Excessive Alcohol Use
Excessive alcohol use is a leading preventable cause of death in the United States, shortening the lives of those who die by an average of 26 years. Excessive alcohol use includes:
- Binge drinking, 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, defined as 8 or more drinks per week for a woman or 15 or more drinks per week for a man.
- Any alcohol use by pregnant women or anyone younger than 21.
A small percentage of adults who drink account for half of the 35 billion total drinks consumed by US adults each year. CDC estimates that 1 in 6 US adults binge drinks [PDF – 171 KB], with 25% doing so at least weekly, on average, and 25% consuming at least 8 drinks during a binge occasion. Binge drinking is responsible for more than 40% of the deaths and three-quarters of the costs due to excessive alcohol use. States and communities can prevent binge drinking by supporting effective policies and programs, such as those recommended by the Community Preventive Services Task Force.
Each year in the United States excessive alcohol use is responsible for:
The Health Effects of Excessive Alcohol Use
Chronic Health Effects
Over time, excessive alcohol use can lead to chronic diseases and other serious problems, including alcohol use disorder and problems with learning, memory, and mental health. Other chronic health conditions 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.
Excessive alcohol use takes a toll on the liver and can lead to fatty liver disease (steatosis), hepatitis, fibrosis, and cirrhosis.
Drinking alcoholic beverages of any kind, including wine, beer, and liquor, can contribute to cancers of the mouth and throat, larynx (voice box), esophagus, colon and rectum, liver, and breast (in women). For some cancers, even less than one drink in a day can increase risk. The less alcohol a person drinks, the lower the risk of these types 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 those from motor vehicle crashes, falls, drownings, and burns. It increases the risk of violence, including homicide, suicide, and sexual assault. Alcohol also contributes to poisonings or overdoses from opioids and other substances.
A recent US study found that more than 40% of people who died violently had alcohol in their bloodstream.
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. It may also increase the risk of miscarriage, premature birth, stillbirth, and sudden infant death syndrome.
To reduce the risk of alcohol-related harms, the 2020–2025 Dietary Guidelines for Americans recommends that adults of legal drinking age can choose not to drink, or to drink in moderation by limiting intake to 2 drinks or less in a day for men or 1 drink or less in a day for women, on days when alcohol is consumed.
The Guidelines also do not recommend that people who do not drink alcohol start drinking for any reason and that if adults of legal drinking age choose to drink alcoholic beverages, drinking less is better for health than drinking more.
Some people should not drink, including women who are or who might be pregnant, people with certain conditions or taking certain medicines, and people who are recovering from an alcohol use disorder or unable to control the amount they drink.
CDC’s Response to Excessive Alcohol Use
CDC’s Alcohol Program works to prevent excessive alcohol use and its impact in states and communities by:
Collecting and Sharing Data to Guide Prevention Strategies
CDC collects data that states and communities can use to inform public health strategies to reduce excessive drinking and related harms.
The Behavioral Risk Factor Surveillance System and the Youth Risk Behavior Surveillance System collect data on alcohol use, including binge and underage drinking. They include measures such as how often binge drinking occurs, the number of drinks consumed per episode, and the rates of binge drinking in different population groups.
CDC’s Alcohol-Related Disease Impact application provides state and national estimates of deaths and years of potential life lost from excessive alcohol use.
CDC also published Measuring Alcohol Outlet Density: A Toolkit for State and Local Surveillance. Outlet density refers to the number and concentration of places that sell alcohol in a community. Higher alcohol outlet density is associated with excessive alcohol use and related harms, such as violence. One way state and local health agencies can use this toolkit is to study disparities in outlet density by the racial and ethnic makeup of a community. States and communities may then choose to use strategies like zoning and licensing to reduce disparities in the availability of alcohol and alcohol-related harms, such as violent crime.
Promoting Proven Strategies and Evaluating Their Effectiveness
CDC supports the use of evidence-based prevention strategies in states and communities with tools, training, and technical assistance. The Community Preventive Services Task Force recommends the following proven strategies to prevent excessive alcohol use and related harms in communities:
- Increase alcohol 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.
The US Preventive Services Task Force recommends that health care providers screen all adults for excessive alcohol use and provide brief intervention and referral to treatment as needed.
CDC also studies other prevention strategies, such as setting a minimum price for alcoholic beverages.
Supporting State and Local Health Agencies
CDC supports alcohol epidemiologists in nine states to conduct public health surveillance on excessive alcohol use and guide state and community efforts to prevent this behavior. Findings from CDC-supported state partnerships include:
- 1 in 5 people who die by drug overdose in New Mexico has a high blood alcohol level at the time of death.
- Deaths fully due to alcohol consumption increased in Minnesota from 2000 to 2018.
- Binge drinking is associated with marijuana use in Colorado.
Providing National Leadership
CDC works with other federal agencies to prevent 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 and reports on state performance and best practices to prevent and reduce underage drinking.
CDC also works with many national organizations, including the Community Anti-Drug Coalitions of America (CADCA), to prevent excessive drinking. CADCA, in turn, works with its member coalitions to translate effective strategies for preventing excessive alcohol use into practice at state and local levels. CDC also supports the Center for Advancing Alcohol Science to Practice to provide training and technical assistance to states and communities on effective strategies to reduce excessive drinking.