Information From News in Health, www.nih.gov
Some people enjoy an occasional glass of wine with dinner. Others might
grab a beer while watching a football game. Most people drink alcohol
moderately, within their limits. Others overdo it occasionally. However,
some people find they can’t control their drinking. How do you know
when drinking is becoming a problem? And what can you do if it is?
About 18 million Americans have an alcohol use disorder. Drinking too
much alcohol raises your risk of injury and accidents, disease, and
other health problems. Heavy drinking is one of the leading causes of
preventable deaths in this country, contributing to nearly 88,000 deaths
How much is too much? Men should not have more than 14 drinks per week
and four drinks on any single day. Women should not have more than seven
drinks per week and no more than three drinks on any day. You might be
surprised at what counts as a drink, however. A five ounce glass of
table wine, a 12-ounce glass of regular beer, and 1½ ounces of hard
liquor each contain the same amount of alcohol, and each counts as one
drink. You may need to adjust the amount you drink, depending on how
alcohol affects you. Some people — such as pregnant women or people
taking certain medications — should not drink alcohol at all.
Alcohol problems come from drinking too much, too fast, or too often.
People with alcohol dependence are addicted to alcohol, and they cannot
control their drinking. When alcohol-dependent people try to stop
drinking, they may feel anxious and irritable — so they may drink some
more, and it becomes a vicious cycle.
“Addiction has three major problems: You lose your ability to feel good,
you get more stressed, and you have a hard time making proper
decisions,” says Dr. George Koob, director of NIH’s National Institute
on Alcohol Abuse and Alcoholism. “That’s a recipe for disaster.”
Signs of an alcohol problem include drinking more, or more often, than
you intended, or making unsuccessful attempts to cut back or quit.
People with alcohol problems often have trouble functioning at work,
home, or school.
“A good indicator is that something is out of whack. Is your personal
life deteriorating because of your drinking? Are people starting to shun
you? If you’re feeling generally miserable, that’s a warning sign,”
Koob says. “You don’t have to hit bottom. You’ll save yourself a lot of
damage socially, professionally, and probably in your own body if you
attend to an alcohol problem a lot earlier.”
“People shouldn’t wait for a physical problem like liver disease,” says
Dr. Lorenzo Leggio, an NIH researcher studying new alcoholism
treatments. “People develop an alcohol disorder before liver problems
get bad. The goal is to identify an alcohol disorder sooner. The sooner
you act can help prevent medical consequences.”
Studies show that most people with an alcohol use disorder can benefit
from some form of treatment. If you or someone you care about may have
an alcohol problem, help is available. The first step is to talk to a
primary care doctor. In some cases, a brief intervention, or an honest
conversation about drinking habits and risks, is all the person needs.
If the problem is more serious, the doctor can help create a treatment
plan, prescribe medications, or refer the person to a specialist. In
more severe cases, the doctor might recommend a treatment clinic or
in-patient addiction center.
“Alcohol dependence is a complex, diverse disorder. There’s not one
treatment that works for everybody,” says Dr. Raye Litten, an alcohol
treatment and recovery expert at NIH. “If one treatment doesn’t work,
you can try another one. Sometimes a combination of these will work.”
Medications can help people stop or reduce their drinking. Three
medications are approved by the U.S. Food and Drug Administration for
treating alcohol use disorders. One of these, disulfiram, causes
unpleasant side effects such as nausea, vomiting, and a racing heart
rate if you consume any alcohol while taking the drug. Understandably,
some people do not want to take this medication for that reason. The two
other drugs, naltrexone and acamprosate, also have been shown effective
at reducing alcohol craving in many heavy drinkers.
“There’s not going to be a drug that cures you of alcoholism,” Koob
says. “I think that drugs can help you along the way, so that some of
the chemical changes in the brain can return to normal. Strengthen that
with behavioral therapy to make recovery as permanent as you can.”
Behavioral therapy, such as counseling or support groups, can help
people develop skills to avoid or overcome stress and other triggers
that could lead to drinking. The approach can help people set realistic
goals, identify the feelings and situations that might lead to heavy
drinking, and offer tips to manage stress. It also helps to build a
strong social support network.
If the treatment plan created by your healthcare team is working, it is
important to stick to that plan. Many people repeatedly try to cut back
or quit drinking, have a setback, then try to quit again. Think of an
alcohol relapse as a temporary setback and keep persisting toward full
“You always have to be aware there’s a possibility of relapse and
temptation,” says Koob. “Any recovering alcoholic will tell you it’s a
daily fight for a long time.
Sources upon Request
Photo credit: Axel Bueckert/iStock
Rethink That Drink
Drinking too much alcohol? Here are some tips to help cut back:
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- Pace yourself. Sip slowly. Drink a glass of water after each alcoholic drink.
- Include food. Do not drink on an empty stomach.
- Avoid triggers. If certain people, places, or activities tempt you to drink, try to avoid them.
- Seek healthy alternatives. Look for new hobbies, interests, or friendships to help fill your time and manage your stress.
- Track and control how much you drink. If offered a drink you do not want, have a polite, convincing “no thanks” reply ready.