Two major trends regarding alcohol use and consequences of alcohol abuse in the United States are showing significant improvement. Continued declines are evident in age-adjusted rates of liver cirrhosis mortality, and per capita alcohol consumption is at its lowest level in 15 years. Two other trends, however, are less clear. After declining in 1982 and continuing through 1984, alcohol-related morbidity--as measured by principal diagnoses listed on short-stay, community hospital discharges--showed a slight increase in 1985. Similarly, after declining every year but one since 1981, alcohol-related motor vehicle fatalities showed a significant increase in 1986. The downward trends suggest that progress is being made in efforts to reduce alcohol-related deaths and morbidity, but there are no easy explanations for any of the trends. Reductions in liver cirrhosis death rates may reflect coding changes in liver disease categories, less chronic heavy drinking, or better medical care. Lower per capita alcohol consumption may indicate the public's increased awareness of drinking risks or the aging of the U.S. population. Ironically, the recent increase in alcohol-related motor vehicle fatalities may reflect stronger enforcement of drunk driving laws and increased BAC (blood alcohol content) testing.