schreiner, preached a powerful sermon from 2 Corinthians 10 this past Sunday on this reality. Even Paul, in Romans 7, continued to be hunted by indwelling sin.

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