How Much is Too Much Alcohol? Low-Risk Drinking Guidelines

(Spring 2015) There is an increasing amount of medical literature available to give people measurable, research-based ways to avoid lifestyle-related health problems. To keep the risk of developing heart disease low, for example, we need to get at least 30 minutes of cardiovascular exercise a day, five days a week; limit salt intake to no more than about a teaspoon a day; and limit trans fats to less than 1% of total daily calorie intake. To avoid diabetes, the American Association of Diabetes Educators has published the “AADE 7” – a list of seven, self-care behaviors to avoid the disease.

And mindful of the role that genetics play, medical professionals ask about family history of these diseases as part of intake information, and many people are now educating their children about grandpa’s history of heart disease or grandma’s diabetes diagnosis.

Let’s apply this phenomenon to another chronic disease influenced by lifestyle choices — alcoholism. How many people who choose to drink know how much is too much — know measurable, research-based guidelines to keep their risk for developing alcohol problems low? Do we share family history of alcoholism with our children or educate them about low-risk drinking guidelines when they turn 21? Highly doubtful – not because we don’t care, but more likely because we don’t realize the information exists.

Similar to guidelines for healthy eating offered by the American Heart Association, The National Institute on Alcohol Abuse and Alcoholism has established low-risk drinking guidelines. Those who have no alcoholism in their birth family and choose to drink these low-risk amounts of alcohol have a slim chance of developing alcoholism:

• For men, no more than four drinks on any given day, spaced at least an hour apart, AND no more than 14 drinks over the course of a week.
• For women, no more than three drinks on any given day, spaced at least an hour apart, AND no more than seven drinks over the course of a week.

Now a couple things about these numbers: The “and” is important. A person must meet both criteria to be low-risk. A man, for example, cannot have four drinks every day because that adds up to a lot more than 14 over the course of a week. He also can’t save up, not drink all week, and be considered a low-risk drinker if he puts away a 12-pack on Saturday.

It’s additionally important that we define what a drink is.  The low-risk drinking guidelines are based on a measured drink — 12 ounces of beer, four to five ounces of wine and a measured shot (1.5 ounces of 80 proof liquor or 1.25 ounces of 100 proof). Each of those has about the same amount of alcohol, and each is classified as a measured drink.

Keep in mind these are low-risk guidelines for people who are at standard risk. But there are some people who are at higher risk and should consider abstinence:

• Those with a strong family history of alcoholism – Biological children of alcoholics are four times more likely than the general public to develop alcohol problems
• Women who are pregnant or trying to become pregnant
• People who are doing something where risk is involved (e.g., driving, getting ready to work at a job or around the house or yard, and other situations where there’s an impairment risk)
• Those taking medication that interacts negatively with alcohol
• Those who have difficulty drinking low-risk amounts
• People under the age of 21 – Research says that the younger a person starts drinking, the more likely that person will be to have problems with it in the future

Over one-third of adults – 35% – don’t drink at all. That doesn’t mean that people in that group have never consumed alcohol. Some of them are in recovery. Some used to drink but don’t anymore. Some have never consumed alcohol. But 35% of adults are abstinent in the U.S.

Thirty-seven percent do consume alcohol, but when they drink they do so in the low-risk range.

Finally, 28% of adults drink more than low-risk amounts. Those are the ones who are experiencing most of the health problems related to alcohol. They’re also the ones responsible for most of the impairment problems – like car crashes and workplace accidents.

Working Partners® suggests that employers establish and follow corporate guidelines to help their workforce prevent alcohol problems from impacting their personal lives and their workplace:

1. Communicate – Be sure your drug-free workplace policy thoughtfully and specifically communicates rules about alcohol consumption on and off the job. Apply objective measures to define terms such as “under the influence” and give clear guidance as to when and how much, if any, employees can drink at work-related events.
2. Model – Be sure your drinking norms and culture match your policy. If your policy is written appropriately, getting drunk at a company party or while traveling out of town on company business is unacceptable and a violation of company policy.

3. Educate – Be sure employees understand the company’s expectations regarding alcohol consumption and about low-risk drinking guidelines. Include this information in your annual drug-free workplace education and/or in other mechanisms used to keep employees updated.

5. Refer – If employees need to know where they or a loved one could get more information or help for an alcohol-related issue, know where to refer them! And management should know how and where to mandatorily refer an employee whose high-risk use has impacted the job.
6. Repeat – There are a lot of myths and misinformation floating around about alcohol abuse and addiction. Recognize that it may take several attempts before employees really understand what they can do to lower their risk of developing an alcohol problem.