The focus of this review is not simply on the use of alcohol. Most Aboriginal and Torres Strait Islander and non-Indigenous people alike consume alcohol in a manner that does not cause harm. We are concerned with the harmful use of alcohol, and why levels of harmful use are higher among Aboriginal and Torres Strait Islander people than among non-Indigenous people. This goes beyond the issue of consumption by dependent drinkers (so-called 'alcoholics'). We are also concerned about those who drink regularly and those who engage in heavy episodic drinking (binge drinkers) because their pattern of drinking contributes significantly to the level of harm to themselves and to others.