Introduction to alcohol

• What is alcohol?
• How does alcohol affect a person?
• Why do some people react differently to alcohol than others?
• What is a standard drink in the United States?
• Is beer or wine safer to drink than hard liquor?

Drinking levels

• What does moderate drinking mean?
• Is it safe to drink alcohol and drive?
• What does it mean to be above the legal limit for drinking?
• How do I know if it’s okay to drink?

Excessive alcohol use

• What do you mean by heavy drinking?
• What is binge drinking?
• What is the difference between alcoholism and alcohol abuse?
• What does it mean to get drunk?

Drinking problems

• How do I know if I have a drinking problem?
• What can I do if I or someone I know has a drinking problem?
• What health problems are associated with excessive alcohol use?

Special populations

• I’m young, is drinking bad for my health?
• Is it okay to drink when pregnant?

What is alcohol?
Ethyl alcohol, or ethanol, is an intoxicating ingredient found in beer, wine, and liquor. Alcohol is produced by the fermentation of yeast, sugars, and starches.

How does alcohol affect a person?
Alcohol affects every organ in the body. It is a central nervous system depressant that is rapidly absorbed from the stomach and small intestine into the bloodstream. Alcohol is metabolized in the liver by enzymes; however, the liver can only metabolize a small amount of alcohol at a time, leaving the excess alcohol to circulate throughout the body. The intensity of the effect of alcohol on the body is directly related to the amount consumed.

Why do some people react differently to alcohol than others?
Individual reactions to alcohol vary, and are influenced by many factors; such as:

• Age.
• Gender.
• Race or ethnicity.
• Physical condition (weight, fitness level, etc).
• Amount of food consumed before drinking.
• How quickly the alcohol was consumed.
• Use of drugs or prescription medicines.
• Family history of alcohol problems.

What is a standard drink in the __________?
A standard drink is equal to 14.0 grams (0.6 ounces) of pure alcohol. Generally, this amount of pure alcohol is found in

• 12-ounces of beer.
• 8-ounces of malt liquor.
• 5-ounces of wine.
• 1.5-ounces or a “shot” of 80-proof distilled spirits or liquor (e.g., gin, rum, vodka, or whiskey).

Is beer or wine safer to drink than liquor?
No. One 12-ounce beer has about the same amount of alcohol as one 5-ounce glass of wine, or 1.5-ounce shot of liquor. It is the amount of alcohol consumed that affects a person most, not the type of alcoholic drink.

What does moderate drinking mean?
According to the Dietary Guidelines for Americans,¹ moderate alcohol consumption is defined as having up to 1 drink per day for women and up to 2 drinks per day for men. This definition is referring to the amount consumed on any single day and is not intended as an average over several days. The Dietary Guidelines also state that it is not recommended that anyone begin drinking or drink more frequently on the basis of potential health benefits because moderate alcohol intake also is associated with increased risk of breast cancer, violence, drowning, and injuries from falls and motor vehicle crashes.

Is it safe to drink alcohol and drive?
No. Alcohol use slows reaction time and impairs judgment and coordination, which are all skills needed to drive a car safely.² The more alcohol consumed, the greater the impairment.

What does it mean to be above the legal limit for drinking?
The legal limit for drinking is the alcohol level above which an individual is subject to legal penalties (e.g., arrest or loss of a driver's license).

• Legal limits are measured using either a blood alcohol test or a breathalyzer.
• Legal limits are typically defined by state law, and may vary based on individual characteristics, such as age and occupation.

All states in the _________ have adopted 0.08% (80 mg/dL) as the legal limit for operating a motor vehicle for drivers aged 21 years or older. However, drivers younger than 21 are not allowed to operate a motor vehicle with any level of alcohol in their system.

Note: Legal limits do not define a level below which it is safe to operate a vehicle or engage in some other activity. Impairment due to alcohol use begins to occur at levels well below the legal limit.

How do I know if it’s okay to drink?
The current Dietary Guidelines for Americans¹ recommend that if you choose to drink alcoholic beverages, do not exceed 1 drink per day for women or 2 drinks per day for men. According to the guidelines, people who should not drink alcoholic beverages at all include the following:

• Children and adolescents.
• Individuals of any age who cannot limit their drinking to low level.
• Women who may become pregnant or who are pregnant.
• Individuals who plan to drive, operate machinery, or take part in other activities that require attention, skill, or coordination.
• Individuals taking prescription or over-the-counter medications that can interact with alcohol.
• Individuals with certain medical conditions.
• Persons recovering from alcoholism.

