Alcohol
Alcohol Use Disorder
Problem drinking that becomes severe is given the medical diagnosis of “alcohol use disorder” or AUD. Approximately 7.2 percent or 17 million adults in the United States ages 18 and older had an AUD in 2012. This includes 11.2 million men and 5.7 million women. Adolescents can be diagnosed with an AUD as well, and in 2012, an estimated 855,000 adolescents ages 12–17 had an AUD.
To be diagnosed with an AUD, individuals must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Under DSM–5, the current version of the DSM, anyone meeting any two of the 11 criteria during the same 12-month period receives a diagnosis of AUD. The severity of an AUD—mild, moderate, or severe—is based on the number of criteria met.
To assess whether you or loved one may have an AUD, here are some questions to ask. In the past year, have you:
- Had times when you ended up drinking more, or longer than you intended?
- More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
- Spent a lot of time drinking? Or being sick or getting over the aftereffects?
- Experienced craving — a strong need, or urge, to drink?
- Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
- Continued to drink even though it was causing trouble with your family or friends?
- Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
- More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
- Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
- Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
- Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?
If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more urgent the need for change. A health professional can conduct a formal assessment of your symptoms to see if an alcohol use disorder is present.
However severe the problem may seem, most people with an alcohol use disorder can benefit from treatment. Unfortunately, only of a fraction of people who could benefit from treatment receive help. In 2012, for example, 1.4 million adults received treatment for an AUD at a specialized facility (8.4 percent of adults in need). This included 416,000 women (7.3 percent of women in need) and 1.0 million men (8.9 percent of men in need).
Some Important Points Regarding Treatment for Alcohol Problems
- Research shows that most people who have alcohol problems are able to reduce their drinking or quit entirely.
- There are many roads to getting better. What is important is finding yours.
- Understanding the available treatment options is the first step.
- The important thing is to remain engaged in whatever method you choose.
- Ultimately, receiving treatment can improve your chances of success.
- Recovery is an Ongoing Process
- Overcoming an alcohol use disorder is an ongoing process, one which can include setbacks.
The Importance of Persistence
Because an alcohol use disorder can be a chronic relapsing disease, persistence is key. It is rare that someone would go to treatment once and then never drink again. More often, people must repeatedly try to quit or cut back, experience recurrences, learn from them, and then keep trying. For many, continued followup with a treatment provider is critical to overcoming problem drinking.
Relapse Is Part of the Process
Relapse is common among people who overcome alcohol problems. People with drinking problems are most likely to relapse during periods of stress or when exposed to people or places associated with past drinking.
Just as some people with diabetes or asthma may have flare-ups of their disease, a relapse to drinking can be seen as a temporary set-back to full recovery and not a complete failure. Seeking professional help can prevent relapse — behavioral therapies can help people develop skills to avoid and overcome triggers, such as stress, that might lead to drinking. Most people benefit from regular checkups with a treatment provider. Medications also can deter drinking during times when individuals may be at greater risk of relapse (e.g., divorce, death of a family member).
Mental Health Issues and Alcohol Use Disorder
Depression and anxiety often go hand in hand with heavy drinking. Studies show that people who are alcohol dependent are two to three times as likely to suffer from major depression or anxiety over their lifetime. When addressing drinking problems, it’s important to also seek treatment for any accompanying medical and mental health issues.
Advice For Friends and Family Members
Caring for a person who has problems with alcohol can be very stressful. It is important that as you try to help your loved one, you find a way to take care of yourself as well. It may help to seek support from others, including friends, family, community, and support groups. If you are developing your own symptoms of depression or anxiety, think about seeking professional help for yourself. Remember that your loved one is ultimately responsible for managing his or her illness.
However, your participation can make a big difference. Based on clinical experience, many health providers believe that support from friends and family members is important in overcoming alcohol problems. But friends and family may feel unsure about how best to provide the support needed. The groups for family and friends listed below under Resources may be a good starting point.
