What Kind of Beer Is Most Likely to Land You in the E.R.?

(Photo: Michelle Tribe)

(Photo: Michelle Tribe)

A new study (gated) published in Substance Abuse & Misuse and summarized by Anahad O’Connor in The New York Times identifies the brands of beer most often drunk by people who end up in a hospital emergency room:

The study, carried out over the course of a year at the Johns Hopkins Hospital in Baltimore, found that five beer brands were consumed most often by people who ended up in the emergency room. They were Budweiser, Steel Reserve, Colt 45, Bud Ice and Bud Light.

Three of the brands are malt liquors, which typically contain more alcohol than regular beer. Four malt liquors accounted for nearly half of the beer consumption by emergency room patients, even though they account for less than 3 percent of beer consumption in the general population.

While it might make some sense to focus on malt liquor because it is more intoxicating, I am guessing it would be more fruitful to focus on the top E.R. brands as demographic markers — i.e., the people most likely to drink these brands are the most likely to drink enough to do something that lands them in the E.R. To that point, price likely plays a big role as well.

It is interesting that the war on smoking has been increasingly successful because of cigarette tax hikes, while the damage caused by alcohol consumption has, to my knowledge, hardly been addressed through similar means.

I recently had a conversation with a college president who, when asked to name the top three problems he’s facing, said:

  1. Alcohol abuse
  2. Alcohol abuse
  3. Alcohol abuse

Would be interested to hear reader comments on this topic …

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  1. Steve says:

    No stunning revelation here… Consider that the stigma around drinking perpetuates a culture among high school and college age kids/adults where drinking cheap beer to get drunk, usually as drunk as possible as quickly as possible. The negative attention and limitations given to it only provide a temptation for someone to abuse it. Gradual and early exposure will take this stigma away, but that’s brought about through parenting – the most critical area where decline continues to detriment many areas of our society.

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    • Enter your name... says:

      Which explains why binge drinking is unheard of among university students in countries where alcohol consumption is just a normal, unremarkable part of everyday life, like Germany, Austria, and The Netherlands.

      Oh, wait… they have alcohol problems there, too. In fact, every European country except Turkey has higher rates of teen alcohol abuse than the U.S. In some of them, binge drinking is 60% in the last month, which is nearly three times the U.S. rate, per this study: https://www.ncjrs.gov/App/Publications/abstract.aspx?ID=232713

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      • Steve says:

        Not to mention the general disregard for the well being of people for fear of intruding into their “space” or the denial and seclusion we force ourselves into when we no longer understand how to handle our emotions so we turn to some vice to “get away.”

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      • Radu says:

        Hidden due to low comment rating. Click here to see.

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      • Mike B says:

        I know that the UK defines “Binge Drinking” as something like having more than 4 or 5 drinks in a night. If one is at a bar or party all night 4 drinks isn’t a binge…its just drinking.

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    • Steve says:

      Hmm, may have missed my previous post… You incorrectly assume that I compare the US to Europe, which is the obvious comparison. My only is between parents who teach their kids not only about alcohol, but the proper way to conduct themselves and handle their emotions.

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      • Enter your name... says:

        I’d challenge your belief that parenting has gotten worse.

        Child abuse has dropped enormously. In 1950, it was legal to whip a child until he had welts or bruises. Now, we have whole countries where even a mild spanking is either illegal or firmly discouraged, and nobody says that beating a child until he is literally in so much pain that he can’t sit down comfortably is either normal or good.

        The number of kids dealing with parents who are half-drunk all the time from the idyllic 1950s-style “martini lunch” is much lower. The US had a major sobriety problem back then.

        Parents spend far more time with their younger children than they have at any point in the last century. “Good parenting” used to mean letting the kids spend most of the day outdoors, which is not a method of parents teaching their kids anything, much less how to regulate their emotions. Now we deliberately teach them to “use your words” and provide them with skills to cope.

        I think, on the whole, that things have gotten better. It is true that we’re raising children to be less afraid of getting beaten, and that does have an effect: these children are less likely to be instantly obedient. But otherwise, I think we are winning all around.

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      • Your Name says:

        I’d challenge your belief that changes in parenting style can be categorized as better or worse.

        I would very much like to see a study correlating time of parenting with quality outcomes, or comparing and contrasting outcomes of children who spend a significant amount of time outdoors unsupervised vs indoors and supervised. I do not find it prima facie better to keep kids indoors rather than outdoors.

        The same is true of changes in behavior regarding corporal punishment or parental use of alcohol. While assertions regarding the benefits of a decrease in both behaviors pass the sniff test, I haven’t seen any data correlating these specific activities with positive outcomes. I would genuinely welcome some science on these topics.

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    • James says:

      WRT teen drinking, consider that alcohol is an anesthetic. I dare say many of us used it, knowingly or not, as a form of self-medication. If we survive until our mid-20s or so, either the causes of the pain have been eliminated, or we’ve developed sufficient scar tissue to deal with life without the anesthetic, so we basically stop drinking.

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    • Steve says:

      I disagree that parenting has gotten better. It’s changed, certainly, but the rate of single parent households is greater than it’s ever been, the number of homes with two working parents is increasing and the number of parents who don’t “Check Out” after a day’s work is dwindling. Kids aren’t brought up with any realistic sense of reality. Many either aren’t self motivated because they have never had a motivating parent or are too afraid of the pressure placed upon them by their parents to fail at anything.

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  2. Chris says:

    The list of the 5 beers most likely to end up in the ER shouldn’t surprise anyone. You’re looking at 5 of the most common and cheapest beers on the market. Additionally, because of the weird way distribution works across the nation, there are beers that are brewed in Pennsylvania that are only distributed to certain states or markets. (Detroit, Michigan for example doesn’t get Yuengling, but you can go to Toledo, Ohio and pick it up). California may be number 1 in microbreweries, but only a handful of those microbrews are available outside of the state or neighborhood.

