Skip Navigation Bar
NIH MedlinePlus the Magazine, Trusted Health Information from the National Institutes of Health

Rethinking Drinking

Dr. George Koob: "Alcohol use disorders are a major problem …"

George Koob, Ph.D.

George Koob, Ph.D., is Director of the NIH's National Institute on Alcohol Abuse and Alcoholism. A renowned expert on how alcohol affects the human brain, he oversees NIAAA's diverse program of research on the genetics, neuroscience, epidemiology, prevention, and treatment of alcohol problems.
Photo Courtesy of NIAAA

What's a Standard Drink? The percent of “pure” alcohol, expressed here as alcohol by volume, varies by beverage. 12 fl oz. beer, about 5%; 8-9 fl oz. malt liquor, about 7%; 5 fl oz. wine, about 12%; 1.5 fl oz. shot hard liquor, about 40%.

Click to enlarge image
What's a "standard drink"

Research suggests that the transition from alcohol use to alcohol use disorder involves an alcohol-induced imbalance in the brain's reward and stress systems. Moderate alcohol use initially leads to the pleasant feelings associated with mild intoxication. With excessive alcohol use, over time brain changes occur that lead to tolerance, the need for greater amounts of alcohol to experience the same pleasurable effects.

At the same time, still other brain adaptations occur that lead to unpleasant feelingsthose associated with withdrawal and depressed mood, for example—when alcohol is no longer present in the brain. These brain changes lead individuals to crave alcohol and drink excessively to ease these stressful feelings.

Research shows that pharmaceutical and behavioral therapies can help people who have alcohol problems.

Ongoing and planned research by NIAAA scientists and grantees will continue to improve our understanding of the unique molecular and cellular actions of alcohol, and how those actions change the brain in ways that lead to excessive drinking and alcohol use disorders. This expanding research knowledge will aid the development of new evidence-based prevention and treatment strategies for alcohol problems across the lifespan, including the diverse alcohol-related diseases that occur throughout the body, and help find better ways to deliver health services for alcohol problems. Another crucial aspect of addressing alcohol problems is increasing our understanding of underage drinking, particularly how high risk drinking by college students and other underage populations can be prevented.

What's a "standard" drink?

A "standard" drink (below) contains about 0.6 fluid ounces or 14 grams of "pure" alcohol. Although the "standard" amounts are helpful for following health guidelines, they may not reflect customary serving sizes. For example, a single mixed drink can contain 1 to 3 or more standard drinks, depending on the type of spirits and the recipe.

Treatment and Support

In addition to Alcohol Anonymous and other mutual support groups, alcohol use disorders can be treated with medications, behavioral therapies, and combinations of treatments. Email and the Internet have opened new avenues for diagnosis and treatment. Researchers continue to develop alternate treatment strategies, as well as multimedia support materials for the public, such as Rethinking Drinking.

For treatment and support in your area, please contact, toll-free: National Drug and Alcohol Treatment Referral Routing Service: 1-800-662-HELP (4357) or the Substance Abuse Treatment Facility Locator, an online, searchable directory of alcohol and drug abuse programs located around the country.

Spring 2014 Issue: Volume 9 Number 1 Page 22