Frequently Asked Questions

Introduction to alcohol

Drinking levels

Excessive alcohol use

Drinking problems

Special populations

What is alcohol?
Ethyl alcohol, or ethanol, is an intoxicating ingredient found in beer, wine, and liquor. Alcohol is produced by the fermentation of yeast, sugars, and starches.

How does alcohol affect a person?
Alcohol affects every organ in the body. It is a central nervous system depressant that is rapidly absorbed from the stomach and small intestine into the bloodstream. Alcohol is metabolized in the liver by enzymes; however, the liver can only metabolize a small amount of alcohol at a time, leaving the excess alcohol to circulate throughout the body. The intensity of the effect of alcohol on the body is directly related to the amount consumed.

Why do some people react differently to alcohol than others?
Individual reactions to alcohol vary, and are influenced by many factors; such as:

Age.
Gender.
Race or ethnicity.
Physical condition (weight, fitness level, etc).
Amount of food consumed before drinking.
How quickly the alcohol was consumed.
Use of drugs or prescription medicines.
Family history of alcohol problems.

What is a standard drink in the United States?
A standard drink is equal to 14.0 grams (0.6 ounces) of pure alcohol. Generally, this amount of pure alcohol is found in

12-ounces of beer (5% alcohol content).
8-ounces of malt liquor (7% alcohol content).
5-ounces of wine (12% alcohol content).
1.5-ounces or a “shot” of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey).

Is beer or wine safer to drink than liquor?
No. One 12-ounce beer has about the same amount of alcohol as one 5-ounce glass of wine, or 1.5-ounce shot of liquor. It is the amount of alcohol consumed that affects a person most, not the type of alcoholic drink.

What does moderate drinking mean?
According to the Dietary Guidelines for Americans,1 moderate alcohol consumption is defined as having up to 1 drink per day for women and up to 2 drinks per day for men. This definition is referring to the amount consumed on any single day and is not intended as an average over several days. The Dietary Guidelines also state that it is not recommended that anyone begin drinking or drink more frequently on the basis of potential health benefits because moderate alcohol intake also is associated with increased risk of breast cancer, violence, drowning, and injuries from falls and motor vehicle crashes.

Is it safe to drink alcohol and drive?
No. Alcohol use slows reaction time and impairs judgment and coordination, which are all skills needed to drive a car safely.2 The more alcohol consumed, the greater the impairment.

What does it mean to be above the legal limit for drinking?
The legal limit for drinking is the alcohol level above which an individual is subject to legal penalties (e.g., arrest or loss of a driver's license).

Legal limits are measured using either a blood alcohol test or a breathalyzer.
Legal limits are typically defined by state law, and may vary based on individual characteristics, such as age and occupation.

All states in the United States have adopted 0.08% (80 mg/dL) as the legal limit for operating a motor vehicle for drivers aged 21 years or older. However, drivers younger than 21 are not allowed to operate a motor vehicle with any level of alcohol in their system.

Note: Legal limits do not define a level below which it is safe to operate a vehicle or engage in some other activity. Impairment due to alcohol use begins to occur at levels well below the legal limit.

How do I know if it’s okay to drink?
The current Dietary Guidelines for Americans1 recommend that if you choose to drink alcoholic beverages, do not exceed 1 drink per day for women or 2 drinks per day for men. According to the guidelines, people who should not drink alcoholic beverages at all include the following:

Children and adolescents.
Individuals of any age who cannot limit their drinking to low level.
Women who may become pregnant or who are pregnant.
Individuals who plan to drive, operate machinery, or take part in other activities that require attention, skill, or coordination.
Individuals taking prescription or over-the-counter medications that can interact with alcohol.
Individuals with certain medical conditions.
Persons recovering from alcoholism.

According to the Dietary Guidelines for Americans, it is not recommended that anyone begin drinking or drink more frequently on the basis of potential health benefits because moderate alcohol intake also is associated with increased risk of breast cancer, violence, drowning, and injuries from falls and motor vehicle crashes.

What is excessive alcohol use?
Excessive alcohol use includes binge drinking, heavy drinking, any alcohol use by people under the age 21 minimum legal drinking age, and any alcohol use by pregnant women.

What is binge drinking?
According to the National Institute on Alcohol Abuse and Alcoholism

binge drinking is defined as a pattern of alcohol consumption that brings the blood alcohol concentration (BAC) level to 0.08% or more. This pattern of drinking usually corresponds to 5 or more drinks on a single occasion for men or 4 or more drinks on a single occasion for women, generally within about 2 hours.3

What do you mean by heavy drinking?
For men, heavy drinking is typically defined as consuming 15 drinks or more per week. For women, heavy drinking is typically defined as consuming 8 drinks or more per week.

What is the difference between alcoholism and alcohol abuse?
Alcohol abuse4 is a pattern of drinking that results in harm to one’s health, interpersonal relationships, or ability to work. Manifestations of alcohol abuse include the following:

Failure to fulfill major responsibilities at work, school, or home.
Drinking in dangerous situations, such as drinking while driving or operating machinery.
Legal problems related to alcohol, such as being arrested for drinking while driving or for physically hurting someone while drunk.
Continued drinking despite ongoing relationship problems that are caused or worsened by drinking.
Long-term alcohol abuse can turn into alcohol dependence.

Dependency on alcohol, also known as alcohol addiction and alcoholism4, is a chronic disease. The signs and symptoms of alcohol dependence include—

A strong craving for alcohol.
Continued use despite repeated physical, psychological, or interpersonal problems.
The inability to limit drinking.

