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Alcohol Use in the United States:

  • Prevalence of Drinking: In 2013, 86.8 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime; 70.7 percent reported that they drank in the past year; 56.4 percent reported that they drank in the past month.1
     
  • Prevalence of Binge Drinking and Heavy Drinking: In 2013, 24.6 percent of people ages 18 or older reported that they engaged in binge drinking in the past month; 6.8 percent reported that they engaged in heavy drinking in the past month.2
     

Alcohol Use Disorders (AUDs) in the United States:

  • Adults (ages 18+): 16.6 million adults ages 18 and older3 (7.0 percent of this age group4) had an AUD in 2013. This includes 10.8 million men3 (9.4 percent of men in this age group4) and 5.8 million women3 (4.7 percent of women in this age group4).
    • About 1.3 million adults received treatment for an AUD at a specialized facility in 2013 (7.8 percent of adults who needed treatment). This included 904,000 million men (8.0 percent of men in need) and 444,000 women (7.3 percent of women who needed treatment).5
       
  • Youth (ages 12–17): In 2013 an estimated 697,000 adolescents ages 12–176 (2.8 percent of this age group7) had an AUD. This number includes 385,000 females6 (3.2 percent of females in this age group7) and 311,000 males6 (2.5 percent of males in this age group7).
    • An estimated 73,000 adolescents (44,000 males and 29,000 females) received treatment for an alcohol problem in a specialized facility in 2013.8
       

Alcohol-Related Deaths:

  • Nearly 88,0009 people (approximately 62,000 men and 26,000 women10) die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States.9
     
  • In 2013, alcohol-impaired driving fatalities accounted for 10,076 deaths (30.8 percent of overall driving fatalities).11
     

Economic Burden:

  • In 2006, alcohol misuse problems cost the United States $223.5 billion.12
     
  • Almost three-quarters of the total cost of alcohol misuse is related to binge drinking.12
     

Global Burden:

  • In 2012, 3.3 million deaths, or 5.9 percent of all global deaths (7.6 percent for men and 4.0 percent for women), were attributable to alcohol consumption.13
     
  • Alcohol contributes to over 200 diseases and injury-related health conditions, most notably alcohol dependence, liver cirrhosis, cancers, and injuries.14 In 2012, 5.1 percent of the burden of disease and injury worldwide (139 million disability-adjusted life years) was attributable to alcohol consumption.13
     
  • Globally, alcohol misuse is the fifth leading risk factor for premature death and disability; among people between the ages of 15 and 49, it is the first.15
     

Family Consequences:

  • More than 10 percent of U.S. children live with a parent with alcohol problems, according to a 2012 study.16
     

Underage Drinking:

  • Prevalence of Underage Alcohol Use:
    • Prevalence of Drinking: According to the 2013 National Survey on Drug Use and Health (NSDUH), 35.1 percent of 15-year-olds report that they have had at least 1 drink in their lives.17 About 8.7 million people ages 12–20 (22.7 percent of this age group) reported drinking alcohol in the past month (23 percent of males and 22.5 percent of females).18
       
    • Prevalence of Binge Drinking: According to the 2013 NSDUH, approximately 5.4 million people (about 14.2 percent) ages 12–20 were binge drinkers (15.8 percent of males and 12.4 percent of females).18
       
    • Prevalence of Heavy Drinking: According to the 2013 NSDUH, approximately 1.4 million people (about 3.7 percent) ages 12–20 were heavy drinkers (4.6 percent of males and 2.7 percent of females).18
       
  • Consequences of Underage Alcohol Use:
    • Research indicates that alcohol use during the teenage years could interfere with normal adolescent brain development and increase the risk of developing an AUD. In addition, underage drinking contributes to a range of acute consequences, including injuries, sexual assaults, and even deaths—including those from car crashes.19
       

Alcohol and College Students:

