alcohol cause and effect essay

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The Cause and Effects of Drinking Alcohol, Essay Example

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Alcohol is widely abused across the world and the effects of excessive alcohol intake can be devastating. When not taken in moderation, alcohol can be harmful to the health and social life of the individual, as well as harmful to the individual’s family. These devastating effects can result in alcohol related disease, outcast from social circles and loss of friends and a breakdown in the family.

Excessive alcohol consumption is extremely harmful to the health of a person. Alcohol abuse can lead to heart disease, liver failure and rapid aging. Many deaths are caused by alcoholism. Excessive drinking also increases the decision to take risky actions, including drinking and driving. Drinking and driving causes many deaths every year and is a major problem among those of all ages. Excessive alcohol consumption can also cause memory loss and other psychological issues.

Consuming alcohol at a high rate can also cause social problems. This can include loss of friends and being outcast from your community. This happens because of the bad choices that come with alcoholism and most people do not want to associate with those who drink excessively. It is not just harmful to the drinker, but harmful to their friends and family.

In relation to loss of friends, it is likely that excessive drinking can cause a breakdown in family. Alcoholism is devastating for families. Many times an excessive drinker will not keep up with their responsibilities within the family. This means that they are likely to not finish school or college, lose their jobs and not participate in taking care of their children. This can lead to financial problems and the inability to take care of the themselves of the family.

There are many reasons why excessively consuming alcohol is dangerous and harmful. Drinking in moderation or abstaining from alcohol altogether is important to live a happy and healthy life. Among the effects of drinking alcohol, the most obvious are major health problems, loss of friends and social status and a breakdown in the family unit.

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Alcoholism: Causes, Risk Factors, and Symptoms

Introduction, causes of alcoholism, effects of alcoholism, works cited.

The term alcoholism may be used to refer to a wide range of issues associated with alcohol. Simply put, it is a situation whereby an individual cannot stay without alcohol. An alcoholic usually drinks alcohol uncontrollably and persistently.

Alcoholism usually leads to ill health, and it affects relationships between the individual and the people around him. It may also be considered as a disease and may be referred to as an alcohol use disorder. Alcohol abuse may also cause damage to vital organs in the human body, including the brain and heart (Mukamal et al. 1965). Therefore, it may lead to psychiatric and medical issues. Psychiatric disorders, such as depression and schizophrenia, may occur.

Others include phobias, dysthymia, mania, and depression. Alcoholism may also cause neurologic deficits. These deficits may be manifested through certain impairments such as brain damage and memory loss. Such individuals also have difficulty executing certain functions and may experience issues with body balance and gait.

The brain might be affected as certain changes occur in its structure and chemistry. With time, a person develops physical dependence and tolerance. This causes the inability to stop drinking and causes complications as one tries to stop the habit.

This is particularly referred to as alcohol withdrawal syndrome. Identifying alcoholics for the purpose of treatment may be difficult since such individuals may avoid seeking help due to stigmatization. However, certain factors influence the risk for the condition.

These factors include mental health, depression, age, gender, ethnicity, and family history (Mukamal et al. 1965). This paper will discuss the genetic and environmental factors that cause alcoholism and highlight the complications, conditions, and diseases associated with the disorder.

The main causes of this disorder may be categorized into two. These include genetic and environmental factors. The genetic material that determines the metabolism of the drink also influences the risk of the disorder. Persons with a family history of the disorder may also develop it.

A particular study argued that the expression of genes was influenced if an individual started using alcoholic beverages at an early stage in life (Agrawal et al. 69). This increased the risk of alcohol dependence among such individuals.

Persons with a genetic disposition to the disorder would most probably start drinking at an early stage. Individuals who start drinking at an early stage are also more likely to develop alcoholism. It is also argued that 40% of alcoholics misuse alcohol by the time they are in their late adolescent stage. However, certain researchers disagree with this idea (Schwandt et al., 74).

Individuals who do not receive support from family and friends are highly likely to develop alcoholism. Therefore, some social and emotional factors may cause an ex-drinker to start drinking again. For example, mental and emotional stress can contribute to alcoholism.

An individual under the influence of alcohol may not be able to feel the pain associated with stress. With the normal alcohol intake, an individual’s brain might be at some equilibrium. When the individual tries to quit, the brain responds. This response may come in terms of stress, anxiety, and depression.

These feelings cause chemical imbalances that force an alcoholic to go back to drinking in order to feel better. Social and cultural pressures from media and other sources may also affect the drinking habits of an individual. The media’s portrayal of alcohol as a pleasurable and beneficial drink may encourage individuals to start drinking or cause ex-drinkers to return to their old habits (Bierut et al. 237).

The damaging effect of alcohol on the nervous system is more profound among adolescents and those with a genetic disposition to the disorder. These effects may cause the degeneration of the cerebral cortex. Consequently, this increases impulse behavior that may lead to alcoholism.

Despite the severe damages to the central nervous system due to alcoholism, it is possible to reverse some of the damages through withdrawal from the drug. Another risk factor is the availability of alcohol. This drug is most commonly abused. In terms of popularity, beer may come next after water and tea.

The difference in genetic characteristics also determines the risk of developing the disorder. This is mainly because different races have certain different genetic characteristics.

Therefore, they differ in terms of alcohol metabolism. The difference in genetic makeup may explain the difference in the rate of alcohol dependence among the different races.

The genetic component that determines the rate at which alcohol metabolizes is referred to as the alcohol dehydrogenase allele. The Native Americans and African Americans are said to have an allele that is not highly associated with alcohol dependence. The Native Americans, on the other hand, are more likely to develop alcohol dependence.

The effects of alcohol abuse are diverse. Consumption of excess alcohol may lead to several diseases and complications. For example, it may lead to the inflammation of the pancreas, liver disease, and cancers. Alcohol-related cancers are believed to form as the elements in the alcoholic drink are converted into acetaldehyde. This is a potent carcinogen.

Different parts of the body may host the cancerous cells. These areas include the liver, breast, and mouth. The larynx and the throat are also likely to be affected. Alcoholics who take tobacco have an increased risk of cancers (Bierut et al. 237).

Liver cirrhosis is another condition that may occur as a result of excessive drinking of alcohol. This is manifested through the scarring of the organ to such an extent that it cannot perform its functions. However, some individuals who drink moderately have also been shown to suffer from the disease (Mukamal et al. 1965).

Pregnant alcoholic mothers may also cause problems for the unborn. Fetal alcohol syndrome may result from such habits. Excessive use of alcohol may cause impaired brain development and brain shrinkage. Although the brain normally shrinks in old age, excessive use of alcohol increases this rate. With the increased rate, such individuals are likely to develop dementia and have memory issues.

Alcoholism also increases the risk of cognitive and neuropsychiatric disorders. Excessive use of the beverage may cause an increase in the level of toxic amino acid in the plasma. This may be the reason why some individuals suffer from withdrawal seizures.

Alcohol abuse may also cause issues with memory and may impair learning. Alcoholism may also greatly affect the brain. For example, brain lesions are likely to occur. Alcohol-related brain damage comes about due to a combination of several factors.

Alcoholism may also cause heart attacks and strokes. Abuse of alcohol increases the risks of a heart attack. Some studies have shown that drinking alcohol in moderation may offer some level of protection to individuals against heart attack (Mukamal et al. 1965).

This applies specifically to individuals who had suffered a heart attack before. Prolonged use of alcohol in large quantities also causes alcohol cardiomyopathy. This disease affects the muscles of the heart. As the heart muscles fail, this may lead to heart failure.

Alcoholism is also associated with alcohol-related death. Many deaths worldwide have been attributed to the excessive use of alcohol (Doll et al. 199). Individuals who use alcohol excessively are at a higher risk of death than those who take alcohol moderately. Individuals with diseases that may be augmented by the excessive use of alcohol are also at great risk of alcohol-related death. Such diseases include oral cancers and liver disease.

Another effect of alcoholism is anemia. Excessive use of alcoholic beverages causes a reduction in the number of erythrocytes. This condition is referred to as anemia. Since red blood cells are used to transport oxygen around the body, the low level of oxygen due to low numbers of the cells leads to fatigue, shortness of breath, and dizziness.

Alcoholism may either be caused by genetic or environmental factors. Persons with a genetic disposition to the disorder are likely to start drinking and become alcoholics. Genetic variations may determine the difference in alcohol metabolism.

The environmental factors that may cause alcoholism include the availability of alcohol and sociocultural pressures. Certain environmental factors lead to depression that may encourage alcoholism. The effects of alcoholism are diverse. Alcoholism may lead to diseases such as liver disease, heart disease, and cancers. Excessive use of alcohol may affect almost all vital organs of the body and may eventually lead to death.

