Seventy (70) percent of the population abstains or drinks less than the NIAAA "safe use" limits. Four (4) percent have severe or chronic dependence according to DSM-IV criteria. (See Table)

That leaves 26%, or one out of four citizens, somewhere between safe use and chronic dependence. These “at-risk” or “harmful use” stages of concern should be seen as an opportunity to improve health, not simply ignored as “self-willed” stair steps to deteriorating health. These are the people who fall through the cracks, failing to get screened and identified for prevention or early treatment. According to SAMHSA research, these same individuals contribute to most of the property, social, and family damage caused by alcohol and drug problems in the United States.

Heterogeneity of Alcohol Use: Diagnosis

None 70% Mild (At Risk) 21% Moderate (Harmful Use) 5% Severe (Dependence) 3% Chronic (Dependence) 1%
Never exceeds daily limits Exceeds daily limitsNo distress or harm Exceeds daily limitsHarmful Daily or nearly daily heavy drinkingImpaired control 3 to 5 criteria Daily or near daily heavy drinkingChronic or relapsing6 to 7 criteria Functional impairment

Willenbring, NIAAA, 2008