Each year, around 88,000 people in the United States die from alcohol-related causes, according to the U.S. Centers for Disease Control and Prevention. This is higher than the number of deaths caused by overdoses from all other drugs, combined.
Alcohol consumption has been causally linked to over 200 disease and injury conditions, per the World Health Organization. Associated health problems include cancer, liver disease, violence-related injuries and increased risk of contracting infectious diseases such as HIV.
Moreover, Americans are drinking more now than they had before. A 2017 study published in JAMA Psychiatry found substantial increases in alcohol use, high-risk drinking and alcohol use disorder in the U.S. between 2001-2002 and 2012-2013.
But in spite of these statistics, media coverage of alcohol tends to be light and bubbly: cocktail recipes for summer, travel spreads about beer halls and wine tastings, a look at the newest spiked seltzer on the market. And these breezy lifestyle pieces often fail to mention the risks associated with drinking.
“I think that for now, alcohol, the default stance is that it’s good and that it’s what adults enjoy, it’s a fun thing associated with fun events, rites of passage, bonding, socializing. It’s in many ways the bedrock of adult society in America and elsewhere,” says Edith Zimmerman, a writer who reports on health for New York Magazine and has detailed her own experiences with drinking there and elsewhere. “I think suggesting that it is inherently problematic is threatening to the majority population’s way of life.”
The fact of the matter, though, is that it is a problem, and the media should reflect that.
To that end, we’re sharing eight tips on how journalists can improve their coverage of alcohol, based on suggestions from journalists and researchers with subject-area expertise.
Tip #1: When covering alcohol through a “lifestyle” perspective, consider mentioning the associated risks, too.
“I suppose this is going to depend so much on where the piece is appearing,” says James Morris, a PhD student at London South Bank University who studies beliefs about alcohol problems and behavior change and editor of Alcohol Policy UK. “But ideally any article about alcohol or drinking, from a public health point of view, ought to somehow try and highlight or recognize the fact that alcohol is a drug, that it’s a potentially addictive and dangerous drug.”
“I think it’s about people understanding it as a risk continuum,” he continues. “Small reductions, or just even keeping track of what you drink, can bring significant benefits. It’s not an all-or-nothing, give up, or drink as much as you like.
“The cultural and media representations of drinking as a positive, enjoyable, glamorous part of society, we can’t ignore or try and suppress that, but yes, it’s trying to bring that into a bit more balance,” Morris says.
Yin Cao, a cancer epidemiologist who authored a landmark study on the link between light-to-moderate drinking and increased risk of breast cancer, agrees. “I think for most people, they don’t know how much they drink, on average.” She suggested journalists point to resources individuals can use to monitor their alcohol intake, such as phone apps.
Zimmerman suggests that lifestyle reporters might think along the lines of “having non-smoking areas at restaurants.”
“In any story that covers alcohol in some way, it would be nice if there was also like a sort of non-lame-seeming option within the story, like, oh, if you’re having Aperol spritzes, if you don’t want to drink alcohol here’s the version you can make with whatever,” she says. “Always having a plausible and vaguely appealing alternative would be nice.”
Tip #2: When reporting on alcohol-related health research, put the findings in context.
When reporting on alcohol-related research, Cao recommends the following:
- Be clear about definitions. From paper to paper, the way alcohol intake is measured can vary. For example, the idea of a standard drink can differ, as can the way “light,” “moderate” and “heavy” drinking are defined. Bear in mind that the standard drink also varies by alcohol type (i.e., liquor vs. beer vs. wine). Because readers often want to know what the study means for them in terms of their drinking habits, Cao said, it’s important to get these details right.
- Note where an individual study fits into the broader body of evidence about alcohol and health effects, and point out its limitations. “Whenever there’s a new study in a high-impact journal, it gets lots of media coverage,” Cao says. “But few [articles] are in the context of previous research, or pointing out the limitations of the study.” She continued, “Nowadays the research seems to show more and more that there are no health benefits… It seems that we should revisit the overall evidence and potentially review these [new individual studies] in a more comprehensive way.”
- Make sure to define the populations studied. Is the research looking at alcohol consumption in a healthy population, a population of cardiovascular patients, or cancer patients, for example? What about the comparison (or reference) group? “My suggestion would be to find an expert in the field to comment on the study, to bring in a neutral perspective, a more professional perspective on the reference group they’re using,” Cao says. “One of the questions should always be asking about the sick quitter reference group,” she adds. The “sick quitter” phenomenon refers to the fact that some studies of alcohol consumption and health effects might find that those who abstain have worse health — but in fact, poor health might be the reason why they don’t drink (i.e., they take medication that can’t be mixed with alcohol, or they previously had alcohol problems and are now sober).
Tip #3: Avoid stereotypes.
The media can portray people with alcohol use disorder in stereotypical ways: homeless, destitute, unemployed, always clutching a bottle, at “rock bottom.”
“On the whole, media narratives reinforce problematic stereotypes — sometimes deliberately and sometimes not — and it would be wonderful if… there were more journalists taking a more nuanced approach, rather than too often relying on the stereotypical narrative of the alcoholic,” Morris said.