Agrawal, Arpana, et al. “Evidence for an interaction between age at 1 st drink and genetic influences on DSM-IV alcohol dependence symptoms.” Alcoholism Clinical & Experimental Research 33.12 (2010): 67-80. Print.

Bierut, Laura, et al. “Co-occurring risk factors for alcohol dependence and habitual smoking.” Alcohol Research & Health 24.4 (2000): 233-241. Print.

Doll, Richard, et al . “Mortality in relation to alcohol consumption: A prospective study among male British doctors.” International Journal of Epidemiology 34.1 (2005): 199-204. Print.

Mukamal, Kenneth, et al. “Prior alcohol consumption and mortality following acute myocardial infarction.” JAMA 285.15 (2001): 1965-1970. Print.

Schwandt, Melanie, et al. “Alcohol response and consumption in adolescent rhesus macaques: Life history and genetic influences.” International Biomedical Journal 44.1 (2010): 67-80. Print.

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StudyCorgi. (2020, January 12). Alcoholism: Causes, Risk Factors, and Symptoms. https://studycorgi.com/alcoholism-causes-and-effects/

"Alcoholism: Causes, Risk Factors, and Symptoms." StudyCorgi , 12 Jan. 2020, studycorgi.com/alcoholism-causes-and-effects/.

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Essay on Alcoholism

Students are often asked to write an essay on Alcoholism in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Alcoholism

Understanding alcoholism.

Alcoholism is a serious issue. It is a disease where a person cannot control their desire to drink alcohol. They keep drinking even when it causes harm.

Alcoholism can be caused by genetics, environment, and mental health. Some people are more prone to it because of their family history. Others might start drinking due to stress or depression.

The Effects

Alcoholism can lead to health problems like liver disease. It can also cause problems at work, school, or with relationships. It’s important to seek help if you or someone you know is struggling.

250 Words Essay on Alcoholism

Introduction.

Alcoholism, also known as alcohol use disorder (AUD), is a chronic disease characterized by an inability to control or abstain from alcohol use despite its negative consequences. It is a pervasive global issue with significant health, social, and economic implications.

Causes and Risk Factors

Impacts and consequences.

The impacts of alcoholism are far-reaching. Physiologically, it can lead to liver disease, cardiovascular problems, and neurological damage. Psychologically, it can result in depression, anxiety, and increased risk of suicide. Socially, it can disrupt relationships, lead to job loss, and contribute to social isolation.

Treatment and Prevention

Treatment for alcoholism typically involves a combination of medication, therapy, and support groups. Prevention strategies include education about the risks of excessive alcohol consumption, early intervention for at-risk individuals, and policies to limit alcohol availability.

Alcoholism is a complex disease with a multitude of contributing factors and consequences. Understanding its causes, impacts, and treatment options is key to addressing this pervasive issue. As future leaders, we must advocate for effective prevention strategies and accessible treatment services to combat alcoholism.

500 Words Essay on Alcoholism

Alcoholism, also known as Alcohol Use Disorder (AUD), is a chronic disease characterized by an inability to control or abstain from alcohol use despite its negative repercussions. It is a multifaceted disease, with complex interactions between genetic, environmental, and psychological factors.

Genetic Underpinnings of Alcoholism

Scientific research has established a strong genetic component to alcoholism. Certain genes can make individuals more susceptible to alcohol addiction, demonstrating that alcoholism is not merely a result of personal weakness or lack of willpower. It is estimated that genetics accounts for about 50% of the risk for AUD. However, having a genetic predisposition does not guarantee the development of alcoholism, indicating the significant role of environmental factors.

Environmental Factors and Alcoholism

The psychological impact of alcoholism.

Alcoholism inflicts significant psychological damage. It can lead to a range of mental health disorders, including depression, anxiety, and increased risk of suicide. Furthermore, alcoholism can negatively impact cognitive functions, impair judgment, and lead to behavioral changes. It is also closely linked to social problems, such as domestic violence, child abuse, and other forms of crime.

Treatment and Recovery

Alcoholism is a treatable disease, with various therapeutic strategies available. These include behavioral treatments, medications, and mutual-support groups. Behavioral treatments aim to change drinking behavior through counseling, while medications can help to manage withdrawal symptoms and prevent relapse. Mutual-support groups like Alcoholics Anonymous provide a supportive community for individuals recovering from alcoholism.

Prevention is Better than Cure

Alcoholism is a complex, multifaceted disease that requires a comprehensive approach for its prevention and treatment. Understanding its genetic, environmental, and psychological dimensions can inform effective strategies to combat this pervasive public health issue. While alcoholism is a serious disease, recovery is possible with the right support and treatment. Therefore, it is essential to foster a supportive environment for those struggling with this disorder, free from stigma and judgment.

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Effects of Alcohol Consumption Essay

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Introduction

Nursing intervention.

Alcohol consumption can have various effects on the people who consume it. The effects may be social, psychological, physiological and medical. Some alcoholic brands (like wine) may have positive effects on our health while others (like spirits) may have negative effects. The duration in which a person consumes alcohol determines the intensity of the negative effects of alcohol on the person. One negative effect of alcohol is the damage of body organs like the liver and the colon, when consumed for a long period of time (Cooper, 2000).

Alcohol is categorized as a depressant due to its ability to slow down the nervous system thereby reducing sensitivity to pain through inducement of sleep like feeling. Some of the immediate impacts of alcohol misuse include lack or loss of one’s awareness, distortion of reality, loss of coordination of the brain activities and one’s motor skills (Toppness, 2011). When used for a long time, it leads to addiction, as well as social and economic irresponsibilities by the addicted individuals (Toppness, 2011).

Research has shown that alcohol consumption is a risk factor to colon cancer. However, the type of alcohol brand matters. While wine may have positive impacts in preventing colon cancer, hard liquor like spirits have been found to increase the chances of alcoholics developing colon cancer. Prolonged alcohol consumption also leads to colon irritation, which in turn leads to diarrhoea and constipation (Toppness, 2011). This can make the individuals lose their appetite and become malnourished. Such individuals may end up being socially and economically irresponsible, which may further lead to depression. The depressed individuals become prone to suicide because their thinking and reasoning becomes impaired, and to them, life loses meaning.

Patients who are addicted to alcohol consumption need to be shown love and care not rebuke and contempt. This is one aspect of the nursing profession and other professions like social work. We should show them love and care through talking to them in a courteous manner, and showing them that they are able to come out of their situation.

Many alcohol addicts have their symptoms as adaptive. This means that they develop or acquire some behaviour which helps them cope with the problems they are facing; one such behaviour is alcohol consumption, which later develops into alcohol misuse or abuse. For example, some may assume or think that other people hate them because they are poor or are of low social status. This is an external pressure to them, and in order for them to safeguard their ego, they engage in alcohol consumption in order to cope in staying with the people who hate them. Our intervention should therefore be centred on behaviour and attitude change.

We should show them that alcohol consumption is not the solution to their problems and help them gain the courage to face life the way it is. We should help them acquire new behaviours which are not depended on alcohol. For instance, they could be helped to boost their people’s skills, their confidence as well as improve on their hygiene, which would boost their self-esteem. These interventions could be done in a community setting or at their homes. In severe cases of addiction, they should be taken to rehabilitation, where they could be helped to recover from withdrawal symptoms.

Even though alcohol can have many negative effects on our bodies, it is a good component of our diet when used properly in the right quantities and frequencies. For instance, it makes our meals complete apart from being used as a social drink. Alcohol consumption therefore becomes dangerous to us and our bodies when we misuse it. Alcohol consumption is regarded as a risk factor in causing colon cancer because it causes diarrhoea and inflammation of the colon. The link is however not clearly established and therefore the need for more research to establish the relationship between alcohol consumption and colon cancer (Hales, 2008).

Cooper, D.B. (2000). Alcohol Use. Abingdon OX14 1AA: Radcliffe Publishing.

Hales, D. (2008). An Invitation to Health. New York: Cengage Learning.

Toppness, H. (2011). Alcohol Effects on the Colon. Web.

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IvyPanda. (2022, March 26). Effects of Alcohol Consumption. https://ivypanda.com/essays/effects-of-alcohol-consumption/

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Alcohol's Effects on Health

Research-based information on drinking and its impact.

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Overview of alcohol consumption.

People drink to socialize, celebrate, and relax. Alcohol often has a strong effect on people – and throughout history, we’ve struggled to understand and manage alcohol’s power. Why does alcohol cause us to act and feel differently? How much is too much? Why do some people develop alcohol use disorder while others do not?

