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Strategic Plan: Fiscal Years 2024-2028
Goal 2: Identify Patterns, Trends, and Public Health Impact of Alcohol Misuse
Updated:
February 2025
NIAAA will continue to support epidemiological research to identify and track patterns of alcohol use and misuse, drinking-related outcomes and disparities, and individual and environmental variables that confer risk or resilience.
NIAAA’s Long-Term Vision
To gain a complete understanding of the patterns and trends of the burden and likelihood of alcohol misuse to inform the diagnosis, prevention, and treatment of alcohol-related problems.
Epidemiological research is key to addressing the public health impact of alcohol misuse. Identifying and tracking patterns and trends in alcohol use and related harms convey the scale and burden of alcohol misuse in the nation. Although significant changes in patterns of drinking behavior and consequences have occurred over time, it is important to acknowledge that population-level averages may not reflect the public health impact of alcohol misuse among various sociodemographic groups. It is important for epidemiology research to focus on alcohol misuse and related consequences among populations that experience health disparities, as well as the general population.
Epidemiological research also plays a critical role in identifying factors that influence the initiation of alcohol use and the progression to alcohol misuse, including heavy drinking and alcohol use disorder (AUD). Knowledge of risk factors associated with alcohol misuse can inform prevention and intervention efforts. Similarly, epidemiological studies can reveal factors that protect against alcohol misuse and consequences. This information can be used to develop prevention strategies that focus on health promotion.
Goal 2 research topics are integrally linked to the Cross-Cutting Research Themes. Examples of NIAAA research priorities in this area include the following objectives.
Objective 1: Identify and Track Trends in Alcohol Misuse and Related Consequences
Collection and analysis of national data on alcohol use are essential for surveilling the patterns and impact of alcohol misuse on public health. For example, recent data have revealed some successes, such as declining alcohol use among youth. These studies also indicate, however, that the recent decrease has been slower among females than males. Among adults, however, alcohol use is increasing, with larger increases found among women, Black men, and older adults.
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Each year, approximately 5 million people visit emergency departments for alcohol-related reasons, from injuries to diseases.1 The rate of alcohol-related deaths in the United States more than doubled between 1999 and 2021. Additional epidemiological reports also indicate that alcohol-associated liver diseases (ALD), such as cirrhosis, are increasing, particularly among women and young adults, and alcohol now accounts for almost half of liver disease deaths in the United States.2 Research tracking the patterns and correlates of alcohol involvement in morbidity and mortality can inform decisions about where to direct prevention and treatment efforts.
NIAAA encourages research to understand the scope and scale of alcohol misuse—for example:
Identifying patterns, trends, and disparities in alcohol misuse, AUD, alcohol-related consequences, as well as treatment access and utilization across demographic groups
Characterizing patterns and trends in co-use of alcohol, cannabis, opioids, and other substances and their contributions to adverse health and social outcomes
Identifying and characterizing secondhand effects of alcohol misuse (e.g., interpersonal violence, assault, homicide, child maltreatment, and motor vehicle crashes)
Improving assay methodologies for validated biomarkers of alcohol consumption considering cost, timeliness, and accessibility in clinical settings
Applying innovative data measurement technologies and approaches for more accurate and/or real-time assessment of alcohol use, related behaviors, and associated changes over time (e.g., ecological momentary assessment, biomarkers, and biosensors)
Utilizing cutting-edge data collection and analytic approaches, such as artificial intelligence, social network analyses, and data analytics to study and predict patterns and trends in alcohol misuse to facilitate timely intervention
Examining the long-term health and societal effects of the increase in alcohol misuse and alcohol-related consequences due to the COVID-19 pandemic, particularly due to coping with stress
1 White AM, Slater ME, Ng G, Hingson R, Breslow R. Trends in alcohol-related emergency department visits in the United States: results from the Nationwide Emergency Department Sample, 2006 to 2014. Alcohol Clin Exp Res. 2018 Feb;42(2):352-9. doi: 10.1111/acer.13559. Epub 2018 Jan 2. PubMed PMID: 29293274
2 Estimated liver disease deaths include deaths with underlying causes coded as alcoholic liver disease (K70); liver cirrhosis, unspecified (K74.0–K74.2, K74.6, K76.0, K76.7, and K76.9); chronic hepatitis (K73); portal hypertension (K76.6); liver cancer (C22); or other liver diseases (K71, K72, K74.3–K74.5, K75, K76.1–K76.5, and K76.8). Number of deaths from Multiple Causes of Deaths Public-Use Data File, 2022 (https://wonder.cdc.gov/mcd.html). Alcohol-attributable fractions (AAFs) from CDC Alcohol-Related Disease Impact (http://nccd.cdc.gov/DPH_ARDI/Default/Default.aspx), accessed March 13, 2024. Prevalence of alcohol consumption from the National Survey on Drug Use and Health, 2022, for estimating indirect AAFs for chronic hepatitis and liver cancer.
