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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

Although historically cisgender women (i.e., women whose sex assigned at birth is consonant with their gender) in the United States have had lower levels of alcohol consumption than cisgender men, recent analyses of historical and cohort data suggest that overall gender differences are narrowing.¹ This narrowing is largely due to substantial increases in cisgender women's alcohol use...

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...

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...

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

The past 50 years of research supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) have resulted in an accumulation of invaluable data to address the multifaceted problems surrounding underage drinking. Youth use of alcohol remains a pervasive social and public health concern in the United States and a leading cause of disability and mortality during...

Introduction

For the past 25 years, a growing number of U.S. states have been progressively legalizing cannabis markets, first through the early adoption of medical cannabis laws, which enabled the purchase and possession of cannabis for specific medicinal purposes, and then more recently through laws regarding adult (i.e., “recreational”) use of cannabis. As of May 2021, more than 70% of U.S...

Introduction

The establishment of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in 1971 was bracketed by three seminal papers that laid the groundwork for the field of fetal alcohol spectrum disorders (FASD) research. In 1968, Lemoine et al.¹ described children with birth defects and neurodevelopmental disorders associated with prenatal alcohol exposure (PAE). This French...

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...