NIAAA is researching these and other questions about alcohol. Findings include: 

Alcohol’s effects vary from person to person, depending on a variety of factors, including:

• How much you drink
• How often you drink
• Your health status
• Your family history

Drinking too much can cause a range of consequences, and increase your risk for a variety of problems .

Consequences of drinking too much Alcohol’s effects can appear rapidly. As you drink, you increase your blood alcohol concentration (BAC), which is the amount of alcohol present in your bloodstream. The higher your BAC, the more impaired you become by alcohol’s effects. These effects can include:

• Reduced inhibitions
• Slurred speech
• Motor impairment
• Memory problems
• Concentration problems
• Breathing problems

Alcohol is a significant factor for the following consequences :

• Car crashes and other accidents
• Unsafe sexual behavior
• Sexual assault
• Suicide and homicide

People who drink too much over a long period of time may experience alcohol’s longer-term effects, which can include:

Alcohol use disorder Health problems Increased risk for certain cancers

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An official website of the National Institutes of Health and the National Institute on Alcohol Abuse and Alcoholism

Alcoholism cause and effect essay

Table of Contents

Introduction

There are several terms that have been developed to define alcoholism, including alcohol dependence and alcohol abuse. As Roh (2015) demonstrates, today alcoholism is referred to as alcohol use disorder that occurs when a person consumers so much alcohol that the body becomes addicted and dependent on alcohol. Alcoholism manifests through addition, which makes alcohol the most important thing in the life of the alcoholic. Inasmuch as the negative consequences of alcohol use disorder are well defined, people with the disorder continue to consume alcohol, a factor that leads to negative effects on their overall livelihoods.

This is a research paper whose theme is alcoholism. This paper aims at answering the following research questions: What are the statistical facts related to alcoholism? Which body systems are affected by alcoholism? Based on the statistics on the prevalence and information on the body systems affected by alcoholism, what are the interventions that can be implemented to reduce the effects and prevalence of alcoholism? By answering these questions, this research aims at proving that there is a relationship between multidisciplinary approaches to alcohol abuse prevention and successful interventions to minimize alcoholism.

There have been several studies that have been conducted to determine the exact causes of alcoholism. Across these studies, Powers, Berger, Fuhrmann and Fendrich (2017) highlighted that there are no specific emergent causes of alcoholism, though the risk factors of alcoholism continue to be defined. According to Roh (2015), there is a thin line between moderate alcohol consumption and excessive consumption, with the latter being attributed to addiction. In an attempt to ascertain this, Allamani (2012) classified males who consume more than 15 drinks weekly and women who take more than 12 drinks weekly as highly at risk of alcoholism. However, Opačić, Oreb and Radat (2017) explained that alcoholism can purely be linked to social and psychological issues. Peer pressure is among the leading social issues associated with alcoholism, while depression, anxiety and mental abuse are the psychological issues that are attributed to alcoholism.

As of 2015 in the US, alcohol use disorder was prevalent across 6.2% of the population aged above 18 years, based on the report by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The prevalence of this disorder was higher among men (8.4%) compared to women (5.3%). On the other hand, 2.5% of youths aged between 12 and 17 were reported to have alcohol use disorder (niaaa.nih.gov, 2018). However, the disorder was prevalent among the females in this age group (2.7%) compared to the 2.3% of the males. The NIAAA further reports that approximately 88,000 deaths occur annually due to alcoholism. Men constitute the larger proportion of these deaths. On the global scale, there are 3.3 million deaths annually that accrue from alcoholism, translating to nearly 6% of the total deaths globally.

The effects of alcoholism on the body have been well documented by Bernstein (2012), who writes that inculcated behavior of excessive alcohol consumption leads to disorders of the digestive system, the circulatory system, the central nervous system and the endocrine system. The most common body part affected by alcoholism is the liver. In 2015, nearly 47% of the liver disease deaths in the USA were attributed to alcoholism (niaaa.nih.gov, 2018). Besides, alcohol has been identified as a leading cause of cirrhosis, a chronic disease of the liver that manifests through inflammation and cell degeneration. Alcoholism was identified by the NIAAA as the major cube of the cirrhosis deaths, as it contributed 48% of these deaths in 2015.

The statistics of alcoholism prevalence and the effects of alcoholism on the body paint a picture of the need to develop appropriate interventions to prevent it. According to Opačić, Oreb and Radat (2017), the prevention measures of alcoholism are aimed at reducing the abuse of alcohol as well as its consequences. As such, legislators, healthcare providers, the community and the potential addicts should all be included in the efforts directed towards preventing alcoholism. Legislators play a critical role in reducing alcohol consumption through increasing the taxes levied on alcohol and increasing the minimum age that is legally accepted for drinking. Besides, legislators also create laws that oblige alcohol manufacturers to inform and warn the drinkers of the effects of alcohol abuse.

Health care providers play the role of promoting the recovery efforts of those diagnosed with alcohol use disorder. Doctors and nurses are influential in enabling the addicts overcome the effects of withdrawal, while psychological health experts enable the addicts to develop a positive attitude towards life. The communities are pivotal in developing programs and educational interventions for saving the lives of the addicts. The communities include the citizen advocacy groups, media, business enterprises, the police and schools. In all these interventions, the input of addicts should be embedded, as Roh (2015) demonstrates that such inclusion increases the suitability of the programs among the populations at high risk of alcoholism.

In this discussion, the statistics of alcoholism prevalence have been provided, indicating that alcoholism is highly prevalent among men than women. The study also establishes that the liver is the body organ that is largely affected by alcoholism, an argument that is supported from the data detailing the number of liver disease deaths associated with alcoholism. The solutions to alcoholism listed in this paper include policy interventions, healthcare prevention approach and community based programs. In conclusion, there is a relationship between multidisciplinary approaches to alcohol abuse prevention and successful interventions to minimize alcoholism.

• Allamani, A. (2012). Alcohol Consumption Policies and the Prevention of Alcohol Consumption-Related Problems: Needs, Duties, and Responsibilities*.  Substance Use & Misuse ,  47 (12), 1252-1259. http://dx.doi.org/10.3109/10826084.2012.716483
• Bernstein, D. (2012). Alcoholic Liver Disease.  Clinics In Liver Disease ,  16 (4), xiii-xiv. http://dx.doi.org/10.1016/j.cld.2012.09.009
• niaaa.nih.gov. (2018).  Alcohol Facts and Statistics | National Institute on Alcohol Abuse and Alcoholism (NIAAA) .  Niaaa.nih.gov . Retrieved 29 January 2018, from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics
• Opačić, A., Oreb, T., & Radat, K. (2017). Characteristics and Significance of Professional-Led Support Groups in the Treatment of Alcoholism.  Alcoholism Treatment Quarterly ,  35 (4), 359-371. http://dx.doi.org/10.1080/07347324.2017.1350541
• Powers, G., Berger, L., Fuhrmann, D., & Fendrich, M. (2017). Family history density of substance use problems among undergraduate college students: Associations with heavy alcohol use and alcohol use disorder.  Addictive Behaviors ,  71 (9), 1-6. http://dx.doi.org/10.1016/j.addbeh.2017.02.015
• Roh, S. (2015). New Directions in Healthcare for Alcohol Use Disorder.  Health Care : Current Reviews ,  03 (02). http://dx.doi.org/10.4172/2375-4273.1000144
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The Risks Associated With Alcohol Use and Alcoholism

Alcohol consumption, particularly heavier drinking, is an important risk factor for many health problems and, thus, is a major contributor to the global burden of disease. In fact, alcohol is a necessary underlying cause for more than 30 conditions and a contributing factor to many more. The most common disease categories that are entirely or partly caused by alcohol consumption include infectious diseases, cancer, diabetes, neuropsychiatric diseases (including alcohol use disorders), cardiovascular disease, liver and pancreas disease, and unintentional and intentional injury. Knowledge of these disease risks has helped in the development of low-risk drinking guidelines. In addition to these disease risks that affect the drinker, alcohol consumption also can affect the health of others and cause social harm both to the drinker and to others, adding to the overall cost associated with alcohol consumption. These findings underscore the need to develop effective prevention efforts to reduce the pain and suffering, and the associated costs, resulting from excessive alcohol use.

