Alcohol is the most used and abused drug in the United States and the leading cause of substance use-related fatalities nationwide. According to the Centers for Disease Control and Prevention (CDC), each year, frequent or excessive drinking causes approximately 178,000 deaths. In 2022, of the 137 million Americans who reported drinking in the last 30 days, 45% reported binge drinking (five or more drinks in a sitting for men; four for women). Nearly 30 million Americans are estimated to have an alcohol use disorder (AUD).
So, as we recognize Alcohol Awareness Month in April, the question, “How much is too much?” is one that many Americans may want to think about.
There are well-established guidelines: For adults of legal drinking age, U.S. dietary guidelines recommend two drinks or fewer in a day for men, and one drink or fewer in a day for women. One drink is defined as 0.6 ounces of pure alcohol—the amount in a 12-ounce beer containing 5% alcohol, a 5-ounce glass of wine containing 12% alcohol, or 1.5 ounces of 80-proof liquor.10
Fifteen or more drinks a week for men, and eight or more for women, is considered heavy and unhealthy drinking and is associated with overuse risks such as drinking and driving, cancer, harm to fetal development, and more.
What are symptoms of an AUD?
Ongoing unhealthy drinking may be a sign of an alcohol use disorder or alcoholism. The American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) of Mental Disorders, Fifth Edition, provides a list of symptoms of AUD and points to questions you can ask yourself:
- Had times when you ended up drinking more, or longer, than you intended?
- More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
- Spent a lot of time drinking, being sick from drinking, or getting over other aftereffects?
- Wanted a drink so badly you couldn’t think of anything else?
- Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
- Continued to drink even though it was causing trouble with your family or friends?
- Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
- More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or engaging in unsafe sexual behavior)?
- Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had an alcohol-related memory blackout?
- Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
- Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, dysphoria (feeling uneasy or unhappy), malaise (general sense of being unwell), feeling low, or a seizure? Or sensed things that were not there?
You also may want to check the National Institutes of Health Rethinking Drinking website Alcohol is the most used and abused drug in the United States and the leading cause of substance use related fatalities nationwide. According to the Centers for Disease Control and Prevention (CDC), each year, frequent or excessive drinking causes approximately 178,000 deaths. In 2022, of the 137 million Americans who reported drinking in the last 30 days, 45% reported binge drinking (five or more drinks in a sitting for men; four for women). Nearly 30 million Americans are estimated to have an alcohol use disorder (AUD).
So, as we recognized Alcohol Awareness Month in April, the question, “How much is too much?” is one that many Americans may want to think about.
There are well-established guidelines: For adults of legal drinking age, U.S. dietary guidelines recommend two drinks or fewer in a day for men, and one drink or fewer in a day for women. One drink is defined as 0.6 ounces of pure alcohol—the amount in a 12-ounce beer containing 5% alcohol, a 5-ounce glass of wine containing 12% alcohol, or 1.5 ounces of 80-proof liquor.10
Fifteen or more drinks a week for men, and eight or more for women is considered heavy and unhealthy drinking and is associated with over-use risks such as drinking and driving, cancer, harm to fetal development and more.
What are symptoms of an AUD?
Ongoing unhealthy drinking may be a sign of an alcohol use disorder or alcoholism. The American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) of Mental Disorders, Fifth Edition, provides a list of symptoms of AUD and points to questions you can ask yourself:
- Had times when you ended up drinking more, or longer, than you intended?
- More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
- Spent a lot of time drinking, being sick from drinking, or getting over other aftereffects?
- Wanted a drink so badly you couldn’t think of anything else?
- Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
- Continued to drink even though it was causing trouble with your family or friends?
- Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
- More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or engaging in unsafe sexual behavior)?
- Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had an alcohol-related memory blackout?
- Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
- Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, dysphoria (feeling uneasy or unhappy), malaise (general sense of being unwell), feeling low, or a seizure? Or sensed things that were not there?
You also may want to check the Rethinking Drinking website, which has many valuable resources, including calculators to help you assess your personal use.
Knowledge is power
It is important to know the facts, be aware of your own drinking habits, know about appropriate actions and learn about getting help for yourself or a loved one if alcohol is a concern.
Here are some good online resources to build awareness and find support:
- Rethinking Drinking website
- The Substance Abuse and Mental Health Services Administration Alcohol Awareness Month site
- The Partners in Prevention Toolkit
- The National Institute on Alcohol Abuse and Alcoholism website
- Partnership to End Addiction – An organization designed to help people get one-on-one help to cope with addiction
- Smart Recovery – Helps provide access to resources for your life after addiction
- How to help an Alcoholic: A guide to Support and Recovery – A resource for families to help a loved one get help
- National Association for Children of Addiction