N.I.A. A.A.

The realization dawned gradually as researchers analyzed data from NIAAA’s 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). In most persons affected, alcohol dependence (commonly known as alcoholism) looks less like Nicolas Cage in Leaving Las Vegas than it does your party-hardy college roommate or that hard-driving colleague in the next cubicle.

We’ve come to expect so much in our lives to be tailored to our personal preferences—from our music playlists, to our coffee choices, to our exercise workouts. Now, thanks to the concept of personalized medicine, health care options are beginning to follow suit. As in other areas of medicine, researchers in the alcohol field are taking a personalized approach to understanding, preventing, and treating alcohol-related problems across the lifespan.

Excessive alcohol use causes an estimated 79,000 deaths per year in the United States. Most people are unaware that close to half of these deaths (approximately 36,000 annually) result from chronic alcohol-related illnesses rather than acute causes such as motor vehicle crashes and falls.

Problematic alcohol use—that is, heavy drinking, or drinking that is accompanied by unpleasant consequences—tends to increase as people go through late adolescence, peaking at about age 22 or so, and then decline as they grow older. Some researchers consider this decline, which has been studied for more than 70 years in many different countries and cultures, a “maturing out” of problem drinking.

Alcohol-related deaths among U.S. college students rose from 1,440 deaths in 1998 to 1,825 in 2005, along with increases in heavy drinking and drunk driving, according to an article in the July supplement of the Journal of Studies on Alcohol and Drugs.

Although the benefits and risks associated with moderate drinking have gained increasing attention in recent years from both researchers and the general public, no universal definition of moderate drinking exists. Most currently used definitions are based on a certain number of drinks consumed in a specific time period. Defining a “drink,” however, also is difficult.

As you change your drinking, it's normal and common to have urges or a craving for alcohol. The words "urge" and "craving" refer to a broad range of thoughts, physical sensations, or emotions that tempt you to drink, even though you have at least some desire not to. Fortunately, urges to drink are short-lived, predictable, and controllable.

Small changes can make a big difference in reducing your chances of having alcohol-related problems. Whatever strategies you choose, give them a fair trial. If one approach doesn't work, try something else. But if you haven't made progress in cutting down after 2 to 3 months, consider quitting drinking altogether, seeking professional help, or both.

Are you ready to change your drinking? If so, choose whether to cut down or quit and make a change plan. Don't be surprised if you continue to have mixed feelings. You may need to re-make your decision several times before becoming comfortable with it.

Individual risks vary. People can still have problems drinking within these limits, particularly if they drink too quickly, have health problems, or are older (both men and women over 65 are generally advised to have no more than 3 drinks a day or 7 per week). Based on your health and how alcohol affects you, you may need to drink less or not at all.