Excessive Alcohol Use

CDC works to reduce the four main risk factors for preventable chronic diseases: tobacco use, poor nutrition, lack of physical activity, and excessive alcohol use.

A man shopping at a liquor store.

Fast Facts

  • Excessive alcohol use is responsible for 88,000 deaths in the United States each year, including 1 in 10 total deaths among working-age adults.
  • In 2010, excessive alcohol use cost the US economy $249 billion, or $2.05 a drink. About 40% of these costs were paid by federal, state, and local governments.
  • Binge drinking is responsible for over half the deaths and three-quarters of the costs due to excessive alcohol use.
  • 9 in 10 adults who binge drink do not have an alcohol use disorder.
  • CDC works to strengthen the scientific foundation for preventing excessive alcohol use.

Excessive alcohol use is responsible for about 88,000 deaths a year in the United States, including 1 in 10 total deaths among working-age adults aged 20 to 64 years. In 2010, excessive alcohol use cost the US economy $249 billion, or $2.05 a drink. About 40% of these costs were paid by federal, state, and local governments.

Excessive alcohol use includes binge drinking, heavy drinking, and any alcohol use by pregnant women or anyone younger than 21. Binge drinking is defined as consuming 4 or more drinks on an occasion for a woman or 5 or more drinks on an occasion for a man. Heavy drinking is defined as consuming 8 or more drinks per week for a woman or 15 or more drinks per week for a man.

Binge drinking is responsible for over half the deaths and three-quarters of the costs due to excessive alcohol use. CDC estimates that 37 million US adults—or 1 in 6—binge drink about once a week, consuming an average of 7 drinks per binge. As a result, US adults consume about 17 billion binge drinks annually, or about 470 binge drinks per binge drinker. Further, 9 in 10 adults who binge drink do not have an alcohol use disorder.

The Health Effects of Excessive Alcohol Use

Chronic Health Effects

Over time, excessive alcohol use can lead to the development of chronic diseases and other serious problems, including alcohol use disorder and problems with learning, memory, and mental health. Chronic health conditions that have been linked to excessive alcohol use include:

High Blood Pressure, Heart Disease, and Stroke

Binge drinking and heavy drinking can cause heart disease, including cardiomyopathy (disease of the heart muscle), as well as irregular heartbeat, high blood pressure, and stroke.

Liver Disease

Excessive alcohol use takes a toll on the liver and can lead to fatty liver disease (steatosis), hepatitis, fibrosis, and cirrhosis.

Cancer

Excessive alcohol use can contribute to cancers of the mouth and throat, larynx (voice box), esophagus, colon and rectum, liver, and breast (in women). The less alcohol a person drinks, the lower the risk of cancer.

Immediate Health Effects

Excessive alcohol use has immediate effects that increase the risk of many harmful health conditions, including the following:

Injuries, Violence, and Poisonings

Drinking too much alcohol increases the risk of injuries, including motor vehicle crashes, falls, drownings, and burns. It also increases the risk of violence, including homicide, suicide, sexual assault, and intimate partner violence. Alcohol also contributes to poisonings and overdoses from opioids and other substances.

Unintended Pregnancy and Sexually Transmitted Infections

People who binge drink are more likely to have unprotected sex and multiple sex partners. These activities increase the risk of unintended pregnancy and sexually transmitted infections, including HIV.

Poor Pregnancy Outcomes

There is no known safe amount of alcohol use during pregnancy. Alcohol use during pregnancy can cause fetal alcohol spectrum disorders for infants. It may also increase the risk of miscarriage, premature birth, stillbirth, and sudden infant death syndrome.

The Dietary Guidelines for Americans advises that adults who choose to drink should do so in moderation—defined as up to 1 drink per day for women and up to 2 drinks per day for men. However, the guidelines do not recommend that people start drinking for any reason. They also state that women who are or who may be pregnant should not drink.

