How To Know If You’re Drinking Too Much
Alcohol is woven into so many parts of modern life, so much so that it’s often framed as an “essential” part of having a happy life. But perspectives about “acceptable” and “problematic” alcohol use are complex. People are expected to “drink responsibly” but aren’t taught how to do that.
People who don’t drink can feel marginalized or feel pressured to drink. People who drink heavily can feel embarrassed or be shunned by society. When someone starts to consider if they are drinking too much, they often feel ashamed or become secretive about their drinking. So how does someone tell if they are drinking too much?
People evaluate themselves in relation to the people they know. When someone has a lot of heavy drinkers in their life, it can distort how they view their alcohol use. When it seems like everyone else drinks as much or more, it normalizes heavy alcohol use.
Regular drinkers are often surprised to learn that around 30% of adults in the US do not drink at all. Conversely, about 60% of American adults drink some alcohol and don’t experience problems related to their alcohol use. However, the remaining 10% of adults consume alcohol at rates that lead to physical, psychological, or social harm to themselves or others. Research shows that around 6% of American adults (roughly 14 million people) meet the criteria for an alcohol use disorder.
Understanding what unhealthy, problematic, or harmful levels of drinking looks like is essential to having a healthy relationship with alcohol, which can help prevent addiction from forming. However, that’s easier said than done.
Below is a brief assessment that can help you better understand your relationship with alcohol and help you determine if you may need additional resources or help.
Metrics For “Low-Risk” Drinking
The number of standard drinks (0.6 fluid ounces of pure alcohol) you typically consume per week can be an indictor of whether your drinking is “low-risk” or not. Take a few minutes to think about your typical alcohol use in a week to answer these two questions:
- How many standard drinks do I typically consume in a typical week?
- What is the highest number of standard drinks I typically consume in a given day?
Write these numbers down. Knowing these numbers will help you evaluate whether your drinking is low-risk or high-risk and can also help you track whether your drinking increases or decreases over time.
Another key factor in understanding how much alcohol leads to problems is that biological females and males process alcohol differently. Females have less water and less of an enzyme critical to alcohol metabolism. That difference makes female bodies more vulnerable to the negative effects of alcohol than male bodies, meaning that “low-risk” drinking limits are different for biological males and females.
Large research studies have examined alcohol consumption patterns in relation to physical health, mental health, social functioning, disability, and mortality. Based on these studies, researchers have determined the following guidelines for “low-risk” drinking:
- Females should consume no more than 7 standard drinks over a week and no more than 3 on a given day.
- Males should consume no more than 14 standard drinks over a week and no more than 4 on a given day.
Look back at the numbers you calculated for yourself. Do you typically drink more than these cutoffs? If so, then your drinking is more likely to cause negative consequences at some point.
Sticking to these limits does not guarantee that you won’t ever have alcohol-related problems, but drinking beyond these limits greatly increases the likelihood of developing alcohol-related problems and alcohol use disorder.
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Quick Assessments For Problem Drinking
The guidelines for “low-risk” drinking are helpful but don’t capture the whole picture. In fact, the diagnostic criteria for alcohol use disorders are not based on how much alcohol is used but instead on the types of problems related to alcohol use.
There are many screening tools to help people understand their relationship with alcohol, and a Google search for “Am I an alcoholic?” yields tons of sites claiming to help people answer that question. However, some screening measures are not based on research or do not have good reliability or validity.
The most reliable and valid screening measure for alcohol use disorder is the Alcohol Use Disorder Identification Test (AUDIT), which is used in 40 languages and has an online version that calculates your score and provides feedback.
Another common screening tool is the CAGE, which asks only four questions:
- C – Have you ever felt you should cut down on your drinking?
- A – Have people annoyed you by criticizing your drinking?
- G – Have you ever felt bad or guilty about your drinking?
- E – Have you ever had an eye-opener such as drinking first thing in the morning to steady your nerves or to get rid of a hangover?
If you answer yes to one of the CAGE questions, then it is worth looking more into the effects of your drinking. If you answer yes to two or more of the CAGE questions, then your drinking is causing at least some problems in your life, and it’s recommended to speak with your doctor about possible treatment interventions.
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Understanding “Standard Drinks”
There is an international metric called a “standard drink” that considers how much of a type of drink includes 0.6 fluid ounces of pure alcohol. Many people are surprised to learn that they are drinking much more than they thought, and alcohol education programs are starting to focus on this information to help people drink responsibly.
In the US, alcohol by volume (ABV) must be listed on any container of alcohol sold; however, this doesn’t translate ABV to standard drinks. For example, most standard beers are about 5% ABV whereas most hard liquors like vodka and bourbon are 40% ABV. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), a standard drink is 12 ounces of 5% ABV beer, 5 ounces of 12% ABV wine, and about 1.5 ounces of 40% ABV liquor.
Following these standard drink guidelines can be hard, especially in settings like bars or restaurants where mixed drinks don’t have any indication of their potency or alcohol content. Craft beers sold in pint glasses (16 ounces) are typically closer to two standard drinks.
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What To Do If You Think Your Alcohol Use Is Problematic
Considering the low-risk drinking guidelines and completing the AUDIT and CAGE screening tools can help you evaluate whether alcohol use is problematic or out of control. However, to see if you meet the diagnostic criteria for an alcohol use disorder, you should contact and licensed addiction therapist or psychologist.
Regardless of diagnosis, if you are experiencing problems related to alcohol use, many resources and treatment programs are available to help you cut down or quit. To learn more about these treatment options, contact a treatment provider today.
Ashish Bhatt, MD, MRO
Doctor of Addiction Medicine
Learn about Dr. Ashish Bhatt
Dr. Bhatt has been Addiction Center's Medical Content Director for more than three years, providing his expertise to ensure quality and accuracy.
Doctor of Addiction Medicine
Expert in adult and child psychiatry
Over 20 years of professional experience