How much is too much alcohol?

Guidelines for alcohol consumption appear to be shifting.

The 2020-2025 Dietary Guidelines for AmericansTrusted Source, a collaboration between the United States Department of Health and Human Services and the U.S. Department of Agriculture, recommends that men drink no more than two drinks per day with women advised to limit their consumption to just one daily drink.

On the other hand, Canada recommends two drinks or fewer per week to avoid alcohol-related health problems while the Netherlands advises zero to one drink per day.

Dr. Michael Olla is the medical director at Valley Spring Recovery Center in New Jersey and specializes in psychiatry and addiction treatment.

He told Medical News Today that there are some standard definitions for drinking: light drinking is one to two drinks per day, moderate drinking is two to three per day, heavy drinking is three to five in a day, and abusive drinking is more than five drinks per day.

“Every person is different and an individual may go through different stages before their alcohol consumption becomes problematic,” Olla explained. “The first stage, occasional abuse and binge drinking, usually becomes a problem quickly. It usually starts with occasional consumption – four or more drinks within two hours.”

The second stage is increased drinking, where a person becomes more dependent on alcohol to have fun or combat stress, while the third stage – problem drinking – is when the effects of alcoholism start to manifest.

“The fourth stage is dependence,” said Olla. “This is when an attachment to alcohol is already formed and increased drinking continues because of tolerance. This is also the stage where withdrawals are apparent when the person sobers up. The final stage is addiction, where compulsive behaviors will start, such as physically and psychologically craving for the substance.”

While these definitions seem self-explanatory, there’s a fair amount of nuance – and even people who see themselves as light drinkers should be mindful. Olla said that, depending on the person, drinking could become problematic during the first stage while others might not start to see the drawbacks until stage two or three.

“It all depends on the frequency and amount of the substance,” explained Olla.

The health effects from excessive alcohol

The health drawbacks of heavy alcohol use are well known. Among other things, it can increases the risk of liver damage and other chronic diseases.

The National Institute on Alcohol Abuse and Alcoholism reportsTrusted Source that 47% of liver disease deaths in the United States in 2021 involved alcohol, 1 in 3 liver transplants in the United States are caused by alcohol-related liver diseases, and the vast majority of cirrhosis deaths come from alcohol use. Heavy drinking also raises the risk of developing cardiovascular diseases, pancreatitis, gastritis, organ damage, and mental health issues.

“Long-term drinking usually results in strained relationships, such as severed friendships and broken families. It can also lead to job loss and financial difficulties,” said Olla. “In worse cases, long-term alcohol consumption can turn your life upside-down, especially when you start facing drinking-related legal issues.”

However, it is possible to stop or reduce alcohol consumption. As noted by the authors of the study, it isn’t necessary to abstain completely in order to see positive results.

A good place to start, says Olla, is by talking with your doctor about your history and struggles with alcohol.

“This will help the doctor understand and know if there are any underlying issues that led to this point,” he said. “Aside from specific alcohol consumption info, you also need to discuss your goals and motivations with your doctor. Doing so can help them determine strategies on how you can achieve these goals and identify the appropriate treatment option for you. It can also help them understand how you want them to work with you.”