Alcoholic drink

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A row of alcoholic beverages–in this case, spirits–in a bar.

An alcoholic beverage is a drink containing ethanol, commonly known as alcohol. Alcoholic beverages are divided into three general classes: beers, wines, and spirits. They are legally consumed in most countries, and over 100 countries have laws regulating their production, sale, and consumption.[1] In particular, such laws specify the minimum age at which a person may legally buy or drink them. This minimum age varies between 16 and 25 years, depending upon the country and the type of drink. Most nations set it at 18 years of age.[1]

The production and consumption of alcohol occurs in most cultures of the world, from hunter-gatherer peoples to nation-states.[2][3] Alcoholic beverages are often an important part of social events in these cultures. In many cultures, drinking plays a significant role in social interaction — mainly because of alcohol’s neurological effects.

Alcohol is a psychoactive drug that has a depressant effect. A high blood alcohol content is usually considered to be legal drunkenness because it reduces attention and slows reaction speed. Alcohol can be addictive, and the state of addiction to alcohol is known as alcoholism.


Alcoholic beverages that have a lower alcohol content (beer and wine) are produced by fermentation of sugar- or starch-containing plant material. Beverages of higher alcohol content (spirits) are produced by fermentation followed by distillation.


Beer is the world's oldest[2] and most widely consumed[3] alcoholic beverage and the third most popular drink overall after water and tea.[4] It is produced by the brewing and fermentation of starches which are mainly derived from cereal grains — most commonly malted barley although wheat, maize (corn), and rice are also used. Alcoholic beverages which are distilled after fermentation, fermented from non-cereal sources such as grapes or honey, or fermented from un-malted cereal grain, are not classified as beer.

The two main types of beer are lager and ale. Ale is further classified into varieties such as pale ale, stout, and brown ale.

Most beer is flavored with hops, which add bitterness and act as a natural preservative. Other flavorings, such as fruits or herbs, may also be used. The alcoholic strength of beer is usually 4% to 6% alcohol by volume (ABV), but it may be less than 1% or more than 20%.

Beer is part of the drinking culture of various nations and has acquired social traditions such as beer festivals, cantus, pub culture, pub games, and pub crawling.

The basics of brewing beer are shared across national and cultural boundaries. The beer-brewing industry is global in scope, consisting of several dominant multinational companies and thousands of smaller producers, which range from regional breweries to microbreweries .


Wine is produced from grapes, and fruit wine is produced from fruits such as plums, cherries, or apples. Wine involves a longer (complete) fermentation process and a long aging process (months or years) that results in an alcohol content of 9%–16% ABV. Sparkling wine can be made by adding a small amount of sugar before bottling, which causes a secondary fermentation to occur in the bottle.


Unsweetened, distilled, alcoholic beverages that have an alcohol content of at least 20% ABV are called spirits.[5] Spirits are produced by the distillation of a fermented base product. Distilling concentrates the alcohol and eliminates some of the congeners.

Spirits can be added to wines to create fortified wines, such as port and sherry.

Alcohol content of beverages

The concentration of alcohol in a beverage is usually stated as the percentage of alcohol by volume (ABV) or—in the United States—as proof. In the U.S., proof is twice the percentage of alcohol by volume at 60 degrees Fahrenheit (e.g., 80 proof = 40% ABV). Degrees proof were formerly used in the United Kingdom, where 100 degrees proof was equivalent to 57.1% ABV. Historically, this was the most dilute spirit that would sustain the combustion of gunpowder.

Ordinary distillation cannot produce alcohol of more than 95.6% ABV (191.2 proof) because at that point alcohol is an azeotrope with water. A spirit which contains a very high level of alcohol and does not contain any added flavoring is commonly called a neutral spirit. Generally, any distilled alcoholic beverage of 170 proof or higher is considered to be a neutral spirit.[6]

Most yeasts cannot reproduce when the concentration of alcohol is higher than about 18%, so that is the practical limit for the strength of fermented beverages such as wine, beer, and sake. Strains of yeast have been developed that can reproduce in solutions of up to 25% ABV.

Standard drinks

A standard drink is a notional drink that contains a specified amount of pure alcohol. The standard drink is used in many countries to quantify alcohol intake. It is usually expressed as a measure of beer, wine, or spirits. One standard drink always contains the same amount of alcohol regardless of serving size or the type of alcoholic beverage.

The standard drink varies significantly from country to country. For example, it is 7.62 ml (6 grams) of alcohol in Austria, but in Japan it is 25 ml (19.75 grams).

In the United Kingdom, there is a system of units of alcohol which serves as a guideline for alcohol consumption. A single unit of alcohol is defined as 10 ml. The number of units present in a typical drink is printed on bottles. The system is intended as an aid to people who are regulating the amount of alcohol they drink; it is not used to determine serving sizes.

In the United States, the standard drink contains 0.6 US fluid ounces (18 ml) of alcohol. This is approximately the amount of alcohol in a 12-US-fluid-ounce (350 ml) glass of beer, a 5-US-fluid-ounce (150 ml) glass of wine, or a 1.5-US-fluid-ounce (44 ml) glass of a 40% ABV (80 proof) spirit.

Serving sizes

In the United Kingdom, serving size in licensed premises is regulated under the Weights and Measures Act (1985). Spirits (gin, whisky, rum, and vodka) are sold in 25 ml or 35 ml quantities or multiples thereof. [7] Beer is typically served in pints (568 ml), but is also served in half-pints or third-pints.

In the Republic of Ireland, serving size is 37.5 ml or multiples thereof. Beer is usually served in glasses of 400 or 500 ml, but may be as much as one liter.

In the Netherlands and Belgium, standard servings are 250 and 500 ml for pilsner; 300 and 330 ml for ales.


Alcohol is a moderately good solvent for many fatty substances and essential oils. This attribute facilitates the use of flavoring and coloring compounds in alcoholic beverages, especially distilled beverages. Flavors may be naturally present in the beverage’s base material. Beer and wine may be flavored before fermentation. Spirits may be flavored before, during, or after distillation.

