Alcohol abuse continues to be the most serious drug problem on college campuses throughout the United States. Every year drinking kills more than 1 700 students and injures about 500 000 more; it is also a factor in 600 000 assaults and 100 000 rapes on college campuses. Enzyme-mediated metabolic pathways break down the toxic ethanol in alcoholic beverages. Ethanol kills liver cells and interferes with normal metabolic processes. Long-term heavy drinking causes alcoholic hepatitis inflammation and destruction of liver tissue and cirrhosis. Cirrhosis prevents the liver from removing drugs and other toxins from the blood so they accumulate in the brain where they impair mental functioning and alter personality. Restricted blood flow through the liver increases susceptibility to diabetes liver cancer and death.