Alcohol consumption has been identified as an important risk factor for illness, disability, and mortality ( Rehm et al. 2009 b ). In fact, in the last comparative risk assessment conducted by the World Health Organization (WHO), the detrimental impact of alcohol consumption on the global burden of disease and injury was surpassed only by unsafe sex and childhood underweight status but exceeded that of many classic risk factors, such as unsafe water and sanitation, hyper-tension, high cholesterol, or tobacco use ( WHO 2009 ). This risk assessment evaluated the net effect of all alcohol consumption—that is, it also took into account the beneficial effects that alcohol consumption (primarily moderate consumption) can have on ischemic diseases 1 and diabetes ( Baliunas et al. 2009 ; Corrao et al. 2000 ; Patra et al. 2010 ; Rehm et al. 2004 ). Although these statistics reflect the consequences of all alcohol consumption, it is clear that most of the burden associated with alcohol use stems from regular heavier drinking, defined, for instance, as drinking more than 40 grams of pure alcohol per day for men and 20 grams of pure alcohol per day for women 2 ( Patra et al. 2009 ; Rehm et al. 2004 ). In addition to the average volume of alcohol consumption, patterns of drinking—especially irregular heavy-drinking occasions, or binge drinking (defined as drinking at least 60 grams of pure alcohol or five standard drinks in one sitting)—markedly contribute to the associated burden of disease and injury ( Gmel et al. 2010 ; Rehm et al. 2004 ). This article first defines which conditions necessarily are caused by alcohol use and for which conditions alcohol use is a contributing factor. It then looks more closely at the most common disease risks associated with excessive alcohol use, before exploring how these risks have influenced guidelines for drinking limits. The article concludes with a discussion of the alcohol-related risk of harm to people other than the drinker.

Disease and Injury Conditions Associated With Alcohol Use

Conditions for which alcohol is a necessary cause.

More than 30 conditions listed in the WHO’s International Classification of Diseases, 10th Edition (ICD–10) ( WHO 2007 ) include the term “alcohol” in their name or definition, indicating that alcohol consumption is a necessary cause underlying these conditions (see table 1 ). The most important disease conditions in this group are alcohol use disorders (AUDs), which include alcohol dependence and harmful use or alcohol abuse. 3 AUDs are less fatal than other chronic disease conditions but are linked to considerable disability ( Samokhvalov et al. 2010 d ). Overall, even though AUDs in themselves do not rank high as a cause of death globally, they are the fourth-most disabling disease category in low- to middle-income countries and the third-most disabling disease category in high-income countries ( WHO 2008 ). Thus, AUDs account for 18.4 million years of life lost to disability (YLDs), or 3.5 percent of all YLDs, in low- and middle-income countries and for 3.9 million YLDs, or 5.7 percent of all YLDs, in high-income countries. However, AUDs do not affect all population subgroups equally; for example, they mainly affect men, globally representing the second-most disabling disease and injury condition for men. In contrast, AUDs are not among the 10 most important causes of disabling disease and injury in women ( WHO 2008 ).

Disease Conditions That by Definition Are Attributable to Alcohol (AAF = 100%)

Note: ICD codes in italics represent subcodes within a main code of classification.

Abbreviations: AAF = alcohol-attributable fraction.

Alcoholic liver disease and alcohol-induced pancreatitis are other alcohol-specific disease categories that are of global importance. However, no global prevalence data on these disease categories exist because they cannot be validly assessed on a global level. Thus, these conditions are too specific to assess using verbal autopsies and other methods normally used in global-burden-of-disease studies ( Lopez et al. 2006 ; pancreatitis can be estimated indirectly Rajaratnam et al. 2010 ). Nevertheless, via the prevalence of alcohol exposure the prevalence of alcohol-attributable and relative risk for the wider, unspecific liver cirrhosis and alcohol-induced disease categories ( Rehm et al. 2010 a ).

Conditions for Which Alcohol Is a Component Cause

Disease and injury conditions for which alcohol consumption is a component cause contribute more to the global burden of disease than do alcohol-specific conditions. Overall, the following are the main disease and injury categories impacted by alcohol consumption (listed in the order of their ICD–10 codes):

• Infectious disease;
• Neuropsychiatric disease;
• Cardiovascular disease;
• Liver and pancreas disease; and
• Unintentional and intentional injury.

For all chronic disease categories for which detailed data are available, those data show that women have a higher risk of these conditions than men who have consumed the same amount of alcohol; however, the differences are small at lower levels of drinking ( Rehm et al. 2010 a ). The following sections will look at these disease categories individually.

Individual Disease and Injury Conditions Associated With Alcohol Use

Infectious diseases.

Although infectious diseases were not included in the WHO’s comparative risk assessments for alcohol conducted in 2000 ( Rehm et al. 2004 ) and 2004 ( Rehm et al. 2009 b ), evidence has been accumulating that alcohol consumption has a detrimental impact on key infectious diseases ( Rehm et al. 2009 a , 2010 a ), such as tuberculosis ( Lönnroth et al. 2008 ; Rehm et al. 2009 c ), infection with the human immunodeficiency virus (HIV) ( Baliunas et al. 2010 ; Shuper et al. 2010 ), and pneumonia ( Samokhvalov et al. 2010 c ). In fact, recent studies (Rehm and Parry 2009 ; Rehm et al. 2009 a ) found that the overall impact of alcohol consumption on infectious diseases is substantial, especially in sub-Saharan Africa.

One of the pathways through which alcohol increases risk for these diseases is via the immune system, which is adversely affected by alcohol consumption, especially heavy drinking ( Rehm et al. 2009 c ; Romeo et al. 2010 ). As a result, although risk for infectious diseases does not differ greatly for people drinking less than 40 grams of pure alcohol per day compared with abstainers, this risk increases substantially for those who drink larger amounts or have been diagnosed with an AUD ( Lönnroth et al. 2008 ; Samokhvalov et al. 2010 c ). In addition, alcohol consumption is associated with poorer outcomes from infectious disease for heavy drinkers by way of social factors. Thus, people with alcohol dependence often are stigmatized and have a higher chance of becoming unemployed and destitute; as a result, they tend to live in more crowded quarters with higher chances for infection and lower chances of recovery ( Lönnroth et al. 2009 ).

The relationship between alcohol consumption and HIV infection and acquired immunodeficiency syndrome (AIDS) is different from that with other infectious diseases. To become infected with HIV, people must exchange body fluids, in most cases either by injecting drugs with a contaminated needle or, more commonly in low-income societies, engaging in unsafe sex. Thus, although significant associations exist between alcohol use, especially heavy drinking, and HIV infection via alcohol’s general effects on the immune system ( Baliunas et al. 2010 ; Kalichman et al. 2007 ; Shuper et al. 2009 , 2010 ), it cannot be excluded that other variables, including personality characteristics, psychiatric disorders, and situational factors may be responsible for both risky drinking and unsafe sex ( Shuper et al. 2010 ). Researchers frequently have pointed out that personality characteristics, such as a propensity for risk-taking, sensation-seeking, and sexual compulsivity, may be involved in the risk of HIV infection. Indeed, a recent consensus meeting determined that there is not yet sufficient evidence to conclude that alcohol has a causal impact on HIV infection ( Parry et al. 2009 ). However, it can be argued that experimental studies in which alcohol consumption led to a greater inclination to engage in unsafe sex indicate that some causal relationship between alcohol and HIV infection exists (e.g., George et al. 2009 ; Norris et al. 2009 ).

Once a person is infected with HIV, alcohol clearly has a detrimental impact on the course of the disease, especially by interfering with effective antiretroviral treatment ( Pandrea et al. 2010 ). A recent meta-analysis found that problem drinking—defined as meeting the National Institute on Alcohol Abuse and Alcoholism (NIAAA)’s criteria for at-risk drinking or having an AUD—was associated with being less than half as likely to adhere to antiretroviral treatment guidelines ( Hendershot et al. 2009 ). Because the level of adherence to the treatment regimen affects treatment success as well as outright survival, alcohol consumption clearly is associated with negative outcomes for people living with HIV and AIDS.

Recently, the Monograph Working Group of the International Agency for Research on Cancer concluded that there was sufficient evidence for the carcinogenicity of alcohol in animals and classified alcoholic beverages as carcinogenic to humans ( Baan et al. 2007 ). In particular, the group confirmed, or newly established, the causal link between alcohol consumption and cancer of the oral cavity, pharynx, larynx, esophagus, liver, colorectum, and female breast. For stomach and lung cancer, carcinogenicity was judged as possible but not established. For all sites where alcohol’s causal role in cancer is established, there is evidence of a dose-response relationship, with relative risk rising linearly with an increasing volume of alcohol consumption ( Corrao et al. 2004 ).

The molecular and biochemical mechanisms by which chronic alcohol consumption leads to the development of cancers of various organs are not fully understood. It has been suggested that these mechanisms differ by target organ and include variations (i.e., polymorphisms) in genes encoding enzymes responsible for ethanol metabolism (e.g., alcohol dehydrogenase, aldehyde dehydrogenase, and cytochrome P450 2E1), increased estrogen concentrations, and changes in folate metabolism and DNA repair ( Boffetta and Hashibe 2006 ; Seitz and Becker 2007 ). In addition, the International Agency for Research on Cancer group concluded that acetaldehyde—which is produced when the body breaks down (i.e., metabolizes) beverage alcohol (i.e., ethanol) but also is ingested as a component of alcoholic beverages— itself is carcinogenic. It likely plays an important role in the development of cancers of the digestive tract, especially those of the upper digestive tract ( Lachenmeier et al. 2009 ; Seitz and Becker 2007 ).

