Screening for Alcohol Misuse and Secondhand Drinking – Alcohol Awareness Month

Screening for Alcohol Misuse and Secondhand Drinking – Alcohol Awareness Month

Alcohol Misuse and Secondhand Drinking are two sides of the same coin - the "family-ness" of

Screening for Alcohol Misuse and Secondhand Drinking can help us better understand they’re two sides of the same coin – the family disease of addiction.

Screening for alcohol misuse and secondhand drinking during Alcohol Awareness Month 2013 can make a world of difference for millions, as well as society as a whole.

This is a bold statement to be sure, but one that’s more easily understood when we understand alcohol misuse and secondhand drinking as two sides of the same coin – the family disease of addiction. And for that, I invite you to read, “The Dance of the Family Disease of Addiction.”

Please understand as you continue reading that this may seem disjointed. It is. We are talking about a complicated dynamic – brain changes associated with alcohol misuse cause drinking behaviors which cause secondhand drinking. Secondhand drinking can cause brain changes that in turn may result in one or more of the risk factors that can result in alcohol misuse.

Hence the importance of screening for alcohol misuse and secondhand drinking. In this manner, we better understand this dynamic and can start the conversations that can result in self-elected, self-directed change.

The Benefits of Screening for Alcohol Misuse and Secondhand Drinking

Why should we all want to understand screening and its benefits? Why should we all anonymously screen ourselves and/or someone we are concerned about?

Because the outcomes of either side of this coin affect the lives of over one-half the (American) population and the economic costs exceed one-half trillion dollars in the U.S. This affect can be directly (as it in one’s loved one’s behavioral changes) or indirectly (as in the outcomes caused by a drunk driver or a distracted co-worker or a distraught teen). For more on this concept, check out “Addiction Impacts Lives of Millions and Costs Billions.”

Perhaps it’s the indirect effects of alcohol misuse, however – those caused by secondhand drinking – that are most misunderstood and yet these are often the cause of the cycle that sets up the next generation to develop a substance abuse problem. This post gives a more detailed explanation, “Why a Child of an Alcoholic | Addict “Chooses” to Drink or Do Drugs – Meeting Ourselves Coming and Going.”

Thus screening can help the person with the drinking problem see more clearly what the problem is (alcohol abuse or alcoholism).

It can help the person coping with secondhand drinking see more clearly the impacts on them (the impacts caused by coping with another’s drinking behaviors, such as: drunken arguments; physical fights; verbal, physical or emotional abuse of others – especially a spouse, child, boy/girlfriend; a person’s driving while impaired; domestic violence; problems at work or in school related to drinking or recovering from heavy drinking bouts; or a person’s criminal activity or engaging in risky sexual behaviors while drunk).

And – perhaps most importantly – it can help all concerned, as well as society as a whole, understand that dealing with both alcohol misuse and secondhand drinking head on – talking about it opening and frequently – can help break the cycles. It can help us help children avoid the brain changes caused by secondhand drinking that can make that young person’s brain more susceptible to developing a substance abuse problem themselves. Check out Coping with Secondhand Drinking | Drugging Can Cause a Young Person to Wire Unhealthy Coping Skills and Youth Alcohol Abuse Prevention Programs From a Different Angle.

Screening for Alcohol Misuse

Alcohol misuse refers to drinking patterns that exceed low-risk or “normal” drinking limits. Alcohol misuse patterns include binge drinking, heavy social drinking, alcohol abuse and alcoholism. When it comes to causing secondhand drinking, the label doesn’t matter. The label does matter when trying to determine how one will change the drinking pattern. An alcoholic, for example, cannot drink any amount of alcohol and treat their chronic, often relapsing brain disease, whereas an alcohol abuser may be able to learn to re-drink, to bring their drinking patterns within low-risk limits. These two short videos explain these distinctions: How Much is Too Much and Alcoholism is a Disease and It’s Not Alcohol Abuse.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has developed a single question to screen for “at-risk” drinking, which may be an indication of any of the alcohol misuse patterns described above because the individual is not staying within low-risk or “normal” drinking limits:

For women: How many times in the past year have you had 4 or more standard drinks on any day?

For men: How many times in the past year have you had 5 or more standard drinks on any day?

Standard drink is defined as 5 ounces of wince, 12 ounces of regular beer and 1.5 ounces of 80 proof hard liquor.

An answer of once or more indicates “at-risk” drinking or alcohol misuse.

To learn more about drinking patterns and further assessments, visit NIAAA’s website, Rethinking Drinking.

You may also wish to use the World Health Organizations Alcohol Use Disorders Identification Test (AUDIT) to anonymously assess.

And NIAAA’s Clinician’s Guide for Helping Patients Who Drink Too Much also offers more information, as well.


Screening for Secondhand Drinking

To screen for secondhand drinking, reframe NIAAA’s single question as follows:

How many times in the past year has a female relative or close friend had 4 or more standard drinks on any day or a male relative or close friend had 5 or more?

An answer of once or more is an indication the person is being exposed to secondhand drinking.

