Alcohol and society have been closely intertwined for a large portion of human history. Some research suggests that our interactions with alcohol can be traced back to our primate ancestors. There are various implications that result from this extensive history between humans and alcohol. Alcoholic drinks can have a range of effects on the individual human, as well as human society as a whole. The topic of alcohol can also spark a variety of opinions on the subject. While some view it as a tool that can be used social situations or as a substance that can calm them down, others criticize it for the ways in which it can degrade human health. According to a 2024 World Health Organization (WHO) report, these harmful consequences of alcohol use result in 2.6 million deaths annually, accounting for 4.7% of all global deaths. Additionally, alcohol can have different uses and societal standards based on where people live and what demographics, cultures, and religions they are part of. The complex nature of society's interaction with this substance is indicative of the diverse way that it's used and perceived.
Evolutionary history and alcohol consumption standards Humans have had interactions with alcohol for an extensive period of time. Some of the earliest evidence points back to our primate ancestors. One hypothesis known as the "drunken monkey" hypothesis proposes that these ancestors were more attracted to riper fruits due to their increased sugar and ethanol content which provided an energy efficient and nutritional substance for consumption. The earliest physical evidence of alcohol production and consumption by humans was discovered by a Stanford research team in 2018. Near what is now known as Haifa, Israel, the research team discovered remnants of alcohol that ranged between 11,700-13,700 years old. More evidence of early human and alcohol interactions come from 7,000 B.C. in ancient China and 5,980 B.C. in Georgia. There are a variety of theories as to why humans began drinking alcohol in the first place. Some of those most prominent are due to its perceived nutritional value, medicinal abilities, as well as its ability to provide hydration when clean water wasn't readily available. Because alcohol could provide these advantages, it started as a substance used to better and prolong the human life. This provides a stark contrast to the unsafe way that some humans interact with alcohol today.
Standard drink
A standard drink is a measure of alcohol consumption representing a fixed amount of pure ethanol, used in relation to recommendations about alcohol consumption and its relative risks to health. The size of a standard drink varies from 8g to 20g across countries, but 10g alcohol (12.7 milliliters) is used in the WHO Alcohol Use Disorders Identification Test (AUDIT)'s questionnaire form example, and has been adopted by more countries than any other amount.
Consumption recommendations
The recommended maximum intake (or ) of alcohol varies from no intake, to daily, weekly, or daily/weekly guidelines provided by health agencies of governments. The WHO published a statement in The Lancet Public Health in April 2023 that "there is no safe amount that does not affect health".
According to the U.S. Department of Agriculture, based on NHANES 2013–2014 surveys, women in the US ages 20 and up consume on average 6.8 grams/day and men consume on average 15.5 grams/day. A March 2023 review found light-moderate daily drinking not significantly associated with increased mortality rate, but higher intake raises risk, with women affected at lower levels than men. However, according to a 2024 systematic review and meta-analysis, even at 20 g/day (1 large beer), the risk of developing an alcohol use disorder (AUD) is nearly 3 times higher than non-drinkers, and the risk of dying from an AUD is about 2 times higher than non-drinkers.
Misconceptions While the terms "drug" and "medicine" are sometimes used interchangeably, "drug" can have a negative connotation, often associated with illegal substances like cocaine or heroin.
The term narcotic usually refers to opiates or opioids, which are called narcotic analgesics. In common parlance and legal usage, it is often used imprecisely to mean illicit drugs, irrespective of their pharmacology.WHO | Lexicon of alcohol and drug terms published by the World Health Organization. Who.int (2010-12-09). Retrieved on 2011-09-24. However, in countries with alcohol prohibition, it is classified and treated as a narcotic. Also, research acknowledges that alcohol can have similar effects to narcotics in head and/or trunk trauma situations. In addition to these findings, recent research indicates that among chronic pain patients on long-term opioid therapy, alcohol consumption is connected to heightened opioid cravings.
The normalization of alcohol consumption, along with past misconceptions about its health benefits, also promoted by the industry, further reinforces the mistaken idea that it is not a "drug". Even within the realm of scientific inquiry, the common phrase "drugs and alcohol" persists, implying that alcohol is somehow separate from other drugs.
Criticism of the alcohol industry may note that the industry argues that "alcohol is not a drug". Also, some religious organizations, such as the Catholic Church, requires alcoholic sacramental wine in the Eucharist and do not explicitly categorize alcohol as a "drug" in the same manner as illicit substances.Code of Canon Law, 1983 This practice has been a longstanding tradition within the Church, reflecting its historical, theological significance, and normalization of alcohol use within its rituals. However, the term "Alcohol and Other Drugs", a term frequently used by public health authorities, emphasizes this inclusion by grouping alcohol with other substances that alter mood and behavior.
Paradoxically, despite being legal, alcohol, scientifically classified as a drug, has demonstrably been linked to greater social harm than most illegal drugs. This contradicts the perception some hold of alcohol being a harmless substance.