The relationship between alcohol consumption and diabetes is complex. A curvilinear relationship exists between the average volume of alcohol consumption and the inception of diabetes ( Baliunas et al. 2009 )—that is, lower alcohol consumption levels have a protective effect, whereas higher consumption is associated with an increased risk. The greatest protective effect has been found with a consumption of about two standard drinks (28 grams of pure alcohol) per day, and a net detrimental effect has been found starting at about four standard drinks (50 to 60 grams of pure alcohol) per day.

Neuropsychiatric Disorders

With respect to neuropsychiatric disorders, alcohol consumption has by far the greatest impact on risk for alcohol dependence. However, alcohol also has been associated with basically all mental disorders (e.g., Kessler et al. 1997 ), although the causality of these associations is not clear. Thus, mental disorders may be caused by AUDs or alcohol use, AUDs may be caused by other mental disorders, or third variables may be causing both AUDs and other mental disorders. This complex relationship makes it difficult to determine the fraction of mental disorders actually caused by alcohol consumption (see Grant et al. 2009 ).

The relationship between alcohol and epilepsy is much clearer. There is substantial evidence that alcohol consumption can cause unprovoked seizures, and researchers have identified plausible biological pathways that may underlie this relationship ( Samokhvalov et al. 2010 a ). Most of the relevant studies found that a high percentage of heavy alcohol users with epilepsy meet the criteria of alcohol dependence.

Cardiovascular Diseases

The overall effect of alcohol consumption on the global cardiovascular disease burden is detrimental (see table 2 ). Cardiovascular disease is a general category that includes several specific conditions, and alcohol’s impact differs for the different conditions. For example, the effect of alcohol consumption on hypertension is almost entirely detrimental, with a dose-response relationship that shows a linear increase of the relative risk with increasing consumption ( Taylor et al. 2009 ). A similar dose-response relationship exists between alcohol consumption and the incidence of atrial fibrillation 4 ( Samokhvalov et al. 2010 b ). On the other hand, for heart disease caused by reduced blood supply to the heart (i.e., ischemic heart disease), the association with alcohol consumption is represented by a J-shaped curve ( Corrao et al. 2000 ), with regular light drinking showing some protective effects. Irregular heavy drinking occasions, however, can nullify any protective effect. In a recent systematic review and meta-analysis comparing the effects of different drinking patterns in people with an overall consumption of less than 60 grams of pure alcohol per day, Roerecke and Rehm (2010) found that consumption of 60 grams of pure alcohol on one occasion at least once a month eliminated any protective effect of alcohol consumption on mortality. The authors concluded that the cardio-protective effect of moderate alcohol consumption disappears when light to moderate drinking is mixed with irregular heavy-drinking occasions. These epidemiological results are consistent with the findings of biological studies that—based on alcohol’s effects on blood lipids and blood clotting—also predict beneficial effects of regular moderate drinking but detrimental effects of irregular heavy drinking ( Puddey et al. 1999 ; Rehm et al. 2003 ).

Global Burden of Alcohol-Attributable Disease in Disability-Adjusted Life Years (DALYs) (in 1,000s) by Sex and Disease Category for the Year 2004

NOTE: M = men; W = women; T = total.

SOURCE: Rehm et al. 2009 a,b .

The effects of alcohol consumption on ischemic stroke 5 are similar to those on ischemic heart disease, both in terms of the risk curve and in terms of biological pathways ( Patra et al. 2010 ; Rehm et al. 2010 a ). On the other hand, alcohol consumption mainly has detrimental effects on the risk for hemorrhagic stroke, which are mediated at least in part by alcohol’s impact on hypertension.

Overall, the effects of alcohol consumption on cardiovascular disease are detrimental in all societies with large proportions of heavy-drinking occasions, which is true for most societies globally ( Rehm et al. 2003 a ). This conclusion also is supported by ecological analyses or natural experiments. For example, studies in Lithuania ( Chenet et al. 2001 ) found that cardiovascular deaths increased on weekends, when heavy drinking is more common. Also, when overall consumption was reduced in the former Soviet Union (a country with a high proportion of heavy-drinking occasions) between 1984 and 1994, the death rate from cardiovascular disease declined, indicating that alcohol consumption had an overall detrimental effect on this disease category ( Leon et al. 1997 ).

Diseases of the Liver and Pancreas

Alcohol consumption has marked and specific effects on the liver and pancreas, as evidenced by the existence of disease categories such as alcoholic liver disease, alcoholic liver cirrhosis, and alcohol-induced acute or chronic pancreatitis. For these disease categories, the dose-response functions for relative risk are close to exponential ( Irving et al. 2009 ; Rehm et al. 2010 b ), although the risks associated with light to moderate drinking (i.e., up to 24 grams of pure alcohol per day) are not necessarily different from the risks associated with abstention. Thus, the incidence of diseases of the liver and pancreas is associated primarily with heavy drinking.

It is important to note that given the same amount of drinking, the increase in the risk for mortality from these diseases is greater than the increase in risk for morbidity, especially at lower levels of consumption. This finding suggests that continued alcohol consumption, even in low doses, after the onset of liver or pancreas disease, increases the risk of severe consequences.

Unintentional Injuries

The link between alcohol and almost all kinds of unintentional injuries has long been established. It depends on the blood alcohol concentration (BAC) and shows an exponential dose-response relationship ( Taylor et al. 2010 ). Alcohol affects psychomotor abilities, with a threshold dose for negative effects generally found at BACs of approximately 0.04 to 0.05 percent (which typically are achieved after consuming two to three drinks in an hour); accordingly, injury resulting from alcohol’s disruption of psychomotor function could occur in people with BACs at this level ( Eckardt et al. 1998 ). However, the epidemiological literature shows that even at lower BACs, injury risk is increased compared with no alcohol consumption ( Taylor et al. 2010 ).

The acute effects of alcohol consumption on injury risk are mediated by how regularly the individual drinks. People who drink less frequently are more likely to be injured or to injure others at a given BAC compared with regular drinkers, presumably because of less tolerance ( Gmel et al. 2010 ). This correlation was demonstrated with respect to traffic injuries in a reanalysis ( Hurst et al. 1994 ) of a classic study conducted in Grand Rapids, Michigan ( Borkenstein et al. 1974 ). It also is important to realize that even if the absolute risk for injury may be relatively small for each occasion of moderate drinking (defined as drinking up 36 grams pure alcohol in one sitting), the lifetime risks from such drinking occasions sums up to a considerable risk for those who often drink at such a level ( Taylor et al. 2008 ).

Intentional Injuries

Alcohol consumption is linked not only to unintentional but also to intentional injury. Both average volume of alcohol consumption and the level of drinking before the event have been shown to affect suicide risk ( Borges and Loera 2010 ). There also is a clear link between alcohol consumption and aggression, including, but not limited to, homicides ( Rehm et al. 2003 b ). Several causal pathways have been identified that play a role in this link, including biological pathways acting via alcohol’s effect on receptors for the brain signaling molecules (i.e., neurotransmitters) serotonin and γ-aminobutyric acid or via alcohol’s effects on cognitive functioning ( Rehm et al. 2003 b ). Cultural factors that are related to both differences in drinking patterns and beliefs and expectations about the effects of alcohol also influence the relationship between drinking and aggression ( Bushman and Cooper 1990 ; Graham 2003 ; Leonard 2005 ; Room and Rossow 2001 ).

Implications of Alcohol-Related Risks for Drinking Guidelines

Overall, the various risks associated with alcohol use at various levels can be combined to derive low-risk drinking guidelines. Such analyses found that overall, any increase in drinking beyond one standard drink on average per day is associated with an increased net risk for morbidity and mortality in high-income countries ( Rehm et al. 2009 ). Moreover, at any given consumption level this risk increase is larger for women than for men. NIAAA has translated the epidemiological findings into low-risk drinking limits of no more than 14 standard drinks per week for men and 7 standard drinks per week for women ( NIAAA 2010 ). These guidelines also specify that to limit the risk of acute consequences, daily consumption should not exceed four standard drinks for men and three for women ( NIAAA 2010 ).

