Skip to main content

Strategic Plan: Fiscal Years 2024-2028

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Director's Message

Dr. Koob Profile Picture

Alcohol-related problems exact an immense toll on individuals, families, and communities. In the United States, more than 178,000 people die per year from alcohol misuse, making alcohol a leading preventable cause of death.1 From the first year of the COVID-19 pandemic in 2019 through 2021, alcohol-related deaths increased approximately 38%, far outpacing previous increases of around 2% per year.2 Alcohol-related traffic fatalities increased by 14% from 2020 to 2021, their highest level since 2009.3

Alcohol misuse is linked to more than 200 diseases and injury-related conditions—including approximately 50% of liver disease deaths, 5% to 6% of cancer cases, and 4% of cancer deaths—and contributes substantially to health care costs and lost productivity.4,5The adverse effects of alcohol are extensive and impact health in ways that many people may not realize. In addition, nearly 30 million people in the United States have alcohol use disorder (AUD), and less than 10% of them receive treatment or help.6,7

The mission of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) is to generate and disseminate fundamental knowledge about the adverse effects of alcohol on health and well-being and to apply that knowledge to improve the diagnosis, prevention, and treatment of alcohol-related problems, including AUD, across the life course. For more than 50 years, NIAAA has been at the forefront of cutting-edge alcohol research that has significantly expanded our understanding of the factors that contribute to alcohol-related problems and the mechanisms through which they develop.

Thanks to NIAAA-supported research, AUD is widely regarded as a treatable chronic disorder stemming from various genetic and environmental factors, like many other common chronic health conditions. Accumulating evidence demonstrating the health risks of alcohol at all levels, along with the recent cultural shift around sober curiosity in the United States, have provided NIAAA new opportunities to lead the changing conversation around alcohol.

We have developed and promoted materials which help individuals and communities reevaluate their relationship with alcohol, and change how alcohol-related health issues are perceived and addressed in health care. These efforts, supported by advances in basic, translational, and clinical research, are leading to more effective prevention, diagnosis, and treatment of alcohol misuse and are helping to reduce stigma associated with alcohol-related problems as well as the stigma associated with choosing not to drink.

NIAAA’s strategic plan charts a course for the next five years as we seek to address alcohol research challenges while maintaining flexibility to address emerging research opportunities and urgent public health needs. Preventing alcohol misuse at all ages, enhancing the diagnosis of AUD, fetal alcohol spectrum disorders (FASD), and other alcohol-associated pathologies, improving treatment for these conditions, and addressing health disparities in alcohol misuse and related consequences are just some of NIAAA’s most salient goals. I am optimistic that NIAAA-supported research will pave the way for future breakthroughs that will help more Americans live healthier, more productive lives.

George F. Koob, Ph.D.
National Institute on Alcohol Abuse and Alcoholism

1Centers for Disease Control and Prevention (CDC). Alcohol and Public Health: Alcohol-Related Disease Impact. [Table], Annual average for United States 2020–2021 alcohol-attributable deaths due to excessive alcohol use, all ages. [cited 2024 Mar 15]. Available from:

2National Center for Health Statistics Mortality Data on CDC WONDER. Current final multiple cause of death data, 2018–2021. [Internet]. U.S. Department of Health and Human Services; 2023 Sept [cited 2023 Feb 9]. Available from:

3National Center for Statistics and Analysis, National Highway Traffic Safety Administration. Overview of motor vehicle crashes in 2021 [Internet]. Washington: U.S. Department of Transportation; 2023 Apr [cited 2023 Apr 12]. 50 p. Available from:

4Estimated liver disease deaths include deaths with underlying causes coded as alcoholic liver disease (K70); liver cirrhosis, unspecified (K74.0–K74.2, K74.6, K76.0, K76.7, and K76.9); chronic hepatitis (K73); portal hypertension (K76.6); liver cancer (C22); or other liver diseases (K71, K72, K74.3–K74.5, K75, K76.1–K76.5, and K76.8). Number of deaths from Multiple Causes of Deaths Public-Use Data File, 2022 ( Alcohol-attributable fractions (AAFs) from CDC Alcohol-Related Disease Impact (, accessed January 12, 2024. Prevalence of alcohol consumption from the National Survey on Drug Use and Health, 2022, for estimating indirect AAFs for chronic hepatitis and liver cancer.

5Islami F, Sauer AG, Miller KD, Siegel RL, Fedewa SA, Jacobs EJ, McCullough ML, Patel AV, Ma J, Soerjomataram I, Flanders WD, Brawley OW, Gapstur SM, Jemal A. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA Cancer J Clin. 2018 Jan;68(1):31-54. doi:10.3322/caac.21440. Epub 2017 Nov 21. PubMed PMID: 29160902

6Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Behavioral Health Statistics and Quality. 2022 National Survey on Drug Use and Health. Table 5.9A—Alcohol use disorder in past year: among people aged 12 or older; by age group and demographic characteristics, numbers in thousands, 2021 and 2022. [cited 2023 Dec 8]. Available from:

7SAMHSA, Center for Behavioral Health Statistics and Quality. 2022 National Survey on Drug Use and Health. Table 5.32B—Received substance use treatment in past year: among people aged 12 or older; by age group and past year drug use disorder, past year alcohol use disorder, past year drug and alcohol use disorder, and past year substance use disorder, percentages, 2021 and 2022. [cited 2023 Dec 13]. Available from:

Looking for U.S. government information and services?