Alcohol use as a long history and is interwoven in the fabric of most cultures. There are large variations in the amount of alcohol consumed across different countries and different religions. The generation of alcohol-related problems is proportional to the amount consumed. Approximately 60% of the population regularly utilizes alcohol but only 20% have alcohol-related problems with about 5% having the more severe problems of alcohol abuse and dependence. There is any very large amount of money spent on alcohol and one half of this is spent on illegal or unhealthy drinking. Alcohol dependence and abuse varies markedly and decreases from age 18 through age 60 and is about 50% less in women. There are ethnic and cultural variations in the amount of alcohol abuse and dependence with the highest rates seen in American Indian/Alaska natives where there are many alcohol related health problems.