Overall Global Impact of Alcohol Consumption on Burden of Disease

The most recent systematic overview on the effects of alcohol on global burden of disease was based on data for the year 2004 ( Rehm et al. 2009 a , b ) (see table 2 ). The analyses found that although AUDs (which constitute the major part of the neuropsychiatric disorders listed in the table) clearly are important contributors to global burden of disease, they only account for less than one-third of the overall impact of alcohol consumption. Almost equally important are the acute effects of alcohol consumption on the risk of both unintentional and intentional injury. In addition, alcohol has a sizable effect on the burden of disease associated with infectious diseases, cancer, cardiovascular disease, and liver cirrhosis. However, alcohol consumption also has beneficial effects on the burden of disease, mainly on diabetes and the ischemic disease subcategory of cardiovascular diseases. Yet these effects are by far outweighed by the detrimental consequences of alcohol consumption.

Effects of Alcohol on People Other Than the Drinker

So far, the discussion has centered on alcohol’s effects on health as measured by indicators that primarily are based on the records of hospitals and health systems. Reflecting the information contained in those records, most of the effects considered refer to the health of the drinker. However, this analytic approach omits two large classes of adverse consequences of alcohol: social harm to the drinker and social and health harms to others that result from the drinker’s alcohol consumption. According to the Constitution of the WHO ( WHO 1946 ), health is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (p. 100); this definition therefore takes into account not just physical and mental harms but also social harms, both for the drinker and for others.

A few examples of harm to others are included in the analysis of alcohol’s contribution to the global burden of disease listed in table 2 . These include perinatal conditions attributable to the mother’s drinking during pregnancy and injuries, particularly assault injuries. However, the scope of alcohol-related social harm and of harm to others stretches well beyond these items. Thus, a recent study in Australia ( Laslett et al. 2010 ) identified the following harms to others associated with drinking:

• Harms identified based on records—these included deaths and hospitalizations (e.g., attributed to traffic injuries because of driving under the influence), child abuse or neglect cases involving a caregiver’s drinking, and domestic and other assaults; and
• Harms based on survey reports—these included negative effects on coworkers, household members, other relatives and friends, strangers, and on the community as a whole.

These effects were quite prevalent. Thus, the researchers estimated that within 1 year, more than 350 deaths were attributed to drinking by others, and more than 10 million Australians (or 70 percent of all adults) were negatively affected by a stranger’s drinking ( Laslett et al. 2010 ).

Social Harm

Drinkers also experience a range of social harms because of their own drinking, including family disruption, problems at the workplace (including unemployment), criminal convictions, and financial problems ( Casswell and Thamarangsi 2009 ; Klingemann and Gmel 2001 ). Unfortunately, assessment of these problems is much less standardized than assessment of health problems, and many of these harms are not reported continuously. Social-cost studies provide irregular updates of alcohol-attributable consequences in selected countries (for an overview, see Rehm et al. 2009 b ; Thavorncharoensap et al. 2009 ). These studies regularly find that health care costs comprise only a small portion of the overall costs associated with alcohol use and that most of the alcohol-associated costs are attributable to productivity losses. In total, the costs associated with alcohol use seem to amount to 1 to 3 percent of the gross domestic product in high-income countries; the alcohol-associated costs in South Korea and Thailand, the only two mid-income countries for which similar studies are available, were at about the same level.

Conclusions

As this review has shown, alcohol use is associated with tremendous costs to the drinker, those around him or her, and society as a whole. These costs result from the increased health risks (both physical and mental) associated with alcohol consumption as well as from the social harms caused by alcohol. To reduce alcohol’s impact on the burden of disease as well as on other social, legal, and monetary costs, it therefore is imperative to develop effective interventions that can prevent or delay initiation of drinking among those who do not drink, particularly adolescents, and limit consumption to low-risk drinking levels among those who do consume alcohol. The remaining articles in this journal issue present several such intervention approaches that are being implemented and evaluated in a variety of settings and/or are targeted at different population subgroups. Together with alcohol-related prevention policies, the implementation of specific interventions with proven effectiveness can help reduce the pain and suffering, and the associated costs, resulting from excessive alcohol use.

Acknowledgments

Financial support for this study was provided by NIAAA contract HHSN267200700041C to conduct the study titled “Alcohol- and Drug-Attributable Burden of Disease and Injury in the U.S.”

The views expressed here do not necessarily reflect the views of the funding agency.

F inancial D isclosure

Jürgen Rehm, Ph.D., received a salary and infrastructure support from the Ontario Ministry of Health and Long-Term Care. No potential conflicts of interest relevant to this article were reported.

1 Ischemic diseases are all conditions that are related to the formation of blood clots, which prevent adequate blood flow to certain tissues.

2 In the United States, a standard drink usually is considered to contain 0.6 fluid ounces (or 14 grams) of pure alcohol. This is the amount of ethanol found in approximately 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of distilled spirits. However, many drinks, as actually poured, contain more alcohol. Thus, for example, a glass of wine often contains more than 5 fluid ounces and therefore may correspond to one and a half or even two standard drinks.

3 The condition referred to as “harmful use” in the ICD–10 loosely corresponds to “alcohol abuse,” as defined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Diseases, 4th Edition (DSM–IV).

4 Atrial fibrillation is an abnormal heart rhythm involving the two upper chambers (i.e., atria) of the heart.

5 A stroke is the disruption of normal blood flow to a brain region. In the case of an ischemic stroke, this is caused by blockage of a blood vessel that prevents the blood from reaching neighboring brain areas. In the case of a hemorrhagic stroke, rupture of a blood vessel and bleeding into the brain occurs, which prevents normal blood supply to other brain regions.

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Understanding alcohol use disorders and their treatment

People with alcohol use disorders drink to excess, endangering both themselves and others. This question-and-answer fact sheet explains alcohol problems and how psychologists can help people recover.

• Substance Use, Abuse, and Addiction

For many people, drinking alcohol is nothing more than a pleasant way to relax. People with alcohol use disorders, however, drink to excess, endangering both themselves and others. This question-and-answer fact sheet explains alcohol problems and how psychologists can help people recover.

When does drinking become a problem?

For most adults, moderate alcohol use — no more than two drinks a day for men and one for women and older people — is relatively harmless. (A "drink" means 1.5 ounces of spirits, 5 ounces of wine, or 12 ounces of beer, all of which contain 0.5 ounces of alcohol.

Moderate use, however, lies at one end of a range that moves through alcohol abuse to alcohol dependence:

Alcohol abuse is a drinking pattern that results in significant and recurrent adverse consequences. Alcohol abusers may fail to fulfill major school, work, or family obligations. They may have drinking-related legal problems, such as repeated arrests for driving while intoxicated. They may have relationship problems related to their drinking.

People with alcoholism — technically known as alcohol dependence — have lost reliable control of their alcohol use. It doesn't matter what kind of alcohol someone drinks or even how much: Alcohol-dependent people are often unable to stop drinking once they start. Alcohol dependence is characterized by tolerance (the need to drink more to achieve the same "high") and withdrawal symptoms if drinking is suddenly stopped. Withdrawal symptoms may include nausea, sweating, restlessness, irritability, tremors, hallucinations and convulsions.

Although severe alcohol problems get the most public attention, even mild to moderate problems cause substantial damage to individuals, their families and the community.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) , 6.2 percent of adults in the United States aged 18 and older had alcohol use disorder. 1 For example, a government survey revealed that about one in five individuals aged 12 to 20 were current alcohol users and about two in five young adults, aged 18 to 25, were binge alcohol users and about one in 10 were heavy alcohol users. 2

What causes alcohol-related disorders?

Problem drinking has multiple causes, with genetic, physiological, psychological,and social factors all playing a role. Not every individual is equally affected by each cause. For some alcohol abusers, psychological traits such as impulsiveness, low self-esteem and a need for approval prompt inappropriate drinking. Some individuals drink to cope with or "medicate" emotional problems. Social and environmental factors such as peer pressure and the easy availability of alcohol can play key roles. Poverty and physical or sexual abuse also increase the odds of developing alcohol dependence.

Genetic factors make some people especially vulnerable to alcohol dependence. Contrary to myth, being able to "hold your liquor" means you're probably more at risk — not less — for alcohol problems. Yet a family history of alcohol problems doesn't mean that children will automatically grow up to have the same problems. Nor does the absence of family drinking problems necessarily protect children from developing these problems.

Once people begin drinking excessively, the problem can perpetuate itself. Heavy drinking can cause physiological changes that make more drinking the only way to avoid discomfort. Individuals with alcohol dependence may drink partly to reduce or avoid withdrawal symptoms.

How do alcohol use disorders affect people?

While some research suggests that small amounts of alcohol may have beneficial cardiovascular effects, there is widespread agreement that heavier drinking can lead to health problems.

