Alcohol Use and Health

There are approximately 75,000 deaths attributable to excessive alcohol use each year in the United States (1). This makes excessive alcohol use the 3rd leading lifestyle-related cause of death for the nation (2). In the single year 2003, there were over 2 million hospitalizations (3) and over 4 million emergency room visits (4) for alcohol-related conditions.

The Standard Measure of Alcohol

In the United States, a standard drink is any drink that contains about half an ounce (13.7 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 (i.e., gin, rum, vodka, whiskey).

Definitions of Patterns of Drinking Alcohol

Binge drinking
  • For women, more than 3 drinks during a single occasion.
  • For men, more than 4 drinks during a single occasion.
Heavy drinking
  • For women, more than 1 drink per day on average.
  • For men, more than 2 drinks per day on average.
Excessive drinking includes heavy drinking, binge drinking or both.

Most people who binge drink are not alcoholics or alcohol dependent (5).
According to the Dietary Guidelines for Americans, if you drink alcoholic beverages, do so in moderation, defined as no more than 1 drink per day for women and no more than 2 drinks per day for men (6). 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.
  • Under the age of 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:

  • Unintentional injuries, including traffic injuries, falls, drowning, burns and unintentional firearm injuries.
  • Violence, including intimate partner violence and child maltreatment. About 35% of victims report that offenders are under the influence of alcohol. Alcohol use is also associated with 2 out of 3 incidents of intimate partner violence. 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.
  • 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.
  • If pregnant, miscarriage, stillbirth, and a combination of physical and mental birth defects that last throughout life.
  • Alcohol poisoning, a medical emergency that results from high blood alcohol levels of alcohol that suppress the central nervous system and cause loss of consciousness, low blood pressure and body temperature, coma, respiratory depression and death.

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.
  • Cardiovascular problems including myocardial infarction, cardiomyopathy, atrial fibrillation and hypertension.
  • Psychiatric problems including depression, suicidality and anxiety.
  • Social problems including unemployment, lost productivity and family problems.
  • Cancer of the mouth, throat, esophagus, liver, prostate and breast for women. In general, the risk of cancer increases with increasing amounts of alcohol.
  • Liver diseases including:
  • Alcoholic hepatitis is inflammation of the liver which can progress to cirrhosis.
  • Cirrhosis is scarring of the liver that prevents this vital organ from functioning properly. This condition often leads to complete liver failure, and it is among the 15 leading causes of all death in the United States.
  • Alcohol use by those with Hepatitis C virus (HCV) can cause the infection to worsen. Alcohol may also interfere with the medications used to treat HCV.
  • Other gastrointestinal problems including pancreatitis and gastritis.

Questions and Answers:

1. Are specific groups of people more likely to have problems?
Alcohol abuse and alcoholism cut across gender, race, and nationality. In the United States, 17.6 million people--about l in every 12 adults--abuse alcohol or are alcohol dependent. In general, more men than women are alcohol dependent or have alcohol problems. And alcohol problems are highest among young adults ages 18-29 and lowest among adults ages 65 and older. We also know that people who start drinking at an early age--for example, at age 14 or younger--are at much higher risk of developing alcohol problems at some point in their lives compared to someone who starts drinking at age 21 or after.

2. Does alcohol affect older people differently?
Alcohol's effects do vary with age. Slower reaction times, problems with hearing and seeing, and a lower tolerance to alcohol's effects put older people at higher risk for falls, car crashes, and other types of injuries that may result from drinking.

Older people also tend to take more medicines than younger people. Mixing alcohol with over-the-counter or prescription medications can be very dangerous, even fatal. In addition, alcohol can make many of the medical conditions common in older people, including high blood pressure and ulcers, more serious. Physical changes associated with aging can make older people feel "high" even after drinking only small amounts of alcohol. So even if there is no medical reason to avoid alcohol, older men and women should limit themselves to one drink per day.

3. Does alcohol affect women differently?
Yes, alcohol affects women differently than men. Women become more impaired than men do after drinking the same amount of alcohol, even when differences in body weight are taken into account. This is because women's bodies have less water than men's bodies. Because alcohol mixes with body water, a given amount of alcohol becomes more highly concentrated in a woman's body than in a man's. In other words, it would be like dropping the same amount of alcohol into a much smaller pail of water. That is why the recommended drinking limit for women is lower than for men.
In addition, chronic alcohol abuse takes a heavier physical toll on women than on men. Alcohol dependence and related medical problems, such as brain, heart, and liver damage, progress more rapidly in women than in men.

4. How can a person get help for an alcohol problem?

There are many national and local resources that can help. The National Drug and Alcohol Treatment Referral Routing Service provides a toll-free telephone number, 1-800-662-HELP (4357), offering various resource information. Through this service you can speak directly to a representative concerning substance abuse treatment, request printed material on alcohol or other drugs, or obtain local substance abuse treatment referral information in your state. Many people also find support groups a helpful aid to recovery. For additional resources, click the Related Information tab below.

* Information comes from the Center of Disease Control.

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