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Alcohol misuse is the fifth-leading risk factor for premature death and disability worldwide, and, adjusting for age, alcohol is the leading risk factor for mortality and the overall burden of disease in the 15 to 59 age group. According to the World Health Organization, in 2004, 4.5% of the global burden of disease and injury was attributable to alcohol: 7.4% for men and 1.4% for women.

There has been a global increase in alcohol misuse and rates of alcohol use disorder (AUD) over the last two decades. Recent substantial increases in the United States come from dramatic rises in the prevalence of alcohol misuse and AUD in women relative to men (women, 84% increase; men, 35% increase).

Sexually dimorphic effects of alcohol exposure throughout life have been documented in clinical and preclinical studies. In the past, rates of alcohol use disorder (AUD) were higher in men than in women, but over the past 10 years, the difference between sexes in prevalence of AUD and binge drinking has narrowed. Recent evidence adds to historical data regarding the influence of sex steroids on...

Extensive clinical and experimental data suggest that alcohol consumption has dose-dependent modulatory effects on the immune system that influence the two arms of the immune response (i.e., innate and adaptive immune responses). In many other organ systems, such as the brain and liver, alcohol consumption has been shown to alter factors that can modify gene expression without changing the DNA...

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...

Epigenetic modifications are emerging as important dynamic mechanisms contributing to both transient and sustained changes in gene expression. In some cases, epigenetic changes even can be inherited, although the mechanism for this remains elusive. Several types of epigenetic modifications have been studied in recent years. For example, several laboratories have actively examined modifications, of...

Introduction

Abundant cross-sectional data indicate that alcohol use and related problems are accompanied by disruptions to sleep and circadian rhythms.¹ Alcohol's negative impacts on sleep are well established, especially in adults, and a smaller body of literature also reports alcohol's disruption of circadian rhythms.^2-4 Growing evidence supports sleep and circadian factors as influencing...

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...