Sometimes flavor is obtained by allowing the beverage to stand for months or years in oak barrels, usually American or French oak.

A few brands of spirits have fruit or herbs inserted into the bottle at the time of bottling.


In many countries, people drink alcoholic beverages at lunch and dinner. Studies have found that when food is eaten before drinking alcohol, alcohol absorption is reduced[8] and the rate at which alcohol is eliminated from the blood is increased. The mechanism for the faster alcohol elimination appears to be unrelated to the type of food. The likely mechanism is food-induced increases in alcohol-metabolizing enzymes and liver blood flow.[8]

At times and places of poor public sanitation (such as Medieval Europe), the consumption of alcoholic drinks was a way of avoiding water-borne diseases such as cholera. Small beer and faux wine, in particular, were used for this purpose. Although alcohol kills bacteria, its low concentration in these beverages would have had only a limited effect. More important was that the boiling of water (required for the brewing of beer) and the growth of yeast (required for fermentation of beer and wine) would tend to kill dangerous microorganisms. The alcohol content of these beverages allowed them to be stored for months or years in simple wood or clay containers without spoiling. For this reason, they were commonly kept aboard sailing vessels as an important (or even the sole) source of hydration for the crew, especially during the long voyages of the early modern period.

In cold climates, potent alcoholic beverages such as vodka are popularly seen as a way to “warm up” the body, possibly because alcohol is a quickly absorbed source of food energy and because it dilates peripheral blood vessels (peripherovascular dilation). This is a misconception because the “warmth” is actually caused by a transfer of heat from the body’s core to its extremities, where it is quickly lost to the environment. However, the perception alone may be welcomed when only comfort, rather than hypothermia, is a concern.

Alcohol consumption by country

Alcohol consumption per capita (age 15 or older), per year, by country, in liters of pure alcohol.[9]

Outright prohibition of alcohol

Some countries forbid alcoholic beverages, or have forbidden them in the past.


In some states of India alcoholic drinks are banned, for example the states of Gujarat and Mizoram. Certain national holidays such as Independence Day and Gandhi Jayanti (birthdate of Mahatma Gandhi) are meant to be dry nationally. The state of Andhra Pradesh had imposed Prohibition under the Chief Ministership of N. T. Rama Rao but this was thereafter lifted. Dry days are also observed on voting days. Prohibition was also observed from 1996 to 1998 in Haryana. Prohibition has become controversial in Gujarat following a July 2009 episode in which widespread poisoning resulted from alcohol that had been sold illegally.[10] All of the Indian states observe dry days on major religious festivals/occasions depending on the popularity of the festival in that region.

Nordic countries

Two Nordic countries (Finland[11], and Norway[12]) had a period of alcohol Prohibition in the early 20th century. This was the result of social democratic campaigning. Prohibition did not have popular support, and it resulted in large-scale smuggling.

In Sweden, prohibition was heavily discussed, but never introduced, replaced by strict rationing and later by more lax regulation, which included allowing alcohol to be sold on Saturdays.

Following the end of prohibition, government alcohol monopolies were established with detailed restrictions and high taxes. Some of these restrictions have since been lifted. For example, supermarkets in Finland are allowed to sell only fermented beverages with an alcohol content up to 4.7% ABV, but Alko, the government monopoly, is allowed to sell wine and spirits. This is also the case with the Swedish Systembolaget and the Norwegian Vinmonopolet.

United States

Detroit police inspecting equipment found in a clandestine brewery during the Prohibition era.

In the United States, there was an attempt from 1920 to 1933 to eliminate the drinking of alcoholic beverages by means of a national prohibition of their manufacture and sale. This period became known as the Prohibition era. During this time, the 18th Amendment to the Constitution of the United States made the manufacture, sale, and transportation of alcoholic beverages illegal throughout the United States.

Prohibition led to the unintended consequence of causing widespread disrespect for the law, as many people procured alcoholic beverages from illegal sources. In this way, a lucrative business was created for illegal producers and sellers of alcohol, which led to the development of organized crime. As a result, Prohibition became extremely unpopular, which ultimately led to the repeal of the 18th Amendment in 1933.

Prior to national Prohibition, beginning in the late 19th century, many states and localities had enacted Prohibition within their jurisdictions. After the repeal of the 18th Amendment, some localities (known as dry counties) continued to ban the sale of alcohol.

Other countries

Some Muslim countries, such as Saudi Arabia, Kuwait, Sudan, and Libya prohibit the production, sale, and consumption of alcoholic beverages because they are forbidden by Islam.

Prohibition of drinking alcohol in public places

A sign prohibiting the drinking of alcohol in public places in Victoria, Australia


It is generally legal to drink alcoholic beverages in the street.[citation needed] Additional restrictions are sometimes applied by local authorities in problem areas. On public transportation, it is generally allowed to drink alcohol, but not to act heavily intoxicated.


Drinking alcohol in public is strictly prohibited in India


Japan allows open containers in some public areas, such as certain streets and trains, and allows alcoholic beverages to be sold from vending machines, which shut down at a specific time of night. Public drunkenness is not illegal in Japan.[citation needed]


Drinking in public places is not banned by national law, but many cities and towns prohibit possession of an open container of an alcoholic beverage in a public place.

United Kingdom

Drinking in public places is not banned by national law, but many cities and towns prohibit possession of an open container of an alcoholic beverage in a public place.

United States

Drinking alcohol in public places, such as streets and parks, is against the law in most of the United States. Moreover, even when a state (such as Nevada, Louisiana, and Missouri) has no such ban, the vast majority of its cities and counties do have it.

In the following places, persons over the age of 21 are allowed to possess alcoholic beverages in plastic cups on the street:

Age restrictions

Most countries have a legal drinking age that prohibits the sale of alcoholic beverages to minors. The age at which this prohibition ends, as well as the degree to which it is enforced, varies significantly from country to country.


In Argentina, the minimum age for buying alcohol is 18 years. It is illegal for anyone to sell alcoholic beverages to people under this age.[13] However, there is no minimum age for its consumption.


