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 …


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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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


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.


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.


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.


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.


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.



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.


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.



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.



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.

Pedro Albuquerque

The puritanical worldview that permeates the field of public health in America is obsessed with words such as "alcohol," "tobacco," "drugs," "sex," "gambling," "gluttony," etc. A more enlightened perspective would focus on the word "abuse." I see too much wasted research effort driven by a puritanical agenda, and very little concern on why a few people misuse things that, on the hands of responsible and smart people, are epicurean delicacies.

peem birrell

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

Alcohol abuse
Alcohol abuse
Alcohol abuse

I hope you advised him not to drink so much


I have a feeling that part of the reason alcohol is more accepted is that it can be enjoyed responsibly without having any effect on the people around the consumer. If I smoke a cigarette, I am filling the room with cigarette smoke and forcing anyone around me to breathe it. If I have a beer, the only thing I've done is lessen the amount of beer available to those around me, and, if I stop there, I should be fine enough to not have harmed anyone around me. If I expect to have a few, I can walk to the bar, stay at home and invite friends, take a cab, or plan to have a DD. There are ways of enjoying alcohol without having a negative impact on people around you. This is harder with smoking.

high on life

I went to a professional meeting this past week. There was an event for alumnae. someone asked me if I wanted a drink. I said no and then he asked again as if I could not possibly have meant what I said. What he did not know is, I don't drink and drive. Never have, never will. Drinking for me is (mostly) a dinner event and only one- as I know my tolerance level. Now with kids, it can be another story. Some parents in the town we lived in encouraged their kids to drink and that had some effect on us all. Some kids have to learn by their mistakes. I just pray, it is not mine. I tell my kid all the time don't drink and drive. Anyway, I dislike beer i.e., except for a special brand sold in Quebec and I have not had that since a high school trip some 46 years ago. Apparently, it was legal to drink at 17 at the time. At least, teachers did not stop us.

Shane L

Great point by Stephen that the alcohol of choice may be a demographic marker. I wonder, though, if price is not quite as important as it might be expected to be. I've noticed before strange associations between certain types of alcohol and socio-economic groups, but which do not relate to price. (For example I've noticed machismo around the consumption of beer in large quantities. Wine often has a higher percentage of alcohol and cheap wine is pretty accessible, but the macho young men looking to make a point about their boozing would probably stick to beer and spirits - in my neck of the woods at least!)


Not much of a study from what I can tell.

"The “study,” if we can even call it that, consisted of giving a survey to 105 people at one inner city Baltimore E.R....

The study was done by David Jernigan, who in addition to being an associate professor in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health, is more importantly the director of the Center on Alcohol Marketing and Youth (CAMY), a notoriously anti-alcohol organization. That affiliation is not disclosed in any of the reports on this particular “study.”"


caleb b

Those brands are also associated with drinking games (beer pong, flip cup, circle of death), all of which almost guarantee excessive drinking.


Or unify them both with price/ml of alcohol?


Why this article caught my eye:
1 I work in an emergency room
2 I am a college student, in a town known as the "Drunkest city in America"
3 I have an idiot brother who, along with his friends, religiously consume Budweiser.

I would be interested in focusing on the amount of consumption and favorites among the groups who consume a lot, such alcoholics, college students, and/or alcoholic, college students.
It seems that those who end up needing Emergent Care are either alcoholics or just plain dumb-asses, and although the latter group may include the former, how often you drink affects what you choose to drink.

This group would want a low cost beer with a high %, and if you do this often, you're going to end up driving/ crashing/jumping your skateboard/ catching a rattlesnake, etc.