  • Prevalence of Alcohol Use:
    • Prevalence of Drinking: In 2013, 59.4 percent of full-time college students ages 18–22 drank alcohol in the past month compared with 50.6 percent of other persons of the same age.20
       
    • Prevalence of Binge Drinking: In 2013, 39 percent of college students ages 18–22 engaged in binge drinking (5 or more drinks on an occasion) in the past month compared with 33.4 percent of other persons of the same age.21
       
    • Prevalence of Heavy Drinking: In 2013, 12.7 percent of college students ages 18–22 engaged in heavy drinking (5 or more drinks on an occasion on 5 or more occasions per month) in the past month compared with 9.3 percent of other persons of the same age.22
       
  • Consequences—Researchers estimate that each year:
    • 1,825 college students between the ages of 18 and 24 die from alcohol-related unintentional injuries, including motor-vehicle crashes.23
       
    • 696,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking.24
       
    • 97,000 students between the ages of 18 and 24 report experiencing alcohol-related sexual assault or date rape.24
       
    • Roughly 20 percent of college students meet the criteria for an AUD.25
       
    • About 1 in 4 college students report academic consequences from drinking, including missing class, falling behind in class, doing poorly on exams or papers, and receiving lower grades overall.26
       

Alcohol and Pregnancy:

  • The prevalence of Fetal Alcohol Syndrome (FAS) in the United States was estimated by the Institute of Medicine in 1996 to be between 0.5 and 3.0 cases per 1,000.27
     
  • More recent reports from specific U.S. sites report the prevalence of FAS to be 2 to 7 cases per 1,000,27 and the prevalence of Fetal Alcohol Spectrum Disorders (FASD) to be as high as 20 to 50 cases per 1,000.28
     

Alcohol and the Human Body:

  • In 2013, of the 71,713 total liver disease deaths among individuals aged 12 and older, 46.4 percent involved alcohol. Among males, 48.9 percent of the 46,240 liver disease deaths involved alcohol. Among females, 42.7 percent of the 25,433 liver disease deaths involved alcohol.29
     
  • Among all cirrhosis deaths in 2011, 48.0 percent were alcohol related. The proportion of alcohol-related cirrhosis was highest (72.7 percent) among decedents ages 25–34, followed by decedents aged 35–44, at 70.3 percent.30
     
  • In 2009, alcohol-related liver disease was the primary cause of almost 1 in 3 liver transplants in the United States.31
     
  • Drinking alcohol increases the risk of cancers of the mouth, esophagus, pharynx, larynx, liver, and breast.32
     

Health Benefits of Moderate Alcohol Consumption:

  • Moderate alcohol consumption, according to the Dietary Guidelines for Americans 2010, is up to 1 drink per day for women and up to 2 drinks per day for men.33
     
  • Moderate alcohol consumption may have beneficial effects on health. These include decreased risk for heart disease and mortality due to heart disease, decreased risk of ischemic stroke (in which the arteries to the brain become narrowed or blocked, resulting in reduced blood flow), and decreased risk of diabetes.34
     
  • In most Western countries where chronic diseases such as coronary heart disease (CHD), cancer, stroke, and diabetes are the primary causes of death, results from large epidemiological studies consistently show that alcohol reduces mortality, especially among middle-aged and older men and women—an association which is likely due to the protective effects of moderate alcohol consumption on CHD, diabetes, and ischemic stroke.35
     
  • It is estimated that 26,000 deaths were averted in 2005 because of reductions in ischemic heart disease, ischemic stroke, and diabetes from the benefits attributed to moderate alcohol consumption.36
     
  • Expanding our understanding of the relationship between moderate alcohol consumption and potential health benefits remains a challenge, and although there are positive effects, alcohol may not benefit everyone who drinks moderately.
     

