March 5 (Bloomberg) -- Japanese dairy farmer Masami drank every night, ran his car into a telephone pole while intoxicated and kept drinking even after he got stomach cancer, his daughter said. It never crossed her mind that he had an alcohol problem.

“Even after all the surgeries and the car accidents, it never occurred to me he was an alcoholic -- the doctors don’t use the word,” said his daughter, who requested her name not be used because of the embarrassment it would cause her family.

Lack of public awareness has given the government little incentive to study alcoholism, said Susumu Higuchi, deputy- director at the nation’s oldest rehabilitation hospital. The issue came under the global spotlight last month when Finance Minister Shoichi Nakagawa, 55, appeared to be drunk at the Group of Seven meeting in Rome. He denied the accusation when he resigned on Feb. 17, but admitted he had a drinking problem in the past.

“People think an alcoholic is the guy lying in front of the station, not somebody who can hold down a job,” said Higuchi, at the Kurihama Alcoholism Center. “It’s a big problem, but people don’t think it’s something that affects them.”

Only about 4.4 million Japanese, 4 percent of adults, are classified as depending on or abusing alcohol, Health Ministry data show. In the U.S., about 7.4 percent of adults are considered alcoholics, according to the U.S. Department of Health and Human Services.

Not Aware

“The average doctor isn’t aware of the problem,” said Noriaki Nozaki, 60, managing director of Alcoholics Anonymous of Japan, an offshoot of the U.S.-based self-help organization. “They just dry you out and send you on your way.”

The health ministry’s division on mental health research had no budget for studying alcoholism last year, according to Masayasu Hashimoto, a ministry official. The U.S. government devoted $436 million to funding its National Institute on Alcohol Abuse and Alcoholism.

Death rates in Japan from alcohol-related heart diseases and digestive-tract cancers more than doubled in the four decades through 2004, said Higuchi, based on health ministry data. Alcohol consumption rose 2.6 times in the period, according to the National Tax Agency.

A 1993 study by researchers at Tokyo University, the latest available, put the annual cost of medical treatment and lost productivity due to alcohol abuse at 6.7 trillion yen ($68 billion).

Drinking Culture

The country’s business and political culture has long depended on alcohol to smooth out differences between bosses and subordinates or between parties in a negotiation, Nozaki said.

“Drinking is part of the job,” said Satoshi Miyazaki, an employee at a Tokyo advertising agency who says he accompanies his section chief to a bar most week nights. “If the boss invites you, you don’t feel comfortable saying no.”

The intimacy that drinking fosters between friends, clients and colleagues has given rise to a new word: “Nomunication,” a bilingual coinage combining the Japanese for drinking with communication.

“You say things you couldn’t say at the office,” said Miyazaki, 32. “In the morning, nobody holds it against you.”

Alcoholism rates among women -- 0.9 percent versus 7 percent for men -- are likely to climb as more of them join the workforce and become enmeshed in Japan’s drinking culture, said Higuchi. The retirement of the baby boomers may also increase the number of addicts, he said.

“A lot of these guys are heavy drinkers who’ve somehow managed to get up every day and go to the office,” Higuchi said. “That framework is going to go away and some of these people are going to lose control.”

Every Night

“All of my friends’ husbands drink every night -- and I’m not talking about having one beer,” said Masami’s daughter, who added that her father, now 82, never missed a day of work, despite his heavy alcohol consumption.

A history of drinking didn’t stop Nakagawa from attaining the post of finance minister.

“Nakagawa is a person who really likes his sake,” former Prime Minister Yoshiro Mori told TBS television on Feb. 16. “I’ve warned him to be careful about it.”

The following day, Nakagawa resigned, saying his actions in Rome “had nothing to do with alcohol,” He added: “It is true that in the past my drinking has caused some problems, but in my current physical condition I wouldn’t even want to drink.”

Recognition of the problem in the U.S. took a leap forward in 1978 when former first lady Betty Ford went public with her struggle with pills and alcohol and checked herself into a rehabilitation center.

Skid Row

“Alcoholics were thought of as people on skid-row,” said Marc Schuckit, director of the Alcohol & Drug Treatment Program at San Diego’s VA Heath Care System. “When people like Betty Ford said: ‘Look at me, I’m somebody you’ve admired and I’m an alcoholic,’ it was a real step forward.”

Higuchi said it may take a similar act of bravery in Japan to change attitudes.

“I’d like Nakagawa to stand up and say ‘I’ve got a problem. I’m going to get help,” Higuchi said. “We need prominent people to stand up.”

To contact the reporter on this story: Jason Clenfield in Tokyo at jclenfield@bloomberg.net

Last Updated: March 4, 2009 10:01 EST