Short-term effects include memory loss, hangovers, and blackouts. Long-term problems associated with heavy drinking include stomach ailments, heart problems, cancer, brain damage, serious memory loss and liver cirrhosis. Heavy drinkers also markedly increase their chances of dying from automobile accidents, homicide, and suicide. Although men are much more likely than women to develop alcoholism, women's health suffers more, even at lower levels of consumption.

Drinking problems also have a very negative impact on mental health. Alcohol abuse and alcoholism can worsen existing conditions such as depression or induce new problems such as serious memory loss, depression or anxiety.

Alcohol problems don't just hurt the drinker. Spouses and children of heavy drinkers may face family violence; children may suffer physical and sexual abuse and neglect and develop psychological problems. Women who drink during pregnancy run a serious risk of damaging their fetuses. Relatives, friends and strangers can be injured or killed in alcohol-related accidents and assaults.

When should someone seek help?

Individuals often hide their drinking or deny they have a problem. How can you tell if you or someone you know is in trouble? Signs of a possible problem include having friends or relatives express concern, being annoyed when people criticize your drinking, feeling guilty about your drinking and thinking that you should cut down but finding yourself unable to do so, or needing a morning drink to steady your nerves or relieve a hangover.

Some people with drinking problems work hard to resolve them. With the support of family members or friends, these individuals are often able to recover on their own. However, those with alcohol dependence usually can't stop drinking through willpower alone. Many need outside help. They may need medically supervised detoxification to avoid potentially life-threatening withdrawal symptoms, such as seizures. Once people are stabilized, they may need help resolving psychological issues associated with problem drinking.

There are several approaches available for treating alcohol problems. No one approach is best for all individuals.

How can a psychologist help?

Psychologists who are trained and experienced in treating alcohol problems can be helpful in many ways. Before the drinker seeks assistance, a psychologist can guide the family or others in helping to increase the drinker's motivation to change.

A psychologist can begin with the drinker by assessing the types and degrees of problems the drinker has experienced. The results of the assessment can offer initial guidance to the drinker about what treatment to seek and help motivate the problem drinker to get treatment. Individuals with drinking problems improve their chances of recovery by seeking help early.

Using one or more of several types of psychological therapies, psychologists can help people address psychological issues involved in their problem drinking. A number of these therapies, including cognitive-behavioral coping skills treatment and motivational enhancement therapy, were developed by psychologists. Additional therapies include 12-Step facilitation approaches that assist those with drinking problems in using self-help programs such as Alcoholics Anonymous (AA).

These therapies can help people boost their motivation to stop drinking, identify circumstances that trigger drinking, learn new methods to cope with high-risk drinking situations, and develop social support systems within their own communities.

All three of these therapies have demonstrated their effectiveness. One analysis  of cognitive-behavioral approaches, for instance, found that 58 percent of patients receiving cognitive-behavioral treatment fared better than those in comparison groups. 3 In another study , motivational interventions reduced how often and how much adolescents drank following alcohol-related emergency room treatment. 4 And an intervention called Making Alcoholics Anonymous Easier significantly increased participants' odds of abstaining from alcohol. 5 Many individuals with alcohol problems suffer from other mental health conditions, such as severe anxiety and depression, at the same time. Psychologists can also diagnose and treat these "co-occurring" psychological conditions. Further, a psychologist may play an important role in coordinating the services a drinker in treatment receives from various health professionals.

Psychologists can also provide marital, family, and group therapies, which often are helpful for repairing interpersonal relationships and for resolving problem drinking over the long term. Family relationships influence drinking behavior, and these relationships often change during an individual's recovery. The psychologist can help the drinker and significant others navigate these complex transitions, help families understand problem drinking and learn how to support family members in recovery, and refer family members to self-help groups such as Al-Anon and Alateen.

Because a person may experience one or more relapses and return to problem drinking, it can be crucial to have a trusted psychologist or other health professional with whom that person can discuss and learn from these events. If the drinker is unable to resolve alcohol problems fully, a psychologist can help with reducing alcohol use and minimizing problems.

Psychologists can also provide referrals to self-help groups. Even after formal treatment ends, many people seek additional support through continued involvement in such groups.

Alcohol-related disorders severely impair functioning and health. But the prospects for successful long-term problem resolution are good for people who seek help from appropriate sources.

The American Psychological Association gratefully acknowledge the assistance of Peter E. Nathan, PhD, John Wallace, PhD, Joan Zweben, PhD, and A. Thomas Horvath, PhD, in developing this fact sheet . 

1 National Institute on Alcohol Abuse and Alcoholism. (2018). "Alcohol Use Disorder."

2 Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/

3 Magill, M., & Ray, L.A. (2009). "Cognitive-behavioral treatment with adult alcohol and illicit drug users: A meta-analysis of randomized controlled trials." Journal of Studies on Alcohol and Drugs, 70 (4): 516-527.

4 Spirito, A., Sindelar-Manning, H., Colby, S.M., Barnett, N.P., Lewander, W., Rohsenow, D.J., & et al. (2011). "Individual and family motivational interventions for alcohol-positive adolescents treated in an emergency department." Archives of Pediatrics and Adolescent Medicine, 165 (3): 269-274.

5 Kaskutas, L.A., Subbaraman, M.S., Witbrodt, J., & Zemore, S.E. (2009). "Effectiveness of Making Alcoholics Anonymous Easier: A group format 12-step facilitation approach." Journal of Substance Abuse Treatment, 37 (3): 228-239.

Updated Sept. 2018

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Does Alcohol Dehydrate You? (And What You Can Do About It)

• How It Causes Dehydration
• Alcohol's Other Effects
• If Dehydrated
• Counteracting Dehydration
• Other Dehydration Causes

When you drink alcohol, you are adding fluid to your body, but the chemical properties of alcoholic drinks can have unintended effects on your body. Alcohol can trigger diuresis (increased urine output), leading to dehydration and other bodily imbalances, all of which can contribute to hangover symptoms.

Vuk Saric / Getty Images

Why Does Alcohol Cause Dehydration?

Alcohol acts as a diuretic.

Alcohol works as a diuretic in your body, increasing urine output. It suppresses the action of vasopressin—a hormone that helps regulate the fluid balance in your body. Vasopressin sends signals from your brain to your kidneys to dictate how much fluid is removed from your body as urine. When this hormone is suppressed, your kidneys remove extra fluids by increasing urination .

Alcohol Alters Electrolytes

In addition to water loss, drinking alcohol can also lead to electrolyte imbalance—especially sodium. Alcohol consumption lowers your  sodium levels, primarily because of low solute (protein and salt) intake as compared to free water intake. Under normal conditions, the kidneys require solute to excrete free water. In the absence of adequate amounts of solute, kidneys hang on to more free water, thereby diluting the sodium concentration in the blood.

You Are Drinking on an Empty Stomach

Any foods or fluids you consume before drinking alcohol help to dilute it, so when you drink alcohol on an empty stomach, alcohol's effects are more potent. You may feel the effects of the alcohol sooner, but it can also amplify other effects, including dehydration.

Drinking on an empty stomach can cause other long-term damage, particularly to the liver . Your liver is responsible for metabolizing alcohol, and heavy drinking over long periods can lead to irreversible damage.

Alcohol Builds Up in Your Bloodstream

As you drink alcohol, it accumulates in your body—especially if you drink large amounts at a fast pace. The higher your blood alcohol level is, the more you will notice its effects.

Below are examples of functional changes you might notice at different levels of intoxication.

• 0.02% blood alcohol level : Relaxation, altered mood, increased body temperature, and reduced cognition
• 0.05% blood alcohol level : Exaggerated behaviors, loss of small muscle control, exaggerated gestures, and an inability to focus your vision
• 0.08% blood alcohol level :   Loss of coordination, decreased balance, speech changes, and slower reaction times
• 0.10% blood alcohol level : Reduced reaction time and physical control, slurred speech, decreased thought and reasoning skills, poor concentration, and decreased physical coordination
• 0.15% blood alcohol level :   Severe loss of control over body movements, balance, and coordination
• 0.20–0.29% blood alcohol level :   Confusion, disorientation, nausea and vomiting, memory loss, and reduced pain thresholds
• 0.30–0.39% blood alcohol level :   Possible loss of consciousness, increased risk of death, increased heart rate, irregular breathing, and loss of bladder control
• 0.40% and over :   A lethal blood alcohol concentration that can put you in a coma or even lead to sudden death from changes in your heart rate and breathing

Blood Alcohol Concentration (BAC)

The legal blood alcohol concentration limit in the United States is 0.08%. It's not safe to consume any alcohol and drive, but at this level, driving a vehicle is considered unsafe and illegal, and driving while intoxicated could lead to fines and jail time.

