Worldwide, people 15 and older consumed 6.2 liters of alcohol per person in 2010, according to a recent World Health Organization (WHO) report. Alcohol, in turn, contributed to some 3.3 million deaths as of 2012.

In some countries, consumption, and the resultant health problems attached to drinking, were worse. In 10 countries residents consumed more than 13 or more liters per person as of 2010. In Belarus, the heaviest drinking nation, residents consumed 17.5 liters on average. Based on figures from the WHO, these are the countries with the highest per capita consumption.

Nearly all of the countries with the highest levels of alcohol consumption are located in Eastern Europe. They include Russia and other former Soviet Union nations such as Belarus, Lithuania, Moldova, and Ukraine. The only top-consuming nation not located in Eastern Europe is Andorra, a principality located between France and Spain in the Pyrenees.

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According to Tom Donaldson, president of the National Organization on Fetal Alcohol Syndrome (NOFAS), historical and societal factors explain why certain countries have higher rates of consumption.

Residents in many of these areas may also lack the information necessary to make informed health decisions, Donaldson added. “In some of those areas, there are no public health awareness efforts whatsoever about the effects of alcohol consumption.” Eight of the nations with the highest consumption did not have public policy initiatives to address the effects of alcohol consumption on the general public.

Residents in these countries were also often among the most likely to suffer from alcohol use disorders. Five of the heaviest drinking countries also had among the 10 highest prevalences of alcohol use disorders. These include alcoholism and other forms of health-damaging use of alcohol. Such disorders lead to physical problems such as liver cirrhosis and mental illnesses such as depression. The three nations with the highest rates of alcohol use disorders, Hungary, Russia, and Belarus, were all among the 10 heaviest drinking nations.

Of the 3.3 million alcohol related deaths worldwide, a third were caused by cardiovascular diseases and diabetes. Unintentional injuries accounted for 17.1% of alcohol-related deaths. Various types of cancer, gastrointestinal diseases, and intentional self-harm were also common causes of deaths related to alcohol. In five of these nations, 30% of deaths in 2012 were alcohol related, compared to 5.9% of deaths worldwide.

A number of serious diseases are largely caused by alcohol. Half of all deaths due to liver cirrhosis are attributable to alcohol. Similarly, more than one quarter of all cases of pancreatitis and various types of mouth cancer are attributable to alcohol use.

Life expectancies in the nations with heavy alcohol use are also shorter. The average life expectancy at birth in high income nations was 79.3 years as of 2012, far higher than in almost all of the heaviest drinking nations. In Romania, the average life expectancy was just 68.7 years. In Russia and Ukraine the average life expectancy was below 72 years as well.

While men in these countries drink much more than women, women in these countries are also heavy drinkers compared to women in other countries. The heaviest drinking countries overall include six nations where women consumed the most alcohol.

Moreover, “Alcohol use among women has been increasing steadily in line with economic development and changing gender roles,” according to the WHO. This presents major health concerns for women who tend to be more vulnerable — physically and socially — to alcohol use.

Women in these countries may also not be aware of the dangers of drinking during pregnancy and the health risks of alcohol on infants in utero. “There are no public health efforts to educate women on fetal alcohol syndrome,” Kathleen Mitchell, vice president and spokesperson for NOFAS said. “What it takes is a compilation of public health measures and awareness for people to change their behavior or take notice.”

Based on figures from WHO’s recent “Global Report on Alcohol and Health 2014” 24/7 Wall St. reviewed the countries with the highest rates of alcohol consumption. Per capita consumption figures are based on a combination of average recorded consumption between 2008 and 2010, as well as unrecorded consumption estimates as of 2010. Figures on alcohol use disorders, which includes drinking behavior that can lead to health problems and alcoholism; heavy episodic drinking, or binge drinking; and data on the relative contribution of alcohol to mortality as of 2012 are also from the report. 24/7 Wall St. also obtained the most recently published data on GDP, unemployment, and inflation from the International Monetary Fund. Figures on life expectancies and poverty levels are from the World Bank and current as of 2012.

