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Fact Sheets- Alcohol Use and Health
Alcohol Use and Health
There are approximately 88,000 deaths attributable to excessive alcohol use each year in the United States.1 This makes excessive alcohol use the 3r d leading lifestyle-related cause of death for the nation.2 Excessive alcohol use is responsible for 2.5 million years of potential life lost (YPLL) annually, or an average of about 30 years of potential life lost for each death.1 In 2006, there were more than 1.2 million emergency room visits and 2.7 million physician office visits due to excessive drinking.3 The economic costs of excessive alcohol consumption in 2006 were estimated at $223.5 billion.3
The Standard Measure of Alcohol
In the United States, a standard drink is any drink that contains 0.6 ounces (14.0 grams or 1.2 tablespoons) of pure alcohol. Generally, this amount of pure alcohol is found in
- 12-ounces of regular beer or wine cooler.
- 8-ounces of malt liquor.
- 5-ounces of wine.
- 1.5-ounces of 80-proof distilled spirits or liquor (e.g., gin, rum, vodka, whiskey).
Definitions of Patterns of Drinking Alcohol
Excessive drinking includes heavy drinking, binge drinking, and any drinking by pregnant women or underage youth.
- Binge drinking, the most common form of excessive alcohol consumption, is defined as consuming
- For women, 4 or more drinks during a single occasion.
- For men, 5 or more drinks during a single occasion.
- Heavy drinking is defined as consuming
- For women, more than 1 drink per day on average.
- For men, more than 2 drinks per day on average.
Most people who binge drink are not alcoholics or alcohol dependent.4
According to the Dietary Guidelines for Americans, if you drink alcoholic beverages, do so in moderation, which is defined as no more than 1 drink per day for women and no more than 2 drinks per day for men.5 However, there are some persons who should not drink any alcohol, including those who are
- Pregnant or trying to become pregnant.
- Taking prescription or over-the-counter medications that may cause harmful reactions when mixed with alcohol.
- Younger than age 21.
- Recovering from alcoholism or are unable to control the amount they drink.
- Suffering from a medical condition that may be worsened by alcohol.
- Driving, planning to drive, or participating in other activities requiring skill, coordination, and alertness.
Immediate Health Risks
Excessive alcohol use has immediate effects that increase the risk of many harmful health conditions. These immediate effects are most often the result of binge drinking and include the following—
- Unintentional injuries, including traffic injuries, falls, drownings, burns, and unintentional firearm injuries.6
- Violence, including intimate partner violence and child maltreatment. About 35% of victims report that offenders are under the influence of alcohol.7 Alcohol use is also associated with 2 out of 3 incidents of intimate partner violence.7 Studies have also shown that alcohol is a leading factor in child maltreatment and neglect cases, and is the most frequent substance abused among these parents.8
- Risky sexual behaviors, including unprotected sex, sex with multiple partners, and increased risk of sexual assault. These behaviors can result in unintended pregnancy or sexually transmitted diseases.9, 10
- Miscarriage and stillbirth among pregnant women, and a combination of physical and mental birth defects among children that last throughout life.11, 12
- Alcohol poisoning, a medical emergency that results from high blood alcohol levels that suppress the central nervous system and can cause loss of consciousness, low blood pressure and body temperature, coma, respiratory depression, or death.13
Long-Term Health Risks
Over time, excessive alcohol use can lead to the development of chronic diseases, neurological impairments and social problems. These include but are not limited to—
- Neurological problems, including dementia, stroke and neuropathy.14, 15
- Cardiovascular problems, including myocardial infarction, cardiomyopathy, atrial fibrillation and hypertension.16
- Psychiatric problems, including depression, anxiety, and suicide.17
- Social problems, including unemployment, lost productivity, and family problems.18, 19
- Cancer of the mouth, throat, esophagus, liver, colon, and breast.20 In general, the risk of cancer increases with increasing amounts of alcohol.
- Liver diseases, including—
- Alcoholic hepatitis.