Stereotypes can be dangerous because they can contribute to stigma and prevent people from identifying their drinking as a problem that needs to be addressed, says Joe Schrank, executive editor of The Small Bow, a website focusing on news and narratives about drugs, and clinical social worker specializing in substance misuse.
“I think America is a giant dysfunctional family denying that we have an alcohol problem,” Schrank says. “Very few people come in [for alcohol misuse treatment] before they’re in acute crisis, and one of the reasons is because they do not want to be called alcoholics, because they have this image, this cultural image, of what an alcoholic is and it lingers.”
Tip #4: Avoid the term “alcoholic.”
While the term “alcoholic” is commonly used by the media, the clinical term for chronic, severe problem drinking is “alcohol use disorder” (AUD). The Diagnostic and Statistical Manual of Mental Disorders (DSM) presents 11 criteria for AUD. To receive a diagnosis of AUD, at least two of the 11 criteria must be met over a 12-month period.
That being said, clinical terms are not always warranted when covering alcohol.
“There’s lots of examples of articles that often report research around problem drinking that’s not necessarily about alcohol dependence, but is say, about cancer risks, or a whole host of problems that affect arguably the whole drinking population… but still those articles would frame it in terms of, ‘alcoholics at risk of cancer,’ or just falsely dichotomize it,” Morris says. “I’m thinking back when there was a new drug launched that was specifically targeting not heavily dependent drinkers, but people who might want to cut down their drinking, so specifically not people who are going to fit the criteria of alcohol dependence that most people would associate with alcoholism. Yet the headlines still talked about alcoholics.”
Tip #5: Try “person-first language.”
“Instead of saying ‘alcoholic’ or ‘addict,’ you say ‘a person with an alcohol problem or alcohol use disorder.’ I think those are always preferable, because they don’t stigmatize or label an individual or define them by their problem — they put the person first,” Morris says.
Some more points about language:
- When appropriate, instead of using the term “alcoholism,” try using “problem drinking,” “alcohol misuse,” or “alcohol problems,” Morris says.
- Definitions for “problem drinking” can vary, but Morris offered the following understanding: “I think the big overlooked aspect of problem drinking is the psychological dependency. People who say they need a drink at the end of the day to unwind, that’s indicative of a degree of psychological dependence.”
- “I try not to say ‘giving up’ drinking, because I prefer something like ‘stopping’ drinking, because giving up implies denial and self-punishment,” Zimmerman says.
Tip #6: Report on the scientific nature of issues related to drinking.
Schrank uses the example of the coverage of Brett Kavanaugh’s Supreme Court confirmation hearing as an example. Senator Amy Klobuchar asked the appointee whether he had ever blacked out while drinking, and he answered in the negative (after asking the senator the same question of herself). While much of the ensuing coverage focused on the particulars of the contentious exchange, Schrank said the media could have done well to delve into the issue with more specificity to shed light on the nature of problem drinking. “That’s a funny part about blackouts — people don’t remember them,” Schrank says. “It’s a process to learn about blackouts in a therapeutic setting, identifying patterns of behavior that either have a fuzzy memory or no memory, and to admit that.”
Tip #7: Diversify perspectives on drinking.
Morris suggests that first-person narratives written by people who self-identify as alcoholics can dominate in the media. “I’m not saying those stories shouldn’t exist, but they should exist in the context of a broad range of narratives which reflect the diverse nature of alcohol problems and experiences,” he says.
“People who are in the middle shouldn’t be afraid to have thoughts and feelings [on drinking]. It’s like, only people on the extreme should be allowed to do that — no, that makes for an awkward cultural conversation… Everyone has opinions and actually I’d be most curious to hear the opinions of people in the middle, who are probably getting a lot of information from both sides. Their delicate thoughts on drinking would be very interesting to me,” Zimmerman says.
Schrank agrees. “Most of the people who write in this capacity are in recovery, and I actually think it would be great if there were serious journalists outside that culture to look objectively at the problem, not with the lens of trying to deal with their own recovery.”
Tip #8: Diversify perspectives on sobriety, too.
Zimmerman mentioned the work of Kristi Coulter, Annie Grace and Julia Wertz as writers who have brought levity to sobriety narratives.
“I’ve been really heartened to see the proliferation of stories around sobriety lately that are nuanced and funny and have a lightness about them,” Zimmerman says “What was most off-putting to me for so long, was like, ‘Oh if I get sober, do I have to become humorless and terrible?’ and like it’s been nice that it hasn’t been that way, but more and more evidence toward that towards that end is nice,” she continued. “It would be fun to have stories around the humorous beauty of sobriety.”
Other angles:
Schrank suggested journalists should consider expanding their coverage of alcohol to consider its relation to social problems, such as domestic violence. Another angle worth considering, Schrank said, is the effects of alcohol on suicide. Schrank said he’d like to see more coverage of medication used to treat alcohol misuse, such as naltrexone and antabuse, to complement the more prevalent coverage of rehab and 12 step programs. Cao noted that journalists would do well to “pay more attention to early adulthood drinking and monitor its long term health consequences.”