Alcohol

In many of today’s societies, alcoholic beverages are a routine part of the social landscape for many in the population. This is particularly true for those in social environments with high visibility and societal influence, nationally and internationally, where alcohol frequently accompanies socializing. In this context, it is easy to overlook or discount the health and social damage caused or contributed to by drinking. 

Alcohol is a toxic and psychoactive substance with dependence producing propensities. Alcohol consumption contributes to 3 million deaths each year globally as well as to the disabilities and poor health of millions of people. Overall, harmful use of alcohol is responsible for 5.1% of the global burden of disease.

Harmful use of alcohol is accountable for 7.1% and 2.2% of the global burden for males and females respectively. Alcohol is the leading risk factor for premature mortality and disability among those aged 15 to 49 years, accounting for 10 percent of all deaths in this age group. Disadvantaged and especially vulnerable populations have higher rates of alcohol-related death and hospitalization.

Alcohol as an intoxicant affects a wide range of structures and processes in the central nervous system and increases the risk for intentional and unintentional injuries and adverse social consequences. Alcohol has considerable toxic effects on the digestive- and cardiovascular systems.  Alcoholic beverages are classified as carcinogenic by the International Agency for Research on Cancer and increase the risk of several cancer types. Alcohol as an immunosuppressant increases the risk of communicable diseases, including tuberculosis and HIV.

Both the volume of lifetime alcohol use and a combination of context, frequency of alcohol consumption and amount consumed per occasion increase the risk of the wide range of health and social harms. The risks increase largely in a dose-dependent manner with the volume of alcohol consumed and with frequency of drinking, and exponentially with the amount consumed on a single occasion. Surrogate and illegally produced alcohols can bring an extra health risk from toxic contaminants.

Since any alcohol use is associated with some short-term and long-term health risks, it is very difficult to define universally applicable population-based thresholds for low-risk drinking.

The protection of the health of the population by preventing and reducing the harmful use of alcohol is a public health priority. Governments have made commitments to reduce the harmful use of alcohol through several WHO and UN resolutions. The 2010 WHO Global strategy to reduce the harmful use of alcohol continues to be the most comprehensive international policy document providing guidance on reducing the harmful use of alcohol at all levels. The harmful use of alcohol is mentioned in several other global strategies and action plans, and most recently – in the UN Sustainable Development Goals (SDGs), with a separate health target 3.5 on substance abuse, including harmful use of alcohol. and the prevention and control of noncommunicable diseases (NCDs).

WHO technical guidance on harmful use of alcohol is following the 10 areas in the WHO Global alcohol strategy and the effective and cost-effective interventions in the NCD “best buy” framework. The most cost-effective actions to reduce the harmful use of alcohol include increasing taxes on alcoholic beverages, enacting and enforcing bans or comprehensive restrictions on exposure to alcohol advertising, and restrictions on the physical availability of retailed alcohol. In addition, enforcing drink driving countermeasures and securing access to screening, brief interventions, and treatment are effective and ethically sound interventions.

Special attention needs to be given to reducing harm to people other than the drinker and to populations that are at particular risk from harmful use of alcohol, such as children, adolescents, women of child-bearing age, pregnant and breastfeeding women, indigenous peoples and other minority groups or groups with low socioeconomic status.