Although each state has its own laws governing alcohol, these laws generally are as follows:

The minimum age for buying and drinking alcohol in a licensed venue is 18 years. It is an offense to sell alcohol to minors.

Responsible consumption of alcohol is permitted at any age if it is consumed on private property. However, persons under the age of 18 must be supervised by an adult and they are held responsible for misbehavior associated with drinking.


In Canada, the legal drinking age is 18 years in the provinces of Alberta, Manitoba, and Quebec, and 19 years in the other provinces.[1]


The legal drinking age and the legal age for buying alcoholic beverages vary from country to country in Europe. The legal drinking age is usually 16 or 18 years.

Some countries have a tiered structure that limits the sale of stronger alcoholic drinks to older adults (typically based upon the percentage of ABV) . For example, in Austria, Belgium, Germany,[14] the Netherlands, and Switzerland, a purchaser of beer or wine must be 16 years of age, and 18 years of age for spirits.

Germany's law is directed toward sellers of alcoholic beverages, not toward minors. German law vests control of the consumption of alcoholic beverages in the hands of parents and guardians.[15]

In the Czech Republic, the Republic of Ireland, Poland, and Slovakia the legal drinking age is 18.


In France, the legal age for buying alcohol was increased from 16 to 18 years on July 23, 2009.

Hong Kong

In Hong Kong, the legal age to buy, possess, and drink alcohol is 18 years.


In India, the legal age for buying and drinking alcohol is 18 to 25 years, depending on the state.[1]

Generally, bars and pubs in India display signs which state that entry is allowed only for persons who are of the legal age.


In Italy, 16 years is the legal age for buying alcohol and for working in a public place where alcohol is sold. Although the minimum age in Italy for legally drinking alcohol is 14 years, it must be noted that this law is rarely enforced. The sale of alcoholic beverages is not restricted, and they are commonly sold in grocery stores and supermarkets, where no proof of age is demanded from the buyer.

A license to sell is required only for those establishments that serve alcoholic beverages to the public, as in a bar.


In Japan, the legal age for buying and drinking alcohol is 20 years.


The legal drinking age is 19 years in Korea. However, it is generally acceptable to drink after graduation from high school, even though high school graduates are usually 18.

Nordic countries

In the Nordic countries (except for Denmark), the legal drinking age is 18 years, but these rights are limited up to the age of 20.

In Iceland and Sweden, purchasers and possessors of alcoholic beverages must be 20 years of age, although 18- and 19-year-olds are allowed to drink alcohol. Also, in Sweden, 18-year-olds can legally buy alcoholic beverages that are sold in grocery stores but not those that are sold in the state-run stores.

In Finland and Norway, the purchase and possession of alcoholic beverages that have up to 22% ABV is allowed from age 18, and for stronger drinks from age 20. In Finland and Sweden (but not in Norway), drinks stronger than 22% ABV may be ordered in a restaurant from age 18.


Denmark forbids alcoholic beverages (above 1.2% ABV) to be sold to people under the age of 16 years.[16] The legal age for buying alcohol is 16 years in shops, and 18 in bars and restaurants.

Possessing and consuming alcoholic beverages is legal at any age.


In Portugal, people must be at least 16 years of age to buy alcoholic beverages.


In Ukraine, the legal drinking age is 18.

United Kingdom

In the United Kingdom, the minimum age for drinking alcohol is 5 years (in private); 16 or 17 years on licensed premises (pubs/bars/restaurants) with a table meal. In England and Wales, an adult must order; in Scotland, no adult is required to be present.

For buying alcohol from an off-license store or supermarket, the minimum age is 18 years.

Shop workers under the age of 18 may not legally sell alcohol.

For fuller information, see Legal drinking age#Europe.

United States

Exceptions to the minimum age of 18 for drinking alcohol in the United States, as of January 1, 2007.

The legal age for buying and possessing (but not necessarily for drinking) has been 21 years in every state since shortly after the passage of the National Minimum Drinking Age Act in 1984, which tied federal highway funds to states' maintaining a minimum drinking age of 21.

Despite a rekindled national debate in 2008 on the established drinking age (initiated by several university presidents) , a Fairleigh Dickinson University PublicMind poll found in September 2008 that 76% of New Jerseyans supported leaving the legal drinking age at 21 years.[17] No significant differences emerged when considering gender, political affiliation, or region. However, parents of younger children were more likely to support keeping the age at 21 (83%) than parents of college-age students (67%). [18]

Seventeen states (Arkansas, California, Connecticut, Florida, Kentucky, Maryland, Massachusetts, Mississippi, Missouri, Nevada, New Hampshire, New Mexico, New York, Oklahoma, Rhode Island, South Carolina, and Wyoming) and the District of Columbia have laws against possession of alcohol by minors, but they do not prohibit its consumption by minors.

Fourteen states (Alaska, Colorado, Delaware, Illinois, Louisiana, Maine, Minnesota, Missouri, Montana, Ohio, Oregon, Texas, Wisconsin, and Virginia) specifically permit minors to drink alcohol given to them by their parents or by someone entrusted by their parents.[citation needed]

Many states also permit the drinking of alcohol under the age of 21 for religious or health reasons.

Puerto Rico, a territory of the United States, has maintained a drinking age of 18.

United States customs laws stipulate that no person under the age of 21 may bring any type or quantity of alcohol into the country.[19]

Restrictions on production

In most countries, the commercial production of alcoholic beverages requires a license from the government, which then levies a tax upon these beverages. In many countries, alcoholic beverages may produced in the home for personal use without a license or tax.


Home production of wine and beer is not regulated. Home distillation of spirits is legal but not common because it is subject to the same tax as spirits sold commercially. Danish alcohol taxes are significantly lower than in Sweden and Norway, but higher than those of most other European countries.

New Zealand

New Zealand is one of the few countries where it is legal to produce any form of alcohol for personal use, including spirits. The beverages produced are neither licensed nor taxed. This situation has made the use of home distillation equipment quite popular.

