In Germany, beer is about the same price as water, and drinking alcohol in public is common as well as legal. But has the ease with which people can consume cheap alcohol created a harmful drinking culture?
Germany is famous for its beer drinking, at events like Oktoberfest
Germany is one of the heaviest alcohol-drinking nations in Europe, placed fifth after Luxembourg, Hungary, Czech Republic and Ireland. Only around five percent of Germans consider themselves teetotalers, making it -- after Luxembourg -- the European country with the lowest percentage of people who abstain from drinking.
According to the World Health Organization the European region has the highest alcohol intake of all other regions in the world and per capita consumption twice as high as the world average.
"Biggest social problem"
Alcoholism is a significant problem in Germany, according to Peter Lang, head of drug prevention and abuse at the German Center for Health Education.
Alcohol abuse is considered one of the biggest social problems in Germany
"It's difficult to say what is causing this, because alcohol is more or less an accepted drug in a lot of circumstances, like for parties or other social occasions," Lang said.
"If you compare Germany to countries like the US, there is drinking in public that is different and more accepted. Consuming alcohol during the day is really more accepted here in Germany," he added.
Most recent data shows that that 1.7 million Germans are dependent on alcohol and need treatment, whilst, 2.7 million use alcohol in a harmful way.
Compared to the US, the most recent annual data from 2001-2002 shows that of a population of nearly 300 million, there are 7.91 million people dependent on alcohol.
"German society as a whole doesn't have a positive image of excessive drinking, but in general, awareness of the dangers of excessive consumption is growing," said Gabriele Barsch of the German Center for Addiction Issues.
"The per capita consumption of pure alcohol in Germany has been regressive for about six years, and fatalities caused by alcohol related accidents has halved since 1995," Barsch said.
"But for young people drinking alcohol is part of their lifestyle, particularly on weekends and parties," she added. Alcohol is consumed "too thoughtlessly and too carelessly."
Drinking, but not alcohol abuse has a 'positive image' in Germany
Mark, who did not want his last name mentioned, is an American who is the coordinator for the English-speaking Alcoholics Anonymous in Germany. He has noticed that German culture is more accepting of alcohol use.
Virginia Patch One Need Card State Kingstowne Va You'll Id Why Coming "However, it seems just as socially unacceptable to drink large quantities and let your drinking get out of control here as in other societies," Mark said.
"A common misperception, both in Germany and the US, is that if you only drink beer or wine, you cannot be an alcoholic," he said. "This seems to be an even more prevalent attitude here in Germany."
Is 16 years too young?
The legal drinking age in Germany is 16, though kids must wait until they're 18 to drink spirits. That five-year difference to the US, where the drinking age is 21, appears to be significant.
The drinking age of 16 is one of the youngest legal drinking ages
"If you drink especially when you are under 18, it can cause massive damage as there is still brain development happening in these years," Lang said. "But to change the law to 18, this cannot be done without health awareness campaigns."
Barsch said she would like to see the minimum age for buying and consuming alcohol increased to 18.
"But we are aware that you cannot reduce the harm done by alcohol by only introducing one new measure or law," she said. "What we need is a comprehensive approach of the problem."
Drink anywhere, anytime
In Germany, alcohol can be purchased in grocery stores, gas stations and even newspaper stands. It can be consumed in restaurants, cafes and snack bars, and it's not uncommon to see people drinking in parks, on the streets and even on public transport.
Drinking in public so openly is a phenomenon that only began about five years ago, according to Lang. He posited that the development might have had to with the increased popularity of alcopops, alcohol mixed with soda designed to appeal to young consumers. But they don't stop at that.
"At the moment you see younger and younger people drinking beer, which is becoming more accepted," he added.
Beer is as cheap as water
In Germany, the price of alcohol in relation to the general costs of living is among the lowest in Europe.
Does the cheap price of alcohol contribute to drinking problems?
Barsch said alcohol is too cheap in Germany. She pointed out that when a tax was imposed on the sale of alcopops, consumption fell significantly.
"Germany as a wine producing country and with a long beer-tradition as well, certainly runs a high risk of alcohol related problems," Barsch said.
"(However) there is a lack of information on how harmful alcohol consumption is, and action to turn around the social norms where alcohol is accepted," she added.