When does drinking become a problem?

For many people, drinking alcohol is nothing more than a pleasant way to relax. However, people with alcohol use disorders drink to excess, endangering both themselves and others. This question-and-answer fact sheet explains alcohol problems and how psychologists can help people recover.

For most adults, moderate alcohol use–no more than two drinks a day for men and one for women and older people–is relatively harmless. (A “drink” means 1.5 ounces of spirits, 5 ounces of wine, or 12 ounces of beer, all of which contain 0.5 ounces of alcohol.)

Moderate use, however, lies at one end of a range that moves through alcohol abuse to alcohol dependence:
– Alcohol abuse is a drinking pattern that results in significant and recurrent adverse consequences. Alcohol abusers may fail to fulfill major school, work or family obligations. They may have drinking-related legal problems, such as repeated arrests for driving while intoxicated. They may have relationship problems related to their drinking.
– People with alcoholism–technically known as alcohol dependence–have lost reliable control of their alcohol use. It doesn’t matter what kind of alcohol someone drinks or even how much: alcohol-dependent people are often unable to stop drinking once they start. Alcohol dependence is characterized by tolerance (the need to drink more to achieve the same “high”) and withdrawal symptoms if drinking is suddenly stopped. Withdrawal symptoms may include nausea, sweating, restlessness, irritability, tremors, hallucinations, and convulsions.

Although severe alcohol problems get the most public attention, even mild to moderate problems cause substantial damage to individuals, their families, and the community.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 1 in 13 American adults is an alcohol abuser or alcoholic at any given time. A 1997 government survey revealed that drinking problems are also common among younger Americans. For example, almost 5 million youths aged 12 to 20 engage in binge drinking, which involves females consuming at least four drinks on a single occasion and males at least five.

Reprinted from apa.org. The American Psychological Association Practice Directorate and the APA Practice Organization College of Professional Psychology gratefully acknowledge the assistance of Peter E. Nathan, Ph.D.; John Wallace, Ph.D.; Joan Zweben, Ph.D.; and A. Thomas Horvath, Ph.D., in developing this fact sheet.