In the United States,
excessive alcohol
use causes:
icon of several faces

1 IN 10 TOTAL DEATHS

among working-age
adults every year
smart phone

$249 BILLION

in economic costs
each year
Binge drinking is
responsible for half
of these deaths and
three-quarters of
these costs.
Patient with her doctor
Man with glass of alcohol

tablet
The front door of a liquor store.
Meeting with a group of people
Liquor sign
A mother holding her baby

CDC’s Response to Excessive Alcohol Use

CDC’s Alcohol Program strengthens the scientific foundation for preventing excessive alcohol use by improving public health surveillance, conducting applied public health research, supporting state and local public health agencies, and working with national partners, including other federal agencies.

Collecting and Sharing Data to Guide Prevention Strategies

CDC uses surveys—such as the Behavioral Risk Factor Surveillance System (BRFSS) and the Youth Risk Behavior Surveillance System—to collect data on excessive alcohol use, including binge and underage drinking. Indicators measured include how often binge drinking occurs, the number of drinks consumed per binge drinking episode, and the rates of binge drinking in different population groups. States and communities can use this information to guide development of public health strategies to reduce excessive drinking and related harms.

CDC developed and is using the online Alcohol-Related Disease Impact application to provide state and national estimates of deaths and years of potential life lost from excessive alcohol use. This information helps states and communities characterize the public health impact of excessive drinking and guides the development of prevention strategies for excessive drinking.

CDC also published the Guide for Measuring Alcohol Outlet Density pdf icon[PDF – 13.2MB]. Outlet density refers to the number and concentration of places that sell alcohol in a defined area. Higher alcohol outlet density is a risk factor for excessive alcohol use and related harms, such as violence. This publication can help state and local health agencies assess outlet density and guide their efforts to regulate it.

Alcohol advertising is common on cable TV. However, industry compliance with voluntary placement guidelines on youth exposure to alcohol advertising has improved. CDC continues to monitor and work to reduce youth exposure to alcohol advertising on cable TV.

Using Proven Strategies and Evaluating Their Effectiveness

On the basis of strong scientific evidence, the Community Preventive Services Task Force recommends the following strategies to prevent excessive alcohol use and related harms:

  • Increase alcohol excise taxes.
  • Regulate alcohol outlet density.
  • Hold retailers accountable for harms that result from illegally serving or selling alcohol.
  • Maintain existing government controls over alcohol sales (avoiding privatization).
  • Maintain limits on the days and hours when alcohol can be sold.
  • Use electronic devices—such as computers, telephones, and mobile devices—to screen people for excessive alcohol use and deliver a brief intervention.
  • Enforce laws that prohibit alcohol sales to minors.

CDC scientists work with state and local health agencies to evaluate the effect of evidence-based prevention strategies on excessive alcohol use and related harms. For example, CDC worked with the Georgia Department of Health to study the effect of regulating alcohol outlet density in one Atlanta neighborhood and found that a modest decrease in exposure to alcohol outlets was associated with a significant decline in exposure to violent crime.

Supporting State and Local Health Agencies

CDC supports alcohol epidemiologists in five states to conduct public health surveillance on excessive alcohol use and guide state and community efforts to prevent this behavior. CDC also helps states and cities improve the usefulness of public health surveillance systems for monitoring and reducing excessive alcohol use. Technical assistance, such as legal research and advice on how to measure alcohol outlet density, is available to help state and local health agencies use effective strategies to reduce excessive drinking.

Providing National Leadership

CDC works with other federal agencies to support the prevention of excessive alcohol use. For example, the agency works with the Substance Abuse and Mental Health Services Administration and other federal agencies on the Interagency Coordinating Committee for the Prevention of Underage Drinking, which prepares an annual report to Congress.

CDC also works with many national organizations, including the Community Anti-Drug Coalitions of America (CADCA), to prevent excessive drinking. CADCA has, in turn, worked with its member coalitions to help translate strategies for preventing excessive alcohol use that are recommended by the Community Preventive Services Task Force into practice at state and local levels.

Excessive Alcohol Use pdf icon[PDF – 2 MB]

Page last reviewed: June 26, 2019