Frequently Asked Questions
Why do some people react differently to alcohol than others?
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.
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).
What does moderate drinking mean?
According to the Dietary Guidelines for AmericansExternalexternal icon,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 refers to the amount consumed on any single day and is not intended as an average over several days. However, the Dietary Guidelines do not recommend that people who do not drink alcohol start drinking for any reason.
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?
Externalexternal iconBinge 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.
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.
- 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.
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,6including
- 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 use disorders.
Special Populations and Alcohol
How do I know if it’s okay to drink?
According to the 2015–2020 Dietary Guidelines for Americans,Externalexternal icon1 some people should not drink alcoholic beverages at all, including:
- Anyone younger than age 21.
- Women who are or may be pregnant.
- People who are driving, planning to drive, or are participating in other activities requiring skill, coordination, and alertness.
- People taking certain prescription or over-the-counter medications that can interact with alcohol.
- People with certain medical conditions.
- People who are recovering from alcoholism or who are unable to control the amount they drink.
The Dietary Guidelines also recommend that if alcohol is consumed, it should be in moderation—up to 1 drink per day for women and up to 2 drinks per day for men—and only by adults of legal drinking age. However, the Guidelines do not recommend that people who do not drink alcohol start drinking for any reason. By following the Dietary Guidelines, you can reduce the risk of harm to yourself or others.
I am young. Is drinking bad for my health?
Yes.8,9 Studies have shown that alcohol use by adolescents and young adults increases the risk of both fatal and nonfatal injuries.10-12 Research has also shown that people who use alcohol before age 15 are six times more likely to become alcohol dependent than adults who begin drinking at age 21.13 Other consequences of youth alcohol use include increased risky sexual behaviors, poor school performance, and increased risk of suicide and homicide.14-16
Is it okay to drink when pregnant?
No. There is no known safe level of alcohol use during pregnancy. Women who are pregnant or plan on becoming pregnant should refrain from drinking alcohol.17 Several conditions, including fetal alcohol spectrum disorders, have been linked to alcohol use during pregnancy. Women of childbearing age should also avoid binge drinking to reduce the risk of unintended pregnancy and potential exposure of a developing fetus to alcohol.
Is it okay to drink when breastfeeding?
Not drinking alcohol is the safest option for breastfeeding mothers. Generally, moderate alcohol consumption by a breastfeeding mother (up to 1 standard drink per day) is not known to be harmful to the infant, especially if the mother waits at least 2 hours after a single drink before nursing. However, exposure to alcohol above moderate levels through breast milk could be damaging to an infant’s development, growth, and sleep patterns. Alcohol consumption above moderate levels may also impair a mother’s judgment and ability to safely care for her child. Drinking alcoholic beverages is not an indication to stop breastfeeding; however, consuming more than one drink per day is not recommended.18
Drinking and Driving
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.2The 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 a person 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 according to 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 (except for Utah, which adopted a 0.05% legal limit in 2018). 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.
Alcohol Use Disorders
Do all excessive drinkers have an alcohol use disorder?
No. About 90% of people who drink excessively would not be expected to meet the clinical diagnostic criteria for having a severe alcohol use disorderExternalexternal icon.4 A severe alcohol use disorder, previously known as alcohol dependence or alcoholism, is a chronic disease.5 Some of the signs and symptoms of a severe alcohol use disorder could include:
- Inability to limit drinking.
- Continuing to drink despite personal or professional problems.
- Needing to drink more to get the same effect.
- Wanting a drink so badly you can’t think of anything else.
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.7
- US Department of Health and Human Services and US Department of Agriculture. 2015–2020 Dietary Guidelines for Americansexternal icon. 8th ed. Washington, DC: US Dept of Health and Human Services and US Dept of Agriculture; 2015.
- National Highway Traffic Safety Administration Drunk Driving website. https://www.nhtsa.gov/risky-driving/drunk-drivingexternal icon. Accessed May 30, 2017.
- National Institute of Alcohol Abuse and Alcoholism. NIAAA council approves definition of binge drinkingpdf iconexternal icon [PDF-1.6MB]. NIAAA Newsletter. 2004;3:3.
- Esser MB, Hedden SL, Kanny D, Brewer RD, Gfroerer JC, Naimi TS. Prevalence of alcohol dependence among US adult drinkers, 2009–2011. Prev Chronic Dis. 2014;11:140329. doi: http://dx.doi.org/10.5888/pcd11.140329.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)external icon. Arlington, VA: American Psychiatric Association; 2013.
- Centers for Disease Control and Prevention. Fact Sheet – Alcohol Use and Your Health website. http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm. Accessed May 30, 2017.
- Substance Abuse and Mental Health Services Administration. Behavioral Health Treatment Services Locator website. https://www.findtreatment.samhsa.gov/external icon. Accessed May 30, 2017.
- Bonnie RJ, O’Connell ME, eds.; National Research Council and Institute of Medicine. Reducing Underage Drinking: A Collective Responsibilityexternal icon. Washington, DC: The National Academies Press; 2004.
- US Department of Health and Human Services. The Surgeon General’s Call to Action to Prevent and Reduce Underage Drinkingexternal icon. Rockville, MD: US Dept of Health and Human Services; 2007.
- Hingson RW, Heeren T, Jamanka A, Howland J. Age of onset and unintentional injury involvement after drinkingexternal icon. 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 2001external icon. Annu Rev Public Health. 2005;26:259–279.
- Levy DT, Mallonee S, Miller TR, et al. Alcohol involvement in burn, submersion, spinal cord, and brain injuriesexternal icon. Med Sci Monit. 2004;10(1):CR17–CR24.
- Substance Abuse and Mental Health Services Administration. Results from the 2013 National Survey on Drug Use and Health: Summary of National Findingspdf iconexternal icon [PDF-3.2MB]. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2014.
- Substance Abuse and Mental Health Services Administration. Report to Congress on the Prevention and Reduction of Underage Drinkingexternal icon. Rockville, MD: U.S. Department of Health and Human Services; 2017.
- Centers for Disease Control and Prevention. Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI). http://www.cdc.gov/ARDI. Accessed May 30, 2017.
- Miller JW, Naimi TS, Brewer RD, Jones SE. Binge drinking and associated health risk behaviors among high school studentsexternal icon. 2007;119:76–85.
- US Department of Health and Human Services. A 2005 Message to Women from the S. Surgeon General: Advisory on Alcohol Use in Pregnancypdf icon. Washington, DC: US Dept of Health and Human Services; 2005.
- Centers for Disease Control and Prevention. Breastfeeding and Special Circumstances – Alcohol. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/alcohol.html. Accessed March 26, 2018.