Remember that changing deep habits is hard, takes time, and requires repeated efforts. We usually experience failures along the way, learn from them, and then keep going. Alcohol use disorders are no different. Try to be patient with your loved one. Overcoming this disorder is not easy or quick.
Pay attention to your loved one when he or she is doing better or simply making an effort. Too often we are so angry or discouraged that we take it for granted when things are going better. A word of appreciation or acknowledgement of a success can go a long way.
Getting Professional Help
Ultimately, receiving treatment can improve an individual’s chances of success in overcoming an AUD. Talk with your doctor to determine the best course of action for you and see Rethinking Drinking and Treatment for Alcohol Problems: Finding and Getting Help for more information.
Your doctor. Primary care and mental health practitioners can provide effective alcoholism treatment by combining new medications with brief counseling visits. To aid clinicians, NIAAA has developed two guides: Helping Patients Who Drink Too Much, and for younger patients, Alcohol Screening and Brief Interventions for Youth: A Practitioner’s Guide. Both are available at www.niaaa.nih.gov/publications/clinical-guides-and-manuals
Specialists in alcohol use disorders. For specialty addiction treatment options, contact your doctor, health insurance plan, or the Cordico EAP. Other resources include:
Medical and non-medical addiction specialists
American Academy of Addiction Psychiatry
www.aaap.org
401–524–3076
American Psychological Association
www.apa.org
1–800–964–2000 (ask for your State’s referral number to find psychologists with addiction specialties)
American Society of Addiction Medicine
www.asam.org
301–656–3920 (ask for the phone number of your State’s chapter)
NAADAC Substance Abuse Professionals
www.naadac.org
1–800–548–0497
National Association of Social Workers
www.helpstartshere.org (search for social workers with addiction specialties)
Treatment facilities
Substance Abuse Treatment Facility Locator
www.findtreatment.samhsa.gov
1–800–662–HELP
Mutual-support groups
Alcoholics Anonymous (AA)
www.aa.org
212–870–3400 or check your local phone directory under “Alcoholism”
Moderation Management
www.moderation.org
212–871–0974
Secular Organizations for Sobriety
www.sossobriety.org
323–666–4295
SMART Recovery
www.smartrecovery.org
440–951–5357
Women for Sobriety
www.womenforsobriety.org
215–536–8026
Groups for family and friends
Al-Anon Family Groups
www.al-anon.alateen.org
1–888–425–2666 for meetings
Adult Children of Alcoholics
www.adultchildren.org
310–534–1815
Information resources
National Institute on Alcohol Abuse and Alcoholism
www.niaaa.nih.gov
301–443–3860
National Institute on Drug Abuse
www.nida.nih.gov
301–443–1124
National Institute of Mental Health
www.nimh.nih.gov
1–866–615–6464
National Clearinghouse for Alcohol and Drug Information
www.samhsa.gov
1–800–729–6686
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.
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 days.
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.
Alcohol Use in the United States
Prevalence of Drinking: In 2014, 87.6 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime; 71.0 percent reported that they drank in the past year; 56.9 percent reported that they drank in the past month.
Prevalence of Binge Drinking and Heavy Drinking: In 2014, 24.7 percent of people ages 18 or older reported that they engaged in binge drinking in the past month; 6.7 percent reported that they engaged in heavy drinking in the past month.
Alcohol Use Disorder (AUD) in the United States
Adults (ages 18+): 16.3 million adults ages 18 and older (6.8 percent of this age group had an AUD in 2014). This includes 10.6 million men (9.2 percent of men in this age group) and 5.7 million women (4.6 percent of women in this age group).
About 1.5 million adults received treatment for an AUD at a specialized facility in 2014 (8.9 percent of adults who needed treatment) . This included 1.1 million men (9.8 percent of men in need) and 431,000 women (7.4 percent of women who needed treatment) .
Youth (ages 12–17): In 2014, an estimated 679,000 adolescents ages 12–17 (2.7 percent of this age group) had an AUD. This number includes 367,000 females6 (3.0 percent of females in this age group) and 311,000 males (2.5 percent of males in this age group) .
