Quite frankly, one of the most significant challenges faced by NCADD and our National Network of Affiliates is putting the problems of alcohol and drugs into a perspective that the general public can understand. When alcohol is combined into any discussion about other drugs, the general public, the media and policy makers tend to focus on the more dramatic issues of the illegal drugs or just drinking and driving, as if it is the only alcohol-related problem.

The focus of this article is not about one or the other being "the real problem." The goal is the presentation of accurate information both to better inform the public about risks and to more effectively shape the needed public and policy response. And these days, as more and more data and information are aggregated under the term "substance abuse" or "behavioral health" it makes it more difficult for us and the general public to fully understand the true scope of the problem.

In the March 2011 issue of Alcoholism: Clinical and Experimental Research Journal, Disaggregating the Burden of Substance Dependence in the United States by Bridget F. Grant, Deborah A. Dawson, and Howard B. Moss provided a powerful chart breaking down the numbers by alcohol, tobacco, cannabis, opiates, sedatives, tranquilizers, hallucinogens, cocaine, amphetamines, inhalants and heroin for U.S. adults, age 18 and older.

For each drug, the research data have been separated into four distinct columns:

• Prevalence of Past-Year Use
• # of Past-Year Users
• % of Past-Year Users with Past-Year Dependence and
• Number With Past-Year Dependence

Prevalence and Population Estimates of Past-Year Substance Use and Past Year Substance Dependence: U.S. Adults 18 Years and Older

Source: Adapted from Disaggregating the Burden of Substance Dependence in the United States by Bridget F. Grant, Deborah A. Dawson and Howard B. Moss, Alcoholism: Clinical and Experimental Research, Vol. 35, No. 3, March 2011, pp 387-388, published by the Research Society on Alcoholism (RSA).

As summarized in the following table, inconsistent with popular public perception, alcohol past-year use and past-year dependence clearly affects far more people than all other drugs combined.

Comparison: Estimated Numbers of Past-Year Users and Past Year Dependence

U.S. Adults 18 Years and Older

Alcohol Alone and All Illegal Drugs Combined

Note: The study utilized in the development of the paper is The National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), is sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).