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Excessive alcohol intake has been recognized as a causal factor for more than 200 major types of diseases, injuries, and other health conditions – CVDs, T2DM, cancers, and gastrointestinal diseases, including liver cirrhosis and mental and behavioral disorders, as well as unintentional or intentional injuries. Figure 3.5 shows the distribution of alcohol‐attributable deaths in 2012, by broad disease category.

According to the US dietary guidelines issued in 2015, excessive alcohol consumption may include binge drinking (i.e., 4 or more drinks for women and 5 or more drinks for men within 2 hours) or heavy drinking (i.e., 8 or more drinks a week for women and 15 or more drinks a week for men) with an alcoholic drink‐equivalent defined as 14 g (0.6 fl oz) of pure alcohol. Examples of one alcoholic drink‐equivalent include 12 fluid ounces (~355 ml) of regular beer (5% alcohol), 5 fluid ounces (~148 ml) of wine (12% alcohol), or 1.5 fluid ounces (~45 ml) of 80 proof distilled spirits (40% alcohol).

Alcohol‐related health effects are associated with the volume of alcohol consumed and the pattern of drinking. For most alcohol‐related diseases, there is a dose–response relationship, which means that the higher the consumption of alcohol the higher the risk for disease development. The drinking pattern, reflecting the way people consume alcohol, may be equally important as to the amount consumed. Heavy episodic drinking or binge drinking, i.e., 60 or more grams of pure alcohol on at least one single occasion at least monthly, is an indicator of the pattern of alcohol consumption associated with detrimental health consequences.