An estimated 55,000 adolescents (18,000 males and 37,000 females) received treatment for an alcohol problem in a specialized facility in 2014.
Alcohol-Related Deaths
Nearly 88,0009 people (approximately 62,000 men and 26,000 women ) die from alcohol-related causes annually, making alcohol the fourth leading preventable cause of death in the United States.
In 2014, alcohol-impaired driving fatalities accounted for 9,967 deaths (31 percent of overall driving fatalities).
Economic Burden
In 2010, alcohol misuse problems cost the United States $249.0 billion.
Three-quarters of the total cost of alcohol misuse is related to binge drinking.
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.
Alcohol contributes to over 200 diseases and injury-related health conditions, most notably alcohol dependence, liver cirrhosis, cancers, and injuries. In 2012, 5.1 percent of the burden of disease and injury worldwide (139 million disability-adjusted life-years) was attributable to alcohol consumption.
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. In the age group 20–39 years, approximately 25 percent of the total deaths are alcohol attributable.
Family Consequences
More than 10 percent of U.S. children live with a parent with alcohol problems, according to a 2012 study.
Underage Drinking
Prevalence of Underage Alcohol Use:
Prevalence of Drinking: According to the 2014 National Survey on Drug Use and Health (NSDUH), 34.7 percent of 15-year-olds report that they have had at least 1 drink in their lives. About 8.7 million people ages 12–2019 (22.8 percent of this age group ) reported drinking alcohol in the past month (23 percent of males and 22.5 percent of females ).
Prevalence of Binge Drinking: According to the 2014 NSDUH, approximately 5.3 million people (about 13.8 percent ) ages 12–20 were binge drinkers (15.8 percent of males and 12.4 percent of females ).
Prevalence of Heavy Drinking: According to the 2014 NSDUH, approximately 1.3 million people (about 3.4 percent ) ages 12–20 were heavy drinkers (4.6 percent of males and 2.7 percent of females ).
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.
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.
More recent reports from specific U.S. sites report the prevalence of FAS to be 2 to 7 cases per 1,000, and the prevalence of Fetal Alcohol Spectrum Disorders (FASD) to be as high as 20 to 50 cases per 1,000.
Alcohol and the Human Body
In 2013, of the 72,559 liver disease deaths among individuals aged 12 and older, 45.8 percent involved alcohol. Among males, 48.5 percent of the 46,568 liver disease deaths involved alcohol. Among females, 41.8 percent of the 25,991 liver disease deaths involved alcohol.
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.
In 2009, alcohol-related liver disease was the primary cause of almost 1 in 3 liver transplants in the United States.
Drinking alcohol increases the risk of cancers of the mouth, esophagus, pharynx, larynx, liver, and breast.
Drinking too much – on a single occasion or over time – can take a serious toll on your health. Here’s how alcohol can affect your body:
Brain:
Alcohol interferes with the brain’s communication pathways, and can affect the way the brain looks and works. These disruptions can change mood and behavior, and make it harder to think clearly and move with coordination.
Heart:
Drinking a lot over a long time or too much on a single occasion can damage the heart, causing problems including:
Cardiomyopathy – Stretching and drooping of heart muscle
Arrhythmias – Irregular heart beat
Stroke
High blood pressure
Research also shows that drinking moderate amounts of alcohol may protect healthy adults from developing coronary heart disease.
Liver:
Heavy drinking takes a toll on the liver, and can lead to a variety of problems and liver inflammations including:
- Steatosis, or fatty liver
- Alcoholic hepatitis
- Fibrosis
- CirrhosisPancreas:
Alcohol causes the pancreas to produce toxic substances that can eventually lead to pancreatitis, a dangerous inflammation and swelling of the blood vessels in the pancreas that prevents proper digestion.
