Misuse of alcohol is extremely common in the U.S., with 138.3 million people ages 12 and older stating they regularly drank alcohol, according to the 2015 National Survey on Drug Use and Health. Of those, 48.2% reported engaging in binge drinking the month prior to taking the survey. Not everyone who drinks excessively develops alcohol use disorder (AUD), also known as alcoholism. The primary difference between heavy or problem drinking and alcoholism is the latter involves addiction. When people become physically dependent on alcohol, they experience an intense compulsion to drink. They may reach the point where nothing else seems to matter. Alcoholism Withdrawal Symptoms Another key difference between problem drinking and alcoholism is the presence of withdrawal symptoms after stopping. This is a commonality in all addictions, both behavioral and substance. Less than 50% of alcohol-dependent people develop significant withdrawal symptoms requiring pharmacologic treatment upon cessation of alcohol intake. Nevertheless, alcohol withdrawal syndrome (AWS) can be painful mentally and physically and cause a wide array of symptoms. The most dangerous is a condition called delirium tremens (DTs), which impacts 5% of people who experience AWS. DTs results in altered mental status and autonomic hyperactivity and can progress to cardiovascular collapse. While everyone is different, alcohol withdrawal typically consist of three stages: early stage, second stage and third stage. Repercussions of Alcohol Abuse Drinking too much alcohol can take a serious toll on one\u2019s physical health, with detrimental effects on the brain, heart, liver, pancreas, immune system and gastrointestinal tract. Moreover, heavy alcohol intake increases the risk of oral, esophageal, throat, liver and breast cancer. The physical effects are not limited to individuals who are addicted \u2013 heavy drinking over a period of time can also inflict serious damage. Every year, an estimated 88,000 people die from alcohol-related causes including drunk driving accidents and disease. Alcohol abuse also wreaks havoc on personal relationships and careers and leads to high levels of stress, depression, anxiety, loneliness, apathy and overall withdrawal from society. Co-Occurring Disorders Of the 15.7 million people ages 12 and older who had an AUD in 2015, 2.7 million also had an illicit drug use disorder. An estimated 623,000 people with AUD and illicit drug disorder were adolescents ages 12 to 17, 3.8 million were ages 18-25 and 11.3 million were ages 26 and older. A study found 53.3% of adolescents who abused ADHD stimulants (e.g., Ritalin or Adderall) also misused alcohol. On a positive note, the number of individuals with co-occurring substance use disorders has been steadily declining since 2002. Nearly 50% of people with any substance abuse problem, including alcohol, also had a co-existing mental illness in 2015. While the prevalence rate for AUDs is 13.5% in the general population, this is more common in bipolar disorder than any other mental illness, impacting an estimated 60% of individuals. About 30% of individuals with major depression report lifetime AUDs. Conversely, depressive symptoms are common in AUD, with more than one-third of people being treated for alcoholism meeting the diagnostic criteria for major depression at some point during their life. The prevalence is higher in women, with epidemiologic data indicating 48.5% of females with lifetime AUDs experience episodes of major depression. Underage Drinking If you are 21 or younger, it is against the law to consume alcoholic beverages, yet people ages 12 to 20 drink 11% of all alcohol consumed in the U.S. More than 90% of this alcohol is consumed when bingeing. Underage drinkers are at greater risk of incurring injuries in incidents such as car crashes, burns, falls, drowning and physical assaults, as well as unwanted pregnancy, sexual transmitted diseases and alcohol poisoning. From 2010 to 2013, there were an estimated 656,827 emergency room (ER) visits in people ages 12 to 20 related to misuse of alcohol. Of these, alcohol alone accounted for 78.8% of ER visits, while drugs and alcohol combined accounted for 21.2%. Sadly, excessive drinking is responsible for more than 4,300 deaths among underage youth every year. Drinking in Older Adults Alcohol abuse also impacts older adults, and is an emerging public health issue in the U.S. A study on about 65,000 men and women age 60 and older who were current drinkers revealed 6,500 men and 1,700 women were binge drinkers. Even though there were more male drinkers, the percentage of older male drinkers increased about 1% versus 2% in female drinkers, between 1997 and 2014. Alcohol poses specific risks to older adults due to physiological changes related to aging, such as chronic diseases and the use of medications. The Latest Alcohol Research A three-part study on non-human primates, rats and humans showed aldosterone, a hormone produced in the adrenal glands, may contribute to AUD. In humans, higher drinking levels were associated with higher aldosterone concentrations. Moreover, greater blood aldosterone concentrations correlated with increasing levels of both alcohol craving and anxiety. Together, the findings across all three species suggest a relationship between alcohol misuse, AUD and specific changes in the aldosterone\/MR pathway in a region of the brain called the amygdala. Researchers believe this pathway holds promise for the development of new pharmacotherapies for AUD.