Alcohol Industry

Alcohol consumption is common in the United States. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that more than half of adults aged eighteen and older drink at least once a month. Most people who choose to drink can do so without disrupting their lives. However, alcohol is a mood-altering and addictive substance that presents health and safety risks. Alcohol abuse is a pattern of excessive consumption of alcohol through heavy drinking or binge drinking. The Centers for Disease Control and Prevention (CDC) defines heavy drinking as eight or more alcoholic drinks per week for women and fifteen or more for men. Binge drinking occurs when a woman consumes four or more alcoholic drinks or a man consumes five or more during a two-hour period.

The alcohol and tobacco industries spend billions of dollars annually to market their products. During the year spanning the third financial quarter of 2016 to the second quarter of 2017, the alcohol industry spent over $2.2 billion on advertising in the United States, representing a steady increase in annual spending for the industry. In 2016 the tobacco industry spent $9.5 billion on advertising and promotional efforts. Companies in both industries have applied a wide variety of marketing strategies. These methods include traditional advertising venues, such as print, radio, and television commercials, but also more sophisticated campaigns that include sponsoring events, providing retailers with promotional materials, arranging to have their products featured in films, and offering customers free merchandise that features a brand's logo. Alcohol and tobacco companies have increasingly used social media for marketing in the twenty-first century, usually by promoting sponsored events or paying popular social media personalities, commonly referred to as influencers, to post pictures of themselves using the product or sharing one of the companies' ads.

Drinking alcoholic beverages is a pastime enjoyed by many people. Alcohol is often consumed for social reasons or for the purposes of relaxation, and drinking may accompany holidays and other celebrations. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), as of 2015, 86.4 percent of US adults (ages eighteen and older) had consumed alcohol during their lifetime. Among all adults, 70.1 percent had consumed alcohol in the past year and 56 percent had done so in the past month. A Gallup poll, meanwhile, found that 65 percent of adults in July 2019 "had occasion to use" alcohol beverages. In the United States, the National Minimum Drinking Age Act permits sales of alcoholic beverages to those twenty-one years and older.

Since the early 1980s, the number of alcohol-related fatalities on US roads has followed a steady downward trend, due in large part to effective public awareness and law enforcement campaigns. However, alcohol-impaired driving remains a serious problem. According to the US Department of Transportation's National Highway Traffic Safety Administration (NHTSA), about thirty people die in the United States every day as the result of a motor vehicle crash involving an alcohol-impaired driver, equating to an average of one death every forty-eight minutes or almost 11,000 fatalities per year. In 2017 alcohol was a factor in 29 percent of all fatal motor vehicle crashes in the United States, including 19 percent of fatal crashes involving children age fourteen and younger.

Many groups require prospective members to go through an initiation ritual in order to gain membership. Initiation rituals are often rooted in tradition and serve to demonstrate the prospective member's commitment to joining the group. For example, individuals joining a Christian church may go through the ritual of baptism. However, when an initiation ritual involves the humiliation, endangerment, or abuse of the prospective member, the practice is referred to as hazing. Hazing comes in many forms and can result in physical and psychological harm. More subtle forms of hazing involve verbal abuse, belittling and humiliating prospective members by ignoring them, forcing them to perform menial tasks, or requiring them to wear embarrassing clothing. Violent hazing can include forced alcohol consumption, forced sleep deprivation, physical abuse, sexual assault, and other forms of harassment.

Peer pressure refers to the pressure people feel to conform to the prevailing behaviors in their peer groups. The related concept of peer influence is used to describe situations in which a person does something he or she would not normally do in an effort to impress or gain the acceptance of peers or friends. While adults also experience peer pressure, these terms are most often used in reference to social interactions among children and adolescents. In theory, individuals are always free to refuse or resist peer pressure. However, in practice, this choice can be difficult to follow through with, particularly among young people who place a very high value on social acceptance. In other cases, a child or adolescent may not know how to safely extract him or herself from a peer pressure situation, which can result in submitting to pressure simply because it is the easiest option.

Rape and sexual assault are violent crimes and forms of sex discrimination that are illegal under federal, state, and tribal law. According to the US Department of Justice (DOJ), sexual assault is the performance of any nonconsensual sexual act prohibited under law. Many behaviors fall under the category of sexual assault, including unwanted touching and verbal threats of sexual violence. Rape is a form of sexual assault defined by federal law enforcement as "the penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim."

Alcohol is produced by a chemical process known as fermentation, in which microorganisms (bacteria or yeast) transform the sugars found naturally in fruits, vegetables, and grains into alcohol, carbon dioxide, and energy. Alcohol production can be expedited by providing optimal environmental conditions for these microbes. Five basic molecular forms of alcohol have been discovered. These forms vary only in the number of carbon atoms in each molecule, but this small difference results in substantial differences in their characteristics. Methanol (CH3OH), for example, is an extremely dangerous form of alcohol that can cause death shortly after ingestion.

Beer and distilled spirits dominate alcohol consumption in the United States, accounting for approximately 56 percent and 30 percent of total consumption (in terms of absolute alcohol), respectively (Impact Databank, 2007). The U.S. alcohol industry is highly concentrated. Two companies—Anheuser-Busch and the merged groups SABMiller and Molson–Coors—account for approximately 80 percent of the beer sold in the United States. Ten distilled spirits companies account for 80 percent of spirits sales; the top five are responsible for 62 percent of total sales.

Fetal alcohol syndrome (FAS) is a constellation of behavioral, growth, and facial abnormalities resulting from prenatal alcohol exposure. Diagnosis is made by a specially trained physician and is based on the presence of three criteria: a pattern of distinct and specific facial abnormalities; growth deficiency; and central nervous system (CNS) damage, with or without confirmed maternal alcohol consumption. FAS is at one end of a spectrum, now termed “fetal alcohol spectrum disorders” (FASD). FASD is used as an umbrella term. If a child has some, but not all, of the criteria for FAS, they have one in a spectrum of disorders, covered by the terms ARBD, alcohol-related birth defects, and ARND, alcohol-related neurodevelopmental disorder. Use of the term FAE, fetal alcohol effects, is discouraged because of non-specificity. FASD, short of full FAS, requires documentation of prenatal alcohol exposure.

The term alcohol-drug interaction refers to the possibility that alcohol may alter the intensity of the pharmacological effect of a drug, so that the overall actions of the combination of alcohol plus drug are additive, potentiated, or antagonistic. Such interactions can be divided into two broad categories—pharmacokinetic and pharmacodynamic. Pharmacokinetics are concerned with the extent and rate of absorption of the drugs, their distribution within the body, binding to tissues, biotransformation (metabolism), and excretion. Pharmacokinetic interactions refer to the ability of alcohol to alter the plasma and tissue concentration of the drug and/or the drug metabolites, such that the effective concentration of the drug at its target site of action is significantly decreased or increased. Pharmacodynamics are concerned with the biochemical and physiological effects of drugs and their mechanisms of action. Pharmacodynamic interactions refer to the combined actions of alcohol and the drug at the target site of action, for example, binding to enzyme, receptor, carrier, or macromolecules. Pharmacodynamic interactions may occur with or without a pharmacokinetic component. For many drugs acting on the central nervous system that exhibit cross-tolerance (a similar tolerance level) with alcohol, pharmacodynamic interactions with alcohol are especially important.