Manage Your Health

Would this help a friend?

Binge and At-Risk Drinking

12 fl oz of regular beer 8-9 fl oz of malt liquor (shown in a 12- oz glass) 5 fl oz of table wine 3-4 fl oz of fortified wine (such as sherry or port; 3.5 oz shown) 2-3 fl oz of cordial, liqueur, or aperitif (2.5 oz shown) 1.5 fl oz of brandy or cognac (a single jigger or shot) 1.5 fl oz shot of 80-proof distilled spirits
Regular Beer Malt Liquor Table Wine Fortified Wine Cordial Bandy 80 Proof Distilled Spirits
about 5% alcohol about 7% alcohol about 12% alcohol about 17% alcohol about 24% alcohol about 40% alcohol 40% alcohol

What’s one drink?

Many people are surprised to learn what counts as a drink.

Typically, one drink of alcohol is found in:

  • 12 ounces of regular beer, which is usually about 5% alcohol
  • 5 ounces of wine, which is typically about 12% alcohol
  • 5 ounces of distilled spirits (for example, vodka, run, whiskey, gin, tequila, brandy) , which is usually about 40% alcohol. Mixing distilled spirits with soda, juice, punch or other beverages does not change the fact that you still consume a standard drink.

Suggested Standards to Follow:
The guidelines for “binge” or “at-risk” drinking is:

  • For Men: drinking five or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) and more than 14 drinks per week.
  • For Women: drinking four or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) and more than 7 drinks per week.

[these standards are from the National Institute of Alcohol Abuse & Alcoholism and the Federal Substance Abuse and Mental Health Services Administration]

No matter how much alcohol is consumed, the body can process only one drink per hour. 

NOTE on Different Standards for Men and Women: 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.

Harm Caused By Alcohol

  • Alcohol-related problems are among the most significant public health issues in the United States.
  • You may have heard that regular light to moderate drinking can be good for the heart. With heavy or at-risk drinking, however, any potential benefits are outweighed by greater risks.
  • Injuries. Drinking too much increases your chances of being injured or even killed. Alcohol is a factor, for example, in about 60% of fatal burn injuries, drowning, and homicides; 50% of severe trauma injuries and sexual assaults; and 40% of fatal motor vehicle crashes, suicides, and fatal falls.
  • Health problems. People who drink heavily have a greater risk of liver disease, heart disease, sleep disorders, depression, stroke, bleeding from the stomach, sexually transmitted infections from unsafe sex, memory impairment, and cancer of the mouth, throat, esophagus liver, and colon. They may have problems managing diabetes, high blood pressure, and other conditions.
  • Birth defects. 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.
  • Lifestyle Problems. Beyond these physical and mental health risks, frequent heavy drinking also is linked with personal problems, including losing a driver’s license and having relationship troubles.

Changing Your Drinking Habits: Pros & Cons

It’s up to you whether and when to change your drinking patterns. Other people may be able to help, but in the end, it’s your decision. Weighing your pros and cons can help. Write down you pros and cons using these suggestions or add your own.

Pros: What are some reasons you might want to change your drinking?

  • To improve my health
  • To improve my relationships
  • To avoid hangovers
  • To do better at work or in school
  • To save money
  • To lose weight or get fit
  • To avoid more serious problems
  • To meet my personal standards
  • Other ____________________

Cons: What are some possible barriers, or reasons you might not want to change your drinking?

  • I’d need another way to unwind
  • It helps me feel more at ease socially.
  • I wouldn’t fit in with some of my friends.
  • Change can be hard.
  • Other__________________

If Yes, If “YES”, you decide to change your drinking habits, then decide whether you will CUT BACK or QUIT.

Cut Back or Quit

For some people, staying within low-risk limits will be sufficient, whereas for others it’s best to quit. It’s a good idea to discuss different options with a doctor, a friend, or someone else you trust.
Quitting is strongly advised if you:

  • Try cutting down but cannot stay within the limits you set.
  • Have had an alcohol use disorder or your doctor has concluded you now have symptoms
  • Have a physical or mental condition that is caused or worsened by drinking.
  • Are taking a medication that interacts with alcohol.
  • Are or may become pregnant.

