Alcoholic drinks are a regulated drug. Alcoholic drinks contain ethanol, an alcohol made by fermentation, where yeast or bacteria reacts with sugars in grains, vegetables, or fruits. Examples of fermented alcoholic beverages are beer and wine. Spirits, such as vodka, go through an additional process call distillation, which removes some of the water, resulting in a higher alcohol concentration. In the United States, one "drink" has 0.6 ounces of pure alcohol in it. Therefore, one "drink" in the U.S. is: 12 ounces of beer, 8 ounces of malt liquor, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits or liquor (40% alcohol proof).
Excessive alcohol consumption includes heavy drinking and binge drinking. Heavy drinking is eight or more drinks per week for women and 15 or more drinks per week for men. Binge drinking is four or more drinks during a single occasion for women and five or more for men. Alcoholism is a chronic disease characterized by excessive drinking and a preoccupation or dependency on alcohol.
While alcohol plays an important social role in many cultures, and the occasional drink is considered harmless, excessive consumption has adverse effects. Alcohol is classified as a depressant because it can slow down motor function, speech, and reaction times. When consumed in low amounts, alcohol can help people "loosen up" socially or relax; however, the more alcohol consumed, the more the depressant effects set in. These include loss of balance, double vision, "spins" or dizziness, slurred speech, and more.
Long-term alcohol misuse or abuse can lead to several health complications. Among these are heart problems, such as stroke, high blood pressure, heart arrhythmias, and cardiomyopathy. Additionally, excessive alcohol consumption can cause fatty liver, alcoholic hepatitis, fibrosis, and cirrhosis in the liver. Alcohol is linked to several cancers, including head and neck cancer, liver cancer, colorectal cancer, esophageal cancer, and breast cancer. Alcohol is responsible for causing drunk driving crashes that claim more than 10,000 lives per year. Because of alcohol's many health complications, it is a significant factor in determining which states are the healthiest.
The legal drinking age is 21 years old in the United States and is strictly enforced. Globally, the United States ranks 25th for alcohol consumption, with about 8.7 liters of pure alcohol consumed per person per year. This is above the global average of 8.3 liters. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that most states in the U.S. exceeded their per capita alcohol consumption goal in 2016. The states set the goal at 2.1 gallons or less per year, and the average was 2.35 gallons.
New Hampshire had the highest consumption of alcohol, with alcohol consumption per capita of 4.76 gallons. This is more than double the goal set for the United States. Utah has the lowest consumption of alcohol, with alcohol consumption per capita of 1.34 gallons. This is most likely attributed to the strict alcohol regulations in Utah. Only nine states have alcohol consumption per capita less than the 2.1-gallon goal.