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Questions & answers

  • Why is being able to "hold your liquor" a concern?

    For some people, it takes quite a few drinks to get a buzz or feel relaxed. Often they are unaware that being able to "hold your liquor" isn't protection from alcohol problems, but instead a reason for caution. They tend to drink more, socialize with people who drink a lot, and develop a tolerance to alcohol. As a result, they have an increased risk for developing alcohol use disorder. The higher alcohol levels can also harm the liver, heart, and brain without the person drinking noticing until it's too late. And all people who drink need to be aware that even moderate amounts of alcohol can significantly impair driving performance, even when they don't feel a buzz from drinking.

  • Why are women's low-risk limits different from men's?

    Research shows that women start to have alcohol-related problems at lower drinking levels than men do. One reason is that, on average, women weigh less than men. In addition, alcohol disperses in body water, and pound for pound, women have less water in their bodies than men do. So after a man and woman of the same weight drink the same amount of alcohol, the woman's blood alcohol concentration will tend to be higher, putting her at greater risk for harm. For more information, see Alcohol: A Women's Health Issue.

  • Isn't drinking good for the heart?

    For some people, the answer can be "yes," depending on the amount. Regular light to moderate drinking can lower the risk for coronary heart disease, mainly among middle-aged and older adults (other factors also cut the risk, including a healthy diet and weight, exercise, and not smoking). Heavy drinking can actually increase blood pressure and damage the heart.

  • Is "low-risk" drinking just another term for "moderate" drinking?

    Not exactly—the weekly amounts may be the same, but the daily ones are different, and the recommendations serve different purposes for people with different drinking patterns.

    • Low-risk drinking, for healthy men under age 65 is no more than 4 drinks on any day and 14 per week and for healthy women (and men over 65) is no more than 3 drinks on any day and 7 per week.
    • Moderate drinking, according to the U.S. dietary guidelines, is up to 2 drinks per day for men and up to 1 drink per day for women. (Per week, this corresponds to an upper limit of 14 drinks for men and 7 for women.)

    In the United States, most people who drink don't have a daily, low-level pattern of 1 or 2 drinks per day. Instead, they tend to have less on weekdays and more on weekends and holidays. Some people may look at the weekly limits of 14 or 7 drinks and wonder if they can have them all on one or two weekend days. As shown by the daily low-risk drinking levels, however, from a health standpoint, it's risky to have more than 4 drinks on any day for men or 3 for women.

    It's important to note that the low-risk drinking levels are not risk free. People who drink lightly to moderately should not increase their intake beyond the moderate drinking guidelines, as this would increase their chances for alcohol-related problems.

  • What medications interact harmfully with alcohol?

    Some medicines that you might never have suspected can react with alcohol, including many that can be purchased "over the counter" without a prescription. Even some herbal remedies don't mix well with alcohol. The pamphlet Harmful Interactions: Mixing Alcohol with Medicines lists medications that can cause harm when taken with alcohol and describes the effects that can result. It does not include all possible medicines that may interact with alcohol, however. Protect yourself by avoiding alcohol if you are taking a medication and don't know its effect, or talk to your pharmacist or other health care provider.

  • Based on the drinking pattern results from your web site, my friends and I are in the "increased risk" or "highest risk" categories. Are you saying we're all drunks or alcoholics?

    Not at all. There's a lot of mistaken "all or nothing" thinking about alcohol use disorder. Many people assume there are two options: Either you don't have a problem with drinking, or you're a "total alcoholic" whose life is falling apart. The reality is not a simple black or white, but more of a spectrum with shades of gray. An "alcohol use disorder"—that is, alcohol abuse or alcohol use disorder--can be mild, moderate, or severe. People with an alcohol use disorder can be highly functioning, highly compromised, or somewhere in between. One of the main purposes of this Web site is to help people to become aware of the risks of heavy drinking and the early symptoms of a problem, so they can prevent more serious problems down the road.

    A related "all or nothing" misconception is that all people who drink heavily are automatically alcoholics. Some are, some aren't. Those without problems at this point are still at risk for developing alcohol use disorder and other conditions such as liver disease in the future.

    The concept of risk is sometimes difficult to grasp. An example is high cholesterol, which increases the chances for a heart attack. Similarly, heavy drinking raises the chances for developing alcohol use disorder. Your individual risk depends in part on how much, how often, and how quickly you drink, along with how young you were when you had a first drink, and whether you have a family history of alcohol use disorder.

