If you find yourself drinking more than usual these days, you’re not alone. Judging by the sheer number of quarantini cocktail recipes, Zoom happy hours, and drinking memes making the online rounds, it’s as if the entire country is operating under the “It’s 5 o’clock somewhere” rule. Not to mention, off-premise alcohol sales were up 22.2 percent during the last week of May compared to the same time last year, according to the market research firm Nielsen. (Though much of that can likely be attributed to what they dubbed “pantry loading” and shuttered bars and restaurants.)

How Much Alcohol Is Too Much?

For most people, having the occasional drink or two can be a perfectly fine way to take the edge off. But if the number and frequency of drinks you down starts to climb well beyond the recommended limit of 1 per day for women and 2 for men, the question becomes, when is it not fine? In other words, could you have an alcohol use disorder (AUD), or be on the brink of one?

In short, the answer is not necessarily. “Somebody can consume a lot of alcohol and have no indications of an addiction,” says Norman Hoffman, Ph.D., an addiction researcher and adjunct professor of psychology at Western Carolina University. “Consumption is really not a good indicator of a problem.”

In fact, he says, alcohol tolerance—defined as the ability to drink more alcohol with fewer ill effects—is probably the “sloppiest” criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) for an AUD. Instead, alcohol dependency really has nothing to do with alcohol quantity, but rather it’s the need to drink any amount of alcohol to avoid withdrawal symptoms or carry out daily functions that signals a disorder.

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What Exactly Is Excessive Drinking?

The research, though somewhat scant, bears this out. In one analysis of the National Survey on Drug Use and Health, researchers at the Centers for Disease Control looked at what they dubbed “excessive drinkers,” which included the following groups of people:

  • Binge drinkers: Women who had 4 or more drinks and men who had 5 or more drinks on one occasion during the past 30 days
  • Heavy drinkers: Women who had 8 or more drinks per week or men who had 15 drinks or more per week during the past 30 days
  • Pregnant women who drank any alcohol during the past 30 days
  • Underage drinkers: Anyone under age 21 who drank

They found that nearly one third of Americans qualify as excessive drinkers, and that the vast majority of them—90 percent—did not meet the criteria for alcohol dependence. (For reference, 2.04 percent of the total U.S. population has an AUD.)

Notably, a higher frequency of binge drinking was associated with a higher prevalence of alcohol dependence. But even among those who reported 10 or more binge drinking episodes in the past month, more than two-thirds didn’t meet the diagnostic criteria for having an AUD.

While those numbers may be reassuring, they shouldn’t be considered carte blanche to keep the alcohol flowing. “Copious consumption of alcohol is definitely not a zero-risk behavior,” says Dr. Hoffman. For one, absence of an AUD doesn’t grant you immunity from the other potential risk factors associated with alcohol. “Over a period of time, heavy consumption can result in all kinds of health issues, from liver function issues to cardiac risks and more.”

Alcohol and Health Issues

It also has psychological ramifications. “For instance, if you’re someone who struggles with depression or anxiety and alcohol chills you out, resorting to drinking actually tends to make things worse,” says Dr. Hoffman.

What’s more, having a preexisting mental health disorder increases your risk for developing alcohol dependence, according to a study published in the journal Addiction. It found that the risk of an AUD is highest among those with intermittent explosive disorder, dysthymia (persistent mild depression), ODD (oppositional defiant disorder), bipolar disorder, social phobia, and any anxiety disorder.

Finally, despite recent rumors to the contrary, alcohol cannot protect you from COVID-19 or prevent an infection. Instead, it’s quite the opposite: Alcohol use, and especially heavy use, weakens the immune system and can actually reduce your ability to cope with infectious diseases like COVID-19 — a fact the World Health Organization urgently warned us about in a new factsheet they released this April.

How To Cut Back

So, where does that leave folks who wonder whether their drinking habits might signal a serious concern? One simple but highly effective self-test is to commit to cutting back for at least a month and then seeing how well you stick with it.

“In my private practice, we had patients sign a contract stipulating that they would have at least one standard drink per week, but never more than two standard drinks in a 24-hour period, for a 30-day period,” explains Dr. Hoffman.

“Of those people that I had identified as probably being alcohol dependent, a few were able to white-knuckle it through week one, but I never saw anybody make it past week two. That pretty much illustrates the difference in a person with a serious substance use disorder: They cannot consistently moderate their use.”

If you do take this tack, be sure to heed the “standard” qualification on drink size, defined as containing about 0.6 ounces of pure alcohol, according to the CDC. That’s about the amount a person’s liver can process in one hour — though that varies based on other factors such as body weight, gender, and genetics. Translated to the glass, a standard drink is the equivalent of 12 ounces of a regular beer at 5 percent alcohol; 8 ounces of malt liquor at 7 percent alcohol, 5 ounces of wine at 12 percent alcohol, or a 1.5 ounce shot of hard liquor at 40 percent alcohol. (Sorry, Ina Garten’s comically large quarantine cosmopolitan does not qualify.)

(Image: Alcohol Research Current Reviews/NIH)

Ultimately, if you find you’re unable to moderate your drinking, or if you meet additional criteria of an AUD—such as experiencing cravings for alcohol; failing to fulfill major role obligations at work, home, or school due to recurrent alcohol use; or sacrificing important social, occupational, or recreational activities due to alcohol use—don’t hesitate to seek professional help. And don’t let fears of leaving home during a pandemic stop you: These days there are sorts of new online recovery resources available. Check out the University of Michigan Addiction Center website for a helpful national list.

Last Updated: Jun 16, 2020