Alcohol Is Slowly Metabolized by the Body

A healthy liver can process about one drink per hour. Drinking more than that—especially with an already damaged liver—can cause alcohol levels to build.

When this happens, the effects of alcohol increase. There is no "safe" level of alcohol in your bloodstream, but there is evidence that side effects increase alongside BAC.

In addition to changes in liver function that can alter your metabolism, alcohol also has effects on other parts of your gut. Less than 10% of the alcohol you drink leaves your body as urine or sweat. The other 90% is absorbed through your digestive system and can lead to issues like:

• Immune dysfunction
• Increased lipid retention ( steatosis )
• Inflammation
• Irritation of the stomach lining
• Pancreatitis

Alcohol’s Components Are Flushed From the Body

You may experience increased urination, sweating, and other means of bodily waste disposal when you drink alcohol. However, when your body works to eliminate alcohol from your system through these processes, other crucial substances, like water and essential nutrients, are removed, too. You can experience water and nutrient depletion, leading to unwanted symptoms such as dehydration .

What Does Alcohol Do to Your Body?

Alcoholic beverages contain ethanol, a toxic substance. Many people consume alcohol for its psychoactive effects. Euphoria, relaxation, and other physical and mental changes are the result of alcohol's impact on your central nervous system.

In addition to the euphoria and relaxation associated with alcohol consumption, alcohol's toxic effects can produce unwanted problems in almost every area of the body. Dehydration is one of these effects, and it alone can have a domino effect on other body systems. For example, severe dehydration—either from alcohol or another cause—can lead to problems such as:

• Acute kidney injury
• Hypovolemic shock and multi-organ damage
• Increased heart rate
• Loss of consciousness
• Reduced urine production

What to Do If You Are Dehydrated

You can usually manage mild cases of dehydration by drinking more fluids that don't contain alcohol. Whether you drink water between each alcoholic drink, after drinking, or even the next day, it's vital to replace lost fluids.

In severe cases of dehydration, drinking water alone may be insufficient. If you are dehydrated to the point that you are experiencing symptoms like weakness or loss of consciousness, you may need intravenous (IV) fluids administered in a healthcare setting.

If you stop making urine, your urine is very dark, or you have symptoms that are bad enough to impact your normal functions, go to an urgent care or emergency room for treatment and fluid replacement.

How to Counteract Alcohol-Induced Dehydration

After consuming a lot of alcohol—and experiencing the dehydration that comes with it—it's very possible that you experience a post-alcohol disorder known as a hangover.

A hangover is a collection of symptoms that you experience as a result of the effects alcohol has on your body. Dehydration, toxic chemicals, fluid and electrolyte imbalances, and more can all contribute to the development of a hangover.

Drinking water alongside alcohol, eating before you start drinking, and drinking water and solute, especially protein, after consuming alcohol can help lessen these effects, but it will not prevent them entirely.

Other Possible Causes of Dehydration

Drinking alcohol is not the only thing that can cause dehydration . It can result from factors such as the following:

• Certain chronic diseases like diabetes
• Certain medications
• Excessive heat
• Inadequate fluid intake
• Intense physical activity
• Skin conditions

Dehydration can happen for many reasons, including alcohol consumption. Alcohol can cause increased urination, increased heart rate or body heat, vomiting, and other issues that can increase dehydration. Avoiding alcohol is the best way to prevent this problem, but if you do drink alcohol, be sure to also drink extra water with solutes such as protein.

Sailer CO, Refardt J, Bissig S, et al. Effects of alcohol consumption on copeptin levels and sodium-water homeostasis . Renal Physiology . 2020. doi:10.1152/ajprenal.00458.2019.

National Institutes of Health. Diuresis .

National Institute on Alcohol Abuse and Alcoholism. Alcohol's effect on health: hangovers .

Cuzzo B, Padala SA, Lappin SL. Physiology, vasopressin. StatPearls . August 2023. PMID: 30252325.

Lewis III, JL. Overview of sodium's role in the body . Merck Manuals . 2023.

Baj J, Flieger W, Teresiński G, Buszewicz G, Sitarz R, Forma A, Karakuła K, Maciejewski R. Magnesium, calcium, potassium, sodium, phosphorus, selenium, zinc, and chromium levels in alcohol use disorder: a review .  Journal of Clinical Medicine . 2020; 9(6):1901. doi:10.3390/jcm9061901

Ali Samjo S, Abbas Z, Asim M, Tahir K. The pattern of alcohol consumption and the severity of alcohol-related liver disease in patients visiting the liver clinic .  Cureus . March 2020;12(3):e7251. doi:10.7759/cureus.7251

Alcohol.org. Blood alcohol concentration levels and how they affect the body .

Hyun J, Han J, Lee C, Yoon M, Jung Y. Pathophysiological aspects of alcohol metabolism in the liver .  International Journal of Molecular Sciences . 2021; 22(11):5717. doi:10.3390/ijms22115717

World Health Organization. Alcohol .

National Institutes of Health. Hydrating for health: why drinking water is so important .

Taghavi S, Nassar Ak, Askari R. Hypovolemic shock.   StatPearls . January 2024.

Harvard Health Publishing. Symptoms of dehydration: what they are and what to do if you experience them .

American Red Cross. Dehydration .

Cedars-Sinai. The science of hangovers .

MedlinePlus. Dehydration .

By Rachael Zimlich, BSN, RN Zimlich is a critical care nurse who has been writing about health care and clinical developments for over 10 years.

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Alcohol Ups Gout Risk in Both Sexes, More Strongly for Men

Edited by Shrabasti Bhattacharya

September 09, 2024

A higher alcohol consumption is associated with an increased risk for gout, more strongly in men than in women. This sex-specific difference may be attributed to the different types of alcohol consumed by men and women, rather than biologic variations.

METHODOLOGY:

• This prospective cohort study investigated the association between total and specific alcohol consumption and the long-term risk for incident gout in 179,828 men (mean age, 56.0 years) and 221,300 women (mean age, 56.0 years) from the UK Biobank who did not have gout at baseline.
• Alcohol consumption was assessed using a computer-assisted touch screen system. Among men, 2.9%, 3.6%, and 93.6% were identified as never, former, and current drinkers, respectively. Among women, 5.9%, 3.6%, and 90.5% were identified as never, former, and current drinkers, respectively.
• Participants were also required to share details about their weekly alcohol intake and the types of alcoholic beverages they consumed (red wine, champagne or white wine, beer or cider, spirits, or fortified wine).
• The median follow-up duration of this study was 12.7 years.
• Cases of incident gout during the follow-up period were identified using hospital records and the International Classification of Diseases codes.
• The risk for gout was 69% higher in men who were current drinkers than in those who were never drinkers (hazard ratio [HR], 1.69; 95% CI, 1.30-2.18), while an inverse association was observed in women who were current drinkers, although it was not statistically significant. A significant interaction was observed between drinking status and sex ( P < .001 for interaction).
• Among current drinkers, more frequent alcohol consumption was associated with a higher risk for gout among both sexes, with the association being stronger in men (HR, 2.05; 95% CI, 1.84-2.30) than in women (HR, 1.34; 95% CI, 1.12-1.61).
• The consumption of beer or cider was higher in men than in women (4.2 vs 0.4 pints/wk).
• Among all alcoholic beverages, the consumption of beer or cider (per 1 pint/d) showed the strongest association with the risk for gout in both men (HR, 1.60; 95% CI, 1.53-1.67) and women (HR, 1.62; 95% CI, 1.02-2.57).

IN PRACTICE:

"The observed sex-specific difference in the association of total alcohol consumption with incident gout may be owing to differences between men and women in the types of alcohol consumed rather than biological differences," the authors wrote.

The study was led by Jie-Qiong Lyu, MPH, Department of Nutrition and Food Hygiene, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China. It was published online on August 28, 2024, in JAMA Network Open .

LIMITATIONS:

The frequency of alcohol consumption was self-reported, leading to potential misclassification. Incident cases of gout were identified from hospital records, which may have caused some undiagnosed cases or those diagnosed only in primary care settings to be missed. Most participants were of European descent and relatively healthier than the general population, limiting generalizability.

DISCLOSURES:

This work was supported by the Gusu Leading Talent Plan for Scientific and Technological Innovation and Entrepreneurship. The authors declared no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

Send comments and news tips to [email protected] .

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Home — Essay Samples — Life — Driving — The Dangers and Consequences Of Drinking And Driving

The Dangers and Consequences of Drinking and Driving

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Published: Mar 25, 2024

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Aggressive driving is a dangerous behavior that poses significant risks to both drivers and the general public. This essay presents a compelling argument against aggressive driving, advocating for its avoidance and exploring the [...]

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