The level of alcohol consumption that qualifies as alcohol abuse varies considerably. In Canada in 1991, it was consumption of more than 15 alcoholic drinks per week, a puritanical figure in the eyes of some Canadian physicians. A 1993 American study labelled a woman's consumption of 4, and a man's consumption of 5 alcoholic drinks in succession as a drinking binge.
Europe takes a more tolerant view. A 1996 study viewed moderate drinking as imbibing 2 to 4 glasses of wine or small glasses of beer a day. A 1997 French study claimed that 3 to 4 glasses of wine a day greatly reduced development of Alzheimer's disease, without making any inference about the dangers of alcohol abuse.
A practical definition is that an alcoholic seriously abuses alcohol and drinks intoxicating amounts of alcoholic beverages several times a day on a regular basis. Alcoholics are excessive drinkers whose addiction to alcohol has attained such a degree that there is noticeable mental disturbance or interference with their bodily or mental health, their interpersonal relations, and their smooth social and economic functioning, or they are those people who show the signs of such development. They are unable to recognize the deleterious effects of their habit or, recognizing them, are nonetheless unable to curtail their alcohol consumption and continue in an almost compulsive way to drink heavily.
Alcohol abuse can be distinguished from chronic alcoholism -- which is morbid dependence on alcohol with an easily awakened craving for alcohol, as well as loss of control (shakes and sweating) -- in that the physical and mental complications of the latter only occur in a minority of alcoholics. The complications of alcohol abuse occur primarily in the social sphere. The alcoholic takes alcohol as a mood-altering drug. He/she very early comes to rely more and more on defence mechanisms including, as well as outright denial and rationalizations, the mechanism of projection, namely the ascribing of his own defects to others; thus everything and everybody is wrong, particularly his family who may already suffer at the alcoholic's hands at a time when friends still think him to be a decent and reasonable person. Children's personality development may often be significantly affected by the alcoholic's unpredictable attitude and behaviour, leading to disturbed emotional relations with parents. Complications also occur at work. Alcoholism releases aggression which may be directed against others in anti-social and criminal acts, as well as in traffic accidents.
WHO has reported that one in ten of the world's people are dependent on alcohol and disabled by drinking.
With very few exceptions, alcoholic beverage consumption has grown markedly all over the industrial world since the Second World War, a trend which is no less prevalent in developing countries. In some countries, overall per capita consumption levels (in terms of 100% ethanol) have doubled or tripled within the last two decades. In countries are varied as America, Australia and Argentina, between one-third and one-half of all the people admitted to psychiatric hospitals need in-patient help because of the damage alcohol has done to their brains. In the developed world driving under the influence of alcohol causes between one-third and one-half of all road deaths.
Health officials estimated in 2001 that some 8 million Americans are alcoholics—they have strong cravings to drink, experience withdrawal, and need increasing amounts to feel satisfied. Another 6 million abuse alcohol but are not deemed physically dependent on it. Ten years earlier another source estimated there were approximately 4.5 million chronic alcoholics in the USA; the incidence of chronic alcoholism of all degrees is 4,390 per 100,000; and the incidence of chronic alcoholism with complications is 1,097 per 100,000.
The abuse of alcohol is a major cause of morbidity and mortality in the countries of the European region. One in ten deaths in France are directly caused by excessive alcohol consumption.
1 in 25 people in Britain are dependent on alcohol - twice as many as are dependent on drugs—causing severe problems for their families and colleagues as well as themselves. 1,4 million men (6%) and half a million women (2%) are drinking at very risky levels, over 50 units a week for men and over 35 units a week for women (1 standard unit = 8g absolute alcohol). While it has been said that 85% of all chronic alcoholics are male, it is generally agreed that females are beginning to account for a greater percentage of chronic alcoholism than was formerly the case. Women alcoholics are usually more careful to hide it for a longer period. About 80% of patients fall within the 35 to 50 year age group (those who appear superficially to be chronic alcoholics at an earlier age are likely to be in the psychopathic or schizophrenic groups.)< Alcoholism is a major killer in Russia. The average age of people suffering from alcoholism in Russia has fallen by between 5 and 7 years in the last decade, and according to research on ill patients, 90% of them started drinking before the age of 15, and one-third of them started before the age of 10. This may mirror an earlier trend in many Asian and African countries, where colonialism commercialized and expanded alcohol production and consumption, a process which often escalated after independence. However, in Russia in 1995, the state monopoly on vodka production was signed back into law as a reaction against rampant alcoholism.
The scale of home-brewed alcohol production is unknown to the authorities in most countries but has to be added to the officially registered per capita consumption figures. Finally, several countries report on increasing multiple use of various drugs and alcohol. This is still more serious as mixing alcohol and narcotic drugs is extremely hazardous.