" The middle-aged man in my exam room wasn’t an alcoholic. At least, that’s what he declared to me as I asked him questions about his drinking.

"I’m not like those people," he said, smiling nervously. "I go to work. I don’t fall down the stairs. I don’t embarrass myself."
As we spoke further about the consequences of drinking six to seven beers every night (and a few shots here and there), he kept pushing back. “I just need to relax. I’m stressed at work and at home. Money’s tight. I’m like everybody else. I’m normal."

As the fourth-leading cause of preventable death, killing an estimated 88,000 Americans a year, alcohol is the most common problem that I encounter as a primary care doctor, and the one that I feel least able to manage. My ineffectiveness is all the more frustrating as addiction deaths continue to rise, contributing to the first drop in the American population's life expectancy in generations.

With all of our incredible medical advances, we have utterly failed to combat the growing plague of addiction. And while opioid disorders are gaining more attention, alcohol still kills more people than all illicit drugs combined.

In researching this problem and speaking to experts across the country, I’ve realized that we as a medical community do not take unhealthy alcohol use as seriously as we should. This is maddening. We have treatment that works, is cost-effective and saves lives; but our patients aren’t getting it. When it comes to alcohol, we are under-trained, under-supported and underfunded. As a result, we have failed to address unhealthy alcohol use in any meaningful way.

The first obstacle we have to face is a fundamental misunderstanding of the problem itself. "