    In any case, you can reduce your chances for harm in the future. If you do not already have symptoms of an alcohol-related problem, then cutting down to within the low-risk limits is a reasonable first step. If you already have symptoms of an alcohol problem, it's safest to quit.

  • According to the drinking patterns quiz, men have an increased risk of a problem if they had more than four drinks just once in the last year, even if they normally have no (or few) drinks per week. This doesn't make sense.

    The quiz serves two purposes – one is to provide "norms" feedback that lets people know when they're drinking more than most U.S. adults, even if it's just once a year. This helps to counter a commonly held misconception that "everybody" drinks a lot.

    The second purpose is to show how different drinking patterns are linked with different rates of alcohol problems. The simple quiz generates some broad categories of results, and you describe a pattern that's at very low end of increased risk. For someone who has one heavy drinking day a year and otherwise stays well within low-risk limits, the risk of having or developing an alcohol use disorder would be minimal.

    However, if you have more than four drinks within a short period of time on any day, you may run the risk of injuring yourself or others, particularly if you drive too soon after drinking. And if you start to increase the number of "heavy drinking days" over time, your chances for alcohol-related harm will increase as well.

  • Can I do anything to protect my liver from the effects of too much alcohol?

    There are no guarantees that anything will protect the liver from too much alcohol. Liver damage from heavy drinking happens in stages. Some relatively mild damage may happen after a single binge drinking episode, but this reverses itself if the heavy drinking stops. If heavy drinking continues, however, liver damage can progress through several more advanced stages, and repair becomes much more difficult, if not impossible. When the damage goes as far as cirrhosis, the only treatment is liver transplant. The best way to protect your liver’s health is by staying within the low-risk drinking limits or -- if you already have liver damage or any signs of an alcohol problem -- by quitting. Also, it’s best if people who drink avoid acetaminophen (found in Tylenol® and other medications). Even the standard recommended dose of acetaminophen can increase the risk of liver damage, particularly among people who drink heavily. For more information, see this report on alcohol-related liver disease and this advisory on acetaminophen and liver injury.

  • I am considering cutting down or quitting drinking. How do I begin?

    The first step, of course, is to decide whether cutting down or quitting is best for you. See these considerations and discuss different options with a doctor, a friend, or someone else you trust.

    Thinking about cutting back? Here are some tips to try, small changes that can make a big difference. Choose two or three to try in the next week or two. It may help to have reminders to reinforce your decision to make a change, such as automated smartphone alerts that you send yourself.

    Thinking about quitting? One size doesn’t fit all, and it’s important to find options that appeal to you. Start by visiting the choose your approach page. Here you’ll find links to self-help strategies, a helpful publication about treatment options, and information about professional help and social support.

    Changing habits such as smoking, overeating, or drinking too much can take a lot of effort, and you may not succeed with the first try. Setbacks are common, but you learn more each time. Each try brings you closer to your goal. Whatever course you choose, give it a fair trial.

  • I’ve decided to cut back on my drinking and I may even quit. How can I get people to stop pressuring me to drink?

    Anyone who is cutting back or quitting drinking is likely to be offered a drink at times when it’s unwanted. Rethinking Drinking has a module or “mini-guide” to help you build resistance skills and stay in control. You’ll learn how to recognize the types of pressure to drink, avoid pressure, and cope with situations you can’t avoid.

    As an example, here’s one tip: Have a polite, convincing "no, thanks" ready. The faster you can say no to drink offers, the less likely you are to give in. If you hesitate, it allows you time to think of excuses to go along. See the module for more insights and suggestions, including a worksheet where you can script your ‘no’ to practice for a situation in which the pressure persists.

    If you worry about how others will react or view you if you make a change, challenge these thoughts by remembering that it's your life and your choice, and that your decision should be respected.

  • What treatments are available for someone with an alcohol problem?

    People commonly think of 12-step programs or 28-day inpatient rehabilitation as the only options for treating alcohol problems. Other choices are available, however. It’s a good idea to start by talking with a primary care doctor to put together an individualized treatment plan. A treatment plan can include:

    • Behavioral treatments. Counseling led by a health professional aims to change drinking behavior. Types of counseling include cognitive-behavioral therapy, motivational enhancement therapy, and marital and family counseling. It’s important to choose an approach that avoids heavy-handed confrontation, incorporates empathy, and increases motivation while focusing on changing drinking behavior.
    • Medications. Three medications are currently approved by the Food and Drug Administration to treat alcohol dependence. These medications help people stop or reduce their drinking and prevent relapse. All approved medications are non-addictive, and can be used alone or in combination with other forms of treatment.
    • Mutual-support groups. People who are quitting or cutting back on their drinking may also find peer support through organizations such as Alcoholics Anonymous and other mutual support groups.

