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1 Substance Abuse and Mental Health Services Administration (SAMHSA). 2018 National Survey on Drug Use and Health (NSDUH). Table 2.1B—Tobacco Product and Alcohol Use in Lifetime, Past Year, and Past Month among Persons Aged 12 or Older, by Age Group: Percentages, 2017 and 2018. Available at: https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect2pe2018.htm#tab2-1b. Accessed 12/2/19.

2 SAMHSA. 2018 National Survey on Drug Use and Health (NSDUH). Table 5.4A—Alcohol Use Disorder in Past Year among Persons Aged 12 or Older, by Age Group and Demographic Characteristics: Numbers in Thousands, 2017 and 2018. Available at: https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect5pe2018.htm#tab5-4a. Accessed 12/2/19.

3 SAMHSA. 2018 National Survey on Drug Use and Health (NSDUH). Table 5.4B—Alcohol Use Disorder in Past Year among Persons Aged 12 or Older, by Age Group and Demographic Characteristics: Percentages, 2017 and 2018. Available at: https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect5pe2018.htm#tab5-4b. Accessed 12/2/19.

4 SAMHSA. Population prevalence estimates (%) are weighted by the person-level analysis weight and derived from the 2018 NSDUH public-use data file, defining “any treatment” as treatment or counseling designed to help reduce or stop alcohol use, including detoxification and any other treatment for medical problems associated with alcohol use, as well as defining AUD as alcohol abuse or alcohol dependence according to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders. National Survey on Drug Use and Health (NSDUH) 2018 (NSDUH-2019) Public-Use File Dataset. Available at: https://www.datafiles.samhsa.gov/study/national-survey-drug-use-and-health-nsduh-2018-nid18757. Accessed 11/15/19.

5 Centers for Disease Control and Prevention (CDC). Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI). Average for United States 2006–2010 Alcohol-Attributable Deaths Due to Excessive Alcohol Use. Available at: https://nccd.cdc.gov/DPH_ARDI/Default/Report.aspx?T=AAM&P=f6d7eda7-036e-4553-9968-9b17ffad620e&R=d7a9b303-48e9-4440-bf47-070a4827e1fd&M=8E1C5233-5640-4EE8-9247-1ECA7DA325B9&F=&D=. Accessed 1/18/17.

6 Mokdad, A.H.; Marks, J.S.; Stroup, D.F.; and Gerberding, J.L. Actual causes of death in the United States 2000. [Published erratum in: JAMA 293(3):293–294, 298] JAMA: Journal of the American Medical Association 291(10):1238–1245, 2004. PMID: 15010446

7 National Center for Statistics and Analysis. 2014 Crash Data Key Findings (Traffic Safety Facts Crash Stats. Report No. DOT HS 812 219). Washington, DC: National Highway Traffic Safety Administration, 2015. Available at: https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/812219. Accessed 9/19/16.

8 Sacks, J.J.; Gonzales, K.R.; Bouchery, E.E.; et al. 2010 national and state costs of excessive alcohol consumption. American Journal of Preventive Medicine 49(5):e73–e79, 2015. PMID: 26477807

9 World Health Organization (WHO). Global Status Report on Alcohol and Health. p. XIV. 2014 ed. Available at: http://www.who.int/substance_abuse/publications/global_alcohol_report/msb_gsr_2014_1.pdf?ua=1. Accessed 1/18/17.

10 World Health Organization (WHO). Global Status Report on Alcohol and Health. p. XIII. 2014 ed. Available at: http://www.who.int/substance_abuse/publications/global_alcohol_report/msb_gsr_2014_1.pdf?ua=1. Accessed 1/18/17.

11 World Health Organization (WHO). Global Status Report on Alcohol and Health. p. 57. 2014 ed. Available at: http://www.who.int/substance_abuse/publications/global_alcohol_report/msb_gsr_2014_1.pdf?ua=1. Accessed 6/15/17.

12 World Health Organization (WHO). Alcohol. 2015. Available at: http://www.who.int/mediacentre/factsheets/fs349/en/#. Accessed 9/19/16.

13 Substance Abuse and Mental Health Services Administration (SAMHSA). Data Spotlight: More than 7 Million Children Live with a Parent with Alcohol Problems, 2012. Available at: https://www.samhsa.gov/data/sites/default/files/Spot061ChildrenOfAlcoholics2012/Spot061ChildrenOfAlcoholics2012.pdf. Accessed 12/2/19.

14 SAMHSA. Population prevalence estimates (%) are weighted by the person-level analysis weight and derived from the 2018 NSDUH public-use data file. Lifetime alcohol use is defined as ever, even once, having had a drink of any type of alcoholic beverage (a can or bottle of beer, a glass of wine or a wine cooler, a shot of distilled spirits, or a mixed drink with distilled spirits in it), not counting a sip or two from a drink. National Survey on Drug Use and Health (NSDUH) 2018 (NSDUH-2018) Public-Use File Dataset. Available at: https://www.datafiles.samhsa.gov/study-dataset/national-survey-drug-use-and-health-2018-nsduh-2018-ds0001-nid18758. Accessed 11/18/19.

15 SAMHSA. 2018 National Survey on Drug Use and Health. Table 7.16A—Alcohol Use in Lifetime, Past Year, and Past Month among Persons Aged 12 to 20, by Gender: Numbers in Thousands, 2002-2018. Available at: https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm#tab7-16a. Accessed 12/2/19.

16 SAMHSA. 2018 National Survey on Drug Use and Health. Table 7.16B—Alcohol Use in Lifetime, Past Year, and Past Month among Persons Aged 12 or Older, by Detailed Age Category: Percentages, 2017 and 2018. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm#tab7-16b. Accessed 12/2/19.

