How Much Alcohol Should You Drink – Really?

Healthy Living

April 26, 2019

Social drinking is such a routine part of many people’s lives that they give it little thought, but that may be a mistake. Some of the latest research suggests risks vary depending on factors like age, health and other habits. A recent study from the National Institutes of Health (NIH) says long-term drinking changes energy patterns in the brain and makes it harder for people to make decisions. Another study shows alcohol use might be riskier than previously thought for certain drinkers, especially young ones.

Alcohol takes a heavy toll on the lives of Americans and the world they live in. A fact sheet from The Centers for Disease Control and Prevention (CDC) says 88,000 people in the United States died from alcohol-related causes every year from 2006 to 2010, and they lived an average of 30 years less than their nondrinking peers. At the same time, 1 in 10 adults between 20 and 62 years old died as a result of drinking. In 2010, drinking cost the country $250 billion, and 75 percent of that cost came from binge drinkers.

You probably know that excessive drinking can cause a host of problems even if you’re not alcoholic. But how much is considered “excessive” – at what point have you crossed the line into “too much” alcohol?

What is a standard drink in the U.S.?

In much the same way Americans eat large servings of food without realizing it, they often consume more alcohol than they think. A standard drink has about 14 grams or .6 ounces of pure alcohol. The National Institute on Alcohol Abuse and Alcoholism offers the following guidance on what constitutes a standard serving:

  • 12 ounces of beer
  • 8 ounces of malt liquor
  • 5 ounces of wine
  • 5 ounces of liquor or distilled spirits (vodka, tequila, etc.)

Excessive drinking includes both heavy drinking and binge drinking as well as alcohol use by people under 21 or women who are pregnant. According to the NIH, you cross into “excess” territory if you have more than 3 drinks (for women) or 4 drinks (for men) in a single day, or 7 drinks (for women) or 14 drinks (for men) during a single week. (Men and women process alcohol differently, partly because men have more water in their bodies.)

Even if you hit these markers for heavy drinking, you might not have an alcohol abuse disorder. The CDC says most excessive drinkers are not dependent on alcohol or addicted to it. But you don’t have to have alcoholism to suffer from the ill effects of excess drinking.

What does the CDC recommend?

For safe consumption, the CDC suggests just one drink a day for women and two for men who are moderate drinkers. It also recommends avoiding alcohol altogether if you’re:

  • Younger than 21
  • Planning to drive or do something that requires focus and coordination
  • Pregnant or trying to conceive
  • Taking medications that conflict with alcohol
  • An alcoholic or recovering addict

People with specific medical conditions may also benefit from passing on alcohol. That’s between you and your doctor. And if you’re unsure about whether any medication you take conflicts with alcohol, check the label or the inserts that come with it when you pick it up from the pharmacy – or ask your pharmacist. Even some over-the-counter meds don’t play well with alcohol, so it’s better to be safe than sorry.

What are the symptoms of short-term drinking?

You likely know your personal limits on alcohol, when you start to feel buzzed or too drunk to drive. But you might be surprised to learn that it only takes 2 to 4 drinks to reach a blood alcohol level (BAC) of 0.08 percent, a BAC that makes driving illegal in every state.

When your BAC reaches .08 percent, you start to slur words and become clumsy. If it goes higher, you may accidentally hurt yourself or others. And if you continue to drink, you could suffer these side effects:

  • Poor judgment
  • Flushed skin or dilated pupils
  • Inattention and lack of coordination
  • Dulled perception and thinking
  • Mood swings
  • Fatigue and sleepiness
  • Nausea and vomiting
  • Stumbling and passing out

Not sure where your cutoff is for a BAC of .08? Here’s a handy calculator from that gives you a better picture of how much you can drink during the evening and still be functional. Just keep in mind that even standard drinks can have varying alcohol levels. Beer, for example, ranges widely in the alcohol amount per volume. If you plan to drink, make sure you’ve got a designated sober driver with you, or someone you can call for backup, just in case.

What are the effects of long-term drinking?

Binge drinking can affect your health in the short term, but even drinking more moderate amounts over a longer period can lead to chronic physical and emotional problems. Cirrhosis and other types of liver damage are some of the most common. Other issues caused by long-term drinking include:

  • Digestive problems
  • Pancreatitis
  • Diabetes
  • A weakened immune system
  • Disorders of the central nervous system
  • Circulatory illnesses
  • Musculoskeletal problems
  • Reproductive issues
  • Risk of cancer

One or two drinks a day can cause memory problems or make it hard to concentrate, but excessive drinking can also lead to mental conditions like anxiety and depression. If the drinking progresses, it can even shrink the brain, causing brain damage. The good news is that the brain mostly returns to normal if the drinking stops. Drinking can also cause Wernicke-Korsakoff syndrome, a vitamin B1 deficiency that limits mobility and causes dementia.

Alcohol-related illnesses like cirrhosis, hepatitis and other forms of liver failure can also cause brain damage if the liver stops filtering toxins from the bloodstream and tissues, leaving waste products in the body. This may happen because harmful particles cross the barrier between the blood and the brain, causing hepatic encephalopathy. Symptoms include lethargy, confusion, forgetfulness, personality changes, poor judgment, lack of small motor coordination and slurred speech. People with chronic forms have better outlooks than those with acute encephalopathy, but complications like brain swelling and organ failure can occur.

Who’s at risk for alcohol overdose?

It’s hard to predict who will overdose. Whether you’re more or less likely to overdose on alcohol depends on factors like tolerance, gender, age, medications, size of the last meal you ate and how fast you drank. Nursing a single shot of whiskey over a couple of hours is quite different from downing two-for-one margaritas in an hour. And mixing alcohol with opioids or anxiety medications is especially risky, but even antihistamines can be a problem.

If you or someone you’re with overdoses on alcohol, don’t try to sleep it off. Alcohol disturbs the gag reflex, making it easier to choke on vomit. Old remedies like cold showers and coffee don’t work, either, and they may even increase the risk of something worse happening than a hangover.

If you suspect an overdose, call 911 immediately. Prepare to give emergency responders any information you can about the person’s name, health background, kind of alcohol consumed and how much, and whether drugs or other substances were involved. Until help arrives, try to prevent accidents, such as falls or choking, and keep the person safe.

Our best advice? We’ll reiterate popular beer commercials: Drink responsibly. You may not have to avoid alcohol – unless you fit into one of the categories above – but you should take care when you’re drinking. You’ll have a better time the next morning and won’t need to worry about anything that happened under the influence (short and long term).