Cancer:
Drinking too much alcohol can increase your risk of developing certain cancers, including cancers of the:
Mouth
Esophagus
Throat
Liver
Breast
Immune System:
Drinking too much can weaken your immune system, making your body a much easier target for disease. Chronic drinkers are more liable to contract diseases like pneumonia and tuberculosis than people who do not drink too much. Drinking a lot on a single occasion slows your body’s ability to ward off infections – even up to 24 hours after getting drunk.
Learn more about alcohol’s effects on the body.
Possible Health Benefits of Moderate Alcohol Consumption
Moderate alcohol consumption, according to the 2015–2020 Dietary Guidelines for Americans, is up to 1 drink per day for women and up to 2 drinks per day for men.
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.
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.
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.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.
References
For more information, please visit: www.niaaa.nih.gov
1 Substance Abuse and Mental Health Services Administration (SAMHSA). 2014 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, 2013 and 2014. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab2-41b
2 Substance Abuse and Mental Health Services Administration (SAMHSA). 2014 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, 2013 and 2014. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab2-46b
3 Substance Abuse and Mental Health Services Administration (SAMHSA). 2014 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, 2013 and 2014. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab5-8a
4 Substance Abuse and Mental Health Services Administration (SAMHSA). 2014 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, 2013 and 2014. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab5-8b
5 Substance Abuse and Mental Health Services Administration (SAMHSA). 2014 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, 2013 and 2014. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab5-49a
6 Substance Abuse and Mental Health Services Administration (SAMHSA). 2014 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, 2013 and 2014. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab5-5a
7 Substance Abuse and Mental Health Services Administration (SAMHSA). 2014 National Survey on Drug Use and Health (NSDUH). Table 5.5B—Substance dependence or abuse in the past year among persons aged 12 to 17, by demographic characteristics: Percentages, 2013 and 2014. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab5-5b
8 Substance Abuse and Mental Health Services Administration (SAMHSA). 2014 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, 2013 and 2014. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab5-29a
9 Centers for Disease Control and Prevention (CDC). Alcohol and public health: Alcohol-related disease impact (ARDI). Available at: http://nccd.cdc.gov/DPH_ARDI/Default/Report.aspx?T=AAM&P=f6d7eda7-036e-4553-9968-9b17ffad620e&R=d7a9b303-48e9-4440-bf47-070a4827e1fd&M=AD96A9C1-285A-44D2-B76D-BA2AE037FC56&F=&D=
10 Stahre, M.; Roeber, J.; Kanny, D.; et al. Contribution of excessive alcohol consumption to deaths and years of potential life lost in the United States. Preventing Chronic Disease 11:E109, 2014. PMID: 24967831
11 National Center for Statistics and Analysis. (2015, November). 2014 Crash Data Key Findings (Traffic Safety Facts Crash Stats. Report No. DOT HS 812 219). Washington, DC: National Highway Traffic Safety Administration. Available at: http://www-nrd.nhtsa.dot.gov/Pubs/812219.pdf
12 Sacks, J.J.; Gonzales, K.R.; Bouchery, E.E.; et al. 2010 national and state costs of excessive alcohol consumption. American Journal of Preventive Medicine 49(5):e73–e79, 2015. PMID: 26477807
13 World Health Organization (WHO). 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 (WHO). 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 World Health Organization (WHO). Alcohol. 2015. Available at: http://www.who.int/mediacentre/factsheets/fs349/en/#. Accessed 1/14/2016
17 Substance Abuse and Mental Health Services Administration (SAMHSA). Data spotlight: More than 7 Million Children Live with a Parent with Alcohol Problems, 2012. Available at: http://media.samhsa.gov/data/spotlight/Spot061ChildrenOfAlcoholics2012.pdf
18 Substance Abuse and Mental Health Services Administration (SAMHSA). 2014 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, 2013 and 2014. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab2-15b