United Kingdom

In the United Kingdom, the Customs and Excise department issues distilling licenses.

United States

The production of distilled beverages is regulated and taxed.[20] The Bureau of Alcohol, Tobacco, Firearms, and Explosives and the Alcohol and Tobacco Tax and Trade Bureau (formerly a single organization called the Bureau of Alcohol, Tobacco and Firearms) enforce federal laws and regulations related to alcohol. All packaging of alcoholic products must contain a health warning from the Surgeon General.

In most of the American states, individuals may produce wine and beer for personal consumption (but not for sale) in amounts [usually] of up to 100 gallons per adult per year, but no more than 200 gallons per household per year.

The illegal (i.e., unlicensed) production of liquor in the United States is commonly referred to as “moonshining.” Illegally produced liquor (popularly called “white lightning”) is not aged and contains a high percentage of alcohol.

Restrictions on sale and possession


In most Canadian provinces, there is a government monopoly on the sale of alcohol. Two examples of this are the Liquor Control Board of Ontario, and the Liquor Distribution Branch of British Columbia. Government control and supervision of the sale of alcohol was a compromise devised in the 1920s between “drys” and “wets” for the purpose of ending Prohibition in Canada. Some provinces have moved away from government monopoly. In Alberta, privately owned liquor stores exist, and in Quebec a limited number of wines and liquors can be purchased at dépanneurs and grocery stores.

Canada has some of the highest excise taxes on alcohol in the world. These taxes are a source of income for governments and are also meant to discourage drinking. (See Taxation in Canada.)

Restrictions on the sale of alcohol vary from province to province. In Alberta, changes introduced in 2008 included a ban on “happy hour,” minimum prices, and a limit on the number of drinks a person can buy in a bar or pub at one time after 1 a.m.[21]

Nordic countries

In each of the Nordic countries, except Denmark, the government has a monopoly on the sale of liquor.

The state-run vendor is called Systembolaget in Sweden, Vinmonopolet in Norway, Alko in Finland, Vínbúð in Iceland, and Rúsdrekkasøla Landsins in the Faroe Islands. The first such monopoly was in Falun in the 19th century.

The governments of these countries claim that the purpose of these monopolies is to reduce the consumption of alcohol. In the Nordic countries, binge drinking is an ancient tradition. These monopolies have had success in the past, but since joining the European Union it has been difficult to curb the importation of liquor, legal or illegal, from other EU countries. That has made the monopolies less effective in reducing excessive drinking.

There is an ongoing debate over whether to retain these state-run monopolies.


In Norway, beers with an alcohol content of 4.74% by volume or less can be legally sold in grocery stores. Stronger beers, wines, and spirits can only be bought at government monopoly vendors. All alcoholic beverages can be bought at licensed bars and restaurants, but they must be consumed on the premises.

Norway levies some of the heaviest taxes in the world on alcoholic beverages, particularly on spirits. These taxes are levied on top of a 25% VAT on all goods and services. For example, 700 mL of Absolut Vodka currently retails at 275 NOK, which is about US $54.


In Sweden, beer with a low alcohol content (called folköl, 2.25% to 3.5% alcohol by weight) can be sold in regular stores to anyone older than 18 years, but beverages with a high alcohol content can only be sold by government-run vendors to people older than 20, or by licensed facilities such as restaurants and bars, where the age limit is 18. Alcoholic drinks bought at these licensed facilities must be consumed on the premises; it is not allowed to consume alcoholic drinks bought elsewhere.

United States

This convenience store in Michigan had its retail license suspended for two weeks because it sold alcoholic beverages to minors.
Map of open container laws in the United States by state, as of September 2007
See also: Alcohol laws of Kansas, Alcohol laws of Missouri, Alcohol laws of New York, Alcohol laws of Oklahoma

In the United States, the sale of alcoholic beverages is controlled by the individual states, by the counties or parishes within each state, and by local jurisdictions. A county that prohibits the sale of alcohol is known as a dry county. In some states, liquor sales are prohibited on Sunday by a blue law.

The places where alcohol may be sold or possessed, like all other alcohol restrictions, vary from state to state. Some states, like Nevada, Louisiana, Missouri, and Connecticut, have very permissive alcohol laws, whereas other states, like Kansas and Oklahoma, have very strict alcohol laws.

For example, in most of North Carolina, beer and wine may be purchased in retail stores, but distilled spirits are only available at state ABC (Alcohol Beverage Control) stores. In Maryland, distilled spirits are available in liquor stores except in Montomery County, where they are sold only by the county.

Many states require that liquor may be sold only in liquor stores. In nineteen alcoholic beverage control states, the state has a monopoly on the sale of liquor. In Nevada, Missouri, and Louisiana, state law does not specify the locations where alcohol may be sold.

Most states follow a three-tier system in which producers cannot sell directly to retailers, but must instead sell to distributors, who in turn sell to retailers. Exceptions often exist for brewpubs (pubs which brew their own beer) and wineries, which are allowed to sell their products directly to consumers.

Most states also do not allow open containers of alcohol inside moving vehicles. The federal Transportation Equity Act for the 21st Century of 1999 mandates that, if a state does not prohibit open containers of alcohol inside moving vehicles, then a percentage of its federal highway funds will be transferred instead to alcohol education programs each year. As of November, 2007, only one state (Mississippi) allows drivers to consume alcohol while driving (below the 0.08% limit), and only seven states (Arkansas, Connecticut, Delaware, Mississippi, Missouri, Virginia, and West Virginia) allow passengers to consume alcohol while the vehicle is in motion.

Five U.S. states limit alcohol sales in grocery stores and gas stations to beer at or below 3.2% alcohol: Colorado, Kansas, Minnesota, Oklahoma, and Utah. In these states, stronger beverages are restricted to liquor stores. In Oklahoma, liquor stores may not refrigerate any beverage containing more than 3.2% alcohol. Missouri also has provisions for 3.2% beer, but its permissive alcohol laws (when compared to other states) make this type of beer a rarity.

