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Alcohol has been a part of human culture throughout history. In a 2015 National Survey on Drug Use and Health (NSDUH) survey, 86% of adults (>18) reported drinking alcohol at some point their life. Most adults who consume alcohol do so responsibly; however, sometimes alcohol may be consumed in patterns that are detrimental to health (for example, drinking too much, too fast and/or too often). Alarmingly, these patterns of alcohol consumption increasingly characterize the manner in which Americans consume alcohol.

An alcohol use disorder (AUD) is a chronic relapsing brain disease characterized by an inability to stop or control alcohol use despite adverse social, occupational, or health consequences. The Diagnostic and Statistic Manual (DSM-IV) describes three disorders: alcohol abuse, alcohol dependence, as well as AUD, which integrates features of both alcohol abuse and alcohol dependence. In 2017, 14.5 million adults (>18) had an AUD.

Binge drinking is an increasingly popular method to consume alcohol. Binge drinking is defined as a pattern of drinking that brings blood alcohol concentration levels to 0.08g/dL, which is typically four drinks for women and five drinks for men over a short period of time. In addition, heavy alcohol use is defined as binge drinking on five or more days in a month.

Byproducts of alcohol metabolism can be detrimental. Alcohol is metabolized by alcohol dehydrogenase and cytochrome P450 (CYP2E1) produces reactive oxygen species (ROS) and other free radicals. The ROS and free radicals react with biological molecules such as amino acids, lipids, and nucleic acids to interfere with cellular homeostasis and function resulting in cytotoxicity and inflammation. Indeed, alcohol has a documented pathological impact on the brain, heart, lungs, liver, pancreas, gastrointestinal tract, and skeleton. The negative health effects of alcohol are well established.

An intriguing observation is that only 30% of alcoholics develop organ damage like intestinal leakiness to endotoxin and alcoholic liver disease (ALD) indicating that although excessive alcohol consumption is required, it is not sufficient to cause tissue injury, and additional factor(s) are required for end organ damage. While factors like sex and genetics contribute to susceptibility to alcohol-induced pathology, additional research is necessary to uncover mechanisms.