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Alcohol

How do you know when drinking becomes unhealthy?

People drink alcohol for a variety of reasons — when socializing with friends, enjoying a celebration, or just relaxing after a long day at work. So how do you know when your relationship with alcohol turns unhealthy?

Recognizing the warning signs of alcohol addiction can help you change course before it becomes a crisis.

Remember: Recovery is possible.

What is alcohol addiction?

The first step to understanding alcohol addiction is defining safe and risky levels of consumption.

Safe drinking

It is always safest to limit your alcohol intake and drink less, instead of more. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines drinking in moderation, which is generally considered to be safe, as an average of:

  • one drink per day for women 
  • two drinks per day for men

The NIAAA recommends that you should not exceed the following limits: 

  • three drinks in a day or 7 drinks in a week for women
  • four drinks in a day or 14 drinks in a week for men

Anyone over age 65 should limit their alcohol intake to an average of one drink per day and not exceed three drinks in a day or seven in a week. And you should not drink if you are under age 21, pregnant, plan to drive, or are taking medications that interact negatively with alcohol.

Unsafe drinking

Unsafe alcohol use behaviors include binge drinking and heavy alcohol use. 

Binge drinking is consuming five or more alcoholic drinks for men and four or more drinks for women on a single occasion, typically in a two-hour period.

Heavy alcohol use involves binge drinking on five or more days in one month, or exceeding the daily and weekly limits listed above.

Binge drinking and heavy alcohol use may indicate an alcohol use disorder (AUD), a chronic, relapsing brain disease. AUD symptoms include compulsive alcohol use, a loss of control over how much you drink, and a negative emotional state when you are not drinking. An AUD can range from mild to moderate to severe.

AUD symptoms are often categorized into three categories, sometimes known as the Three C's:

  • CRAVINGS to drink
  • Loss of CONTROL over drinking
  • Negative CONSEQUENCES as a result of drinking

People with an AUD often feel a negative emotional state when they are not drinking or experience alcohol withdrawal symptoms.

Among all U.S. adults, 29% meet criteria for AUD in their lifetime.

Signs and risks of alcohol misuse

Unhealthy alcohol use can take many forms. Heavy drinking, binge drinking, and alcohol use disorders can all go unrecognized if the person affected appears to be functioning in society.

Even if you aren’t sure if a loved one’s or your own drinking habits indicate an alcohol use disorder, understanding and being on the lookout for signs of alcohol misuse can help you get support before drinking reaches a crisis point.

It’s also important to know the risk factors for alcohol addiction: Some people are more likely than others to develop an alcohol use disorder in their lifetime. Anyone can develop an AUD, but the people who are more at risk are:

  • Male
  • Age 18-29
  • People with mood disorders such as depression
  • People who have a family history of alcohol use issues or other genetic factors

Knowing the risk factors also allows us to take steps to reduce the chance of developing an addiction.

A person with AUD may not fit the stereotypical image of hitting "rock bottom" or having their life fall apart due to their drinking — and indeed, it is much better to connect them with treatment early on.

Alcohol withdrawal

When someone who is physically dependent on alcohol suddenly stops drinking or significantly reduces their alcohol consumption, a set of symptoms known as alcohol withdrawal syndrome can occur. This sudden reduction of drinking disrupts brain activity, which leads to numerous withdrawal symptoms — physical reactions that can appear the same day that drinking stops. Learn more about the symptoms and timeline of alcohol withdrawal.​

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Recovery and treatment

Recovery is a personal and often emotional journey, with progress, setbacks, and experiences that can sometimes seem scary. Professional treatment can improve the chances of success in overcoming addiction. No matter how severe your alcohol use disorder is, remember that resources are available and recovery is possible.

Find Treatment and Support Near You

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Medical Reviewer

Jasleen Salwan

Jasleen Salwan

M.D., M.P.H., F.A.S.A.M.

Dr. Salwan is a board-certified physician specializing in Addiction Medicine and Internal Medicine. She provides comprehensive care at Montgomery Family & Internal Medicine Associates in Silver Spring, Maryland, where she integrates primary care with substance use disorder treatment. Beyond her practice, she contributes to the American Society of Addiction Medicine as a member of the education faculty and consults for the Washington, DC, Addiction Consultation Service. Her academic background includes dual degrees in medicine and public health from the Icahn School of Medicine at Mount Sinai, followed by her residency at the Yale Primary Care Program and a fellowship in Addiction Medicine at Johns Hopkins Bayview.