• Overview
• Definition
• Incidence, prevalence and trends
• Risk factors
• Health consequences
• Costs
• Contributors

Overview

The problems resulting from alcohol misuse extend far beyond "alcoholism" or even severe alcohol dependence. Excessive drinking of alcohol is responsible for a wide range of health and social problems. ¹

Excessive drinking contributes 4 percent of the total global disease burden, as measured by disability adjusted life years (DALYS). ² This burden is more evident in developed countries, where alcohol ranks third after smoking and hypertension as the leading cause of morbidity and premature death. ³ An estimated 3 percent of deaths worldwide are caused by excessive drinking. ²

The death rate from liver cirrhosis is an important indicator of population levels of harm from alcohol. In Britain, cirrhosis mortality has steeply increased over the past 30 years, particularly in men in Scotland (104 percent increase) but also in men in England and Wales (69 percent increase). ⁴ The corresponding increase in mortality in women was 46 percent in Scotland and 44 percent in England and Wales. This rise in alcohol related mortality is important because rates for liver cirrhosis in the European Union have reduced by 30 percent over the same time period. ⁴

In England, the first national alcohol needs assessment in 2004 reported that 38 percent of men and 16 percent of women (aged 16-64) have an alcohol use disorder (including hazardous, harmful, or dependent drinking), which is equivalent to 8.2 million people. ⁵ Of this total, just 1.1 million people were alcohol dependent. Thus, when those at risk of harm from alcohol consumption are added to those who have already experienced harm, the proportion of people adversely affected by alcohol approaches one in four of the adult population. This proportion is similar to the number of people whose health is directly affected by smoking. ⁶

The true impact of alcohol on the health and wellbeing of individuals and the wider community is difficult to quantify because of the many hidden effects resulting from its use. This includes increased levels of violence, injuries, and suicide. ⁷ Many of the social problems arising from alcohol misuse affect individuals other than the drinker, such as family members, including children, and victims of alcohol related crime and disorder who may not be known to the offender.

Excessive drinking costs the United Kingdom (UK) about £20bn each year. ⁸ Much of this cost is incurred by health, social care, and criminal justice services as they respond to the consequences of heavy drinking. As excessive drinking is responsive to even brief intervention in community based settings, ⁹ the public health community must act to prevent alcohol related risk and harm across the population.