In the United States, it is legal for any adult who is at least 21 years old to purchase and enjoy alcoholic beverages. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that, per a 2015 survey, 86.4 percent of U.S. residents ages 18 and older drink alcohol at some point in their lives. An article from The Washington Post points out that everyone has different drinking habits: 30 percent of American adults do not drink at all, and another 30 percent drink less than one serving of alcohol per week.
It is often a normal part of life to have a drink with dinner or enjoy an alcoholic beverage with friends or coworkers once in a while. However, there are drinking patterns that are dangerous. The U.S. Centers for Disease Control and Prevention (CDC) calls problematic drinking excessive drinking and classifies these patterns as binge drinking, heavy drinking, and alcohol use disorder (AUD).
In the U.S., 88,000 people die every year from alcohol-related harm, from issues ranging from drunk-driving car accidents to liver cancer. About 1 in 10 working-age adults, between the ages of 20 and 64, dies because of alcohol issues. Understanding how much alcohol is too much can help you monitor your own drinking patterns and recognize if a loved one is struggling with alcohol abuse.
The CDC and NIAAA clearly state that any amount of drinking has some risks associated with it. There is no such thing as “no-risk” drinking, but you can engage in low-risk drinking. An NIAAA chart shows that women should drink no more than three drinks on any single day while men should drink no more than four drinks on any given day. Consuming more than seven drinks per week for women, and more than 14 drinks per week for men, puts them in danger of more serious health problems. These guidelines are considered the standard for moderate drinking.
It is essential to know the serving sizes of alcoholic beverages before one can practice moderate drinking. One serving of alcohol is equal to:
A study published in 2018 found there is a point when the amount of alcohol consumed becomes harmful. This occurs with 100 grams per week, or about six glasses of wine. This amount on a regular basis can increase the risk of chronic diseases and early death.
Pints of beer, large glasses of wine, and large pours into cocktails are common in dining establishments and bars. Many drink containers sold in stores are larger than the standard serving size. It is easy to pour yourself more than one serving of alcohol at home. This means that you likely drink more than one serving of alcohol per hour, which can lead to intoxication.
Drinking a serving that is slightly larger than recommended does not mean you have a problem with excessive drinking. When your behavior follows specific patterns of consumption, however, you may have a problem with drinking too much.
While many people drink regularly, too many people do not know when drinking becomes problematic. There are a few forms of excessive drinking that can be harmful and are considered alcohol abuse, although they are not technically alcohol addiction.
Generally, alcohol abuse occurs when someone drinks too much on occasion, and this behavior leads to other risky behaviors and poor judgment. Dependence means the person feels like they need alcohol consistently to get through the day. Addiction is associated with both compulsive overdrinking and consistent drinking.
Binge drinking: This form of excessive drinking is most infamous for leading to alcohol poisoning. The CDC defines binge drinking as at least four servings of alcohol in a two-hour timeframe for women and at least five servings of alcohol in the same timeframe for men. In 2015, 26.9 percent of U.S. adults reported binge drinking a minimum of one time in the past month.
Binge drinking is often associated with college students because there is peer pressure to drink a lot at parties to fit in. NIAAA reports that an annual average of 1,825 college students between the ages of 18 and 24 die from unintentional, alcohol-related injuries, like drunk driving. About 696,000 students are assaulted by another student who has been drinking, of which 97,000 students report their assault was sexual assault or date rape.
One in four college students report academic problems from drinking too much. Students who binge drink at least three times per week were about six times more likely to perform poorly on a test or project compared to their non-drinking peers; they were five times more likely to miss class. The most vulnerable time for binge drinking is the first six weeks of freshman year when students face new social pressures, hectic personal lives, and new academic stresses.
Although binge drinking is usually associated with young people, new survey data shows that binge drinking among older adults is on the rise as baby boomers age into retirement. Older women in the U.S., in particular, are increasingly binge drinking. Between 1997 and 2014, older men binge drank at about the same rate while binge drinking among older women increased, on average, 2 percent every year.
Younger boomers, between the ages of 60 and 64, are drinking significantly more compared to this age group in previous generations. This can be very dangerous for both men and women because it increases the likelihood of falls, which risk brain trauma, and broken bones and injuries that take longer to heal in older adults compared to younger people.
Additionally, older adults are more likely to take prescription medications. Mixing alcohol with pain relievers, heart medication, cholesterol medication, or psychiatric prescriptions can be dangerous, increasing the risk of overdose on these substances and decreasing the medications’ effectiveness.