19 Substance Abuse and Mental Health Services Administration (SAMHSA). 2014 National Survey on Drug Use and Health (NSDUH). Table 2.15A – Alcohol use in lifetime, past year, and past month, by detailed age category: Numbers in thousands, 2013 and 2014. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab2-15a
20 Substance Abuse and Mental Health Services Administration (SAMHSA). Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf
21 Substance Abuse and Mental Health Services Administration (SAMHSA). Results from the 2013 National Survey on Drug Use and Health: Summary of national findings. (Section 3.2) Available at: http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.htm#3.2
22 Substance Abuse and Mental Health Services Administration (SAMHSA). 2014 National Survey on Drug Use and Health (NSDUH). Table 2.16A—Alcohol use, binge alcohol use, and heavy alcohol use in the past month, by detailed age category: Numbers in thousands, 2013 and 2014. http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab2-16a
23 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
24 Substance Abuse and Mental Health Services Administration (SAMHSA). 2014 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, 2013 and 2014. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab6-88b
25 Substance Abuse and Mental Health Services Administration (SAMHSA). 2014 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, 2013 and 2014. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab6-89b
26 Substance Abuse and Mental Health Services Administration (SAMHSA). 2014 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, 2013 and 2014. Available at: http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab6-90b
27 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
28 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
29 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 Psychiatry65(12):1429–1437, 2008. PMID: 19047530
30 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
31 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.
32 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
33 May, P.A.; Keaster, C.; Bozeman, R.; et al. Prevalence and characteristics of fetal alcohol syndrome and partial fetal alcohol syndrome in a Rocky Mountain Region City. Drug Alcohol Dependence 155:118–127, 2015. PMID: 26321671
34 Liver disease deaths include deaths with the underlying cause of death coded as alcoholic liver disease (K70), liver cirrhosis, unspecified (K74.3–K74.6, K76.0, K76.9), liver cancer (C22), or other liver diseases (K71, K72, K73, K74.0–K74.2, K75, and K76.1–K76.8). Number of deaths from Multiple Cause of Death Public-Use Data File, 2013 (http://wonder.cdc.gov/mcd.html). Alcohol-attributable fractions (AAFs) from CDC Alcohol-Related Disease Impact (http://nccd.cdc.gov/DPH_ARDI/Default/Default.aspx). Prevalence of alcohol consumption from the National Survey on Drug Use and Health, 2013 for estimating indirect AAFs for liver cancer.
35 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: National Institute on Alcohol Abuse and Alcoholism (NIAAA), 2014. Available at: http://pubs.niaaa.nih.gov/publications/Surveillance100/Cirr11.pdf
36 Singal, A.K.; Guturu, P.; Hmoud, B.; et al. Evolving frequency and outcomes of liver transplantation based on etiology of liver disease. Transplantation 95(5):755–760, 2013. 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.)
37 National Cancer Institute. Alcohol Consumption, November 2015 update. Available at: Available at: http://www.progressreport.cancer.gov/prevention/alcohol
38 U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2015–2020 Dietary Guidelines for Americans. 8th ed., Appendix 9. Available at: http://health.gov/dietaryguidelines/2015/guidelines/appendix-9/
39 U.S. Department of Agriculture. Scientific Report of the 2015 Dietary Guidelines Advisory Committee, Part D. Chapter 2, Table D2.3, p. 43. Available at: http://health.gov/dietaryguidelines/2015-scientific-report/pdfs/scientific-report-of-the-2015-dietary-guidelines-advisory-committee.pdf
40 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
41 National Institute on Alcohol Abuse and Alcoholism (NIAAA). NIAAA Council Approves Definition of Binge Drinking. NIAAA Newsletter, No. 3, Winter 2004. Available at: http://pubs.niaaa.nih.gov/publications/Newsletter/winter2004/Newsletter_Number3.pdf
42 Substance Abuse and Mental Health Services Administration (SAMHSA). Binge Drinking: Terminology and patterns of use. Available at: http://www.samhsa.gov/capt/tools-learning-resources/binge-drinking-terminology-patterns
Source: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
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