These are the heaviest drinking countries in the world.

10. Slovakia
> Alcohol per capita (APC) consumption: 13.0 liters (tied, 9th highest)
> Pct. binge drinking: 26.2% (16th highest)
> Pct. of deaths, alcohol-related: 7.7% (14th highest)
> Life expectancy at birth: 76.1 years

Nearly 8% of deaths in Slovakia were alcohol related in 2012, one of the highest proportions among countries reviewed. By contrast, just 3.2% of deaths in the U.S. were alcohol related. In general, residents had bad drinking habits. More than 10% of people 15 years and older in the country had alcohol use disorders, including alcohol dependency. The rate for men was considerably higher, at 19.1%. Residents prefer spirits — which include distilled beverages such as vodka — considerably more than other forms of alcohol such as beer or wine. According to the WHO, Slovakia has also had issues with the use of alcohol not intended for human consumption, such as alcohol that is used for industrial purposes.

9. Czech Republic
> Alcohol per capita (APC) consumption: 13.0 liters
> Pct. binge drinking: 36.5% (3rd highest)
> Pct. of deaths, alcohol-related: 5.8% (33rd highest)
> Life expectancy at birth: 78.1 years

Only Austria and Lithuania had a higher percentage of binge drinkers than the Czech Republic. Czech males took the top spot in binge drinking, and Czech females drank among the most alcohol per-capita out of the countries reviewed. According to WHO data, Czechs prefer to drink beer over any other alcoholic beverage. One factor that could contribute to the country’s heavy alcohol consumption is its lax alcohol policies. The Czech Republic does not have any systems in place to monitor the health or social consequences of alcohol consumption, nor does the government regulate the sale of alcohol.

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8. Hungary
> Alcohol per capita (APC) consumption: 13.3 liters
> Pct. binge drinking: 25.4% (17th highest)
> Pct. of deaths, alcohol-related: 6.7% (22nd highest)
> Life expectancy at birth: 75.1 years

Hungarians consumed an average of 13.3 liters of alcohol per person in 2010, less than just seven nations. No country had a higher rate of alcohol use disorders than Hungary, where 19.3% of the population abused alcohol in some form. As many as 32.2% of Hungarian men and 6.8% of women suffered from alcohol use disorders, the highest among countries reviewed. The country is also cited by the WHO as lacking key notifications on beverage containers, including labels for alcohol content.

7. Andorra
> Alcohol per capita (APC) consumption: 13.8 liters
> Pct. binge drinking: 4.2% (69th lowest)
> Pct. of deaths, alcohol-related: 3.9% (77th highest)
> Life expectancy at birth: n/a

Unlike many countries with high levels of alcohol consumption, Andorra’s economy is fairly prosperous. The small principality, located between France and Spain in the Pyrenees mountains, has an exceptionally strong tourism industry, which accounts for the majority of the country’s GDP. Illegal alcohol production was less common in Andorra than in many other heavy drinking nations, accounting for just 1.4 liters of per capita consumption. This may mean demand for alcohol is readily met through legal channels. Andorra’s population consumed 12.4 liters per capita on average when only legitimate purchases were measured, higher than all but two other countries. Most Andorrans prefer wine over other alcoholic beverages. Country residents were also considerably less likely to binge drink — just 4.2% of residents 15 and older engaged in binge drinking in the previous 30 days.

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6. Ukraine
> Alcohol per capita (APC) consumption: 13.9 liters
> Pct. binge drinking: 23.2% (24th highest)
> Pct. of deaths, alcohol-related: 34.4% (2nd highest)
> Life expectancy at birth: 70.9 years

In addition to its current political turmoil, Ukraine has struggled with the effects of heavy alcohol consumption for some time Only Belarus had a higher percentage of alcohol-related deaths than Ukraine. Spirits were the drink of choice in the country, accounting for nearly half of the alcoholic beverages consumed. Additionally, only people in the Republic of Moldova consumed more illegal alcoholic beverages per capita than in Ukraine. The country also had high percentages of both males and females 15 years of age and older who engaged in binge drinking.

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.

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