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The burden of alcohol use usually is expressed as a function of the contribution of alcohol use in a population to morbidity and mortality in that population (Rehm et al. 2010). It is difficult to calculate the burden of alcohol use for middle-school and high-school adolescents (see Patrick and Schulembery, p. 193 in this issue) and nearly impossible to do so for children and preadolescents. There...

Since 1976, when the National Institute on Alcohol Abuse and Alcoholism (NIAAA) issued its first report on alcohol misuse by college students, research advances have transformed our understanding of excessive drinking on college campuses and the negative outcomes that follow from it. For instance, we now know that a broad array of factors influence whether a particular college student will choose...

In the United States, alcohol use typically begins and escalates during adolescence and young adulthood. To describe the historical and developmental trends in substance use in this age group, the Monitoring the Future (MTF) study (Johnston et al. 2012) was designed in 1975. Since then, this ongoing national-cohort sequential longitudinal study assessing the epidemiology and etiology of substance...

Alcohol and Mortality

Alcohol is causally linked to more than 200 different diseases, conditions, and injuries (as specified in the International Classification of Diseases, Revision 10 [ICD-10] three-digit codes [see Rehm 2011; Rehm et al. 2009; Shield et al., 2013c [pp. 155–173 of this issue]). All of these disease, condition, and injury categories cause mortality and disability, and, thus...

Even though the prevalence of alcohol use in the United States generally is lower among women compared with men (Substance Abuse and Mental Health Services Administration [SAMHSA] 2011), this gap has narrowed (Grucza et al. 2008). Furthermore, although women consume alcohol at lower levels than men, their body composition puts them at higher risk than men of developing some alcohol-related...

With growing awareness of the impact of alcohol consumption on global health (Rehm et al. 2004; World Health Organization [WHO] 2002, 2009) the demand for global information on alcohol consumption and alcohol-attributable and alcohol-related harm as well as related policy responses has increased significantly. Public health problems attributable to harmful alcohol consumption have become the focus...

Whether a specific gene is transcribed or repressed is determined by the specific status (i.e., conformational state) of the complex of chromosomal DNA and proteins (i.e., the chromatin) and by the recruitment of specific proteins (i.e., transcription factors) to regulatory sites on the DNA (Copeland et al. 2010). Chromatin states can change as a result of enzyme-mediated covalent modifications of...

A comprehensive understanding of the relationship between stress and alcohol use is important for understanding the risks of developing alcohol problems and subsequent relapse. Although the relationship is complex, substantial evidence supports that exposure to chronic stress early in life (e.g., Sher et al. 1997), adult trauma (Kessler et al. 1995), and the presence of anxiety disorders (Grant et...

It has long been known that stress increases the risk of alcohol relapse (Sinha 2001). Clinical observations, surveys, and epidemiological studies document an association between self-reports of stressors and subsequent return to drinking. Studies assessing alcohol relapse after treatment completion and discharge also indicate the contribution of highly stressful events independent of alcohol use...

Exposure to varying forms of stress is an integral life experience that can provoke a variety of reactions. In research on alcohol, drug, and psychiatric disorders, the term “stress” often is understood to indicate any experience denoting adversity (Dohrenwend 2000). Stress exposures consist of external stimuli that are threatening or harmful; elicit fear, anxiety, anger, excitement, and/or...