Definitions

Alcohol Use Disorder (AUD): AUDs are medical conditions that doctors diagnose when a patient’s drinking causes distress or harm. The fourth edition of the Diagnostic and Statistical Manual (DSM–IV), published by the American Psychiatric Association, described two distinct disorders—alcohol abuse and alcohol dependence—with specific criteria for each. The fifth edition, DSM–5, integrates the two DSM–IV disorders, alcohol abuse and alcohol dependence, into a single disorder called alcohol use disorder, or AUD, with mild, moderate, and severe subclassifications.
 

Binge Drinking:

  • NIAAA defines binge drinking as a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 g/dL. This typically occurs after 4 drinks for women and 5 drinks for men—in about 2 hours.37
     
  • The Substance Abuse and Mental Health Services Administration (SAMHSA), which conducts the annual National Survey on Drug Use and Health (NSDUH), defines binge drinking as drinking 5 or more alcoholic drinks on the same occasion on at least 1 day in the past 30 days38
     

Heavy Drinking: SAMHSA defines heavy drinking as drinking 5 or more drinks on the same occasion on each of 5 or more days in the past 30 days.
 

NIAAA’s Definition of Drinking at Low Risk for Developing an AUD: For women, low-risk drinking is defined as no more than 3 drinks on any single day and no more than 7 drinks per week. For men, it is defined as no more than 4 drinks on any single day and no more than 14 drinks per week. NIAAA research shows that only about 2 in 100 people who drink within these limits have an AUD.
 

Substance Use Treatment at a Specialty Facility: Treatment received at a hospital (inpatient only), rehabilitation facility (inpatient or outpatient), or mental health center to reduce alcohol use, or to address medical problems associated with alcohol use.
 

Alcohol-Impaired-Driving Fatality: A fatality in a crash involving a driver or motorcycle rider (operator) with a BAC of 0.08 g/dL or greater.
 

Disability Adjusted Life Years (DALYs): A measure of years of life lost or lived in less than full health.
 

Underage Drinking: Alcohol use by anyone under the age of 21. In the United States, the legal drinking age is 21.
 

 

For more information, please visit: www.niaaa.nih.gov


 

1 Substance Abuse and Mental Health Services Administration (SAMHSA). 2013 National Survey on Drug Use and Health (NSDUH). Table 2.41B—Alcohol Use in Lifetime, Past Year, and Past Month among Persons Aged 18 or Older, by Demographic Characteristics: Percentages, 2012 and 2013. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsSect2peTabs1to42-2013.htm#tab2.41b

2 SAMHSA. 2013 National Survey on Drug Use and Health (NSDUH). Table 2.46B—Alcohol Use, Binge Alcohol Use, and Heavy Alcohol Use in the Past Month among Persons Aged 18 or Older, by Demographic Characteristics: Percentages, 2012 and 2013. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsSect2peTabs43to84-2013.htm#tab2.46b

3 SAMHSA. 2013 National Survey on Drug Use and Health (NSDUH). Table 5.8A—Substance Dependence or Abuse in the Past Year among Persons Aged 18 or Older, by Demographic Characteristics: Numbers in Thousands, 2012 and 2013. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsSect5peTabs1to56-2013.htm#tab5.8a

4 SAMHSA. 2013 National Survey on Drug Use and Health (NSDUH). Table 5.8B—Substance Dependence or Abuse in the Past Year among Persons Aged 18 or Older, by Demographic Characteristics: Percentages, 2012 and 2013. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsSect5peTabs1to56-2013.htm#tab5.8b

5 SAMHSA. 2013 National Survey on Drug Use and Health (NSDUH). Table 5.49A—Need for and Receipt of Treatment at a Specialty Facility for an Alcohol Problem in the Past Year among Persons Aged 18 or Older, by Demographic Characteristics: Numbers in Thousands and Percentages, 2012 and 2013. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsSect5peTabs1to56-2013.htm#tab5.49a

6 SAMHSA. 2013 National Survey on Drug Use and Health (NSDUH). Table 5.5A—Substance Dependence or Abuse in the Past Year among Persons Aged 12 to 17, by Demographic Characteristics: Numbers in Thousands, 2012 and 2013. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsSect5peTabs1to56-2013.htm#tab5.5a

