“Houston is ground zero for DWI fatalities.” That’s the conclusion of Harris County District Attorney Kim Ogg in a recent Houston Chronicle article. Drunk and drugged driving has caused more than 3,000 fatal traffic wrecks in the Houston area over the past 16 years, far more than any other major metropolitan area in the country. This tops all major metropolitan areas by 1,100 deaths. The Chronicle goes on to discuss the complexity of criminal justice approaches, lack of law enforcement capacity to run DWI checkpoints, alcohol industry opposition to lower blood alcohol content limits, and the emergence of impairment due to prescription drug use.

Putting other drugs aside, alcohol use disorder puts individuals at great risk, and not just because of impaired driving. In Houston, law enforcement brings DWI’s to jail and diverts public intoxication Class C misdemeanors to either the Houston Recovery Center or a responsible adult. Roughly two thirds of our sobering center clients are publicly intoxicated due to alcohol use, and more than 90 percent are only admitted once or twice. In other words, a single night of unusually heavy drinking can seem innocent, yet it puts a person and those around them in immediate danger. According to the Center for Disease Control, “binge drinking is the most common, costly, and deadly pattern of excessive alcohol use in the United States.” A person can go many months without consuming any alcohol, and then a single episode of four or more drinks in an evening can result in a blood alcohol content of .08 or higher. Partly because it’s “only one night”, these sporadic binges are not seen by society as an alcohol use disorder. But they are. The body can only process alcohol so quickly, and that means how fast you drink is just as important as how much you drink.

So how much and how fast can alcohol be consumed? That’s a question most people don’t think about very much, and it turns out there are varying answers. Countries around the world have their own legal limits. A medical journal called the Lancet recently published an article concluding that alcohol-related deaths would be lowest by having no more than 7 standard drinks a week, spaced out as evenly as possible, for both men and women. The World Health Organization has a different perspective. They place alcohol consumption as one of the top ten global public health issues, and they do not endorse healthy limits. Instead, they call for all countries to reduce harmful drinking by implementing a legal blood alcohol content level of .05, which research shows dramatically reduces related injuries and fatalities. For cultures where drinking is socially ingrained and commercially supported, however, lowering the legal limit can be akin to turning the Titanic around.

It’s also fitting that the Harris County District Attorney described Houston as “ground zero” because society often believes a ground zero myth about addiction recovery: “wait until they hit rock bottom” before offering help. In the past, this may have been a strategy because we didn’t understand substance use disorder. Yet new medical technology and ongoing research helps us to see it differently. Intervening early on active substance use and halting overconsumption is an impactful and effective strategy. Many individuals who drink regularly or socially do not realize they are overconsuming because there is no widely accepted healthy drinking benchmark.

We can’t wait for rock bottom. Instead, we have to make it less rocky by proactively intervening on substance use that can bring awareness to overconsumption. Before it is too late.