According to the Dietary Guidelines for Americans, it is not recommended that anyone begin drinking or drink more frequently on the basis of potential health benefits because moderate alcohol intake also is associated with increased risk of breast cancer, violence, drowning, and injuries from falls and motor vehicle crashes.

What do you mean by heavy drinking?
For men, heavy drinking is typically defined as consuming an average of more than 2 drinks per day. For women, heavy drinking is typically defined as consuming an average of more than 1 drink per day.

What is binge drinking?
According to the _________ on Alcohol Abuse and Alcoholism binge drinking is defined as a pattern of alcohol consumption that brings the blood alcohol concentration (BAC) level to 0.08% or more. This pattern of drinking usually corresponds to 5 or more drinks on a single occasion for men or 4 or more drinks on a single occasion for women, generally within about 2 hours.³

What is the difference between alcoholism and alcohol abuse?
Alcohol abuse⁴ is a pattern of drinking that results in harm to one’s health, interpersonal relationships, or ability to work. Manifestations of alcohol abuse include the following:

• Failure to fulfill major responsibilities at work, school, or home.
• Drinking in dangerous situations, such as drinking while driving or operating machinery.
• Legal problems related to alcohol, such as being arrested for drinking while driving or for physically hurting someone while drunk.
• Continued drinking despite ongoing relationship problems that are caused or worsened by drinking.
• Long-term alcohol abuse can turn into alcohol dependence.

Dependency on alcohol, also known as alcohol addiction and alcoholism⁴, is a chronic disease. The signs and symptoms of alcohol dependence include—

• A strong craving for alcohol.
• Continued use despite repeated physical, psychological, or interpersonal problems.
• The inability to limit drinking.

What does it mean to get drunk?
“Getting drunk” or intoxicated is the result of consuming excessive amounts of alcohol. Binge drinking typically results in acute intoxication.

Alcohol intoxication can be harmful for a variety of reasons, including—

• Impaired brain function resulting in poor judgment, reduced reaction time, loss of balance and motor skills, or slurred speech.
• Dilation of blood vessels causing a feeling of warmth but resulting in rapid loss of body heat.
• Increased risk of certain cancers, stroke, and liver diseases (e.g., cirrhosis), particularly when excessive amounts of alcohol are consumed over extended periods of time.
• Damage to a developing fetus if consumed by pregnant women.⁵
• Increased risk of motor-vehicle traffic crashes, violence, and other injuries.

Coma and death can occur if alcohol is consumed rapidly and in large amounts.

How do I know if I have a drinking problem?
Drinking is a problem if it causes trouble in your relationships, in school, in social activities, or in how you think and feel. If you are concerned that either you or someone in your family might have a drinking problem, consult your personal health care provider.

What can I do if I or someone I know has a drinking problem?
Consult your personal health care provider if you feel you or someone you know has a drinking problem. Other resources include the National Drug and Alcohol Treatment Referral Routing Service available at 1-800-662-HELP. This service can provide you with information about treatment programs in your local community and allow you to speak with someone about alcohol problems.⁶

What health problems are associated with excessive alcohol use?
Excessive drinking both in the form of heavy drinking or binge drinking, is associated with numerous health problems, including—

• Chronic diseases such as liver cirrhosis (damage to liver cells); pancreatitis (inflammation of the pancreas); various cancers, including liver, mouth, throat, larynx (the voice box), and esophagus; high blood pressure; and psychological disorders.
• Unintentional injuries, such as motor-vehicle traffic crashes, falls, drowning, burns and firearm injuries.
• Violence, such as child maltreatment, homicide, and suicide.
• Harm to a developing fetus if a woman drinks while pregnant, such as fetal alcohol spectrum disorders.
• Sudden infant death syndrome (SIDS).
• Alcohol abuse or dependence.

I’m young. Is drinking bad for my health?
Yes.^{7, 8} Studies have shown that alcohol use by youth and young adults increases the risk of both fatal and nonfatal injuries.^{9, 10, 11} Research has also shown that youth who use alcohol before age 15 are five times more likely to become alcohol dependent than adults who begin drinking at age 21.¹² Other consequences of youth alcohol use include increased risky sexual behaviors, poor school performance, and increased risk of suicide and homicide.^{13, 14, 15}

Is it okay to drink when pregnant?
No. There is no safe level of alcohol use during pregnancy. Women who are pregnant or plan on becoming pregnant should refrain from drinking alcohol.¹⁶ Several conditions, including Fetal Alcohol Spectrum Disorders have been linked to alcohol use during pregnancy. Women of child bearing age should also avoid binge drinking to reduce the risk of unintended pregnancy and potential exposure of a developing fetus to alcohol.