If none of the conditions above apply to you, then talk with your doctor to determine whether you should cut down or quit based on factors such as:

  • Family History of alcohol problems
  • Your age
  • Whether you’ve had drinking-related injuries
  • Symptoms such as sleep disorders and sexual dysfunction

Develop Your Action Plan

Once you have decided whether to Cut Back or Quit, then develop an Action Plan.

What if I’m Not Ready?
If you are not yet ready, don’t be surprised if you continue to have mixed feelings. You may need to re-make your decision several times before becoming comfortable with it.

If not ready, consider these suggestions in the meantime:

  • Keep track of how often and how much you’re drinking.
  • Notice how drinking affects you.
  • Make or re-make a list of pros and cons about changing.
  • Deal with other priorities that may be in the way.
  • Ask for support from your doctor, a friend, or someone else you trust.
  • Take steps to be safe.

Don’t Wait For A Crisis Or To Hit Bottom

When someone is drinking too much, making a change earlier is likely to be more successful and less destructive to individuals and their families.

Your Action Plan

Even when you commit to making a change, you still may have mixed feelings at times. Making a written “Action Plan” will help you to develop your goals, clarify why you want to reach them, and identify strategies on how to reach them. For ideas on strategies, continue below.

A sample form for your Action Plan is provided below.

Change can be hard, so it helps to have concrete reminders of why and how you’ve decided to do it. You can print your Action Plan or email it to yourself.

  • You can also store your strategies in your mobile phone as short text messages or notepad entries that you can retrieve when an urge hits.
  • Set up calendar alerts that deliver reminders when you choose, such as a few hours before you usually go out.
  • Create passwords that are motivating phrases in code, which you’ll reinforce each time you log in, such as
    • 1Day@aTime
    • 1stThings1st!
    • 0Pain=0Gain
  • Set a Goal: (select one)
    • ____ I want to drink no more than ____ drink(s) on any day.
    • ____ I want to drink no more than ____ drink(s) per week.
    • ____ I want to stop drinking.
  • Timing: I will start my action plan on this date: ____________
  • Reasons: My most important reasons to make these changes are: ________________________________________
  • Strategies: I will use these strategies: ________________________________________
  • People: The people who can help me are (names and how they can help): ________________________________________
  • Signs of success: I will know my plan is working if: ________________________________________
  • Possible roadblocks: Some things that might interfere: ________________________________________
  • How I’ll handle them: ________________________________________

Tips To Try

Here are several simple yet useful tips or strategies that you can use to help you reduce or quit your drinking. Most of them are simple, small steps. But, small changes can make a big difference in reducing your chances of having alcohol-related problems. Whatever ideas you choose, give them a fair trial. If one plan doesn’t work, try something else. But if you haven’t made progress in cutting down after 2 to 3 months, consider quitting drinking altogether, seeking professional help, or both.

Keep track. Keep track of how much you drink. Find a way that works for you. Carry a 4-week drinking tracker card in your wallet, make check marks on a kitchen calendar, or enter notes in a mobile phone notepad or personal digital assistant. Making note of each drink before you drink it may help you slow down when needed.
Keep Track of your Drinks

Count and Measure. Review the standard drink sizes above, so you can count your drinks accurately. Measure drinks at home. Away from home, it can be hard to keep track, especially with mixed drinks, and at times, you may be getting more alcohol than you think. With wine, you may need to ask the host or server not to “top off” a partially filled glass.

Set goals. Decide how many days a week you want to drink and how many drinks you’ll have on those days. It’s a good idea to have some days when you don’t drink. People who always stay within the low-risk limits when they drink have the lowest rates of alcohol-related problems.

Pace and space. When you do drink, pace yourself. Sip slowly. Have no more than one standard drink per hour. Have “drink spacers”—make every other drink a non-alcoholic one, such as water, soda, or juice. Note that it takes about 2 hours for the adult body to completely break down a single drink.