- Cirrhosis, which is among the 15 leading causes of all deaths in the United States.21
- Among persons with Hepatitis C virus, worsening of liver function and interference with medications used to treat this condition.22
- Other gastrointestinal problems, including pancreatitis and gastritis.23, 24
References
Fact Sheets - Age 21 Minimum Legal Drinking Age
Age 21 Minimum Legal Drinking Age
Public Health Problem
- Excessive alcohol consumption contributes to more than 4,300 deaths among underage youth, that is, persons less than 21 years of age, in the United States each year.1
- Underage drinking is strongly associated with many health and social problems among youth including alcohol-impaired driving, physical fighting, poor school performance, sexual activity, and smoking.2
- About 2 in 3 high school students who drink do so to the point of intoxication, that is, they binge drink (defined as having five or more drinks in a row), typically on multiple occasions.2,3
- Current drinking during the previous month among persons aged 18 to 20 years declined significantly from 59% in 1985 to 40% in 1991, coincident with states’ adopting an age 21 minimum legal drinking age, but increased to 47% by 1999.4
- The prevalence of current drinking among persons aged 21 to 25 also declined significantly from 70% in 1985 to 56% in 1991, coincident with states’ adopting an age 21 minimum legal drinking age, but then increased to 60% by 1999.4
Relationship between Youth and Adult Drinking
- Binge drinking by adults is a strong predictor of binge drinking by high school and college students living in the same state.5,6
- There are approximately 1.5 billion episodes of binge drinking among persons aged 18 years or older in the United States annually, most of which involve adults age 26 years and older.7
- More than half of all active duty military personnel report binge drinking in the past month, and young adult service members exposed to combat are at significantly greater risk of binge drinking than older service members.8
- More than 90% of adult binge drinkers are not alcohol dependent.9
Prevention of Underage Drinking
- The Task Force on Community Preventive Services recommends implementing and maintaining an age 21 minimum legal drinking age (MLDA) based on strong evidence of effectiveness, including a median 16% decline in motor vehicle crashes among underage youth in states that increased the legal drinking age to 21 years.10
- The Task Force on Community Preventive Services also recommends enhanced enforcement of laws prohibiting the sale of alcohol to minors to reduce such sales.11
- Age 21 MLDA laws result in lower levels of alcohol consumption among young adults age 21 years and older as well as those less than age 21 years.12
- States with more stringent alcohol control policies tend to have lower adult and college binge drinking rates.6
- In addition to the age 21 MLDA, other effective strategies for preventing underage drinking include increasing alcohol excise taxes13 and limiting alcohol outlet density14. Youth exposure to alcohol marketing should also be reduced.15
References
Fact Sheets - Caffeinated Alcoholic Beverages
Caffeinated Alcoholic Beverages
Public Health Impact of Excessive Alcohol Use
- Excessive alcohol consumption is responsible for over 79,000 deaths and 2.3 million years of potential life lost (YPLL) in the United States each year.1
- Binge drinking (consuming 4 or more drinks per occasion for women; 5 or more drinks per occasion for men) is responsible for over half of the deaths and two-thirds of the YPLL due to excessive drinking2, and is associated with many health and social problems, including alcohol-impaired driving, interpersonal violence, risky sexual activity, and unintended pregnancy.3
- Most underage youth who drink report binge drinking, usually on multiple occasions.4
Dangers of Mixing Alcohol and Energy Drinks
- Energy drinks are beverages that typically contain caffeine, other plant-based stimulants, simple sugars, and other additives.5 They are very popular among youth and are regularly consumed by 31% of 12- to 17-year-olds and 34% of 18- to 24-year-olds.6
- When alcoholic beverages are mixed with energy drinks, a popular practice among youth, the caffeine in these drinks can mask the depressant effects of alcohol.7 At the same time, caffeine has no effect on the metabolism of alcohol by the liver and thus does not reduce breath alcohol concentrations or reduce the risk of alcohol-attributable harms.7
- Drinkers who consume alcohol mixed with energy drinks are 3 times more likely to binge drink (based on breath alcohol levels) than drinkers who do not report mixing alcohol with energy drinks.8
- Drinkers who consume alcohol with energy drinks are about twice as likely as drinkers who do not report mixing alcohol with energy drinks to report being taken advantage of sexually, to report taking advantage of someone else sexually, and to report riding with a driver who was under the influence of alcohol.5
Caffeinated Alcoholic Beverages
- Caffeinated Alcoholic Beverages (CABs) are premixed beverages that combine alcohol, caffeine, and other stimulants. They may be malt- or distilled-spirits-based and usually have higher alcohol content than beer (i.e., 5%–12% on average for CABs and 4%–5% for beer). The caffeine content in these beverages is usually not reported.9
- CABs have experienced rapid growth in popularity since being introduced into the marketplace. For example, two leading brands of CABs together experienced a 67-fold increase in sales, from 337,500 gallons in 2002 (the first year of significant CAB production) to 22,905,000 gallons in 2008.10
- Currently, more than 25 brands of CABs are sold in a variety of U.S. retail alcohol outlets, including many convenience stores.9
- CABs are heavily marketed in youth-friendly media (e.g., on web sites with downloadable images) and with youth-oriented graphics and messaging (e.g., connected with extreme sports or other risk-taking behaviors).11
Prevention Strategies
