Overview of Alcohol Abuse

Americans have a complicated history with alcohol. At the end of the 19th century, politicians, women's groups, and churches banded together to convince lawmakers to outlaw alcohol. In 1919, the U.S. Congress passed the 18th Amendment, making the sale and distribution of alcohol illegal. Alcohol consumption declined but did not stop. In 1933, Prohibition ended and since then, millions of Americans have made alcohol a part of their social life.

In the 1960s, E. M. Jellinek pioneered the idea that excessive and harmful use of alcohol is a disease. Within a decade, public campaigns were launched in the United States to educate people about alcoholism as an illness.

Alcohol Abuse Definitions

In 1980, the American Psychiatric Association's Diagnostic and Statistical Manual III refined the definition of alcoholism by differentiating between alcohol abuse and dependence. People continue to use the terms "alcoholism" when they mean any harmful use of alcohol and "problem drinking" when they mean abuse, when in fact alcoholism and abuse have specific clinical definitions.

Alcoholism, also known as alcohol dependence, is a chronic, progressive, and potentially fatal disease. Characteristics of alcoholism include the following:

  • Drinking excessive amounts frequently
  • Inability to curb drinking despite medical, psychological, or social complications
  • Increased tolerance to alcohol
  • Occurrence of withdrawal symptoms when the person stops drinking

Alcohol abuse is a chronic disease in which the person refuses to give up drinking even though it causes neglect of important family and work obligations. Abuse, left untreated, can lead to dependence. Characteristics of alcohol abuse include the following:

  • Drinking when it is dangerous (e.g., while driving)
  • Frequent, excessive drinking
  • Interpersonal difficulties with family, friends, or coworkers caused by alcohol
  • Legal problems related to drinking

Incidence & Prevalence of Alcohol Abuse

Alcohol use typically begins in the late teens and early twenties—although a substantial number of people start drinking even earlier. The National Institutes of Health (NIH) reports that the younger a person starts drinking, the greater the chance he/she will abuse or become dependent on alcohol.

According to a February 2011 report from the World Health Organization (WHO), alcohol contributes to approximately 2.5 million deaths each year worldwide (nearly 4 percent of all deaths). About 6 percent of all male deaths and 1 percent of all female deaths are related to harmful effects of alcohol. In young people ages 15–29, 320,000 (9 percent) of all deaths are alcohol related.

In January 2013, the Center for Disease Control and Prevention (CDC) issued a sobering report indicating that binge drinking—defined as consuming 4 or more drinks on one occasion for females—occurs about 1 in 8 women and 1 in 5 high school girls. According to the CDC, binge drinking increases the risk for several health problems in women, including breast cancer, STDs, heart disease, and unwanted pregnancy.

In June 2014, the CDC reported that excessive alcohol use accounts for 1 in 10 deaths among adults 20–64 years of age in the United States each year (88,000 deaths per year from 2006 to 2010). These deaths were attributed to health effects caused by drinking too much over time and health effects from drinking too much in a short period of time.

Common causes for alcohol-related deaths include injuries (e.g., violence, car crashes), cancer, heart disease and liver disease (e.g., cirrhosis of the liver).

Excessive drinking includes binge drinking (4 or more drinks on one occasion for women, 5 or more for men), heavy drinking (8 or more drinks in a week for women, 15 or more for men), and any alcohol use in young adults under the age of 21 or women who are pregnant.

Publication Review By: Debra Emmite, M.D., Stanley J. Swierzewski, III, M.D.

Published: 02 Apr 2001

Last Modified: 28 Aug 2015