Medical consequences of alcohol abuse
There are approximately 79,000 deaths attributable to excessive alcohol use each year in the United States. 1 This makes excessive alcohol use the 3rd leading lifestyle-related cause of death for the nation. 2 Additionally, excessive alcohol use is responsible for 2.3 million years of potential life lost (YPLL) annually, or an average of about 30 years of potential life lost for each death. In the single year 2005, there were more than 1.6 million hospitalizations3 and more than 4 million emergency room visits4 for alcohol-related conditions.
The standard measure of alcohol
In the United States, a standard drink is any drink that contains 0.6 ounces (13.7 grams or 1.2 tablespoons) of pure alcohol. Generally, this amount of pure alcohol is found in:
- 12 ounces of regular beer or wine cooler.
- 8 ounces of malt liquor.
- 5 ounces of wine.
- 1.5 ounces of 80-proof distilled spirits or liquor (e.g., gin, rum, vodka, whiskey).
Definitions of patterns of drinking alcohol
- For women, 4 or more drinks during a single occasion.
- For men, 5 or more drinks during a single occasion.
- For women, more than 1 drink per day on average.
- For men, more than 2 drinks per day on average
Excessive drinking includes heavy drinking, binge drinking or both.
Most people who binge drink are not alcoholics or alcohol dependent.5
According to the Dietary Guidelines for Americans, if you drink alcoholic beverages, do so in moderation, which is defined as no more than 1 drink per day for women and no more than 2 drinks per day for men.6 However, there are some persons who should not drink any alcohol, including those who are
- Pregnant or trying to become pregnant.
- Taking prescription or over-the-counter medications that may cause harmful reactions when mixed with alcohol.
- Younger than age 21.
- Recovering from alcoholism or are unable to control the amount they drink.
- Suffering from a medical condition that may be worsened by alcohol.
- Driving, planning to drive, or participating in other activities requiring skill, coordination, and alertness.
Immediate health risks
Excessive alcohol use has immediate effects that increase the risk of many harmful health conditions. These immediate effects are most often the result of binge drinking and include the following:
- Unintentional injuries, including traffic injuries, falls, drownings, burns, and unintentional firearm injuries.7
- Violence, including intimate partner violence and child maltreatment. About 35 percent of victims report that offenders are under the influence of alcohol.8 Alcohol use is also associated with 2 out of 3 incidents of intimate partner violence.8 Studies have also shown that alcohol is a leading factor in child maltreatment and neglect cases, and is the most frequent substance abused among these parents.9
- Risky sexual behaviors, including unprotected sex, sex with multiple partners, and increased risk of sexual assault. These behaviors can result in unintended pregnancy or sexually transmitted diseases.10, 11
- Miscarriage and stillbirth among pregnant women, and a combination of physical and mental birth defects among children that last throughout life.12, 13
- Alcohol poisoning, a medical emergency that results from high blood alcohol levels that suppress the central nervous system and can cause loss of consciousness, low blood pressure and body temperature, coma, respiratory depression, or death.14
Long-term health risks
Over time, excessive alcohol use can lead to the development of chronic diseases, neurological impairments, and social problems. These include but are not limited to:
- Neurological problems, including dementia, stroke and neuropathy.15, 16
- Cardiovascular problems, including myocardial infarction, cardiomyopathy, atrial fibrillation and hypertension.17
- Psychiatric problems, including depression, anxiety, and suicide.18
- Social problems, including unemployment, lost productivity, and family problems.19, 20
- Cancer of the mouth, throat, esophagus, liver, colon, and breast.21 In general, the risk of cancer increases with increasing amounts of alcohol.
- Liver diseases, including:
- Alcoholic hepatitis.
- Cirrhosis, which is among the 15 leading causes of all deaths in the United States.22
- Among persons with Hepatitis C virus, worsening of liver function and interference with medications used to treat this condition.23
- Other gastrointestinal problems, including pancreatitis and gastritis.24, 25
Centers for Disease Control and Prevention (CDC). Alcohol-Related Disease Impact (ARDI). Atlanta, GA: CDC. Available at http://www.cdc.gov/alcohol/ardi.htm. Accessed March 28, 2008.
Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000 . JAMA 2004;291(10):1238–1245.
Chen CM, Yi H. Trends in Alcohol-Related Morbidity Among Short-Stay Community Hospital Discharges, United States, 1979–2005. Bethesda, MD: National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism. NIAAA Surveillance Report #80, 2007.
