Alcoholics generally drink excessively, often much more than four drinks per day and in a manner they can’t control.
Excessive drinking is a serious health problem for millions of people in the United States. Alcohol addiction, or alcohol use disorder (AUD), is one facet of problem drinking.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) provides 11 criteria for clinicians to screen people who potentially have AUD. Mild AUD is two to three of these; moderate is four to five criteria; and severe addiction meets six or more of these criteria.
About 10 percent of American adults drink 74 or more servings of alcohol per week, indicating the severity of the country’s problem with drinking alcohol.
What Is Excessive Alcohol Use?
Heavy drinking and binge drinking are not addiction, but both of these conditions increase the risk of becoming dependent on, and addicted to, alcohol.
Excessive alcohol use is one of the leading causes of illness, reduced quality of life, and death in the United States. According to the Centers for Disease Control and Prevention (CDC), drinking too much in the form of binge drinking, heavy drinking, and alcohol use disorder (AUD) leads to 95,000 preventable deaths, on average, every year.
One of the most severe types of excessive alcohol consumption is AUD, also referred to as alcoholism or alcohol addiction.
What Is the Medical Definition of Alcohol Addiction?
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists three levels of alcohol addiction: mild, moderate, and severe. The manual lists 11 criteria that can determine whether someone is becoming addicted to alcohol. These are:
- You drink more and for longer than you want to.
- You try to cut down on drinking, but you cannot.
- You spend a lot of time drinking or recovering from the effects of drinking.
- You have wanted to drink so badly that you could not think of anything else.
- You find that drinking, or being sick after drinking, interferes with your personal responsibilities like work and family.
- You have continued to drink even though it hurts your relationships with your family and friends.
- You cut back on, or give up on, activities that are important to you in order to drink instead.
- You have, more than once, gotten into situations that could lead to you getting hurt, such as driving while drunk.
- You continued to drink despite knowing it contributes to health problems, including depression and anxiety, or you continued to drink after having a memory blackout.
- You find you need to drink more than you used to in order to feel the same effects, or you have found that your “usual” number of drinks is not effective.
- You experience withdrawal symptoms when you do not drink or as alcohol wears off, including restlessness, trouble sleeping, a racing heart, or nausea.
If one of these statements applies to you, you may engage in a type of excessive drinking like binge drinking or heavy drinking, which can still be dangerous to your health. If two or three of these statements apply to you, you are likely to have a mild type of alcohol addiction or AUD. Four or five statements applying to you suggests you have a moderate addiction to alcohol, while six or more symptoms may indicate a severe addiction.
Seek out a physician, therapist, and addiction specialist so you can get the treatment you need for the level of AUD you experience.
How Many Drinks Per Day Is Considered Alcoholism?
Understanding the signs of alcoholism listed above is important, but many people do not know what a standard drink is, so they have a difficult time determining what is too much alcohol.
The CDC and other health organizations around the world recommend no more than one to two drinks per day, or fewer than seven drinks per week for women and fewer than 15 drinks per week for men. And health organizations note that drinking moderately still carries some risks. There is no such thing as safe drinking, only moderate drinking.
Standard alcohol portions are:
- One 12-ounce beer, which has 5 percent alcohol content.
- 8 ounces of malt liquor, which has 7 percent alcohol content
- 5 ounces of wine, which has 12 percent alcohol content.
- 5 ounces of hard liquor, or 80-proof alcohol, which has 40 percent alcohol content.
It is also important to remember that many bars and restaurants have larger servings than the above portions. For example, wine often comes in larger glasses and might be two servings; a mixed drink with hard alcohol often has more than one 1.5-ounce shot; and a pint of beer is 16 US fluid ounces, not 15 ounces.
Drinking two bottles of beer at home is within moderate drinking guidance, but having two glasses of wine at a bar might become binge drinking.
Binge drinking is defined as four or more drinks on one occasion. The liver processes about one standard serving of alcohol, as listed above, per hour. Drinking more than that in one hour can quickly cause intoxication, leading to unsafe decisions and potential risk of injury. Drinking four or more drinks most days of the week is a dangerous level of heavy drinking, and it can lead to long-term health problems like liver damage, diabetes, and even cancer.
According to data reported on by the Washington Post, about 30 percent of American adults do not drink alcohol at all, and another 30 percent consume less than one drink per week. But 10 percent of American adults consume about 74 drinks per week, or more than 10 drinks per day. This 10 percent represents about 24 million people. Many of the people in this group likely struggle with alcohol dependence and addiction.
The National Institute on Alcohol Addiction and Alcoholism (NIAAA) has found that nearly 15 million people, ages 12 and older, meet the DSM-5’s criteria for alcohol addiction. While many people who have problematic drinking patterns like binge or heavy drinking are not necessarily addicted to alcohol, millions of people do have alcohol use disorder and need evidence-based treatment, including detox and rehabilitation.
Frequently Asked Questions About Alcohol Consumption & Addiction
If I drink a glass of wine with dinner every night, am I an alcoholic?
If you are only drinking one 5-ounce glass of wine with dinner, and not drinking more before or after the meal, this is well within the guidelines of moderate drinking. For women, drinking one glass of wine per night, less than seven days per week, is moderate drinking. For men, two glasses of wine per night is moderate drinking. While you may still experience some side effects from drinking this frequently, it is not considered AUD or addiction. However, if your standard glass of wine is part of drinking more throughout the night, drinking consistently during the day, drinking too much on a weekend, or following other problematic drinking patterns, you may meet the DSM-5’s criteria for alcohol addiction. You can get help from an experienced physician or therapist for a diagnosis.
If I drink heavily, five or more drinks once a week, am I an alcoholic?
Again, this does not necessarily classify as addiction. However, if those five drinks are consumed in one evening or at one event, this is binge drinking, and it can be very dangerous to your health. Having between five and seven drinks spread out through the week is a type of moderate drinking, which might still have some health effects.
How do I cut back on the amount of drinks I have per day/week?
Stopping habitual behaviors can be difficult for anyone, but people who are addicted to alcohol need additional medical support. If you meet the criteria for AUD, get in touch with a doctor or counselor for a diagnosis and referrals to treatment. If you struggle with excessive drinking but are not physically dependent on alcohol, you may not need the detox step of recovery, but you may still benefit from support and therapy to manage compulsive behaviors and cravings. You can ask a doctor, therapist, or support group for help.
- Alcohol Use and Your Health. (May 2021). Centers for Disease Control and Prevention (CDC).
- Alcohol Use Disorder: A Comparison Between DSM-IV and DSM-5. (April 2021). National Institute on Alcohol Abuse and Alcoholism (NIAAA).
- Drinking Levels Defined. National Institute on Alcohol Abuse and Alcoholism (NIAAA).
- Think You Drink a Lot? This Chart Will Tell You. (September 2014). The Washington Post.
- Alcohol Facts and Statistics. (June 2021). National Institute on Alcohol Abuse and Alcoholism (NIAAA).