7 SAMHSA. 2013 National Survey on Drug Use and Health (NSDUH). Table 5.5B—Substance Dependence or Abuse in the Past Year among Persons Aged 18 or Older, by Demographic Characteristics: Percentages, 2012 and 2013. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsSect5peTabs1to56-2013.htm#tab5.5b

8 SAMHSA. 2013 National Survey on Drug Use and Health (NSDUH). Table 5.29A— Received Substance Use Treatment at a Specialty Facility in the Past Year among Persons Aged 12 to 17, by Demographic Characteristics: Numbers in Thousands, 2012 and 2013. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsSect5peTabs1to56-2013.htm#tab5.29a

9 Centers for Disease Control and Prevention. Alcohol use and health. Available at: http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

10 Centers for Disease Control and Prevention. Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI). Available at: http://www.cdc.gov/Alcohol/

11 National Highway Traffic Safety Administration. 2013 motor vehicle crashes: Overview. Available at: http://www-nrd.nhtsa.dot.gov/Pubs/812101.pdf

12 Centers for Disease Control and Prevention. Excessive drinking costs U.S. $223.5 billion. Available at: http://www.cdc.gov/features/alcoholconsumption/

13 World Health Organization. Global status report on alcohol and health, p. XIV. 2014 ed. Available at: http://www.who.int/substance_abuse/publications/global_alcohol_report/msb_gsr_2014_1.pdf?ua=1

14 World Health Organization. Global status report on alcohol and health, p. XIII. 2014 ed. Available at: http://www.who.int/substance_abuse/publications/global_alcohol_report/msb_gsr_2014_1.pdf?ua=1

15 Lim, S.S.; Vos, T.; Flaxman, A.D.; et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010.Lancet 380(9859):2224–2260, 2012. PMID: 23245609

16 SAMHSA. Data spotlight: Over 7 million children live with a parent with alcohol problems. 2012. Available at: http://media.samhsa.gov/data/spotlight/Spot061ChildrenOfAlcoholics2012.pdf

17 SAMHSA. 2013 National Survey on Drug Use and Health (NSDUH). Table 2.15B—Alcohol Use in Lifetime, Past Year, and Past Month, by Detailed Age Category: Percentages, 2012 and 2013. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsSect2peTabs1to42-2013.htm#tab2.15b

18 SAMHSA. Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf (pages 44–45)

19 National Institute on Alcohol Abuse and Alcoholism (NIAAA). Alcohol Alert, No. 67 “Underage Drinking,” 2006. Available at: http://pubs.niaaa.nih.gov/publications/AA67/AA67.htm

20 SAMHSA. 2013 National Survey on Drug Use and Health (NSDUH). Table 6.88B—Alcohol Use in the Past Month among Persons Aged 18 to 22, by College Enrollment Status and Demographic Characteristics: Percentages, 2012 and 2013. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsSect6peTabs55to107-2013.htm#tab6.88b

21 SAMHSA. 2013 National Survey on Drug Use and Health (NSDUH). Table 6.89B—Binge Alcohol Use in the Past Month among Persons Aged 18 to 22, by College Enrollment Status and Demographic Characteristics: Percentages, 2012 and 2013. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsSect6peTabs55to107-2013.htm#tab6.89b

22 SAMHSA. 2013 National Survey on Drug Use and Health (NSDUH). Table 6.90B—Heavy Alcohol Use in the Past Month among Persons Aged 18 to 22, by College Enrollment Status and Demographic Characteristics: Percentages, 2012 and 2013. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsSect6peTabs55to107-2013.htm#tab6.90b

23 Hingson, R.W.; Zha, W.; and Weitzman, E.R. Magnitude of and trends in alcohol-related mortality and morbidity among U.S. college students ages 18–24, 1998–2005. Journal of Studies on Alcohol and Drugs (Suppl. 16):12–20, 2009. PMID: 19538908   http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2701090/