Laws, policies, and initiatives
Legal status
Alcohol consumption is fully legal and available in most countries of the world. Home made alcoholic beverages with low alcohol content like wine, and beer is also legal in most countries, but distilling moonshine outside of a registered distillery remains illegal in most of them.
Some majority-Muslim countries, such as Saudi Arabia, Kuwait, Pakistan, Iran and Libya prohibit the production, sale, and consumption of alcoholic beverages because they are forbidden by Islam. Laws banning alcohol consumption are found in some Indian states as well as some Native American reservations in the U.S.
In addition, there are regulations on alcohol sales and use in many countries throughout the world. For instance, the majority of countries have a minimum legal drinking age to purchase or consume alcoholic beverages, although there are often exceptions such as underage consumption of small amounts of alcohol with parental supervision. Also, some countries have bans on public intoxication. Drinking while driving or intoxicated driving is frequently outlawed and it may be illegal to have an open container of alcohol or liquor bottle in an automobile, bus or aircraft.
In Iran, consumption of alcohol (one glass) is punished by 80 lashes, but repeated offenses may lead to death penalty, although rarely exercised. In 2012, two men were sentenced to death after a third offense in Khorasan.
Minimum pricing policies The "R" in WHO's SAFER initiative stands for "Raise prices on alcohol through excise taxes and pricing policies," emphasizing the importance of economic measures to mitigate alcohol-related harm.
The Alcohol (Minimum Pricing) (Scotland) Act 2012 is an Act of the Scottish Parliament, which introduces a statutory minimum price for alcohol, initially 50p per unit, as an element in the program to counter alcohol problems.
The Liquor Act 2019 is an act enacted and signed into legislation by the Northern Territory Legislative Assembly in 2019, which introduces a statutory minimum price for alcohol in order to counter alcohol problems.
The Public Health (Minimum Price for Alcohol) (Wales) Act 2018 (anaw 5) is an Act of the National Assembly for Wales, which introduces a statutory minimum price for alcohol, initially 50p per unit, as an element in the programme to counter alcohol problems.
Austria, Switzerland and Germany determine that a barkeeper has to offer one or more non-alcoholic beverages at a cheaper price than any alcoholic drink. Before the so-called Apfelsaft-Paragraph (apple juice clause) was established in Germany in 2002 beer was often the cheapest beverage available.
Alcohol packaging warning messages
Alcohol packaging warning messages (alcohol warning labels, AWLs) are warning messages that appear on the packaging of alcoholic drinks concerning their health effects.
A WHO report, published in 2017, stated:
Alcohol server training
Alcohol server training is a form of occupational education typically provided to servers, sellers and consumers of alcohol to prevent intoxication, drunk driving and underage drinking. This training is sometimes regulated and mandated by state and local laws, predominantly in North America, and increasingly in other English-speaking countries such as Australia. In some places, such as Australia, gaining such qualifications is required by law, before one can work to sell alcohol.
Parental supervision of alcohol consumption for minors
Some parents are willing to provide alcohol for their children if they drink it in a controlled environment. Furnishing alcohol to one's own children is permitted in 31 states, while it's illegal to do so for other people's children in all fifty states. However, despite research indicating negative consequences, many parents mistakenly believe that providing alcohol to their underage children will protect them from drinking-related harm. This misconception persists even though studies have shown a connection between parental alcohol supply and unfavorable outcomes related to alcohol consumption among minors. Parental provision of alcohol during childhood may raise the risk of risky drinking in adolescence. However, methodological limitations hinder causal conclusions. To clarify this relationship, more robust longitudinal studies are needed that differentiate between sips and full drinks, accurately measure confounding factors, and apply multivariable adjustments.
Parental attitudes that are less restrictive regarding children's alcohol consumption are linked to an earlier onset of alcohol use, increased frequency of use, and higher instances of drunkenness among children. Additionally, when children perceive their parents as having more lenient attitudes towards alcohol, they are more likely to engage in drinking themselves. Adolescents permitted to drink by their parents were more likely to quickly move from their first drink to binge drinking (5 or more drinks at once) and heavy drinking (3 or more times in the past year). These findings contradict the belief that parental approval of underage drinking protects against alcohol misuse, highlighting the risks associated with adolescent heavy drinking.
Parents may face significant legal consequences in various countries and jurisdictions if they knowingly allow their children to drink alcohol without supervision. This liability arises from a perceived failure to protect the child from the risks associated with alcohol consumption, which could lead to investigations by child protective services.
Alcohol-use initiatives
United Nations Sustainable Development Goal 3 is part of "The Alcohol Policy Playbook," which is a resource for reaching the goals of the WHO European Framework for Action on Alcohol (2022–2025) and the WHO Global Alcohol Action Plan (2022–2030).