1. Rationale – Actual Death

2. What are the leading causes of death in the U.S.?
ASK “Many of you are likely familiar with the leading causes of death in the United States. When you think about that, what are some of the first things that come to mind.”

3. Leading Causes of Death - United States, 2000
“You hit many of the top ones. When we look at causes of death we see things like heart disease, cancer, and stroke taking the lead.”

4. Most, if not all, medical issues reduce to the need for
Most, if not all, medical issues reduce to the need for behavioral change.
Most, if not all,
medical issues reduce
to the need for
behavioral change.
“However, underlying all of these causes of death there are often underlying behavioral health or lifestyle issues. Behavioral health issues can often cause disease or injury to develop and, regardless of the causes, once disease does develop, behavioral changes are often needed to effectively manage the disease.”
ASK “How might behavioral health issues be related to some of the leading causes of death we just discussed?”

5. JAMA Actual Causes of Death
“Modifiable behavioral risk factors are leading causes of mortality in the United States.”
“This train of thinking led researcher to investigate the underlying causes of death empirically, in a groundbreaking systematic review conducted in The results of this review have helped us to reframe the leading actual causes of mortality as being modifiable behavioral risk factors.”

6. Leading causes of death vs. Actual causes of death
“Here, you can see the actual causes of death in the United States. Topping the list are tobacco use, poor diet and physical in activity, and alcohol consumption.”

7. Leading causes of death vs. Actual causes of death
“Alcohol consumption is the third leading actual cause of death in the United States, resulting in 85,000 deaths annually.”

8. 2,200 Americans died each year of alcohol poisoning—an average of 6 deaths every day Alcohol poisoning death rates varied widely across states, from 5.3 deaths per million residents in Alabama to deaths per million residents in Alaska
“Alcohol can kill people in many ways. The most direct route in alcohol poisoning, which kills over 2,000 Americans each year.”
A Shot of Truth: Myth Busting Excessive Alcohol
Use February 23, 2015 By: Jessica B. Mesnick
A Shot of Truth: Myth Busting Excessive Alcohol Use February 23, 2015 By: Jessica B. Mesnick

9. The Prevention Paradox
> 50% of alcohol-related health consequences occur in risky and problem drinkers (not AUD drinkers)
“Interestingly, however, the majority of deaths and alcohol related health problems that occur are not among individuals who have an alcohol use disorder or who are drinking so heavily that they literally overdose on alcohol, but are among individuals who are drinking at risky levels. This is known as the prevention paradox, a phenomenon in which a large number of people at small risk contribute more cases of a particular condition than a smaller number of people who are individually at greater risk >50% of health consequences of alcohol occur in risky and problem drinkers, not dependent drinkers.”