24 Hingson R, Heeren T, Winter M. et al. Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18–24: changes from 1998 to 2001. Annual Review of Public Health 26: 259–279, 2005. PMID: 15760289  http://www.ncbi.nlm.nih.gov/pubmed/15760289

25 Blanco, C.; Okuda, M.; Wright, C. et al. Mental health of college students and their non-college-attending peers: Results from the National Epidemiologic Study on Alcohol and Related Conditions. Archives of General Psychiatry 65(12):1429–1437, 2008. PMID: 19047530  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2734947/

26 Wechsler, H.; Dowdall, G.W.; Maenner, G.; et al. Changes in binge drinking and related problems among American college students between 1993 and 1997: Results of the Harvard School of Public Health College Alcohol Study. Journal of American College Health 47(2):57–68, 1998. PMID: 9782661  http://www.tandfonline.com/doi/pdf/10.1080/07448489809595621

27 Stratton, K., Howe, C., Battaglia, F., eds. 1996 Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: Institute of Medicine, National Academy Press, 1996.

28 May, P.A.; Gossage, J.P.; Kalberg, W.O.; et al. Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies. Developmental Disabilities Research Reviews 15(3):176–192, 2009.PMID:19731384  http://onlinelibrary.wiley.com/doi/10.1002/ddrr.68/pdf

29 Multiple Cause of Death Public-Use Data File, 2012 and 2013. AAFs from CDC Alcohol-Related Disease Impact (ARDI). National Survey on Drug Use and Health, 2012 and 2013 for estimating indirect AAFs for Liver Cancer. Available at: http://www.cdc.gov/alcohol/ardi.htm

30 Yoon, Y.H., Chen, C.M. and Yi, H.Y. Surveillance Report #100: Liver Cirrhosis Mortality in the United States: National, State, and Regional Trends, 2000–2011. Bethesda, MD: NIAAA, 2014. Available at: http://pubs.niaaa.nih.gov/publications/Surveillance100/Cirr11.pdf

31 Singal, A.K.; Guturu, P.; and Hmoud, B.; et al. Evolving frequency and outcomes of liver transplantation based on etiology of liver disease. Transplantation 95(5):755–760, 2012. PMID: 23370710 (Please note: The “almost 1 in 3” figure aggregates the total number of transplants necessitated by alcoholic cirrhosis, alcoholic liver disease plus hepatitis C virus infection, and 40 percent of transplants necessitated by hepatocellular carcinoma.)

32 National Cancer Institute. Cancer Trends Progress Report, 2011–2012 Update. Available at: http://progressreport.cancer.gov/sites/default/files/archive/report2011.pdf

33 U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th Edition, p. 31. Available at: http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf

34 U.S. Department of Agriculture. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010, pp. 355, 359. Available at: http://www.cnpp.usda.gov/sites/default/files/dietary_guidelines_for_americans/2010DGACReport-camera-ready-Jan11-11.pdf

35 U.S. Department of Agriculture. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010, pp. 355–356. Available at: http://www.cnpp.usda.gov/sites/default/files/dietary_guidelines_for_americans/2010DGACReport-camera-ready-Jan11-11.pdf

36 Danaei, G.; Ding, E.L.; Mozaffarian, D.; et al. The preventable causes of death in the United States: Comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Medicine 6(4):1–23, 2009. PMID: 19399161

37 National Institute on Alcohol Abuse and Alcoholism (NIAAA). NIAAA Council Approves Definition of Binge Drinking. NIAAA Newsletter, Number 3, Winter 2004. Available at: http://pubs.niaaa.nih.gov/publications/Newsletter/winter2004/Newsletter_Number3.pdf

38 Substance Abuse and Mental Health Services Administration (SAMHSA). Binge Drinking: Terminology and Patterns of Use. Available at: http://captus.samhsa.gov/access-resources/binge-drinking-terminology-and-patterns-use

 

March 2015