17 National Institute on Alcohol Abuse and Alcoholism (NIAAA). Alcohol Alert, No. 67, “Underage Drinking,” 2006. Available at: https://pubs.niaaa.nih.gov/publications/AA67/AA67.htm. Accessed 9/19/16.

18 SAMHSA. The estimates are weighted by the person-level analysis weight and derived from the 2018 NSDUH public-use data file. Past-month alcohol use: a drink of an alcoholic beverage (a can or bottle of beer, a glass of wine or a wine cooler, a shot of distilled spirits, or a mixed drink with distilled spirits in it), not counting a sip or two from a drink in the past 30 days. Past-month binge alcohol use: 5 or more drinks on the same occasion for males or 4 or more drinks on the same occasion for females on at least 1 day in the past 30 days. Past-month heavy alcohol use: 5 or more drinks on the same occasion for males or 4 or more drinks on the same occasion for females on each of 5 or more days in the past 30 days. Full-time college students: full-time students ages 18 to 22 enrolled in school and at college level. Other persons aged 18–22: those not enrolled in school, enrolled in college part-time, enrolled in other grades either full- or part-time, or enrolled with no other information available. National Survey on Drug Use and Health (NSDUH) 2018 (NSDUH-2018) Public-Use File Dataset. Available at: https://www.datafiles.samhsa.gov/study/national-survey-drug-use-and-health-nsduh-2018-nid18757. Accessed 11/15/19.

19 Hingson, R.W.; Zha, W.; and Weitzman, E.R. Magnitude of and trends in alcohol-related mortality and morbidity among U.S. college students ages 18–24, 1998–2005. Journal of Studies on Alcohol and Drugs (Suppl. 16):12–20, 2009. PMID: 19538908.

20 Hingson, R.; Heeren, T.; Winter, M.; et al. Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18–24: Changes from 1998 to 2001. Annual Review of Public Health 26:259–279, 2005. PMID: 15760289

21 Blanco, C.; Okuda, M.; Wright, C. et al. Mental health of college students and their non-college-attending peers: Results from the National Epidemiologic Study on Alcohol and Related Conditions. Archives of General Psychiatry 65(12):1429–1437, 2008. PMID: 19047530

22 Wechsler, H.; Dowdall, G.W.; Maenner, G.; et al. Changes in binge drinking and related problems among American college students between 1993 and 1997: Results of the Harvard School of Public Health College Alcohol Study. Journal of American College Health 47(2):57–68, 1998. PMID: 9782661

23 Stratton, K.; Howe, C.; Battaglia, F.; Eds. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: Institute of Medicine, National Academy Press, 1996.

24 May, P.A.; Gossage, J.P.; Kalberg, W.O.; et al. Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies. Developmental Disabilities Research Reviews 15(3):176–192, 2009. PMID: 19731384

25 May, P.A.; Keaster, C.; Bozeman, R.; et al. Prevalence and characteristics of fetal alcohol syndrome and partial fetal alcohol syndrome in a Rocky Mountain Region City. Drug and Alcohol Dependence 155:118–127, 2015. PMID: 26321671

26 Estimated liver disease deaths include deaths with the underlying cause of death coded as alcoholic liver disease (K70), liver cirrhosis, unspecified (K74.3–K74.6, K76.0, K76.9), liver cancer (C22), or other liver diseases (K71, K72, K73, K74.0–K74.2, K75, and K76.1–K76.8). Number of deaths from Multiple Cause of Death Public-Use Data File, 2018 (http://wonder.cdc.gov/mcd.html). Alcohol-attributable fractions (AAFs) from CDC Alcohol-Related Disease Impact (http://nccd.cdc.gov/DPH_ARDI/Default/Default.aspx, accessed 2/4/20). Prevalence of alcohol consumption from the National Survey on Drug Use and Health, 2018, for estimating indirect AAFs for liver cancer.

27 Yoon, Y.H.; and Chen, C.M. Surveillance Report #105: Liver Cirrhosis Mortality in the United States: National, State, and Regional Trends, 2000–2013. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism (NIAAA), 2016. Available at: http://pubs.niaaa.nih.gov/publications/Surveillance105/Cirr13.pdf. Accessed 11/7/16.

28 Singal, A.K.; Guturu, P.; Hmoud, B.; et al. Evolving frequency and outcomes of liver transplantation based on etiology of liver disease. Transplantation 95(5):755–760, 2013. PMID: 23370710 (Please note: The “almost 1 in 3” figure aggregates the total number of transplants necessitated by alcoholic cirrhosis, alcoholic liver disease plus hepatitis C virus infection, and 40 percent of transplants necessitated by hepatocellular carcinoma.)

29 National Cancer Institute. Alcohol Consumption, November 2015 update. Available at: http://www.progressreport.cancer.gov/prevention/alcohol. Accessed 9/19/16.

30 National Institute on Alcohol Abuse and Alcoholism (NIAAA). NIAAA Council Approves Definition of Binge Drinking. NIAAA Newsletter, No. 3, Winter 2004. Available at: https://pubs.niaaa.nih.gov/publications/Newsletter/winter2004/Newsletter_Number3.pdf. Accessed 9/19/16.

31 Substance Abuse and Mental Health Services Administration (SAMHSA). Binge Drinking: Terminology and Patterns of Use, 2016. Available at: https://www.samhsa.gov/data/report/2017-methodological-summary-and-definitions. Accessed 1/18/17.

Updated: February 2020