McCaig LF, Burt CW. National Hospital Ambulatory Medical Care Survey: 2003 emergency department summary [PDF–875K]. Advance data from vital and health statistics; No 358. Hyattsville, Maryland: National Center for Health Statistics. 2005.
Dawson DA, Grant BF, LI T-K. Quantifying the risks associated with exceeding recommended drinking limits . Alcohol Clin Exp Res 2005;29:902–908.
Washington, DC: US Government Printing Office; 2005, p. 43–46. Available at http://www.health.gov/DIETARYGUIDELINES/dga2005/document/html/chapter9.htm . Accessed March 28, 2008.
Smith GS, Branas CC, Miller TR. Fatal nontraffic injuries involving alcohol: a metaanalysis . Ann of Emer Med 1999;33(6):659–668.
Greenfield LA. Alcohol and Crime: An Analysis of National Data on the Prevalence of Alcohol Involvement in Crime. Report prepared for the Assistant Attorney General’s National Symposium on Alcohol Abuse and Crime. Washington, DC: U.S. Department of Justice, 1998.
The National Center on Addiction and Substance Abuse at Columbia University, 1999. No safe haven: children of substance-abusing parents. Available at http://www.casacolumbia.org/templates/publications_reports.aspx . Accessed April 1, 2010.
Naimi TS, Lipscomb LE, Brewer RD, Colley BG. Binge drinking in the preconception period and the risk of unintended pregnancy: Implications for women and their children . Pediatrics 2003;11(5):1136–1141.
Wechsler H, Davenport A, Dowdall G, Moeykens B, Castillo S. Health and behavioral consequences of binge drinking in college . JAMA 1994;272)21):1672–1677.
Kesmodel U, Wisborg K, Olsen SF, Henriksen TB, Sechler NJ. Moderate alcohol intake in pregnancy and the risk of spontaneous abortion . Alcohol & Alcoholism 2002;37(1):87–92.
American Academy of Pediatrics, Committee on Substance Abuse and Committee on Children with Disabilities. 2000. Fetal alcohol syndrome and alcohol-related neurodevelopmental disorders . Pediatrics 2000;106:358–361.
Sanap M, Chapman MJ. Severe ethanol poisoning: a case report and brief review . Crit Care Resusc 2003;5(2):106–108.
Corrao G, Rubbiati L, Zambon A, Arico S. Alcohol-attributable and alcohol-preventable mortality in Italy. A balance in 1983 and 1996 . European J of Public Health 2002;12:214–223.
Corrao G, Bagnardi V, Zambon A, La Vecchia C. A meta-analysis of alcohol consumption and the risk of 15 diseases . Prev Med 2004;38:613–619.
Rehm J, Gmel G, Sepos CT, Trevisan M. Alcohol-related morbidity and mortality . Alcohol Research and Health 2003;27(1)39–51.
Castaneda R, Sussman N, Westreich L, Levy R, O'Malley M. A review of the effects of moderate alcohol intake on the treatment of anxiety and mood disorders . J Clin Psychiatry 1996;57(5):207–212.
Booth BM, Feng W. The impact of drinking and drinking consequences on short-term employment outcomes in at-risk drinkers in six southern states . J Behavioral Health Services and Research 2002;29(2):157–166.
Leonard KE, Rothbard JC. Alcohol and the marriage effect . J Stud Alcohol Suppl 1999;13:139–146.
Baan R, Straif K, Grosse Y, Secretan B, et al. on behalf of the WHO International Agency for Research on Cancer Monograph Working Group. Carcinogenicity of alcoholic beverages. Lancet Oncol. 2007;8:292–293.
Heron MP. Deaths: Leading causes for 2004. National vital statistics reports; vol 56 no 5. Hyattsville, MD: National Center for Health Statistics. 2007. Available at http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_05.pdf [PDF–3.16MB]. Accessed March 28, 2008.
Schiff ER. Hepatitis C and alcohol . Hepatology 1997;26 (Suppl 1): 39S–42S.
Lesher SDH, Lee YTM. Acute pancreatitis in a military hospital . Military Med 1989;154(11):559–564.
Kelly JP, Kaufman DW, Koff RS, Laszlo A, Wilholm BE, Shapiro S. Alcohol consumption and the risk of major upper gastrointestinal bleeding . Am J Gastroenterol 1995;90(7):1058–1064.