Alcoholism, also known as “alcohol dependence,” is a disease that includes four symptoms:

• Craving: A strong need, or compulsion, to drink.
• Loss of control: The inability to limit one’s drinking on any given occasion.
• Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, occur when alcohol use is stopped after a period of heavy drinking.
• Tolerance: The need to drink greater amounts of alcohol in order to “get high.”

People who are not alcoholic sometimes do not understand why an alcoholic can’t just “use a little willpower” to stop drinking. However, alcoholism has little to do with willpower. Alcoholics are in the grip of a powerful “craving,” or uncontrollable need, for alcohol that overrides their ability to stop drinking. This need can be as strong as the need for food or water.

Although some people are able to recover from alcoholism without help, the majority of alcoholics need assistance. With treatment and support, many individuals are able to stop drinking and rebuild their lives.

Many people wonder why some individuals can use alcohol without problems but others cannot. One important reason has to do with genetics. Scientists have found that having an alcoholic family member makes it more likely that if you choose to drink you too may develop alcoholism. Genes, however, are not the whole story. In fact, scientists now believe that certain factors in a person’s environment influence whether a person with a genetic risk for alcoholism ever develops the disease. A person’s risk for developing alcoholism can increase based on the person’s environment, including where and how he or she lives; family, friends, and culture; peer pressure; and even how easy it is to get alcohol.

Almost half of Americans aged 12 or older reported being current drinkers of alcohol in the 2001 survey (48.3 percent). This translates to an estimated 109 million people.

Both the rate of alcohol use and the number of drinkers increased from 2000, when 104 million, or 46.6 percent, of people aged 12 or older reported drinking in the past 30 days.

Approximately one fifth (20.5 percent) of persons aged 12 or older participated in binge drinking at least once in the 30 days prior to the survey. Although the number of current drinkers increased between 2000 and 2001, the number of those reporting binge drinking did not change significantly.

Heavy drinking was reported by 5.7 percent of the population aged 12 or older, or 12.9 million people. These 2001 estimates are similar to the 2000 estimates.

The prevalence of current alcohol use in 2001 increased with increasing age for youths, from 2.6 percent at age 12 to a peak of 67.5 percent for persons 21 years old. Unlike prevalence patterns observed for cigarettes and illicit drugs, current alcohol use remained steady among older age groups. For people aged 21 to 25 and those aged 26 to 34, the rates of current alcohol use in 2001 were 64.3 and 59.9 percent, respectively. The prevalence of alcohol use was slightly lower for persons in their 40s. Past month drinking was reported by 45.6 percent of respondents aged 60 to 64, and 33.0 percent of persons 65 or older (Figure 3.1).

The highest prevalence of both binge and heavy drinking in 2001 was for young adults aged 18 to 25, with the peak rate occurring at age 21. The rate of binge drinking was 38.7 percent for young adults and 48.2 percent at age 21. Heavy alcohol use was reported by 13.6 percent of persons aged 18 to 25, and by 17.8 percent of persons aged 21. Binge and heavy alcohol use rates decreased faster with increasing age than did rates of past month alcohol use. While 55.2 percent of the population aged 45 to 49 in 2001 were current drinkers, 19.1 percent of persons within this age range binge drank and 5.4 percent drank heavily (Figure 3.1). Binge and heavy drinking were relatively rare among people aged 65 or older, with reported rates of 5.8 and 1.4 percent, respectively.

Among youths aged 12 to 17, an estimated 17.3 percent used alcohol in the month prior to the survey interview. This rate was higher than the rate of youth alcohol use reported in 2000 (16.4 percent). Of all youths, 10.6 percent were binge drinkers, and 2.5 percent were heavy drinkers. These are roughly the same percentages as those reported in 2000 (10.4 and 2.6 percent, respectively).

Forty-four percent of the adult U.S. population (aged 18 and over) are current drinkers who have consumed at least 12 drinks in the preceding year (Dawson et al. 1995). Although most people who drink do so safely, the minority who consume alcohol heavily produce an impact that ripples outward to encompass their families, friends, and communities. The following statistics give a glimpse of the magnitude of problem drinking:

• Approximately 14 million Americans—7.4 percent of the population —meet the diagnostic criteria for alcohol abuse or alcoholism (Gran et al. 1994).
• More than one-half of American adults have a close family member who has or has had alcoholism ( Dawson and Grant 1998).
• Approximately one in four children younger than 18 years old in the United States is exposed to alcohol abuse or alcohol dependence in the family (Grant 2000).

Alcohol consumption has consequences for the health and well - being of those who drink and, by extension, the lives of those around them.