Include food. Don’t drink on an empty stomach. Eat some food so the alcohol will be absorbed into your system more slowly.

Find alternatives. If drinking has occupied a lot of your time, then fill free time by developing new, healthy activities, hobbies, and relationships, or renewing ones you’ve missed. If you have counted on alcohol to be more comfortable in social situations, manage moods or cope with problems, then seek other, healthy ways to deal with those areas of your life.

Avoid “triggers.” What triggers your urge to drink? If certain people or places make you drink even when you don’t want to, try to avoid them. If certain activities, times of day, or feelings trigger the urge, plan something else to do instead of drinking. If drinking at home is a problem, keep little or no alcohol there.

Plan to handle urges. Urges to drink are short-lived, predictable, and controllable. With time, and by practicing new responses, you’ll find that your urges to drink will lose strength, and you’ll gain confidence in your ability to deal with urges that may still arise at times. If you are having a very difficult time with urges, or do not make progress after a few weeks, then consult your doctor or therapist for support. In addition, some new, non-habit forming medications can reduce the desire to drink or lessen the rewarding effect of drinking so it is easier to stop.

Consider tracking and analyzing your urges to drink for a couple of weeks. This will help you become more aware of when and how you experience urges, what triggers them, and ways to avoid or control them. A sample tracking form can be downloaded here.

Avoid high-risk situations.   In many cases, your best strategy will be to avoid taking the chance that you’ll have an urge, then slip and drink. At home, keep little or no alcohol. Socially, avoid activities involving drinking. If you feel guilty about turning down an invitation, remind yourself that you are not necessarily talking about “forever.” When the urges subside or become more manageable, you may decide to ease gradually into some situations you now choose to avoid. In the meantime, you can stay connected with friends by suggesting alternate activities that don’t involve drinking.

Cope with triggers you can’t avoid. It’s not possible to avoid all high-risk situations or to block internal triggers, so you’ll need a range of strategies to handle urges to drink. Here are some options:

  • Remind yourself of your reasons for making a change.
  • Talk it through with someone you trust.
  • Distract yourself with a healthy, alternative activity.
  • Challenge the thought that drives the urge.
  • Ride it out without giving in. Instead of fighting an urge, accept it as normal and temporary. As you ride it out, keep in mind that it will soon crest like an ocean wave and pass.
  • Leave high-risk situations quickly and gracefully. It helps to plan your escape in advance.

Know your “no.” You’re likely to be offered a drink at times when you don’t want one. Have a polite, convincing “no, thanks” ready. The faster you can say no to these offers, the less likely you are to give in. If you hesitate, it allows you time to think of excuses to go along. Look directly at the person and make eye contact. Keep your response short, clear, and simple

The person offering you a drink may not know you are trying to cut down or stop, and his or her level of insistence may vary. It’s a good idea to plan a series of responses in case the person persists, from a simple refusal to a more assertive reply. Consider a sequence like this:
– No, thank you.
– No, thanks, I don’t want to.
– You know, I’m (cutting back/not drinking) now (to get healthier/to take care of myself/because my doctor said to). I’d really appreciate it if you’d help me out.

Broken Record. You can try the “broken record” strategy. Each time the person makes a statement, you can simply repeat the same short, clear response. You might want to acknowledge some part of the person’s points (“I hear you…”) and then go back to your broken-record reply (“…but no thanks”). And if words fail, you can walk away.

Script and practice your “no.”

Ask others to refrain from pressuring you or drinking in your presence (this can be hard).

Ask for support from others to cope with temptation.

What Works. If you have successfully refused drink offers before, then recall what worked and build on it.

Escape Route. Plan an escape if the temptation gets too great.

Remember, it’s your choice. Many people who decide to cut back or quit drinking think, “I am not allowed to drink” as if some outside authority were imposing rules on them. Thoughts like this can breed resentment and make it easier to give in. Remind yourself that you are in charge, that you know how you want your life to be, and that you have decided to make a change.

People Should Respect Your Decision. You may worry about how others will react or view you if you make a change. Again, challenge these thoughts by remembering that it’s your life and your choice, and that your decision should be respected

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