Who Let The Doc Out?! #013: How much alcohol is too much alcohol?

Alcohol is one of the most widely consumed substances in the world. It is available in many different forms like beers, spirits, and wines. However, it is also extremely dangerous, with alcohol consumption causing an estimated 2.8 million deaths globally every year. And this number doesn’t account for the deaths caused by behavioral changes due to excessive alcohol consumption.

Having a couple of beers every few weeks may not be detrimental to your mental and physical health. But without the appropriate information of how much alcohol is too much, many people may fail to figure out what the healthy threshold for alcohol consumption should be.

This is why today, we shall discuss how much alcohol you can consume safely, and how much could put you at a risk of developing mental and physical issues.

How much alcohol should a person consume?

The guidelines on how much alcohol a person can consume vary depending on different factors like sex, age, and body weight. However, the most widely used guidelines base their estimations on the person’s sex.

According to the Dietary Guidelines for Americans, the average man should consume two standard drinks or less in a day, and the average woman should consume one standard drink or less in a day. The limits are lower for women because their bodies tend to be smaller and have less water to dilute alcohol, leading to higher alcohol concentration in the blood for the same amount of alcohol than a man.

The guidelines quantify a standard drink as 14.0 grams (17.74ml) of pure alcohol, and this amount of pure alcohol can be found in approximately:

  • 355ml of beer (5% alcohol content)
  • 237ml of malt liquor (7% alcohol content)
  • 148ml of wine (12% alcohol content)
  • 44ml or a shot of 80-proof distilled spirits or liquor (40% alcohol content)

Some drinks like cocktails and certain beers will count as more than one standard drink. Cocktails, for example, may contain more shots of liquor or spirit, which would count as more standard drinks. Also, despite the daily recommendation being 2 or 1 standard drinks a day, the guidelines actually dissuade people from drinking alcohol every day, as this can cause harmful cumulative effects too, and they advise that people who have not started drinking should avoid starting at all.

Moderate drinking, heavy drinking, and binge drinking

The definitions for levels of drinking alcohol vary depending on the region. The National Institute on Alcohol Abuse and Alcoholism(NIAAA) qualifies the different levels as follows:

  • For women: Moderate drinking is less than two drinks per day. Heavy drinking is more than three drinks per occasion or more than seven drinks a week.
  • For men: Moderate drinking is less than three drinks a day. Heavy drinking is more than four drinks per occasion or more than 14 drinks every week.

The NIAAA goes further to define binge drinking as “a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08% – or 0.08 grams of alcohol per deciliter – or higher.” For a typical adult male, this pattern corresponds to taking 5 or more drinks, or 4 or more drinks for an adult female, in a duration of about 2 hours.

The Substance Abuse and Mental Health Services Administration (SAMHSA) defines binge drinking as “5 or more alcoholic drinks for males, or 4 or more alcoholic drinks for females, on the same occasion on at least 1 day in the past month.

While the effects of moderate drinking are often long term and can be caught early and corrected by cessation of alcohol intake, heavy and binge drinking are quite dangerous as they predispose alcohol consumers to several issues like:

  • Alcohol use disorders
  • Loss of inhibition, causing accidents, violence, and unsafe sexual practices
  • Chronic diseases like hypertension, stroke, heart disease, liver disease
  • Cancer of the breast, mouth, throat, esophagus, liver, and colon
  • Fetal alcohol disorders

Who should not drink alcohol?

The Dietary Guidelines for Americans state that some people should not drink alcohol at all. These groups of people include:

  • Pregnant women
  • People under the legal age for drinking
  • People on medications that may interact with alcohol
  • People recovering from an alcohol use disorder

People suffering from chronic diseases like hypertension, liver failure, kidney disease, heart disease, and stroke are also advised against consuming alcohol as this may worsen their prognosis.

While some research reports that moderate consumption of alcohol has some benefits like cardioprotection, it is still more advisable to avoid drinking alcohol altogether, as the risks far outweigh the benefits.

Innocent Immaculate Acan is a medical doctor and writer. She won the Writivism Short Story Prize in 2016 and has published an illustrated children’s book titled The Pearl Trotters in Black, Yellow, Red. She was part of the 2018 class of the Young and Emerging Leaders Project.

Innocent Immaculate Acan