Insights on Alcohol Use and Related Health Effects

Definitions

Alcohol Use Disorder (AUD)

AUD is a chronic brain disorder that often recurs. It is characterized by a lack of control over alcohol consumption despite its negative effects on social life, work, or health. AUD varies in severity, ranging from mild to severe, but recovery is possible regardless of its level.

Previously, the Diagnostic and Statistical Manual (DSM-IV), published by the American Psychiatric Association, categorized alcohol-related conditions into two separate disorders: alcohol abuse and alcohol dependence. The updated DSM-5 combines these into one condition, alcohol use disorder (AUD), and identifies it as mild, moderate, or severe based on its impact.

Binge Drinking

• The National Institute on Alcohol Abuse and Alcoholism (NIAAA) describes binge drinking as consuming enough alcohol to raise blood alcohol concentration (BAC) to 0.08 g/dL. This typically occurs after 4 drinks for women or 5 drinks for men within about 2 hours.

• The Substance Abuse and Mental Health Services Administration (SAMHSA) defines binge drinking slightly differently. For SAMHSA, it involves 5 or more drinks for men or 4 or more for women on a single occasion, occurring at least once in the past month.

Heavy Alcohol Use

SAMHSA defines heavy alcohol use as engaging in binge drinking on 5 or more days during the past month.

Low-Risk Drinking and AUD

According to NIAAA, low-risk drinking for women means no more than 3 drinks in a single day and no more than 7 drinks per week. For men, it is no more than 4 drinks in a day and no more than 14 drinks per week. NIAAA research indicates that only about 2% of people who drink within these limits develop AUD.

Alcohol-Impaired-Driving Fatality

This term refers to a death caused by a crash where the driver or motorcycle operator had a BAC of 0.08 g/dL or higher.

Disability-Adjusted Life-Years (DALYs)

DALYs measure the total years lost due to premature death or the years lived with a disability or health condition that affects quality of life.

Underage Drinking

Underage drinking refers to alcohol consumption by anyone under the age of 21. In the United States, the legal drinking age is 21.

Alcohol Use in the United States

• Prevalence of Drinking:
  The 2015 National Survey on Drug Use and Health (NSDUH) reported that 86.4% of adults aged 18 or older said they had consumed alcohol at some point in their lives. Additionally, 70.1% said they drank in the past year, and 56.0% reported drinking in the past month.

• Prevalence of Binge Drinking and Heavy Alcohol Use:
  According to the same survey, 26.9% of adults aged 18 or older engaged in binge drinking in the past month, while 7.0% reported heavy alcohol use during the same period.

Alcohol Use Disorder (AUD) in the United States

• Adults (ages 18+):
  In 2015, approximately 15.1 million adults (6.2% of those aged 18 or older) had AUD. This included 9.8 million men (8.4% of men in this age group) and 5.3 million women (4.2% of women in this age group). Among those with AUD, only 6.7% received treatment during the past year, including 7.4% of men and 5.4% of women.

• Youth (ages 12–17):
  The same survey estimated that 623,000 adolescents (2.5% of this age group) had AUD. This included 298,000 males (2.3% of boys) and 325,000 females (2.7% of girls). Of those with AUD, 5.2% received treatment, with 5.1% of boys and 5.3% of girls seeking help.

Alcohol-Related Deaths

• Each year, about 88,000 people (62,000 men and 26,000 women) die from alcohol-related causes. This makes alcohol the third most preventable cause of death in the United States, following tobacco and poor diet combined with physical inactivity.

• In 2014, alcohol-impaired driving caused 9,967 fatalities, accounting for 31% of all driving-related deaths.

Economic Burden

In 2010, alcohol misuse cost the U.S. an estimated $249 billion. Around 75% of this cost was related to binge drinking.

Global Burden

• In 2012, alcohol use was responsible for 3.3 million deaths worldwide, making up 5.9% of all deaths globally. Among men, alcohol-related deaths accounted for 7.6%, while for women, the rate was 4.1%.

• In 2014, the World Health Organization (WHO) identified alcohol as a contributing factor in over 200 diseases and injury-related conditions, including liver cirrhosis, certain cancers, and injuries. Alcohol accounted for 5.1% of the global burden of disease and injury, equating to 139 million DALYs.

Family Consequences

In 2012, a study found that over 10% of U.S. children live with a parent who struggles with alcohol-related problems.

Underage Drinking

Prevalence of Underage Alcohol Use

• Drinking:

  The 2015 NSDUH reported that 33.1% of 15-year-olds had consumed at least one drink in their lifetime. Additionally, 20.3% of individuals aged 12–20 drank alcohol in the past month, including 19.8% of males and 20.8% of females.

• Binge Drinking and Heavy Alcohol Use:

  The survey also showed that 13.4% of youth aged 12–20 engaged in binge drinking in the past month, while 3.3% reported heavy alcohol use during the same period.

Consequences of Underage Alcohol Use

Drinking during adolescence can interfere with brain development and increase the risk of developing AUD later in life. Underage drinking is also linked to injuries, sexual assaults, and fatalities, including those caused by motor vehicle accidents.

Alcohol and College Students

Prevalence of Alcohol Use

• Drinking:

  In 2015, 58.0% of full-time college students aged 18–22 drank alcohol in the past month, compared to 48.2% of their peers not in college.

• Binge Drinking and Heavy Alcohol Use:

  The same survey found that 37.9% of college students engaged in binge drinking, while 12.5% reported heavy alcohol use in the past month, compared to 32.6% and 8.5%, respectively, among non-college peers.

Consequences

Each year, 1,825 college students aged 18–24 die from alcohol-related injuries, including car accidents. Additionally, 696,000 students are assaulted by another student who has been drinking, and 97,000 report alcohol-related sexual assault or date rape.

Alcohol and Pregnancy

The prevalence of Fetal Alcohol Syndrome (FAS) in the U.S. was estimated at 0.5 to 3.0 cases per 1,000 births in 1996. More recent studies indicate FAS rates of 2–7 cases per 1,000 births, while Fetal Alcohol Spectrum Disorders (FASD) occur at rates as high as 20–50 cases per 1,000 births.

Alcohol and the Human Body

• In 2015, alcohol contributed to 47% of 78,529 deaths from liver disease in individuals aged 12 and older. Among men, alcohol was linked to 49.5% of liver disease deaths, while among women, it accounted for 43.5%.

• In 2013, 47.9% of cirrhosis deaths were alcohol-related, with the highest rates among individuals aged 25–34 (76.5%) and 35–44 (70.0%).

• Alcohol use also raises the risk of cancers affecting the mouth, throat, liver, and breast.