Pennsylvania is starting to allow grocery stores and gas stations to sell alcohol. Wines and spirits are still sold at locations called "state stores," but wine kiosks are starting to be put in at grocery stores. The kiosks are connected to a database in Harrisburg, and purchasers must present valid ID, signature, and look into a camera for facial identification to purchase wine. Only after all of these measures are passed is the individual allowed to obtain 1 bottle of wine from the "vending machine". The kiosks are only open during the same hours as the state run liquor stores, and are not open on Sundays.

Drunk driving laws

Most countries have laws against drunk driving, i.e., driving with a certain concentration of alcohol in the blood or while impaired by alcohol. Punishments for violation include fines, temporary or permanent loss of driver's license, and imprisonment. Similar prohibitions exist for drunk sailing, drunk bicycling, and even drunk rollerblading.

The legal threshold of blood alcohol content ranges from 0.0% to 0.08% (eight hundredths of one percent).

In many places in the United States, it is illegal to have an open container of an alcoholic beverage in the passenger compartment of a vehicle.

Effects of alcohol on health

Data from The Lancet shows ethanol in comparison to other psychoactive drugs.[22]

Short-term effects of alcohol consumption include intoxication and dehydration. Long-term effects of alcohol include changes in the metabolism of the liver and brain and alcoholism (addiction to alcohol).

Alcohol intoxication affects the brain, causing slurred speech, clumsiness, and delayed reflexes. Alcohol stimulates insulin production, which speeds up glucose metabolism and can result in low blood sugar, causing irritability and (for diabetics) possible death. Severe alcohol poisoning can be fatal.

A blood alcohol content of .45% in test animals results in a median lethal dose of LD50. This means that .45% is the concentration of blood alcohol that is fatal in 50% of the test subjects. That is about six times the level of ordinary intoxication (0.08%), but vomiting or unconsciousness may occur much sooner in people who have a low tolerance for alcohol.[23] The high tolerance of chronic heavy drinkers may allow some of them to remain conscious at levels above .40%, although serious health dangers are incurred at this level.

Alcohol also limits the production of vasopressin (ADH) from the hypothalamus and the secretion of this hormone from the posterior pituitary gland. This is what causes severe dehydration when large amounts of alcohol are drunk. It also causes a high concentration of water in the urine and vomit and the intense thirst that goes along with a hangover.


Proclivity to alcoholism may be partially genetic. Persons who have this proclivity may have an atypical biochemical response to alcohol, although this is disputed.

Alcoholism can lead to malnutrition because it can alter digestion and the metabolism of most nutrients. Severe thiamine deficiency is common in alcoholism due to deficiency of folate, riboflavin, vitamin B6, and selenium ; this can lead to Korsakoff's syndrome. Alcoholism is also associated with a type of dementia called Wernicke-Korsakoff syndrome, which is caused by a deficiency in thiamine (vitamin B1).[24]

Muscle cramps, nausea, loss of appetite, nerve disorders, and depression are common symptoms of alcoholism. Osteoporosis and bone fractures may occur due to deficiency of vitamin D.

Heart disease

One study found that men who drank moderate amounts of alcohol three or more times a week were up to 35% less likely to have a heart attack than non-drinkers, and men who increased their alcohol consumption by one drink per day over the 12 years of the study had a 22% lower risk of heart attack.[25]

Daily intake of one or two units of alcohol (a half or full standard glass of wine) is associated with a lower risk of coronary heart disease in men over 40, and in women who have been through menopause.[26] However, getting drunk one or more times per month put women at a significantly increased risk of heart attack, negating alcohol's potential protective effect.[27]

Increased longevity due to alcohol consumption is almost entirely the result of a reduced rate of coronary heart disease.[28]


Long-term moderate or short-term excessive (binge) drinking has been linked to dementia; it is estimated that 10% to 24% of dementia cases are caused by alcohol consumption, with women being at greater risk than men.[29][30]

Alcoholism is associated with a type of dementia called Wernicke-Korsakoff syndrome, which is caused by a deficiency in thiamine (vitamin B1).[24]

The neurotoxic effects of alcohol on the brain are caused by alcohol's interaction with nutritional deficiencies and by the neurotoxicity of withdrawal from alcohol.[31] In rats, extended consumption of alcohol "did not produce anatomic deficits", but withdrawal from alcohol was associated with neuronal loss.[31] Alcohol interferes with the neurotransmitter glutamate, increasing (upregulating) the number of glutamate receptors in the brain. When alcohol intake is reduced, the glutamate receptors become overactive and neurotoxic.[24]

Other effects that could contribute to the toxicity of withdrawal from alcohol include the facilitation of GABA, upregulation of certain voltage sensitive calcium channels, and dopamine release.[31]

In people aged 55 or older, daily light-to-moderate drinking (one to three drinks) was associated with a 42% reduction in the probability of developing dementia and a 70% reduction in risk of vascular dementia.[32] The researchers suggest that alcohol may stimulate the release of acetylcholine in the hippocampus area of the brain.[32]


Alcohol consumption has been linked with seven types of cancer: mouth cancer, pharyngeal cancer, oesophageal cancer, laryngeal cancer, breast cancer, bowel cancer and liver cancer.[33] Heavy drinkers are more likely to develop liver cancer due to cirrhosis of the liver.[33]

The risk of developing cancer increases even with consumption of as little as three units of alcohol (one pint of lager or a large glass of wine) a day.[33]

A global study found that 3.6% of all cancer cases worldwide are caused by drinking alcohol, resulting in 3.5% of all global cancer deaths.[34] A study in the United Kingdom found that alcohol causes about 6% of cancer deaths in the UK (9,000 deaths per year).[33] A study in China found that alcohol causes about 4.40% of all cancer deaths and 3.63% of all cancer incidences.[35] For both men and women, the consumption of two or more drinks daily increases the risk of pancreatic cancer by 22%.[36]

Women who regularly consume low to moderate amounts of alcohol have an increased risk of cancer of the upper digestive tract, rectum, liver, and breast.[37][38]