- In 2008, thirteen State Attorneys General and the San Francisco, CA, City Attorney initiated an investigation of CABs, which resulted in negotiated settlements with two CAB producers, who agreed to remove all stimulants from their products.9
- Because CABs may have higher alcohol content than beer, some states (e.g., Montana) have classified CABs as liquor, thereby limiting the locations where these beverages can be sold.12
- States and communities are also developing educational strategies to alert consumers to the risks of mixing alcohol with energy drinks and CABs. One community has enacted an ordinance requiring retailers to post signs warning of the risks of CABs.13
- Effective population-based strategies for preventing excessive alcohol consumption and related harms should also be implemented, including increasing alcohol excise taxes, limiting alcohol outlet density, and maintaining existing restrictions on days of sale.14
- Youth exposure to alcohol marketing should also be reduced by lowering the voluntary industry standard governing the placement of alcohol advertising from the current 30% threshold to 15%, based on the proportion of the audience that is age 12-20 years.15
References
Fact Sheets - Binge Drinking
Binge Drinking
Binge drinking is the most common pattern of excessive alcohol use in the United States. The National Institute on Alcohol Abuse and Alcoholism
defines binge drinking as a pattern of drinking that brings a person’s blood alcohol concentration (BAC) to 0.08 grams percent or above. This typically happens when men consume 5 or more drinks, and when women consume 4 or more drinks, in about 2 hours.1
defines binge drinking as a pattern of drinking that brings a person’s blood alcohol concentration (BAC) to 0.08 grams percent or above. This typically happens when men consume 5 or more drinks, and when women consume 4 or more drinks, in about 2 hours.1Most people who binge drink are not alcohol dependent.
According to national surveys
- One in six U.S. adults binge drinks about four times a month, consuming about eight drinks per binge.2
- While binge drinking is more common among young adults aged 18–34 years, binge drinkers aged 65 years and older report binge drinking more often—an average of five to six times a month.2
- Binge drinking is more common among those with household incomes of $75,000 or more than among those with lower incomes.2
- Approximately 92% of U.S. adults who drink excessively report binge drinking in the past 30 days.3
- Although college students commonly binge drink, 70% of binge drinking episodes involve adults age 26 years and older.4
- The prevalence of binge drinking among men is twice the prevalence among women.2
- Binge drinkers are 14 times more likely to report alcohol-impaired driving than non-binge drinkers.4
- About 90% of the alcohol consumed by youth under the age of 21 in the United States is in the form of binge drinks.5
- More than half of the alcohol consumed by adults in the United States is in the form of binge drinks.5
Binge drinking is associated with many health problems, including—
- Unintentional injuries (e.g., car crashes, falls, burns, drowning)
- Intentional injuries (e.g., firearm injuries, sexual assault, domestic violence)
- Alcohol poisoning
- Sexually transmitted diseases
- Unintended pregnancy
- Children born with Fetal Alcohol Spectrum Disorders
- High blood pressure, stroke, and other cardiovascular diseases
- Liver disease
- Neurological damage
- Sexual dysfunction, and
- Poor control of diabetes.
Binge drinking costs everyone.
- Drinking too much, including binge drinking, cost the United States $223.5 billion in 2006, or $1.90 a drink, from losses in productivity, health care, crime, and other expenses.6
- Binge drinking cost federal, state, and local governments about 62 cents per drink in 2006, while federal and state income from taxes on alcohol totaled only about 12 cents per drink.6
Evidence-based interventions to prevent binge drinking and related harms7-11 include
- Increasing alcoholic beverage costs and excise taxes.
- Limiting the number of retail alcohol outlets that sell alcoholic beverages in a given area.
- Holding alcohol retailers responsible for the harms caused by their underage or intoxicated patrons (dram shop liability).
- Restricting access to alcohol by maintaining limits on the days and hours of alcohol retail sales.
- Consistent enforcement of laws against underage drinking and alcohol-impaired driving.
- Maintaining government controls on alcohol sales (avoiding privatization).
- Screening and counseling for alcohol misuse.
References:
Fact Sheets - Excessive Alcohol Use and Risks to Women's Health
Excessive Alcohol Use and Risks to Women’s Health
Although men are more likely to drink alcohol and drink in larger amounts, gender differences in body structure and chemistry cause women to absorb more alcohol, and take longer to break it down and remove it from their bodies (i.e., to metabolize it). In other words, upon drinking equal amounts, women have higher alcohol levels in their blood than men, and the immediate effects occur more quickly and last longer. These differences also make women more vulnerable to alcohol’s long-term effects on their health.1
Reproductive Health
- National surveys show that about 1 in 2 women of child-bearing age (i.e., aged 18–44 years) use alcohol, and 15% of women who drink alcohol in this age group binge drink.2
- About 7.6% of pregnant women used alcohol.2
- Excessive drinking may disrupt menstrual cycling and increase the risk of infertility, miscarriage, stillbirth, and premature delivery.3, 4
- Women who binge drink are more likely to have unprotected sex and multiple sex partners. These activities increase the risks of unintended pregnancy5 and sexually transmitted diseases.6
Alcohol and Pregnancy
- Women who drink alcohol while pregnant increase their risk of having a baby with Fetal Alcohol Spectrum Disorders (FASD). The most severe form is Fetal Alcohol Syndrome (FAS), which causes mental retardation and birth defects.
