Native Americans eliminate alcohol more quickly as well due to the expression of beta-3 Class 1 ADH isoforms as opposed to subjects only expressing the beta-1 isoform. Fetal livers also eliminate alcohol more slowly due to CYP2E1 and ADH not being fully expressed. Females tend to eliminate alcohol faster than men, although their first-pass metabolism is slower due to lower alcohol dehydrogenase (ADH) levels, resulting in higher blood alcohol concentration initially. The metabolism of alcohol is affected by many factors. Globally, alcohol use disorder affects 240 million people, mostly in Europe and the Americas. Overall, alcohol use disorder tends to be more common in individuals with less education and low income. Almost half of the people with any substance abuse problem, including alcohol, also had a co-existing mental illness. However, this number has been steadily declining since 2002. Almost four million (3.8 million) individuals ages 18 to 25 (10.9% of young adults) and 11.3 million individuals 26 years or older (5.4%) had both an alcohol use disorder and substance use disorder. Of the people with alcohol use disorder and illicit drug disorder, 623,000 were adolescents ages 12 to 17 (2.5% of all adolescents). This number makes alcohol the leading substance abused in the United States. Of those, 2.7 million had an illicit drug use disorder as well. In addition, motor vehicle accidents, dementia, depression, homicide, and suicide have all been linked to alcohol use disorder.Īccording to the 2015, National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Administration, an estimated 20.8 million Americans age 12 and older had a substance use disorder, of which 15.7 million were alcohol use disorders. More than 85,000 deaths per year can be attributed to alcohol. This means that 5.9%, or 15.7 million people in the United States aged 12 and older, meet the criteria for an alcohol use disorder (see image for criteria). Of those who reported binge drinking, 26% reported heavy alcohol use, defined as binge drinking five or more days in the previous 30 days, which accounts for 12.5% of total alcohol users.
Of those, 48.2% report that they had binge-drinking episode(s) within 30 days before taking the survey. In the United States, 138.3 million people age 12 and older surveyed report that they actively use alcohol, according to the 2015 National Survey on Drug Use and Health. Estimates vary but have suggested that up to 40% of patients have experienced complications of alcohol misuse. Alcohol misuse has been linked to numerous social, economic, and health problems.
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