Red wine contains resveratrol, which has some anti-cancer effect. However, based on studies done so far, there is no strong evidence that red wine protects against cancer in humans.[39]


Daily consumption of a small amount of pure alcohol by older women may slow or prevent the onset of diabetes by lowering the level of blood glucose.[40] However, the researchers caution that the study used pure alcohol and that alcoholic beverages contain additives, including sugar, which would negate this effect.[40]

People with diabetes should avoid sugary drinks such as dessert wines and liqueurs.[41]


A study found that lifelong abstainers were 2.36 times more likely to suffer a stroke than those who regularly drank a moderate amount of alcohol beverages. Heavy drinkers were 2.88 times more likely to suffer a stroke than moderate drinkers.[42]


Alcohol consumption by the elderly results in increased longevity, which is almost entirely a result of lowered coronary heart disease.[28] A British study found that consumption of two units of alcohol (one regular glass of wine) daily by doctors aged 48+ years increased longevity by reducing the risk of death by ischaemic heart disease and respiratory disease.[43] Deaths for which alcohol consumption is known to increase risk accounted for only 5% of the total deaths, but this figure increased among those who drank more than two units of alcohol per day.[43]

In a 2010 long-term study of an older population, the beneficial effects of moderate drinking were confirmed, but abstainers and heavy drinkers showed an increase of about 50% in mortality (even after controlling for confounding factors).[44]

Mortality rate

A report of the United States Centers for Disease Control estimated that medium and high consumption of alcohol led to 75,754 deaths in the U.S. in 2001. Low consumption of alcohol had some beneficial effects, so a net 59,180 deaths were attributed to alcohol.[45]

In the United Kingdom, heavy drinking is blamed for about 33,000 deaths a year.[46]

A study in Sweden found that 29% to 44% of "unnatural" deaths (those not caused by illness) were related to alcohol. The causes of death included murder, suicide, falls, traffic accidents, asphyxia, and intoxication.[47]

A global study found that 3.6% of all cancer cases worldwide are caused by alcohol drinking, resulting in 3.5% of all global cancer deaths.[34] A study in the United Kingdom found that alcohol causes about 6% of cancer deaths in the UK (9,000 deaths per year).[33]

Alcohol expectations

Alcohol expectations are beliefs and attitudes that people have about the effects they will experience when drinking alcoholic beverages. They are largely beliefs about alcohol's effects on a person’s behaviors, abilities, and emotions. Some people believe that if alcohol expectations can be changed, then alcohol abuse might be reduced.[48]

The phenomenon of alcohol expectations recognizes that intoxication has real physiological consequences that alter a drinker's perception of space and time, reduce psychomotor skills, and disrupt equilibrium.[49] The manner and degree to which alcohol expectations interact with the physiological effects of intoxication, resulting in specific behaviors, is unclear.

If a society believes that intoxication leads to sexual behavior, rowdy behavior, or aggression, then people tend to act that way when intoxicated. But if a society believes that intoxication leads to relaxation and tranquil behavior, then it usually leads to those outcomes. Alcohol expectations vary within a society, so these outcomes are not certain.[50]

People tend to conform to social expectations, and some societies expect that drinking alcohol will cause disinhibition. However, in societies in which the people do not expect that alcohol will disinhibit, intoxication seldom leads to disinhibition and bad behavior.[49]

Alcohol expectations can operate in the absence of actual consumption of alcohol. Research in the United States over a period of decades has shown that men tend to become more sexually aroused when they think they have been drinking alcohol, — even when they have not been drinking it. Women report feeling more sexually aroused when they falsely believe the beverages they have been drinking contained alcohol (although one measure of their physiological arousal shows that they became less aroused).

Men tend to become more aggressive in laboratory studies in which they are drinking only tonic water but believe that it contains alcohol. They also become less aggressive when they believe they are drinking only tonic water, but are actually drinking tonic water that contains alcohol.[48]

Alcohol and religion

Some religions—most notably Islam, Jainism, the Bahá'í Faith, The Church of Jesus Christ of Latter-day Saints, the Seventh-day Adventist Church, the Church of Christ, Scientist, the United Pentecostal Church International, Theravada, most Mahayana schools of Buddhism, some Protestant denominations of Christianity, and some sects of Hinduism—forbid, discourage, or restrict the drinking of alcoholic beverages for various reasons.

Many Christian denominations use wine in the Eucharist or Communion and permit alcohol in moderation. Other denominations use unfermented grape juice in Communion and either abstain from alcohol by choice or prohibit it outright.

Judaism uses wine on Shabbat for Kiddush as well as in the Passover ceremony, Purim, and other religious ceremonies. The drinking of alcohol is allowed. Some ancient Jewish texts, e.g., the Talmud, even encourage moderate drinking on holidays (such as Purim) in order to make the occasion more joyous.

Buddhist texts recommend refraining from drugs and alcohol because they may inhibit mindfulness.

Some pagan religions, however, had a completely opposite view of alcohol and drunkenness. They actively promoted them as a means of fostering fertility. Alcohol was believed to increase sexual desire and to make it easier to approach another person for sex. For example, Norse paganism considered alcohol to be the sap of Yggdrasil. Drunkenness was an important fertility rite in this religion.


Alcoholic beverages have been drunk by people around the world since ancient times. Reasons that have been proposed for drinking them include:

Some alcoholic beverages have been invested with religious significance, as in the ancient Greco-Roman religion, in the ecstatic rituals of Dionysus (also called Bacchus), in the Christian Eucharist, and in the Jewish Shabbat and festivals (particularly Passover).

Fermented beverages

Chemical analysis of traces absorbed and preserved in pottery jars from the neolithic village of Jiahu in Henan province in northern China has revealed that a mixed fermented beverage made from rice, honey, and fruit was being produced as early as 9,000 years ago. This is approximately the time when barley beer and grape wine were beginning to be made in the Middle East.

Recipes have been found on clay tablets and art in Mesopotamia that show people using straws to drink beer from large vats and pots.

The Hindu ayurvedic texts describe both the beneficial effects of alcoholic beverages and the consequences of intoxication and alcoholic diseases.

