Like many people, after a long day at work, you may find yourself having a beer or two to unwind after an 8-hour day. Or, maybe a couple glasses of wine each night help you fall asleep better. While having an occasional drink doesn’t necessarily mean you have a drinking problem, if you feel the need to have it most nights, it could indicate a more serious issue, even if you aren’t getting drunk every night.
Alcoholism affects people of all shapes and sizes, and because it progresses over time, understanding your own drinking habits could help you to make changes that might lessen the risk of developing this chronic disorder. Though a person cannot be addicted to just wine or just beer, it is important to know that any type of excessive drinking can cross into dangerous territory, as the onset of compulsive patterns of alcohol use may signal the development of an alcohol use disorder (AUD).
Why Does Alcohol by Volume (ABV) Matter?
The amount of alcohol in a drink is determined by the size of your drink and the concentration of alcohol in it, which is known as alcohol by volume (ABV). ABV is the percentage of pure alcohol in your drink. It is important to be aware of the ABV because drinks vary by strength and serving size—so different types of drinks of the same size can contain different amounts of alcohol.1
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), a standard drink contains around 14 grams (0.6 fluid ounces) of pure alcohol.1 In the U.S., this can generally be found in 12 ounces of regular beer, which has an average of 5% alcohol; a 5-ounce glass of wine, which is around 12% alcohol; or 1.5 ounces of distilled spirits (an average shot), which is around 40% alcohol.1
When a person drinks alcohol, it is absorbed into the bloodstream from the GI tract and circulated throughout the body.2 Most people begin to feel alcohol’s full effects within 15 to 45 minutes after the first drink.2 On average, it takes your body about 1 hour to break down a standard drink.3 This can also vary based on gender, age, weight, metabolism, and the medications you’re taking, among other factors.3
Although standard drink sizes can help you make informed decisions about your drinking, not all alcoholic beverages can be considered a “standard drink.” See how different types of wine and beer can vary in ABV:
ABV in Beer
Many beers contain between 4-7% ABV, with the average being 5%; and a standard serving of beer is 12 ounces, or about the size of a bottle of beer.4 If you’re drinking a 12-ounce beer at 5% ABV, that equals 0.6 ounces of alcohol per serving. However, a pint of beer at a brewery is generally 15 ounces, which is larger than the standard serving size. And if you’re consuming a craft beer such as an IPA with a higher ABV, your alcohol per serving can be closer to 0.9 ounces which will therefore take the liver longer to process.
ABV in Wine
A standard serving of wine is 5 ounces, and on average, most wines contain between 11% and 13% ABV.4 However, some wines can have a much lower or higher ABVs.4 White wines tend to have a lower ABV than red wine. For example, white wines like Riesling generally have a relatively low ABV, around 10.5%, while certain red wines (such as a Californian Zinfandel or an Australian Shiraz) can have up to 16% ABV, and fortified wines like sherry or port can have up to 26% ABV.5
So, while you may only be having a couple of glasses of wine or a few bottles of beer each night, because their sizes and ABV can vary, you may be drinking more than you actually realize. Over time, excessive alcohol use of any kind can lead to the development of chronic diseases such as high blood pressure, heart disease, stroke, liver disease, digestive problems, and eventually, alcoholism.6
What Are Low- and High-Risk Drinking Habits?
Though you may only be drinking one type of alcohol, how much and how often you consume it can help you determine if you may be putting yourself at risk of developing an AUD. According to the NIAAA, low-risk drinking is defined as no more than 4 drinks per day and no more than 14 drinks per week for men, and no more than 3 drinks a day with no more than 7 drinks per week for women.7
However, low-risk does not mean no-risk.7 Even within these limits, alcohol can cause problems if, for example, you have health issues, drink too quickly, or are older. For healthy adults, high-risk or heavy drinking is defined as more than 4 drinks a day or 14 per week for men, and more than 3 drinks per day or 7 per week for women.8 About 1 in 4 people who go over these limits already has an alcohol use disorder, while the rest are at greater risk for developing an AUD as well as other health or personal issues.8
Common Myths About Alcoholism
Because there are many common myths and misconceptions about alcoholism, it can be difficult to know if your own drinking habits put you at risk of an AUD. If you’ve ever caught yourself saying any of the below, we’ve unpacked those statements to help you understand why they are risky ways of thinking:9
- “I don’t have a problem because I can hold my alcohol.” While you may not feel “out of control,” if you need to drink more to feel alcohol’s effects, this could be a sign you’ve developed a tolerance which can lead to ever-increasing patterns of drinking, physical dependence and ultimately, alcoholism.
- “I only drink on weekends.” You don’t need to drink daily to have a problem with alcohol. The threshold for heavy drinking, which can put you at a higher risk for developing an AUD, can be met based on the total number of drinks you have across an entire week, not necessarily every day.
- “I’m too old to have a drinking problem.” Many people can actually become more sensitive to the effects of alcohol as they age, and at times, may drink because they feel depressed or lonely.
- “I don’t have a problem because I only drink wine or beer.” What you drink is not as important as how much and how often you imbibe as well as how it affects your life.
