Alcohol consumption in the U.S. has been steadily rising since the end of Prohibition in 1933, peaking in the early 1990s. Not surprisingly, more Americans over the years have been treated for alcoholism.

But where is the line between heavy drinking and clinical alcoholism? A study in the Centers for Disease Control and Prevention (CDC) journal Preventing Chronic Disease says it isn't where you think it is.

The researchers found a distinction between drinking too much and being alcohol dependent. They say 9 in 10 Americans who drink too much shouldn't be classified as alcoholics.

“This study shows that, contrary to popular opinion, most people who drink too much are not alcohol dependent or alcoholics,” said Dr. Robert Brewer, Alcohol Program Lead at CDC and one of the report’s authors. “It also emphasizes the importance of taking a comprehensive approach to reducing excessive drinking that includes evidence-based community strategies, screening and counseling in healthcare settings, and high-quality substance abuse treatment for those who need it.”

But heavy drinking is a problem

But just because someone isn't classified as “alcoholic” doesn't mean they aren't doing real damage physically and socially. In recent years binge drinking has been a growing concern, especially among young adults.

Binge drinking is defined as 4 or more drinks on an occasion for women, 5 or more drinks on an occasion for men. Consuming 8 or more drinks a week for women or 15 or more drinks a week for men also falls within the binge drinking definition.

And it turns out millions fall into that category. The study found that nearly 1 in 3 adults is an excessive drinker, and most of them binge drink, usually on multiple occasions. That, in itself, is a big problem.

Death toll

The researchers say excessive drinking is responsible for 88,000 deaths in the U.S. each year and only 3,700 of those deaths are linked to alcohol dependence. Putting a dollar figure on all this imbibing, the tab came to $223.5 billion in 2006.

The alcohol-related deaths tracked by the study were due to health effects from drinking too much over time, such as breast cancer, liver disease, and heart disease. The National Institutes of Health (NIH) reports that 48% of all cirrhosis deaths in 2009 were alcohol related.

There were also serious health effects from drinking too much in a short period of time, such as violence, alcohol poisoning, and car accidents.

What to do

This may be timely information, coming at the beginning of the holiday season when alcohol flows with abandon. To get through the next few weeks without over indulging, specialists at the University of California Davis Health Center offer these tips:

Think about how much alcohol you will consume before arriving at a party, then stick to your budget

Don't pressure anyone to have another drink

If you're the host, offer a wide selection of non-alcohol beverages

If someone is intoxicated, don't serve them another drink and, by all means, don't let them drive home

Are there ways to reduce the growing tendency to drink to excess? The Community Preventive Services Task Force has recommended increasing alcohol taxes, regulating alcohol outlet density, and holding alcohol retailers liable for harms resulting from illegal sales to minors or intoxicated patrons.