Wine was consumed in Classical Greece at breakfast or at symposia, and in the 1st century BC it was part of the diet of most Roman citizens. Both the Greeks and the Romans generally drank diluted wine (the strength varying from 1 part wine and 1 part water, to 1 part wine and 4 parts water).

In Europe during the Middle Ages, beer was drunk by the whole family. A triple fermentation process was used — the men drank the strongest beer, the women drank weaker, and children drank the weakest. A document from that time mentions nuns having an allowance of six pints of ale each day. Cider and pomace wine were also widely available; grape wine was the prerogative of the higher classes.

By the time the Europeans reached the Americas in the 15th century, several native civilizations had developed alcoholic beverages. According to a post-conquest Aztec document, consumption of the local "wine" (pulque) was generally restricted to religious ceremonies but was freely allowed to those who were older than 70 years.

The natives of South America produced a beer-like beverage from cassava or maize, which had to be chewed before fermentation in order to turn the starch into sugar. (Beverages of this kind are known today as cauim or chicha.) This chewing technique was also used in ancient Japan to make sake from rice and other starchy crops.

The medicinal use of alcohol was mentioned in Sumerian and Egyptian texts dating from about 2100 BC. The Hebrew Bible recommends giving alcoholic drinks to those who are dying or depressed, so that they can forget their misery (Proverbs 31:6-7).

Distilled beverages

Distilled alcoholic beverages were first recorded in Europe in the mid-12th century. By the early 14th century, they had spread throughout the European continent.[51] They also spread eastward from Europe, mainly due to the Mongols, and began to be seen in China no later than the 14th century.[citation needed]

Paracelsus gave alcohol its modern name, which is derived from an Arabic word that means “finely divided” (a reference to distillation).

Alcoholic beverages in American history

In the early 19th century, Americans had inherited a hearty drinking tradition. Many different types of alcoholic beverages were consumed. One reason for this heavy drinking was an overabundance of corn on the western frontier. This overabundance encouraged the widespread production of cheap whiskey. It was at this time that alcoholic beverages became an important part of the American diet. In the mid 1820s, Americans drank seven gallons of alcohol per capita annually.[52][53]

During the 19th century, Americans drank an abundance of alcohol and drank it in two distinctive ways.

One way was to drink small amounts daily and regularly, usually at home or alone. The other way consisted of communal binges. Groups of people would gather in a public place for elections, court sessions, militia musters, holiday celebrations, or neighborly festivities. Participants would typically drink until they became intoxicated.

Chemistry and toxicology

Ethanol (CH3CH2OH), the active ingredient in alcoholic drinks, for consumption purposes is always produced by fermentation – the metabolism of carbohydrates - by certain species of yeast in the absence of oxygen. The process of culturing yeast under alcohol-producing conditions is referred to as brewing. The same process produces carbon dioxide in situ, and may be used to carbonate the drink. However, this method leaves yeast residues and on the industrial scale, carbonation is usually done separately.

Drinks with a concentration of more than about 50 percent ethanol by volume (100 US proof) are flammable liquids and easily ignited. Some exotic drinks gain their distinctive flavors through intentional ignition, such as the Flaming Dr Pepper. Spirits with a higher ethanol content can be ignited with ease by heating slightly, e.g. adding the spirit to a warmed shot glass.

In the liver, the enzyme alcohol dehydrogenase oxidizes ethanol into acetaldehyde, which is then further oxidized into harmless acetic acid by acetaldehyde dehydrogenase. Acetic acid is esterified with coenzyme A to produce acetyl CoA. Acetyl CoA carries the acetyl moiety into the citric acid cycle, which produces energy by oxidizing the acetyl moiety into carbon dioxide. Acetyl CoA can also be used for biosynthesis. Acetyl CoA is an intermediate common with the metabolism of sugars and fats, and it is the product of glycolysis, the breakdown of glucose.

When compared to other alcohols, ethanol is only slightly toxic, with a lowest known lethal dose in humans of 1400 mg/kg (about 20 shots for a 100 kg person), and an LD50 of 9000 mg/kg (oral, rat). Nevertheless, accidental overdosing of alcoholic drinks, especially those of concentrated variety, is a risk, especially for women, lightweight persons and children. These people have a smaller quantity of water in their bodies, so that alcohol is diluted less. A blood alcohol concentration of 50 to 100 mg/dL may be considered legal drunkenness (laws vary by jurisdiction). The threshold of effects is at 22 mg/dL.[54]

Alcohol affects the gamma-aminobutyric acid (GABA) receptors, to produce a depressant (neurochemical inhibitory) effect. Alcohol is similar to other sedative-hypnotics such as barbiturates and benzodiazepines both in its effect on the GABAA receptor although its pharmacological profile is not identical. It has anxiolytic, anticonvulsant, hypnotic and sedative actions similar to many other sedative-hypnotic drugs. Alcohol is also cross-tolerant with benzodiazepines and barbiturates.[55]

Excessive consumption of alcohol leads to a toxication-induced delayed poisoning called hangover (in Latin, crapula refers to intoxication and hangover). Various factors contribute, including the toxication of ethanol itself to acetaldehyde, the direct toxic effects and toxication of impurities called congeners, and dehydration. The hangover starts after the euphoric effects of alcohol itself have subsided, typically in the night and morning after alcoholic drinks were consumed. However, the blood alcohol concentration may still be substantial and above the limits imposed for drivers and operators of other dangerous equipment. The effects of a hangover subside over time. Various treatments to cure hangover have been suggested, many of them pseudoscientific.

In chemistry, alcohol is a general term for any organic compound in which a hydroxyl group (-OH) is bound to a carbon atom, which in turn may be bound to other carbon atoms and further hydrogens. Other alcohols such as propylene glycol and the sugar alcohols may appear in food or beverages regularly, but these alcohols do not make them "alcoholic". Methanol (one carbon), the propanols (three carbons giving two isomers), and the butanols (four carbons, four isomers) are all commonly found alcohols, and none of these three should ever be consumed in any form. Alcohols are toxicated into the corresponding aldehydes and then into the corresponding carboxylic acids. These metabolic products cause a poisoning and acidosis. In the case of other alcohols than ethanol, the aldehydes and carboxylic acids are poisonous and the acidosis can be lethal. In contrast, fatalities from ethanol are mainly found in extreme doses and related to induction of unconsciousness or chronic addiction (alcoholism).

