Drinking in moderation means consuming no more than one drink weekly for females and two drinks weekly for males. Heavy drinking consists of 8 or more drinks per day for females and 15 or more for males. A person can discuss any concerns about their drinking with a doctor.

Occasional or light drinking generally does not cause health problems. Heavy drinking, however, can have serious health risks, including cancer and damage to multiple organs.

The World Health Organization (WHO) attributes 3 million annual deaths to harmful alcohol consumption.

There is no safe level of drinking. However, keeping track of alcohol intake can help a person reduce their risk of alcohol-related health conditions or injury.

This article reviews current guidelines on alcohol consumption to help distinguish drinking in moderation from excessive drinking. It also explores heavy drinking, its risks, and how to prevent alcohol dependence.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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According to the Dietary Guidelines for Americans 2020-2025, for adults of legal drinking age, drinking in moderation involves consuming no more than two drinks per day for males and no more than one per day for females.

The guidelines also mention that the following groups of people should not drink alcoholic beverages:

  • people who are pregnant or might be pregnant
  • those younger than 21
  • those recovering from alcohol use disorder (AUD)
  • people who cannot regulate the amount they drink

Standard drink guidelines

A standard drink in the United States consists of 14 grams (g), which is equivalent to 0.6 fluid ounces of pure alcohol. This corresponds to the following:

  • 12 ounces (oz) of regular beer, typically 5% alcohol
  • 5 oz of wine, typically 12% alcohol
  • 1.5 oz of distilled spirits, typically 40% alcohol

The following organizations have defined excessive alcohol use in males and females:

Centers for Disease Control and Prevention (CDC)

According to the CDC, excessive drinking includes:

  • heavy drinking
  • underage drinking
  • drinking while pregnant

Heavy drinking is the most common pattern of excessive alcohol use in the United States — 1 in 6 adults drink excessively, and 25% of them do so at least weekly.

However, in a 2014 study, the CDC found that 9 out of 10 people who drank heavily were not dependent on alcohol.

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

The NIAAA considers a female a heavy drinker if they consume more than three drinks in a day or seven drinks in a week. A male who consumes 4 drinks in a day or 14 in a week also qualifies as a heavy drinker.

The NIAAA defines heavy drinking as a drinking pattern that causes a person’s blood alcohol concentration to reach 0.08 grams per deciliter (0.08%) or higher.

This typically happens after consuming five or more drinks (for males) or four or more drinks (for females) in 2 hours.

Substance Abuse and Mental Health Services Administration (SAMHSA)

Meanwhile, SAMHSA defines heavy drinking as drinking on 5 or more days in the past month.

SAMHSA also considers a person’s drinking heavy if they have consumed four or more drinks (for females) or five or more drinks (for males) within 1 day in the past month.

Excessive drinking may carry certain risks for a person’s health.

Health problems

Heavy drinking can seriously affect a person’s health because it affects the brain, the heart, and other organs. Below are some of the health problems it may cause:

Heavy episodic alcohol use during early adulthood can also contribute to excess weight gain and promote the transition to obesity or overweight status.

Weak immune system

Chronic heavy drinking lowers a person’s immunity and puts them at risk of bacterial and viral infections. This makes them more likely to contract diseases such as pneumonia and tuberculosis.

Learn more about the symptoms of a bacterial infection.

Mental health conditions

Excessive alcohol use increases a person’s risk of experiencing a new depressive episode. Plus, a 2016 study found that frequent drinking increases a person’s risk of subsequent depressive symptoms.

Cancer

The more drinks a person regularly consumes over time, the greater their risk of developing alcohol-related cancers such as:

Violence and accidents

Excessive drinking may lead to external incidents, including:

  • motor vehicle accidents
  • falls
  • burns
  • drowning
  • firearm injuries
  • homicide
  • suicide
  • domestic abuse or child abuse

Below are some ways a person can manage their drinking on single occasions:

  • setting a limit and sticking to it
  • counting each drink and its alcohol content
  • drinking water beforehand
  • eating before and while drinking
  • finishing each drink before starting another
  • drinking nonalcoholic beverages between alcoholic drinks
  • drinking slowly
  • putting down the drink between sips

It can be helpful for a person to identify the triggers that cause them to drink or situations that tempt them. They may also develop other strategies to reduce alcohol intake, such as socializing with friends who do not drink or setting up alcohol-free gatherings.

Not all people who drink excessively have an AUD, which doctors previously referred to as alcohol addiction or dependence.

Symptoms of an AUD

According to the CDC, a person may have a severe AUD if they experience the following:

  • an inability to limit their drinking
  • continuation of drinking despite personal or professional problems
  • a desire to drink so strong that they cannot think of anything else
  • the need to drink more to experience the same effect

Anyone who plans to seek treatment for an AUD may first consult their doctor. A doctor can evaluate a person’s drinking pattern and overall health and craft a treatment plan.

Treatment options include:

A person can speak with their doctor to determine the best treatment method.

Stopping drinking alcohol has a wide array of physical and mental health benefits.

Depending on the severity of their alcohol use, a person may experience withdrawal symptoms that begin within 6 hours after they stop drinking. Symptoms can be mild, such as headaches and palpitations, or severe, such as delirium tremens.

Withdrawal symptoms may last about a week, but most people can recover fully with proper medical detox and professional help.

Learn more about the alcohol withdrawal timeline.

The Dietary Guidelines for Americans 2020-2025 recommend drinking moderately, if at all. Moderate drinking consists of no more than one drink per day for females and no more than two per day for males.

Not everyone who drinks excessively has an AUD. However, a person should consult a doctor if they notice their behavior and drinking patterns worsening.

A medical professional can evaluate a person’s drinking pattern, prescribe any necessary medications, and refer a person to specialists who can help them quit drinking alcohol.