What does it mean to get drunk?
“Getting drunk” or intoxicated is the result of consuming excessive amounts of alcohol. Binge drinking typically results in acute intoxication.

Alcohol intoxication can be harmful for a variety of reasons, including—

Impaired brain function resulting in poor judgment, reduced reaction time, loss of balance and motor skills, or slurred speech.
Dilation of blood vessels causing a feeling of warmth but resulting in rapid loss of body heat.
Increased risk of certain cancers, stroke, and liver diseases (e.g., cirrhosis), particularly when excessive amounts of alcohol are consumed over extended periods of time.
Damage to a developing fetus if consumed by pregnant women.5
Increased risk of motor-vehicle traffic crashes, violence, and other injuries.

Coma and death can occur if alcohol is consumed rapidly and in large amounts.

How do I know if I have a drinking problem?
Drinking is a problem if it causes trouble in your relationships, in school, in social activities, or in how you think and feel. If you are concerned that either you or someone in your family might have a drinking problem, consult your personal health care provider.

What can I do if I or someone I know has a drinking problem?
Consult your personal health care provider if you feel you or someone you know has a drinking problem. Other resources include the National Drug and Alcohol Treatment Referral Routing Service available at 1-800-662-HELP. This service can provide you with information about treatment programs in your local community and allow you to speak with someone about alcohol problems.6

What health problems are associated with excessive alcohol use?
Excessive drinking both in the form of heavy drinking or binge drinking, is associated with numerous health problems, including—

Chronic diseases such as liver cirrhosis (damage to liver cells); pancreatitis (inflammation of the pancreas); various cancers, including liver, mouth, throat, larynx (the voice box), and esophagus; high blood pressure; and psychological disorders.
Unintentional injuries, such as motor-vehicle traffic crashes, falls, drowning, burns and firearm injuries.
Violence, such as child maltreatment, homicide, and suicide.
Harm to a developing fetus if a woman drinks while pregnant, such as fetal alcohol spectrum disorders.
Sudden infant death syndrome (SIDS).
Alcohol abuse or dependence.

I’m young. Is drinking bad for my health?
Yes.7, 8 Studies have shown that alcohol use by youth and young adults increases the risk of both fatal and nonfatal injuries.9, 10, 11 Research has also shown that youth who use alcohol before age 15 are five times more likely to become alcohol dependent than adults who begin drinking at age 21.12 Other consequences of youth alcohol use include increased risky sexual behaviors, poor school performance, and increased risk of suicide and homicide.13, 14, 15

Is it okay to drink when pregnant?
No. There is no safe level of alcohol use during pregnancy. Women who are pregnant or plan on becoming pregnant should refrain from drinking alcohol.16 Several conditions, including Fetal Alcohol Spectrum Disorders have been linked to alcohol use during pregnancy. Women of child bearing age should also avoid Binge drinking to reduce the risk of unintended pregnancy and potential exposure of a developing fetus to alcohol.

References

U.S. Department of Agriculture and U.S. Department of Health and Human Services. In:Dietary Guidelines for Americans, 2010. Chapter 3 – Foods and Food Components to Reduce [PDF-967KB]. 7th Edition, Washington, DC: US Government Printing Office; 2010, p. 30–32.
National Highway Traffic Safety Administration. Available at http://www.nhtsa.dot.gov/.
National Institute of Alcohol Abuse and Alcoholism. NIAAA council approves definition of binge drinking [PDF-1.6MB]. NIAAA Newsletter 2004;3:3.
Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV), published by the American Psychiatric Association, Washington D.C., 1994.
Centers for Disease Control and Prevention. Fetal Alcohol Spectrum Disorders. Available athttp://www.cdc.gov/ncbddd/fas/default.htm.
Substance Abuse and Mental Health Services Administration. Substance Abuse Treatment Facility Locator. Available at http://www.samhsa.gov/treatment/treatment_public_i.aspx .
Bonnie RJ and O’Connell ME, editors. National Research Council and Institute of Medicine.Reducing Underage Drinking: A Collective Responsibility . Committee on Developing a Strategy to Reduce and Prevent Underage Drinking. Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press; 2004.
U.S. Department of Health and Human Services. The Surgeon General's Call to Action to Prevent and Reduce Underage Drinking. Rockville, MD: U.S. Department of Health and Human Services: 2007.
Hingson RW, Heeren T, Jamanka A, Howland J. Age of onset and unintentional injury involvement after drinking . JAMA 2000;284(12):1527–1533.
Hingson RW, Heeren T, Winter M, Wechsler H. Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18–24: Changes from 1998 to 2001 . Annu Rev Public Health 2005;26:259–79.
Levy DT, Mallonee S, Miller TR, Smith GS, Spicer RS, Romano EO, Fisher DA. Alcohol involvement in burn, submersion, spinal cord, and brain injuries . Medical Science Monitor2004;10(1):CR17–24.
Office of Applied Studies. The NSDUH Report: Alcohol Dependence or Abuse and Age at First Use. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2004.
Substance Abuse and Mental Health Services Administration. A Comprehensive Plan for Preventing and Reducing Underage Drinking [PDF-513KB]. Washington, DC; 2006.
Centers for Disease Control and Prevention (CDC). Alcohol-Related Disease Impact (ARDI).Atlanta, GA: CDC.
Miller JW, Naimi TS, Brewer RD, Jones SE. Binge drinking and associated health risk behaviors among high school students . Pediatrics 2007;119:76–85.
Department of Health and Human Services. U.S. Surgeon General Releases Advisory on Alcohol Use in Pregnancy; urges women who are pregnant or who may become pregnant to abstain from alcohol . Washington, DC; 2005.