The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has played a pivotal role in advancing the understanding, prevention, and treatment of alcoholism. Since its establishment in 1970, NIAAA has provided leadership and financial support for approximately 90% of all alcohol-related research in the United States. This article reviews key advancements in alcohol research and outlines future goals. Alcoholism is recognized as a medical disorder, characterized by abnormal alcohol-seeking behavior and impaired control over drinking. Research has identified reinforcement, tolerance, and both physical and psychological dependence as significant phenomena contributing to alcoholism. NIAAA-funded studies have explored the molecular mechanisms underlying these processes, particularly the interaction between alcohol and specific receptors in the brain. Genetic and environmental factors influence vulnerability to alcoholism. Population-based studies and genetic research, including the Cooperative Agreement on Genetics of Alcoholism (COGA), have identified genetic markers and linked alcoholism to specific chromosomal locations. Animal models have also been developed to study the genetic basis of alcoholism. Environmental factors, such as sociocultural beliefs and drinking patterns, play a crucial role in alcohol-related behavior. NIAAA-sponsored research has investigated the impact of these factors on drinking behavior and the nervous system. Alcohol's medical effects include alcoholic cirrhosis, cognitive impairment, fetal alcohol syndrome (FAS), and alcohol-related trauma. NIAAA research has contributed to the development of treatments and prevention strategies, including the use of medications like naltrexone and disulfiram. Prevention efforts have expanded beyond educational programs to include targeted interventions for high-risk populations and broader strategies to reduce alcohol availability and promote healthy drinking behaviors. NIAAA research has influenced public policy, leading to initiatives such as the Federal Uniform Drinking Age Act and the inclusion of warning labels on alcoholic beverages. Treatment research has focused on improving the effectiveness of interventions through rigorous evaluation methods and patient-treatment matching. Looking ahead, NIAAA aims to determine the genetic and environmental contributors to alcoholism, develop new treatment methods, and address the needs of underserved populations. The ultimate goal is to reduce the stigma associated with alcoholism and provide hope for those affected by this disease.The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has played a pivotal role in advancing the understanding, prevention, and treatment of alcoholism. Since its establishment in 1970, NIAAA has provided leadership and financial support for approximately 90% of all alcohol-related research in the United States. This article reviews key advancements in alcohol research and outlines future goals. Alcoholism is recognized as a medical disorder, characterized by abnormal alcohol-seeking behavior and impaired control over drinking. Research has identified reinforcement, tolerance, and both physical and psychological dependence as significant phenomena contributing to alcoholism. NIAAA-funded studies have explored the molecular mechanisms underlying these processes, particularly the interaction between alcohol and specific receptors in the brain. Genetic and environmental factors influence vulnerability to alcoholism. Population-based studies and genetic research, including the Cooperative Agreement on Genetics of Alcoholism (COGA), have identified genetic markers and linked alcoholism to specific chromosomal locations. Animal models have also been developed to study the genetic basis of alcoholism. Environmental factors, such as sociocultural beliefs and drinking patterns, play a crucial role in alcohol-related behavior. NIAAA-sponsored research has investigated the impact of these factors on drinking behavior and the nervous system. Alcohol's medical effects include alcoholic cirrhosis, cognitive impairment, fetal alcohol syndrome (FAS), and alcohol-related trauma. NIAAA research has contributed to the development of treatments and prevention strategies, including the use of medications like naltrexone and disulfiram. Prevention efforts have expanded beyond educational programs to include targeted interventions for high-risk populations and broader strategies to reduce alcohol availability and promote healthy drinking behaviors. NIAAA research has influenced public policy, leading to initiatives such as the Federal Uniform Drinking Age Act and the inclusion of warning labels on alcoholic beverages. Treatment research has focused on improving the effectiveness of interventions through rigorous evaluation methods and patient-treatment matching. Looking ahead, NIAAA aims to determine the genetic and environmental contributors to alcoholism, develop new treatment methods, and address the needs of underserved populations. The ultimate goal is to reduce the stigma associated with alcoholism and provide hope for those affected by this disease.