If you’re wondering whether you’re drinking too much, the answer might depend on whether you’re thinking about your long-term risk of disease, or about whether your relationship with alcohol is becoming unhealthy right now.
The U.S. Dietary Guidelines are based on reducing the risk of long-term health problems, like an increased risk of multiple cancers, diabetes and liver disease. They offer you a relatively simple answer, with a daily maximum allowance for cisgender men and women. (The guidelines don’t specify what transgender people should do.)
The question of whether alcohol is playing an unhealthy role in your life isn’t as straightforward, though, and is based on how well you’re functioning, rather than a drink threshold.
One rule of thumb is that alcohol is a problem if a person has injured themselves or someone else while drinking, or if family or friends have expressed concern about the person’s alcohol use, said Dr. Joseph Schacht, who studies alcohol use disorder at the University of Colorado’s Anschutz Medical Campus.
“If you are questioning how much you’re drinking, you probably should cut back,” he said.
No more than one or two a day
The U.S. Dietary Guidelines recommend no more than one standard drink on any day for women and no more than two drinks for men.
On average, women produce less of an enzyme needed to break down alcohol, and have less water in their bodies to dilute it. That means that women tend to develop health problems at lower levels of drinking than men do.
The guidelines are supposed to be a ceiling for each day, not an average; they don’t equate to having seven drinks on Saturday and then abstaining for the rest of the week. Also, a drink as the guidelines define it isn’t necessarily a typical serving, with the following counting as a standard drink:
- 12 ounces of beer that’s 5% alcohol
- Eight to 10 ounces of hard seltzer
- Five ounces of table wine
- Three to four ounces of stronger wines, such as sherry or port
- Two to three ounces of liqueurs or cordials
- 1.5 ounces of brandy, cognac or distilled spirits, such as whiskey or rum
If you’re not sure how much alcohol might be in your favorite cocktail, you can find out by trying the National Institute of Alcohol Abuse and Alcoholism’s online calculator.
What are you giving up?
When drinking is causing a problem in someone’s life now, rather than just setting them up for potential health problems later, that’s what’s known as an alcohol use disorder.
The disorder can be mild, if someone has two or three symptoms; moderate; or severe, if they have at least six symptoms.
Those symptoms are:
- Drinking more than intended
- Inability to cut down on drinking
- Spending significant time drinking or recovering after drinking
- Strong cravings to use alcohol
- Drinking interferes with life at work, home or school
- Alcohol use causes problems with friends or family
- Giving up other activities because of drinking
- Using alcohol in dangerous situations, or doing something unsafe while intoxicated
- Continuing to use alcohol even though it causes or worsens other health problems, or drinking until you black out
- Needing more alcohol to get the same effect
- Experiencing withdrawal symptoms (such as difficulty sleeping, shakiness or nausea) or drinking to avoid withdrawal
If some of those symptoms sound familiar, you’re not alone: The Substance Abuse and Mental Health Services Administration estimated about 12% of Coloradans who are 12 or older had an alcohol use disorder as of 2021. While the survey question changed somewhat, meaning the numbers don’t exactly compare to pre-pandemic data, it appears the prevalence of unhealthy alcohol use has gone up since 2019.
If you’re concerned about your drinking, the first step is to talk to your doctor about what options might work for you. Those range from visiting a counselor to talk about better coping strategies, to taking medication to reduce cravings, to short inpatient stays to make sure withdrawal doesn’t become dangerous.
The National Institute on Alcohol Abuse and Alcoholism has a resource where you can look up addiction treatment programs, as well as doctors and therapists specializing in addiction care. The state of Colorado also has a search tool called Own Path, where you can find providers offering care for mental health and substance use disorders.
If your first attempt to cut back isn’t successful, don’t get discouraged. A national survey found about half of people are able to stop or significantly reduce drinking in two or fewer tries, though the average is five tries because people with greater mental health needs tend to require more attempts. The journey isn’t always linear, though, and many people return to drinking more than they wanted to at least once.
Marc Condojani, director of adult treatment and recovery at the Colorado Behavioral Health Administration, said most people will recover from alcohol use disorder, and that in some ways, the odds are better than they ever have been. People looking for help have more options for peer support and sober housing, whether as part of a program or run democratically by people in recovery, he said.
“There are probably more people living in recovery… than who are struggling with active addiction,” he said. “Recovery is not just possible, it’s the expected outcome.”
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The Denver Post is part of the Mental Health Parity Collaborative, a group of newsrooms that are covering stories on mental health care access and inequities in the U.S. The partners on this project include The Carter Center, The Center for Public Integrity and newsrooms in select states across the country.