For help with what to do with a “yes” answer, visit Alcohol Abuse Going On in the Family? If Only My Doctor Had Asked

To better understand why it’s important to address secondhand drinking, please visit The Health Consequences of Secondhand Drinking.


Bottom line:

This is a lot of information to read all in one post. But as you’ve gathered, it’s a two-sided coin. If you have any questions, please feel free to call me at 650-362-3026 or send a confidential email to

Lisa Frederiksen

Lisa Frederiksen

Author | Speaker | Consultant | Founder at
Lisa is the author of hundreds of articles and 11 books, including "If You Loved Me, You'd Stop!," "Addiction Recovery: What Helps, What Doesn't," and "Secondhand Drinking: the Phenomenon That Affects Millions." She is a national keynote speaker with over 25 years speaking experience, consultant, and founder of She has spent more than 14 years studying 21st century brain research in order to write, speak, and consult on substance use disorders prevention, intervention and treatment; mental disorders; addiction (aka substance use disorders) as a brain disease; adolescent addiction treatment vs adult addiction treatment; effective treatment for co-occurring disorders (having both a substance use and mental disorder); secondhand drinking | drugging; help for the family; and related subjects. In 2015, she founded SHD Prevention, providing training and consulting to companies, public agencies, unions, nonprofits and other entities to address the workplace impacts of employee secondhand drinking and alcohol misuse.
Lisa Frederiksen

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27 Responses to Screening for Alcohol Misuse and Secondhand Drinking – Alcohol Awareness Month

  1. Thanks for such an in depth post, Lisa and all the links where one can receive help. I am so thankful I do not have this problem. God bless you for all the help you offer.

  2. Sherie says:

    I think that screening for alcohol misuse is a very good idea. I don’t personally drink alcohol at all (can’t stand the taste!). However, I think this would be a valuable tool for those who do!

    • Thanks, Sherie! And this screening tool can be used by those within the sphere of someone whose drinking is of concern, which can help them be better prepared to effectively talk about their concerns.

  3. MamaRed says:

    There are so many paying the price for this and know I have family members who are paying the price of this happening in their childhood years. It is painful and it hurts and it is a drain on the amazingness possible in this world.

    • The impacts of this in childhood are so sad and not understood. And then the ripple effects beyond the individual to their spouses or in-laws and their children and their co-workers…. Truly astounding. Thanks for your comment!!

  4. MarVeena says:

    Thanks for this important reminder! I do my best to practice clean life style, clean and pure foods and same for thoughts! :~)

  5. Tom H says:

    Thanks for sharing, it is important to understand when you are crossing the line to abuse

  6. Lisa, thank you for sharing such excellent and detailed post on the reasons to screen for second had drinking and possible alcohol misuse.

  7. Interesting. However, the people who need the information, so many times don’t have it. Your blog is an eye-opener!

  8. Thanks for sharing such great information – screening and helping grow awareness on the effects of over-use of alcohol is really important.

  9. This article makes me think that the majority of people I know have practiced misuse of alcohol. I think a large reason for this is how alcohol is portrayed in our society, such as media. There is no solution for the problem, but educating people is a large step to help at least some. Thank you for your informative articles and for caring so much about others. YOu are awesome Lisa!

    • I think a majority of us have a similar experience, Daniele, with the majority of people we know having practiced alcohol misuse (which does not necessarily mean alcoholism or alcohol abuse). I agree the way it’s portrayed in the media and other venues is a huge part of the problem, as is a lack of real understanding of what it is and how it happens. I really appreciate you commenting and your compliment!

  10. Great information here, Lisa. The more aware we are of standard drink limits, the better. I also find this question very helpful – “How many times in the past year has a female relative or close friend had 4 or more standard drinks on any day or a male relative or close friend had 5 or more?” This is an excellent way to get a true sense of a person’s drinking habits. Thank you for sharing this information. It is so needed not only during this month, but the rest of the year as well.

    • Thanks, Cathy! Hopefully this question can help family members better appreciate the “simplicity” of alcohol misuse and that worrying about a label is not the point. Rather, it’s identifying the source of one’s problem as a loved one’s drinking (drinking behaviors) – if in fact, it is.

  11. Pat Moon says:

    As I was reading your article I couldn’t help but think that if somehow we could get people who are addicted to alcohol and drugs sober and drug free it would be a huge answer to so many health problems as well as social problems. Just think if everyone was sober, drug free, and not obese how much money we would save in health care costs.. it would solve many of the current economic problems.. just a thought.

    • I TOTALLY agree with you, Pat. And then just think of the quality of life for all concerned – the family members, the addict/alcoholic, co-workers, fellow students…, and on top of that, the health care cost savings – it would truly be remarkable!

  12. Sharon O'Day says:

    When you read the percentage of the population affected by the two aspects (alcohol misuse and second-hand drinking), you realize how underfunded this issue is. And then when you see the economic cost, it’s even more obvious. Thanks for turning the spotlight on these truths, Lisa!

  13. It’s really sad that so many people are affected by second-hand drinking, and that it’s been pretty much ignored for so long. Kudos to you Lisa, for all the work you do to help people and create awareness.

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