- “Drinking helps take the edge off my chronic pain.” Heavy alcohol use can actually increase pain sensitivity in the long-term. And, if you drink and take painkillers, it can increase your risk for serious issues like stomach bleeding or liver problems.
What is Alcohol Use Disorder?
Alcoholism, or an AUD, is a chronic, relapsing disease that is diagnosed based on a person meeting certain criteria outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). To be diagnosed with AUD, individuals must meet any two of the below criteria within the same 12-month period:10
- Using alcohol in larger amounts or for a longer time than originally intended.
- Being unable to reduce alcohol use.
- Spending a lot of time obtaining, using, and recovering from the effects of alcohol.
- Cravings, or strong desires to drink.
- Failing to fulfill obligations at work, home, or school because of alcohol use.
- Continuing drinking even though you experience persistent social or interpersonal problems because of alcohol use.
- Giving up important social, occupational, or recreational activities because of alcohol use.
- Drinking in situations where it is physically dangerous to do so (such as driving or operating machinery).
- Continuing to drink despite knowing that you have a physical or psychological problem that is probably caused by alcohol use.
- Tolerance, meaning you need higher amounts of alcohol to achieve previous results.
- Withdrawal, meaning you experience unpleasant symptoms when you try to stop drinking. These symptoms are alleviated when you drink again.
How Do I Know If I Have a Drinking Problem?
If you think you may already be struggling with alcoholism, or you’re unsure if your drinking places you at risk for developing AUD, there are several assessment tests which can be completed to better understand your level of alcohol use. Some of these assessments include:11
C – Have you ever felt you should cut down on your drinking?
A – Have people annoyed you by criticizing your drinking?
G – Have you ever felt bad or guilty about your drinking?
E – Eye opener: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?
Two positive responses could signal the need for further assessment.
MAST: The Michigan Alcohol Screening Test (MAST) is a self-scoring questionnaire developed to help identify problematic drinking.12,13 Different forms of the test have been utilized over the years, with various iterations containing as few as 10 to more than 20 yes/no questions. It was created to assess the presence and severity of a person’s drinking.
AUDIT: The Alcohol Use Disorders Identification Test (AUDIT) was created by the World Health Organization as a tool to detect alcohol problems experienced within the past year. A score of 8 or more on typically indicates harmful or hazardous drinking.
While helpful, self-assessment with these tests should not be considered as a final diagnosis but can be useful in determining whether your current drinking habits may put you at risk of an AUD, which could warrant additional evaluation by a treatment professional.
When Is It Time to Seek Treatment?
If you feel that your drinking has become a problem, is uncontrollable, and has negatively affected your life and the lives of those around you, or you feel that you meet the criteria for AUD, it’s likely a good time to consider seeking help. The more symptoms of AUD you have, the more serious the problem may be.14 Remember that no matter how severe the problem is, it’s never too late to get help and recover from alcoholism.
Though earlier treatment may help prevent the accumulation of many of the adverse consequences of compulsive drinking—it’s never too late to get help. Depending on your specific needs, a wide range of treatment options exist including both inpatient and outpatient rehabilitation.
Inpatient treatment facilities offer stays within a residential facility where you’ll receive round-the-clock care and monitoring for the duration of treatment.15 Outpatient treatment may be an option if there is no need for intensive medical detox and withdrawal management, or otherwise for people with strong systems of support, fewer addiction-related issues, and less severe addictions.
If you are ready to discuss treatment, our admissions navigators are available 24/7 to speak with you today. The type of treatment that will be most suitable for you will likely be influenced by your alcohol history, previous attempts at treatment, any co-occurring medical and/or mental health conditions, other substance use history, and your current living situation. Taking the first step toward recovery by seeking treatment is one of the best moves you can make for your overall health, well-being, and happiness.
. National Institute on Alcohol Abuse and Alcoholism. (n.d.). What is a standard drink?
. Bowling Green State University. (n.d.). Alcohol Metabolism.
. National Health Services. (2018). How long does alcohol stay in your blood?
. National Consumers League. (2008). Alcohol: How it all adds up.
. Wine Folly. (2019). Alcohol content in wine and other drinks (Infographic).
. Centers for Disease Control and Prevention. (2018). Fact Sheets – Alcohol Use and Your Health.
. National Institute on Alcohol Abuse and Alcoholism. (n.d.). What’s “low-risk” drinking for AUD?
. National Institute on Alcohol Abuse and Alcoholism. (n.d.). What’s “at-risk” or “heavy” drinking?
. MedlinePlus. (2018). Myths about drinking alcohol.
. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association.
. National Institute on Alcohol Abuse and Alcoholism. (n.d.). Screening Tests.
. Selzer, M.L. (1971). The Michigan Alcoholism Screening Test (MAST): The Quest for a New Diagnostic Instrument. American Journal of Psychiatry, 3:176-181.
. Substance Abuse and Mental Health Services Administration. (n.d.). Michigan Alcohol Screening Test.
. National Institute on Alcohol Abuse and Alcoholism. (2014). Treatment for Alcohol Problems: Finding and Getting Help.
. National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Types of Treatment Programs.