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Introduction

In 2020, an estimated 17% of the U.S. population was older than age 65; this proportion is projected to rise to about 23% by 2060.^1,2 This prompts an urgent need for identifying potential and modifiable risk factors contributing to health decline.^3,4 After tobacco, alcohol is the most misused substance in the United States and abroad.⁵ Even prior to the coronavirus disease 2019 (COVID...

Introduction

Alcohol-associated liver disease (ALD) is a leading cause of morbidity and mortality in people with alcohol use disorder (AUD).¹ Alcohol exerts its effect on the liver through both direct and indirect pathways and can eventually lead to steatosis, steatohepatitis, fibrosis, hepatocellular carcinoma, and cirrhosis.² However, only approximately 10% to 20% of patients with ALD develop...

Introduction

Alcohol misuse is the most common form of substance misuse and is associated with liver, cardiovascular, and metabolic diseases as well as with infections and cancers.¹ Although an estimated 20% to 25% of people who drink heavily develop alcohol-related liver disease,² 40% to 60% of people with alcohol misuse have alcohol-related myopathy.³ Evidence that alcohol use leads to skeletal...

Introduction

Although the awareness of the negative impact of prenatal alcohol exposure (PAE) was already alluded to in ancient writings¹ and the impact of ethanol embryopathy in animal models was studied as early as 1910,² the conceptualization of a syndrome associated with PAE was not recognized within modern medicine until the mid-20th century.^3,4 The syndrome or disorder was not uniformly...

A Look Back

NIAAA’s 50th anniversary is truly a highlight in the history of public health. More than 5 decades ago, a group of researchers, advocates, and elected officials made a farsighted decision when they pushed for the creation of a federal institution dedicated to research that improves the lives of millions of Americans and their families devastated by alcohol misuse. As a result, on...

Introduction

Alcohol use disorder (AUD) is prevalent worldwide, and the burden of heavy alcohol consumption has been increasing over time. An important complication of prolonged, heavy alcohol use is alcohol-associated liver disease (ALD), which can progress from liver steatosis to fibrosis and cirrhosis and frequently involves alcohol-associated hepatitis. In particular, cirrhosis—the most...

Introduction

According to national surveys, more than 85% of U.S. adults have consumed alcohol at some point in their lifetime, and about 70% did so in the last year.¹ Most individuals drink responsibly and without adverse effects. However, a substantial proportion of people misuse alcohol.^1,2 Drinking patterns associated with alcohol misuse include binge drinking, heavy drinking, and high...

Alcohol is frequently used in association with cannabis, with co-use now perceived as normative with expanding cannabis legalization. Cannabinoid products are increasingly used for a number of medical and recreational purposes, including to enhance alcohol-reinforcing properties or in some cases to substitute for alcohol. Rates of alcohol use disorder (AUD) are higher among cannabis users relative...

Introduction

Use of alcohol and related problems cause significant global and individual health-related harms, and alcohol use is currently the third-leading cause of preventable death in the United States.^1,2 Alcohol and cannabis are among the most commonly used psychoactive substances in the United States.³ Although concurrent use of alcohol and cannabis (i.e., co-use: defined as using both...

Introduction

The prevalence of alcohol use disorder has been steadily rising around the world in recent years, and reducing the burden of alcohol-associated liver disease (ALD) caused by chronic alcohol consumption has become one of the most important global health issues.^1,2 Excessive alcohol drinking (more than 40 g of pure alcohol per day) is closely associated with increased risk of all-cause...