Do I Have a Problem With Alcohol?

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By Amanda MacMillan

People often think that you can either handle alcohol or you're an alcoholic. But that kind of black-and-white view of our complicated relationship with alcohol is false. Drinking habits exist on a spectrum, and the majority of people who drink excessively are not alcohol-dependent. But that does not mean that their level of drinking is good for them.

Last week, we explored the latest research on women and alcohol which shows that women and moms are drinking more. The experts we spoke with suggested that anyone who drinks regularly take a look at how they are drinking and decide if it is time to make a change.

In general, studies show that women who stay within "low-risk" limits of alcohol use (no more than three drinks on any day and no more than seven drinks a week) have only a 2 percent chance of developing an alcohol use disorder, but these numbers only tell part of the story.

"I'm always reluctant to be quick to judge someone's use just by frequency alone," says Sheila Vakharia, PhD, MSW, assistant professor of social work at Long Island University-Brooklyn. "There are so many other factors to take into account: How quickly are you drinking? Are you drinking on an empty stomach? Are you drinking before you have to drive or supervise your kids? Did one drink lead to another, which led to another?" And some situations make drinking any amount of alcohol unsafe, like if you're pregnant or taking certain medications.

Even if you're not addicted to alcohol, you could still have an unhealthy relationship with it. According to the Centers for Disease Control and Prevention, 90 percent of people who drink excessively are not alcohol dependent. For women, binge drinking (four or more drinks on one occasion) or heavy drinking (8 or more drinks per week) is considered excessive. In the past year, only about 2.5 percent of women met the diagnostic criteria for alcohol dependence, but 12 percent report binge drinking three times a month.

That's why the term "alcoholism" has been replaced by "alcohol use disorder," which encompasses a wider range of drinking behaviors that can be stressful or harmful. Take a survey on the National Institute on Alcohol Abuse and Alcoholism (NIAAA) Rethinking Drinking website to see how many of the disorder's 11 symptoms you have. Meeting even one of these suggests that your drinking may be cause for concern, says NIAAA director George F. Koob, PhD, but meeting four or five should be an immediate red flag.

Most importantly, says Vakharia, trust your instincts and reexamine your priorities. For you, drinking too much may mean something as simple as not being able to lose those extra five pounds or not being fully present when reading your kids a bedtime story. "If you're wondering whether you might have a problem or if maybe you should cut back, it's worth getting a second opinion or giving it a try," she says.