Alcohol is a regulated drug. It is made with grains, vegetables, or fruits that are put through fermentation, a process where yeast or bacteria reacts with the sugars in the food resulting in ethanol and carbon dioxide. Beer and wine are fermented alcohols. Spirits go through an additional distillation process that removes some of the water, leaving a higher alcohol concentration and more flavor.

Alcohol is classified as a depressant as it slows down motor functions, reaction times, and speech. Alcohol consumed in low amounts, such as a glass of beer or wine, is often used to “loosen up” and will have more of a stimulant effect. When consumed in larger amounts, the depressant effects will begin to set in.

In the United States, a “drink” has 0.6 ounces of pure alcohol. A “drink” is considered to be:

Excessive drinking includes heavy drinking and binge drinking. Heavy drinking is defined as eight or more drinks per week for women and 15 or more drinks per week for men. Binge drinking is, during a single occasion, four or more drinks for women and five or more drinks for men.

While having an occasional drink is considered to be harmless, excessive consumption can lead to several health complications. Alcohol can have negative effects on the heart, including high blood pressure, stroke, arrhythmias, and cardiomyopathy. The liver can experience steatosis (fatty liver), alcoholic hepatitis, fibrosis, and cirrhosis. Additionally, alcohol consumption is linked to head and neck cancer, esophageal cancer, liver cancer, breast cancer, and colorectal cancer.

Alcohol is regulated by laws such as minimum drinking ages (most commonly 18 or 21, but varies by country), restricting open carry outside of establishments, required liquor licenses for restaurants and stores, and prohibiting the operation of motor vehicles under the influence.

The consumption of alcohol in each country varies greatly and is affected by the laws, culture, and other characteristics of each country. Alcohol.org found each country’s beer, wine, and spirits consumption per capita and converted the numbers to the pure alcohol consumption of each of these drinks. For example, one handle of vodka (1.75 liters) is about 300 milliliters of pure alcohol. The ten countries with the highest consumption of alcohol (in liters of pure alcohol per capita) are:

Belarus consumes the most alcohol in the world of 14.4 liters per person per year. This is about 48 handles of vodka per person per year. Although the Ministry of Health of Belarus denied these figures, the government implemented regulations to restrict the productions, selling, and advertisement of alcohol. These include increasing the punishment for drunk driving and increasing alcohol prices and soon raising the minimum legal drinking age to 21. A majority of the top ten countries are located in Europe.

The United States has an annual consumption per person of 8.7 liters of pure alcohol. This is above the worldwide average of 8.3 but puts the United States at the 25th spot. The minimum drinking age in the United States is 21 and is strictly enforced.