National studies report that binge drinking among college students is holding steady at 44 percent -- 75 percent in fraternities. But the University of Iowa proportion is 60 percent. The studies say that 32 percent of high school seniors binge drink. This year City and West high schools had more than 100 cases of drug and alcohol police reports and suspensions.

Disturbing numbers, and the problem starts in grade schools.

By every measure alcohol is our nation's – and Iowa City’s -- number one hard drug problem. The harm it causes is far more serious – starting with six times more youthful deaths – than that from all other illicit drugs combined.

Numbers affected: Of 40 million heavy drinkers, 20 million are alcohol abusers. They impact the lives of half of all Americans.

Health:  Unlike heroin, alcohol is a poison that can cause permanent brain damage. Complications from alcohol, even withdrawal, can kill. It contributes to esophageal and breast cancer. Some school children suffer from the mental retardation called "fetal alcohol syndrome." Fatalities from alcohol-related traffic and other accidents are up. And binge drinking correlates with student gun ownership.

The mythology is that "prohibition didn't work."  The facts are otherwise.  Politically unpopular and repealed? Yes. But those 15 years showed enough decrease in alcohol's adverse health effects to make it a smashing public health success.

Economic impact:  Absenteeism, property damage and other alcohol-related costs exceed $200 billion annually. An average Iowan pays $1000 in excess, alcohol-related taxes; and health, auto and property insurance premiums. Roughly half of two million prison inmates are there in part because of alcohol – at a cost of $40 billion. The $2.6 billion slated for prison construction makes it our largest public housing program – including proposals for a $19 million, 255-bed addition to our jail.
 
Crime: The numbers vary, but one-third to one-half of homicides, suicides, robberies, rapes (date and stranger) and abuse of wives and children involve alcohol. Over 20 percent of some local fraternities' members have been arrested for alcohol-related crimes.

We're talking about a global, alcohol-media-industrial complex pushing the joys of alcohol consumption in story lines, product placement and commercials – $700 million just on beer ads targeting youth.

OK, so alcohol creates problems with dramatic dimensions. What can we do about it?

That’s the wrong question. Multiple sources offer dozens of things to do. The first question is, why aren’t we doing them?

Could some of us – abusers or enablers ourselves – be in denial?

Maybe it’s a class thing. The problems come from “their” hard drugs. Alcohol is our hard drug.

Maybe we care, but don't want to rock the downtown merchants' boat that sails on a $70 billion (wholesale) sea of alcohol.

Maybe all we want is the "feel good" sensation from "doing something." But if you can’t reduce 400,000 deaths annually from cigarettes by telling teenagers to “smoke responsibly,” why would similar approaches reduce alcohol’s devastation?

We received $800,000 for the “Stepping Up” project a few years ago. But coalitions with those who profit from increasing alcohol consumption aren’t very effective. So most of the stepping up we did was to the bar – and a binge drinking level 50 percent greater than national averages.

Now we’ve snagged another $3.75 million grant. Will it accomplish more?

It is too early to ask for proposals just to have them ignored. Maybe we’re like the alcoholic who needs to be face down in the gutter before he can ask for the help that’s available. Or the mule, hit in the head with a two-by-four because, said his owner, “First you have to get his attention.”

It’s not too early to ask, “What will it take to get our attention?” Will we only respond to deaths? How many? Two a year? Two a month?

Only when we’re willing to address those questions can we begin researching, and implementing, solutions.

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Nicholas Johnson is former co-director of the University of Iowa’s Institute for Health, Behavior and Environmental Policy, an FCC commissioner, and an Iowa City School Board member. He now teaches at the Iowa College of Law.