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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.

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...

Research has shown differential social and health effects from alcohol use across U.S. ethnic groups, including Whites, Blacks, Hispanics, Asians, and Native Americans. The relationship of ethnicity to alcohol-related social and health harms partially is attributed to the different rates and patterns of drinking across ethnicities. Some ethnic groups have higher rates of alcohol consumption...

Alcohol can permeate virtually every organ and tissue in the body, resulting in tissue injury and organ dysfunction. Considerable evidence indicates that alcohol abuse results in clinical abnormalities of one of the body’s most important systems, the endocrine system. This system ensures proper communication between various organs, also interfacing with the immune and nervous systems, and is...

Alcohol has been a part of human culture for all of recorded history, with almost all societies in which alcohol is consumed experiencing net health and social problems (McGovern 2009; Tramacere et al. 2012b, c). With the industrialization of alcohol production and the globalization of its marketing and promotion, alcohol consumption and its related harms have increased worldwide (see Alcohol...

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...

The duration and extent of the body’s exposure to beverage alcohol (i.e., ethanol) is the primary determinant of ethanol’s pleiotropic effects on human health (Edenberg 2007). The time course of its concentration and the concentration of its byproducts in the tissues and the circulation, and, consequently, its effects, are determined mainly by the rate of ethanol’s processing (i.e., metabolism) in...

The concept that only DNA and proteins can impact disease states is an oversimplification. It does not take into account different metabolic pathways in which key metabolites bind to transcription factors and alter gene expression patterns that contribute to the observable characteristics (the phenotype) of a given disease. Simple metabolites dictate the actions of specific transcription factors...

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...