Heavy drinking: In contrast to binge drinking, people who drink heavily tend to drink regularly. Rather than drinking too much at a party or work event, heavy drinkers drink a couple of beverages on most days. Per the CDC, heavy drinking is eight or more drinks per week for women, which is slightly more than one drink per day, and 15 or more drinks per week for men, or just over two drinks per day. About 7 percent of U.S. adults reported drinking heavily in the past month in 2015.
The article in TheWashington Post found that, while 60 percent of U.S. adults rarely drink, if ever, 10 percent of American adults drink very heavily. This amounts to as much as 74 drinks per week, which is more than 10 servings of alcohol per day.
Heavy drinking may not cause acute or immediate problems, but on a long-term basis, consistent alcohol consumption will damage the body. Certain conditions can result, such as:
Developing a pattern of heavy drinking can lead to alcohol dependence, which is when the body relies on the presence of alcohol to feel stable. While dependence on alcohol and alcoholism–or alcohol use disorder–are not the same thing, they are closely correlated.
Alcohol use disorder: Originally called alcoholism and then alcohol addiction, alcohol use disorder (AUD) is the pattern of compulsively drinking too much, too often. Per the National Survey on Drug Use and Health (NSDUH) in 2015, there were 15.1 million adults and 623,000 adolescents (ages 12 to 17) in this country who had AUD.
NIAAA found that about 20 percent of college students meet the criteria for AUD. About 10 percent of schoolchildren have parents with AUD. Less than 10 percent of people struggling with AUD get the treatment they need.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines AUD according to these 11 criteria:
Many people struggle with drinking too much at parties or feeling like they always need a drink after work to relax. While binge drinking and heavy drinking are problematic, they do not equal alcohol use disorder. However, having symptoms of both of these forms of excessive drinking can indicate an AUD. Bingeing or drinking every day may be a sign that you are developing an AUD.
There are some general stages of AUD. They are:
In 2018, the American Psychiatric Association (APA) created new clinical guidelines for treating alcohol use disorder. The guidelines reiterate the importance of available pharmaceutical interventions to manage AUD, which must be prescribed alongside behavioral therapy.
Typically, addictions such as AUD are treated with medically supervised detox and rehabilitation as the two foundational steps. This is considered evidence-based treatment, and it involves working with medical professionals to reduce the risk of relapse and change behaviors around drugs and alcohol, using the latest research and science to create an appropriate treatment plan.
Once a rehabilitation program is complete, ongoing commitment to recovery is essential. Mutual support groups, individual therapy, and complementary treatments that support sobriety can be key to a successful aftercare plan.
Alcohol Facts and Statistics. (June 2017). National Institute on Alcohol Abuse and Alcoholism. from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics
Think You Drink a Lot? This Chart Will Tell You. (September 25, 2014). The Washington Post. from https://www.washingtonpost.com/news/wonk/wp/2014/09/25/think-you-drink-a-lot-this-chart-will-tell-you/?utm_term=.4cb23ffa8f31
Fact Sheets – Alcohol Use and Your Health. (January 3, 2018). Centers for Disease Control and Prevention. from https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
What’s “Low-Risk” Drinking? Rethinking Drinking: Alcohol & Your Health, National Institute on Alcohol Abuse and Alcoholism. from https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Is-your-drinking-pattern-risky/Whats-Low-Risk-Drinking.aspx
What’s a “Standard” Drink? Rethinking Drinking: Alcohol & Your Health, National Institute on Alcohol Abuse and Alcoholism. from https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/What-counts-as-a-drink/Whats-A-Standard-Drink.aspx
How Much Alcohol Is Too Much? A New Study Says It’s Found the Number. (April 12, 2018). PBS News Hour. from https://www.pbs.org/newshour/health/how-much-alcohol-is-too-much-a-new-study-says-its-found-the-number
Alcohol Abuse and Alcoholism: What Are the Differences? (July 29, 2016). Healthline. from https://www.healthline.com/health/alcohol-use-and-abuse
College Drinking. (December 2015). National Institute on Alcohol Abuse and Alcoholism. from https://pubs.niaaa.nih.gov/publications/CollegeFactSheet/Collegefactsheet.pdf
More Older Women Are Drinking Hard. (March 29, 2017). CBS News. from https://www.cbsnews.com/news/more-older-women-baby-boomers-binge-drinking/
Alcohol Use Disorder. National Institute on Alcohol Abuse and Alcoholism. from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders