1. Alcohol and Drinking leads to many bad things and causes problems in a family.

2. Alcohol use health consequences are considerable; prevention efforts are needed, particularly for Adolescents and college students. The national minimum legal drinking age of 21 years is a primary alcohol- control policy in the United States. An advocacy group supported by some college presidents seeks public debate on the minimum legal drinking age and proposes reducing it to 18 years.

3. We reviewed recent trends in drinking and related consequences, evidence on effectiveness of the minimum legal drinking age of 21 years, research on drinking among college students related to the minimum legal drinking age, and the case to lower the minimum legal drinking age.

4. Evidence supporting the minimum legal drinking age of 21 years is strong and growing. A wide range of empirically supported interventions is available to reduce underage drinking. Public health professionals can play a role in advocating these interventions.

5. Alcohol consumption is the third leading actual cause of death in the United States, a major contributing factor to unintentional injuries, the leading cause of death for youths and young adults, and accounts for an estimated 75 000 or more total deaths in the United States annually.

6. Gaining access to information concerning mood states and expectations of change preceding a typical drinking occasion is important for understanding the trigger factors for drinking, and for alcohol abuse treatment planning. The objective of the present study was twofold: (i) to explore self-reported states of mood and expectancies preceding a typical drinking occasion vs. relations with parents and drinking outcome; and (ii) to investigate if vulnerability factors in terms of personality and health are related to severity of alcohol problems.

7. Moods were described by patients as mostly negative and expectancies of change were evenly distributed between reducing, enhancing or flight from feeling. An expectancy of flight when drinking was also related to a positive relation to mother. The findings pointed to the need for differentiating between coping with and expectancies of drinking. Further, a hierarchical cluster analysis resulted in two groups, indicating one group characterized by higher risk values on personality scales and more severe consequences of drinking.

8. Addressing the expectancies of alcohol- induced changes associated with drinking is crucial for establishing a motivation to reduce drinking, and is related to successful treatment for alcohol abusers. Motives or trigger factors to regulate emotions include different mood states where drinking alcohol is a way to change both positive and negative emotions. A number of evidence-based methods have been developed for psychological treatment of women with alcohol problems aiming to enhance motivation and self- efficacy, such as Motivational Interviewing and the Relapse Prevention Model.

9. Common assumptions for these treatment methods are that drinking alcohol is characterized by unique patterns of antecedents and consequences for changing moods and attaining certain valued outcomes. Mood states during alcohol intoxication are generally seen as promoting affective response, but for individuals with an increased alcohol tolerance, additional aspects must be taken into consideration.

10. Studies on alcohol expectancies have indicated a significant relation to the history of parental alcohol abuse. It was reported that offspring from parents with alcohol problems have different expectancies of drinking concerning both problem drinking symptoms and quantity/frequency of alcohol use. In another study, neither differences were found in relation to personal consumption nor in alcohol expectancies when the total group was analyzed; however, among the women who felt personal responsibility for their parents’ alcohol abuse behavior, a typical characteristic of higher global positive expectancies of drinking was obtained.

11. A community sample of 719 adults between 55 and 65 years of age who consumed alcohol at or prior to baseline participated in a survey of alcohol consumption and drinking problems and was followed 10 years and 20 years later. The likelihood of excessive drinking declined over the 20-year interval as adults matured into their 70s and 80s. However, at ages 75–85, 27.1% of women and 48.6% of men consumed more than two drinks per day or seven drinks per week.

12. A significant number of older adults have ongoing problems with alcohol. It has been estimated that between 10% and 50% of individuals aged 60 years or older drink in excess of current guidelines for alcohol consumption. Even among adults 75 years or older, up to 20–25% may engage in episodic heavy drinking. Such excessive alcohol consumption contributes to elevated mortality, morbidity and health- care costs.

13. Most of the research on high-risk patterns of alcohol consumption and their associations with drinking problems has focused upon mixed-age samples that include relatively few older adults. Some cross-sectional findings on older adults show that alcohol consumption and heavy drinking tends to decline with age, and these findings have been supported by a recent longitudinal cohort study. In general, however, it is not clear whether these declines in alcohol use are linked to reductions in older adults’ drinking problems or, if so, whether there are gender differences in any such reductions.

14. To examine these issues, we use longitudinal data from a community sample of older women and men to address two sets of questions: among older adults who consume alcohol, how frequently do they drink and what proportion engage in guideline-defined excessive patterns of consumption? Does this proportion decline over a 20-year interval from ages 55–65 to 75–85? Are there gender differences in excessive patterns of alcohol consumption and in changes in these patterns over time? What is the association between alternative guidelines for excessive alcohol consumption and late-life drinking problems, and do these associations vary by age or gender? Are older adults who exceed alcohol consumption guidelines more likely to incur drinking problems at ages 75–85 than at ages 55–65?

15. Several guidelines have been proposed to identify high risk drinking patterns in mixed-age populations. General nutritional guidelines recommend limits of no more than one drink per day for women and two drinks per day for men. The National Institute on Alcohol Abuse and Alcoholism has advised limits of no more than three drinks per day or seven drinks per week for women and no more than four drinks per day or 14 drinks per week for men. The American Geriatrics Society has defined high-risk drinking as more than three drinks on heavier drinking occasions or more than seven drinks per week for adults 65 and older.

16. People often justify their evening nightcap by pointing to alcohol’s ability to protect the heart. But as the chart below shows, alcohol harms far more people than it helps. That’s especially true for men since they tend to drink more than women and are more likely to binge drink as well

17. The benefits: Moderate, regular drinking generally no more than one drink a day for women and two drinks a day for men raises HDL (good) cholesterol and cuts the risk of death from heart disease by about 25 percent. It may also help prevent type 2 diabetes and ischemic strokes, the kind caused by blood clots

18. The risks: Each drink may increase the risk of cancers of the colon, rectum, liver, mouth and throat, and in women, the breast. Alcohol can also contribute to birth defects, depression, and hemorrhagic strokes, the kind caused by bleeding in the brain. Heavy drinking can harm the liver and heart as well as increase the risk of accidents, addiction, and violence. So can binge drinking, which is defined as more than three drinks in any one day for women and more than four for men.

19. The balance: The benefits of moderate drinking appear to be highest among people at increased risk of heart disease, notably men about 40 or older and women about 50 or older. In younger people, the increased risk of accidents, cancer, and violence may erase that benefit.

20. The bottom line: No one should start drinking because of alcohol’s possible health benefits. Those with a known drinking problem or certain medical conditions, or those who take medications that interact with alcohol should avoid alcohol or restrict their intake. But current drinkers don’t need to stop if they truly have it under control.