- FASD are completely preventable if a woman does not drink while pregnant or while she may become pregnant.
- Studies have shown that about 1 of 20 pregnant women drank excessively before finding out they were pregnant.7 No amount of alcohol is safe to drink during pregnancy. For women who drink during pregnancy, stopping as soon as possible may lower the risk of having a child with physical, mental, or emotional problems.
- Research suggests that women who drink alcohol while pregnant are more likely to have a baby die from Sudden Infant Death Syndrome (SIDS). This risk substantially increases if a woman binge drinks during her first trimester of pregnancy.8
- The risk of miscarriage is also increased if a woman drinks excessively during her first trimester of pregnancy.9
Other Health Concerns
- Liver Disease: The risk of cirrhosis and other alcohol-related liver diseases is higher for women than for men.10
- Impact on the Brain: Excessive drinking may result in memory loss and shrinkage of the brain.11 Research suggests that women are more vulnerable than men to the brain damaging effects of excessive alcohol use, and the damage tends to appear with shorter periods of excessive drinking for women than for men.12
- Impact on the Heart: Studies have shown that women who drink excessively are at increased risk for damage to the heart muscle than men even for women drinking at lower levels.13
- Cancer: Alcohol consumption increases the risk of cancer of the mouth, throat, esophagus, liver, colon, and breast among women. The risk of breast cancer increases as alcohol use increases.14-17
- Sexual Assault: Binge drinking is a risk factor for sexual assault, especially among young women in college settings. Each year, about 1 in 20 college women are sexually assaulted. Research suggests that there is an increase in the risk of rape or sexual assault when both the attacker and victim have used alcohol prior to the attack.18, 19
References:
Fact Sheets - Underage Drinking
Underage Drinking
Alcohol use by persons under age 21 years is a major public health problem.1 Alcohol is the most commonly used and abused drug among youth in the United States, more than tobacco and illicit drugs1, and is responsible for more than 4,300 annual deaths among underage youth2. Although drinking by persons under the age of 21 is illegal, people aged 12 to 20 years drink 11% of all alcohol consumed in the United States.3 More than 90% of this alcohol is consumed in the form of binge drinks.3 On average, underage drinkers consume more drinks per drinking occasion than adult drinkers.4 In 2010, there were approximately 189,000 emergency rooms visits by persons under age 21 for injuries and other conditions linked to alcohol.5
Drinking Levels among Youth
The 2011 Youth Risk Behavior Survey6 found that among high school students, during the past 30 days
- 39% drank some amount of alcohol.
- 22% binge drank.
- 8% drove after drinking alcohol.
- 24% rode with a driver who had been drinking alcohol.
Other national surveys
- In 2011 the National Survey on Drug Use and Health
- In 2011, the Monitoring the Future Survey
Consequences of Underage Drinking
Youth who drink alcohol 1, 4, 9 are more likely to experience
- School problems, such as higher absence and poor or failing grades.
- Social problems, such as fighting and lack of participation in youth activities.
- Legal problems, such as arrest for driving or physically hurting someone while drunk.
- Physical problems, such as hangovers or illnesses.
- Unwanted, unplanned, and unprotected sexual activity.
- Disruption of normal growth and sexual development.
- Physical and sexual assault.
- Higher risk for suicide and homicide.
- Alcohol-related car crashes and other unintentional injuries, such as burns, falls, and drowning.
- Memory problems.
- Abuse of other drugs.
- Changes in brain development that may have life-long effects.
- Death from alcohol poisoning.
In general, the risk of youth experiencing these problems is greater for those who binge drink than for those who do not binge drink.9
Youth who start drinking before age 15 years are five times more likely to develop alcohol dependence or abuse later in life than those who begin drinking at or after age 21 years.10, 11
Prevention of Underage Drinking
Reducing underage drinking will require community-based efforts to monitor the activities of youth and decrease youth access to alcohol. Recent publications by the Surgeon General1 and the Institute of Medicine4 outlined many prevention strategies that will require actions on the national, state, and local levels, such as enforcement of minimum legal drinking age laws, national media campaigns targeting youth and adults, increasing alcohol excise taxes, reducing youth exposure to alcohol advertising, and development of comprehensive community-based programs. These efforts will require continued research and evaluation to determine their success and to improve their effectiveness.
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