The raw materials of alcoholic beverages

The names of some beverages are determined by the source of the material fermented. In general, a beverage fermented from a starch-heavy source (grain or potato), in which the starch must first be broken down into sugars (by malting, for example), will be called a beer; if the mash is distilled, the end product is a spirit. Wine is made from fermented grapes.

Brandy and wine are made only from grapes. If an alcoholic beverage is made from another kind of fruit, it is distinguished as fruit brandy or fruit wine. The fruit variety must be specified, such as "cherry brandy" or "plum wine".

In the USA and Canada, cider often means unfermented apple juice while fermented cider is called hard cider. Unfermented cider is sometimes called sweet cider. In the UK, cider refers to the alcoholic drink, although in Australia the term is ambiguous.

Beer is generally made from barley, but can sometimes contain a mix of other grains. Whiskey (or whisky) is sometimes made from a blend of different grains, especially Irish whiskey which may contain several different grains. The style of whiskey (Scotch, rye, Bourbon, corn) generally determines the primary grain used, with additional grains usually added to the blend (most often barley, and sometimes oats). American Bourbon and rye whiskey must be at least 51% of respective constituent at fermentation. Corn whiskey (as opposed to Bourbon) must be at least 81%—all by American law similar to the French A.O.C (Appellation d'Origine Controlée).

Two common distilled beverages are vodka and gin. Vodka is distilled from fermented grain and potatoes. It is highly distilled so as to exhibit less of the flavors derived from its source material. Gin is a similar distillate flavored by contact with herbs and other plant products—especially juniper berries.

Applejack is made by freeze distillation.



Source Name of fermented beverage Name of distilled beverage
barley beer, ale, barley wine Scotch whisky, Irish whiskey, shōchū (mugijōchū) (Japan)
rye rye beer, kvass rye whiskey, vodka (Poland), korn (Germany)
corn chicha, corn beer, tesguino Bourbon whiskey; and vodka (rarely)
sorghum burukutu (Nigeria), pito (Ghana), merisa (southern Sudan), bilibili (Chad, Central African Republic, Cameroon) maotai, gaoliang, certain other types of baijiu (China).
wheat wheat beer horilka (Ukraine), vodka, wheat whisky, weizenkorn (Germany)
rice Beer, brem (Bali), huangjiu and choujiu (China), Ruou gao (Vietnam), sake (Japan), sonti (India), makgeolli (Korea), tuak (Borneo Island), thwon (Nepal) aila (Nepal), rice baijiu (China), shōchū (komejōchū) and awamori (Japan), soju (Korea)
millet millet beer (Sub-Saharan Africa), tongba (Nepal, Tibet)
buckwheat shōchū (sobajōchū) (Japan)

Juice of fruits

Source Name of fermented beverage Name of distilled beverage
juice of grapes, wine brandy, Cognac (France), Vermouth, Armagnac (France), Branntwein (Germany), pisco (Chile and Peru), Rakia (The Balkans, Turkey), singani (Bolivia), Arak (Syria, Lebanon, Jordan), törkölypálinka (Hungary)
juice of apples cider (U.S.: "hard cider"), apfelwein applejack (or apple brandy), calvados, cider
juice of pears perry, or pear cider; poiré (France) Poire Williams, pear brandy, Eau-de-vie (France), pálinka (Hungary)
juice of plums plum wine slivovitz, tzuica, palinca, umeshu, pálinka
juice of pineapples tepache (Mexico)
bananas or plantains Chuoi hot (Vietnam), urgwagwa (Uganda, Rwanda), mbege (with millet malt; Tanzania), kasikisi (with sorghum malt; Democratic Republic of the Congo)
gouqi gouqi jiu (China) gouqi jiu (China)
coconut Toddy (Sri Lanka) arrack, lambanog (Sri Lanka, India, Philippines)
ginger with sugar, ginger with raisins ginger ale, ginger beer, ginger wine
Myrica rubra yangmei jiu (China) yangmei jiu (China)
pomace pomace wine Raki/Ouzo/Pastis/Sambuca (Turkey/Greece/France/Italy), tsipouro/tsikoudia (Greece), grappa (Italy), Trester (Germany), marc (France), zivania (Cyprus), aguardente (Portugal), tescovină (Romania), Arak (Iraq)


Source Name of fermented beverage Name of distilled beverage
juice of ginger root ginger beer (Botswana)
potatoes or grain potato beer horilka (Ukraine), vodka: Potatoes are mostly used in Poland and Germany, otherwise grain or potatoes. A strong drink called akvavit, popular in Scandinavia, is made from potatoes or grain. In Ireland, poitín (or poteen) is a traditional liquor made from potatoes, which was illegal from 1661 to 1997.
sweet potato shōchū (imojōchū) (Japan), soju (Korea)
cassava/manioc/yuca nihamanchi (South America), kasiri (Sub-Saharan Africa), chicha (Ecuador)
juice of sugarcane, or molasses basi, betsa-betsa (regional) rum (Caribbean), pinga or cachaça (Brasil), aguardiente, guaro
juice of agave pulque tequila, mezcal, raicilla


Source Name of fermented beverage Name of distilled beverage
sap of palm coyol wine (Central America), tembo (Sub-Saharan Africa), toddy (Indian subcontinent)
sap of Arenga pinnata, Coconut, Borassus flabellifer Tuak (Indonesia) Arrack
honey mead, horilka (Ukraine), tej (Ethiopia) distilled mead (mead brandy or honey brandy)
milk kumis, kefir, blaand
sugar kilju and mead or sima (Finland) shōchū (kokutō shōchū): made from brown sugar (Japan)

See also


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