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  3. Peter says:

    Definitely a direct correlation of high alcohol percentage and low price. People looking only to get hammered have a much bigger problem than the professor mentioned above, who can still keep a job. A primary attribute that comes with getting hammered is loss of judgement and impulse control, which can lead to driving, fighting, and general recklessness, which many times lands one in the ER.

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  4. Jane says:

    Alcohol abuse is certainly a problem and I have read about the college presidents who are trying to deal with enforcing the laws. Some have stepped it up, but it has pushed the drinking off campus and into the communities. As a parent to 4 teens, it is a constant worry about peer pressure and what they might encounter. I cannot believe how many people will allow teen drinking in their homes. When I was young we had 3.2 beer legal for 18 year olds in OH. I don’t know if the level of abuse was any different back then compared to now. One option might be to lower the drinking age for beer to 19 as it is in some other countries. But I’m not sure this will decrease the level of abuse.

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    • Matt says:

      Over here in Europe most countries will serve you whatever alcohol you want by the age of 18.

      Austria, Belgium, Germany, Liechtenstein and parts of Switzerland all allow beer etc. to be purchased by 16 year olds. A minimum age of 16 applies to all alcohol in Italy and Luxembourg.

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  5. Shan says:

    I think education played a bigger role than price hikes in reducing cigarette consumption, and a similar approach would be effective for alcohol abuse. Instead of telling students not to drink, schools and universities should be telling students how to drink responsibly. But it is difficult for schools to do this because by teaching underage students to drink responsibly they are seemingly “advocating” for breaking the law. At my school, this creates an environment where administrators know that students drink and accept that it is part of college life, but reprimand them only if they get caught. The mentality is “We know you are doing this, just don’t get caught.” As you can imagine, this policy is pretty ineffective. I think reducing the drinking age would actually help schools address the problem of alcohol abuse head on, because they wouldn’t have to pretend that their students aren’t drinking.

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    • Thomas Manson says:

      Exactly. When I read that cigarette tax hikes caused the war on smoking to be a “success,” I laughed. I think these guys are mistaking simple correlation for causality.

      You would think they know better.

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  6. HBuck says:

    Did they consider adjusting for market share? The most popular beer would have more people in the ER even if there was no relationship between choice and chance of an ER visit. I’d also guess they didn’t adjust for repeat customers at the ER.

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  7. Chris says:

    As a recovering alcoholic with just shy of two years sobriety, I have to say I am surprised to see these brands on there. Steel Reserve is what I drank at the end of my drinking career while drinking beer solely for the purpose of getting the job done quickly and cheaply. But the Bud brands are relatively low in alcohol content compared to micros or malts so the only thing I can think of is my own experience with those brands. I drank them when I needed to be able to drink all day/night. You need a lower content beer, for example, if you will be drinking all day at a tailgater or else you will pass out eventually. But by not passing out, you are awake and doing stupid $H!T instead blacked out… in my experience a pass out is more favorable than a blackout in terms of consequences. If I needed to “function” (using that term loosely) I would drink a lower content beer, such as Bud/Bud light.

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  8. Eric says:

    As a medical student, I’ve noticed that my class is much better at accepting science when it doesn’t go against our personal actions. When a doctor talks to us about the effects of smoking, we accept everything he says, (since the average student doesn’t smoke). However, we disagree with a lecturer who talks to us about the negative effects of drinking alcohol or coffee, even if the evidence is just as supportive (since the average student uses both drinks to prepare for or recover from an exam).

    I’ve noticed this trend in the medical community in general, in politicians, and in our society as a whole. We want to think that we make evidence-based decisions, but we sometimes throw the evidence away when it goes against something we want to do. I don’t think the war against smoking would be as effective if most doctors and politicians still smoked, and I’m not sure why alcohol would be much different.

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    • Parker says:

      I wonder if the consideration that smoking tobacco presents harmful effects beyond that of the consumer (i.e. second hand smoke), whereas consuming alcohol does not.

      Likewise, small amounts of alcohol consumption are not nearly as physiologically handful or habit forming as minimal amounts of tobacco use.

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      • James says:

        In fact, there is considerable scientific evidence that moderate consumption of alcohol and caffeine have positive effects on health.

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      • Paul K. Ogden says:

        Actually the evidence that second hand smoke represents a health hazard to others is extremely weak. Epidemiological meta-studies show a risk factor of only 1.2 and many individual studies show a less than 1.0 risk factor, which is a protective effect. Generally you need a 2.0 risk factor for there to be a conclusion that there is a cause and effect relationship. Second hand smoking studies are not even close to reaching that level.

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      • James says:

        Depends on what you mean by evidence. My coughing & clogged sinuses from exposure to second-hand smoke is sufficient evidence for me.

        In any case, why should it have to be proved “harmful” (using whatever definition of harm you like)? It’s enough that it’s unpleasant.

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    • Daran says:

      Yes, you bring up the phenomena of motivated reasoning, which I learned about in this interesting Mother Jones article, The Science of Why We Don’t Believe Science.


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    • J1 says:

      I don’t know of anyone who disputes the negative effects of drinking alcohol – it’s just that you have to use way too much of it to experience those ill effects, and there are allegedly some positive effects before you get there. At reasonable levels of use, there are no significant negative effects.

      By contrast, there is absolutely no situation in which inhaling smoke is good for you.

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    • Steve says:

      You’re referring to the self-serving bias among your colleagues (ie. this doesn’t apply to me, the facts may say otherwise).

      Also, I think it’s also important to delineate between use and abuse. It’s likely that those who are abusing alcohol already have a bevy of other problems that they are dealing with.

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