Alcohol: Lowering Risk

While some people may enjoy drinking alcohol, there are ways of consuming alcohol that pose more risks than others. To understand how to lower your risk, you may want to know what moderate drinking is, as well as what behaviors both increase and reduce risk. 

What is considered a standard drink? 

A standard drink is equal to: 

• 12 ounces of beer at 5 percent alcohol 
• 5 ounces of wine at 12 percent alcohol 
• 8 ounces of malt liquor at 7 percent alcohol 
• 1.5 ounces of liquor at 40 percent (or 80 proof) alcohol  
• Examples of types of liquor include brandy, gin, rum, whiskey, tequila, and vodka. 

Be aware that a beverage you drink may have more than one standard drink of alcohol in it.  

What is moderate alcohol use? 

Moderate alcohol use is defined as: 

• Assigned female at birth (AFAB) - one drink or less in a day 
• Assigned male at birth (AMAB) - two drinks or less in a day  

Note: It’s important to recognize and appreciate that not all individuals fall within these binary constructs. While there are other biological factors that influence drinking, the behaviors described are referring to sex assigned at birth and its role in how alcohol impacts the body. Because alcohol typically distributes throughout the water in the body, it will be more concentrated in those who have less water in their bodies. This means, drink for drink, someone of a smaller size and weight will have a higher blood alcohol content (BAC) than someone of a larger size and weight. On average, those assigned female at birth have less water in their body than those assigned male at birth. This is the reason for the difference in number of standard drinks in the drinking behaviors described. 

What are harmful drinking behaviors?  

Harmful drinking behaviors are grouped under the term ‘excessive alcohol use.’ Excessive alcohol use includes binge drinking and heavy drinking. 

• Binge drinking is defined as a person AMAB drinking five or more standard drinks, or a person AFAB drinking four or more standard drinks during one occasion.  
• Heavy drinking is defined as, a person AMAB drinking 15 or more standard drinks, or a person AFAB drinking eight or more standard drinks over one week. 

What are signs of alcohol intoxication? 

Signs of alcohol intoxication can include the loss of:  

• Inhibitions: You may feel more talkative, over-friendly, less able to control yourself, and more prone to mood swings. 
• Judgement: You may behave more inappropriately or out of character or use language that’s out of character.  
• Reaction time: You may have glassy or unfocused eyes, slurred speech, or you may talk, think, or move slower than usual. 
• Coordination: You may stumble or sway, drop belongings, have trouble holding a drink, or frequently walk into things.  

These signs may become more pronounced even after you stop drinking because alcohol can remain in your system for over twelve hours.  

What are signs of alcohol poisoning? 

Severe alcohol poisoning can be fatal. If you observe someone experiencing these symptoms, get help immediately:  

• Semi-consciousness or unconsciousness and cannot be awakened 
• Severe mental confusion  
• Seizure 
• Cold, clammy, pale, or bluish skin 
• Slow heart rate 
• Slowed breathing (less than eight breaths per minute)  
• Irregular breathing (ten seconds or more between breaths) 
• Loss of gag reflex  
• Vomiting while "sleeping" or passed out, and not waking up after vomiting  
• Low body temperature 

If a person has any of these symptoms, “sleeping it off” may not help and could put them at increased risk of severe injury or death. Therefore, it’s critical to act swiftly by:  

• Calling 911 immediately and being prepared to provide the emergency personnel with information regarding the person’s alcohol consumption.  
• Never leaving the person alone, especially if they’re unconscious. Alcohol poisoning can disrupt individuals’ gag reflex and cause them to choke on their own vomit.  
• Helping the person if they’re vomiting. Either help the person sit up or help them lie down on their side so that they don’t choke on their own vomit.  

What is lower risk drinking? 

Lower-risk drinking is a form of drinking that can help maximize the fun and minimize the harm that alcohol intoxication may cause. 

Lower-risk drinking involves practicing strategies such as:  

• Being mindful of how fast you’re drinking. Drink at a pace of no more than one standard drink per hour, as that’s how long it may take your liver to process it.  
• Making a plan for the night. Determine the number of drinks you plan to consume before you start to drink and use counting strategies, so you know how many you’ve had. Ask friends for help sticking with your plan and know how you’re going to get home before you start drinking. 
• Knowing your limits. Pay attention to how intoxicated you are before having another drink. Recognize how your height and weight may be impacting your rate of intoxication.  
• Being careful about not mixing. Avoid mixing alcohol with over-the-counter medications, prescriptions, and other substances such as marijuana, tobacco, and stimulants. 
• Hydrating and eating before and during your drinking. Alternate alcohol-free drinks (especially water) and drinks containing alcohol. If you want an alcohol look-alike, consider “dressing up” your water by ordering a seltzer with lime, or asking for a non-alcoholic beer or a mocktail. 
• Minding your drink. Ask questions about its contents to the person that’s making it and never leave it unattended. 
• Being thoughtful about drinking games and shots. Limit the number of shots, if any, that you take. If you choose to play drinking games, set a limit for how long you’ll take part or how much you’ll drink. 

What are additional resources to lower my alcohol risk? 

For additional resources to lower your alcohol risk, you may want to consider making an appointment with a health care professional or substance use specialist to learn more about how alcohol is impacting you.  

Some resources to help you find providers include: 

• FindTreatment.gov 
• American Psychological Association 
• NIAAA Alcohol Treatment Navigator®—How to Find Quality Alcohol Treatment