alcohol

How much alcohol is too much?

Drinking alcohol in moderation is common, enjoyable, and even has health benefits. Unfortunately, there’s a very thin line between moderate drinking and more problematic intake, and many people don’t realize which side they’re on. Are you hitting one too many happy hours each week?

How much booze is in that glass?

The amount of alcohol in each drink can depend on the size of your glass and your bartender’s mood, but a standard pour has 14 grams (g) of pure alcohol. In case you forget your metric scale at home, you can use this quick guide:

  • One glass of beer (twelve fluid ounces): 1 standard drink
  • One pint of beer: 1.3 standard drinks
  • One glass of wine (five fluid ounces): 1 standard drink
  • One bottle of wine: 5 standard drinks
  • One shot of liquor (1.5 fluid ounces): 1 standard drink
  • A “fifth” of liquor: 17 standard drinks (!!!)

But I must be a moderate drinker… right?!

The National Institute for Alcohol Abuse and Alcoholism (NIAAA) categorizes drinking as moderate or heavy. The exact thresholds are different for men and women.

Men

  • Moderate drinking: up to 14 drinks/week, with no more than 4 drinks on one day
  • Heavy drinking: more than 14 drinks/week, or binge drinking (5 or more drinks on 5 or more days in the last month)

Women

  • Moderate drinking: up to 7 drinks/week, with no more than 3 drinks on one day
  • Heavy drinking: more than 7 drinks/week, or binge drinking (4 or more drinks on 5 or more days in the last month)

You may have noticed men are “allowed” twice as many drinks as women. This difference is based on three factors: women have less body water than men (to dilute the alcohol), women usually weigh less than men, and women have lower levels of the chemical that metabolizes alcohol. Of note, it’s important to speak with your doctor about your specific body type and alcohol use.

Even if I’m a “heavy” drinker, is it really a big deal?

One way you can check your drinking habits is to run through these four questions in your head:

  1. Have you ever felt you should cut down on your drinking?
  2. Have people annoyed you by criticizing your drinking?
  3. Have you ever felt bad or guilty about your drinking?
  4. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?

A positive response to two or more questions indicates that your drinking may be problematic, and that you should discuss it with your doctor.

A large study found that your risk of death (mortality) actually decreases if you have an average of one drink per day, but increases beyond that.

Are there any benefits to moderate alcohol drinking?

Yes. Moderate alcohol intake lowers your risk for heart disease, diabetes, and stroke. On the other hand, it can also increase your risk of high blood pressure, liver cancer, breast cancer, memory problems, depression, anxiety, and alcohol abuse. The overall effect, however, seems to be protective, since moderate intake has been associated with a longer lifespan.

What are the long-term risks of heavy drinking?

You’ll increase your risk for liver disease, pancreatitis (inflammation of the pancreas, the organ that regulates blood sugar and helps digest foods), type II diabetes, heart failure, many cancers (liver, breast, throat, mouth, and colon), and accidental injury or death. Many of these health problems can be reduced or reversed if you lower your intake to the moderate range.

Brianna Hickey

Brianna Hickey is a second-year medical student at Columbia University College of Physicians and Surgeons.

Christopher Kelly, M.D., M.S.

Christopher Rehbeck Kelly, M.D., M.S., is a cardiology fellow at NewYork-Presbyterian Hospital / Columbia University Medical Center.

Marc Eisenberg, M.D., F.A.C.C.

Marc Sabin Eisenberg, M.D., F.A.C.C., is an associate professor of medicine at Columbia University Medical Center and an attending cardiologist at NewYork-Presbyterian Hospital.