    Find a summary of treatment options in the NIAAA publication Treatment for Alcohol Problems: Finding and Getting Help. The good news is that no matter how severe the problem may seem, most people with an alcohol problem can benefit from some form of treatment.

. Although we are unable to provide a personal response on this page, we will post answers to questions of general public interest.

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Is your "lite" beer light in alcohol?

Not necessarily. Although they have fewer calories, many light beers have almost as much alcohol as regular beer—about 85% as much, or 4.2% versus 5.0% alcohol by volume, on average.

Check the alcohol content of your beverage. Malt beverages are not required to list their alcohol content on the labels, so you may need to visit the bottler's Web site.

See What's a standard drink?

How many "drinks" are in a bottle of wine?

A typical 25-ounce (750 ml) bottle of table wine holds about 5 "standard" drinks, each containing about 5 ounces. This serving size of wine contains about the same amount of alcohol as a 12-ounce regular beer or 1.5 ounces of 80-proof spirits.

Get to know what 5 ounces looks like by measuring it out at home. That way you can estimate how many standard drinks you're being served in a restaurant or bar that uses large glasses and generous serving sizes.

See What's a standard drink?

Mixing alcohol with certain medications can cause nausea, headaches, drowsiness, fainting, a loss of coordination, internal bleeding, heart problems, and difficulties in breathing. Alcohol can also make a medication less effective. For more information, see Harmful Interactions: Mixing Alcohol with Medicines.

Examples of medical conditions for which it's safest to avoid drinking include liver disease (such as from hepatitis C), bipolar disorder, abnormal heart rhythm, and chronic pain.

Among the dangers of underage drinking:

Even moderate amounts of alcohol can significantly impair driving performance and your ability to operate other machinery, whether or not you feel the effects of alcohol.

Heavy drinking during pregnancy can cause brain damage and other serious problems in the baby. Because it is not yet known whether any amount of alcohol is safe for a developing baby, women who are pregnant or may become pregnant should not drink.

Highest risk

About 50% of people who drink in this group have an alcohol use disorder.

Increased risk

This "increased risk" category contains three different drinking pattern groups. Overall, nearly 20% of people who drink in this category have an alcohol use disorder.

Low-risk drinking

Only about 2% of drinkers in this group has an alcohol use disorder.

A U.S. "standard" drink contains about 0.6 fluid ounces or 14 grams of "pure" alcohol. That's the amount in 12 ounces of regular beer, 5 ounces of table wine, or 1.5 ounces of 80-proof distilled spirits.

Low risk drinking levels - On any single day: Men, no more than 4 drinks on any day. Women, no more than 3 drinks on any day. Per week: Men, no more than 14 drinks per week. Women no more than 7 drinks per week.

Distilled spirits include vodka, whiskey, gin, rum, and tequila.

Light to moderate drinking

Heavy or at-risk drinking

Low-risk drinking

Men: No more than 4 drinks on any day and no more than 14 per week

Women: No more than 3 drinks on any day and no more than 7 per week

People with a parent, grandparent, or other close relative with alcoholism have a higher risk for becoming dependent on alcohol. For many, it may be difficult to maintain low-risk drinking habits. For more information, see A Family History of Alcoholism: Are You at Risk?

Pace yourself: It's best to have no more than one standard drink per hour, with nonalcoholic "drink spacers" between alcohol beverages. On any day, stay within low-risk levels of no more than 4 drinks for men or 3 for women. Note that it takes about 2 hours for the adult body to completely break down a single drink. Do not drive after drinking.

For comparison, regular beer is 5% alcohol by volume (alc/vol), table wine is about 12% alc/vol, and straight 80-proof distilled spirits is 40% alc/vol.

The percent alcohol by volume (alc/vol) for distilled spirits is listed on bottle labels and may be found online as well. It is half the "proof," such that 80-proof spirits is 40% alc/vol.

Convert proof to alc/vol

Enter in the proof of the alcohol in the left field to automatically calculate the alc/vol.


Convert to fluid ounces

Enter in the measurement in milliliters in the left field to automatically calculate the amount in fluid ounces.