5. Romania
> Alcohol per capita (APC) consumption: 14.4 liters
> Pct. binge drinking: 7.9% (75th highest)
> Pct. of deaths, alcohol-related: 8.9% (11th highest)
> Life expectancy at birth: 68.7 years

Drinking rates among younger Romanians were particularly high. More than 37% of teenagers between 15 and 19 years old had engaged in binge drinking in the last 30 days, more than in all but a handful of countries. As is usually the case, alcohol consumption was more of an issue among males — more than 55% of Romanian men ages 15 to 19 said they had engaged in binge drinking in the previous 30 days, considerably higher than most other countries. Binge drinking may be associated with alcohol related fatalities in the county. Nearly 9% of all deaths in 2012 were alcohol related, more than in all but a handful of nations.

4. Russian Federation
> Alcohol per capita (APC) consumption: 15.1 liters
> Pct. binge drinking: 19.3% (32nd highest)
> Pct. of deaths, alcohol-related: 30.5% (5th highest)
> Life expectancy at birth: 70.5 years

Russians drank 15.1 liters of alcohol per capita in 2010, among the highest averages in the world. And annual consumption is expected to remain high in the future, staying roughly around 15 liters per capita through 2025. With 18.2% of residents suffering from alcohol use disorders, more than any country except Hungary, alcohol abuse had adverse health effects for the Russian population. As of 2012, 30.5% of all deaths in Russia were related to alcohol consumption, among the highest rates in the world. A recent study in the acclaimed British medical journal, The Lancet, noted that “Russian adults have extraordinarily high rates of premature death” and that high levels of vodka consumption contributed to higher risks of early death in the country.

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3. Lithuania
> Alcohol per capita (APC) consumption: 15.4 liters
> Pct. binge drinking: 36.7% (2nd highest)
> Pct. of deaths, alcohol-related: 30.9% (4th highest)
> Life expectancy at birth: 73.9 years

Lithuania was second only to Austria in terms of the percentage of drinkers who engaged in binge-drinking. In fact, nearly one-quarter of the women in the country engaged in binge drinking, more than women in any other country. More than 30% of deaths in Lithuania were related to alcohol consumption in 2012, a higher percentage than all but three other countries reviewed. Nearly 10% of the country’s population suffered from an alcohol use disorder, among the highest out of all nations reviewed. Although Lithuania does monitor alcohol consumption and measures its social and health consequences, drinking is still a national problem. In March, Lithuania’s Prime Minister Algirdas Butkevičius announced that his office is working with the country’s liquor industry to draft a new excise tax on alcohol as a way, in part, to fight alcoholism and help decrease the amount of alcohol sold illegally.

2. Republic of Moldova
> Alcohol per capita (APC) consumption: 16.8 liters
> Pct. binge drinking: 32.2% (8th highest)
> Pct. of deaths, alcohol-related: 33.1% (3rd highest)
> Life expectancy at birth: 81.4 years

The Republic of Moldova’s economy is relatively underdeveloped, with GDP at just $3,562 per capita in 2013. A sluggish economy and high poverty rates — 16.6% in 2012, the highest rate in Europe — may make it more difficult for residents to acquire alcohol through legitimate channels. Moldova was among the only countries where illicit alcohol consumption exceeded government sanctioned alcohol consumption, with the population consuming 10.5 liters per capita on average of illegal alcohol. Roughly one third of all deaths in Moldova could be linked to alcohol, more than in all but two other countries. Moldova’s consumption of alcohol trailed only Belarus in the WHO’s most recent study. Consumption rates, however, are projected to reach 17.4% by 2015, ahead of the prediction for Belarus. While increases in consumption rates are expected to continue well past 2015, the country adopted the National Programme of Alcohol Control in 2012 to reduce harmful alcohol use.

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1. Belarus
> Alcohol per capita (APC) consumption: 17.5 liters
> Pct. binge drinking: 26.5% (14th highest)
> Pct. of deaths, alcohol-related: 34.7% (the highest)
> Life expectancy at birth: 72.1 years

Belarus had the world’s highest level of alcohol consumption, with 17.5 liters of alcohol consumed per capita. The country’s high level of consumption has had serious health consequences on its residents. Belarus trailed just two other countries, Russia and Hungary, with 17.5% of the population suffering from an alcohol use disorder. In all, alcohol was a factor in nearly 35% of all deaths in the country, the most out of any nation in the world. Belarus has publicly and aggressively cracked down on production of bootleg alcohol. Alcohol produced illegally accounted for 3.2 liters of per capita consumption on average, among the highest levels in the world. Despite a low unemployment rate, Belarus’ economy is heavily state-controlled and often considered inefficient. The country has suffered from extraordinarily high inflation for years as well.