Moderate Drinker Or Alcoholic? Many Americans Fall In Between

Nov 21, 2014
Originally published on December 24, 2014 6:39 pm

A lot of us make the assumption that there are two kinds of drinkers: moderate drinkers who have a glass of wine with dinner, and on the other end of the spectrum, alcoholics.

But this is not an accurate picture, according to researchers.

"The reality of the situation is that most adults who drink, they're drinking maybe a couple drinks during week and then typically drinking [larger] amounts on weekends," says Robert Brewer, an epidemiologist with the Centers for Disease Control and Prevention and co-author of a new study published in Preventing Chronic Disease.

And what that means is that 1 in 3 adults drinks excessively.

What counts as excessive? Less than you might think.

Women who consume eight or more drinks per week are considered excessive drinkers. And for men, excess is defined as 15 or more drinks a week. (The researchers defined a drink as just 5 ounces of wine, 12 ounces of beer or 1.5 ounces of spirits.)

So, say I have a smallish glass of wine with dinner most nights of the week. Then I go out on Saturday night and have a cocktail and a beer, or maybe more wine. Does this means I am drinking excessively?

"That's correct, as a woman, if you were to drink eight or more [drinks] per week, that is considered in the category of excessive drinking," Brewer says.

Turns out, a lot of us are not the moderate drinkers we thought we were.

Now, Brewer points out that most excessive drinkers follow much more of a binge-like pattern, where they're drinking four or more drinks per occasion.

And, from a health perspective, the more people drink to excess, the higher their risks. Brewer points to a host of diseases that are linked to excessive alcohol use over time. "This could include breast cancer, for example, liver disease, liver cancer, heart disease," to name a few.

Excessive alcohol consumption, according to the CDC, is responsible for 88,000 deaths per year and costs the U.S. more than $200 billion.

Now, there's also a surprising finding to the new study: 90 percent of excessive drinkers are not alcohol dependent, i.e., alcoholics.

"This study shows that, contrary to popular opinion, most people who drink too much are not alcohol dependent," says Brewer.

This means that despite drinking a lot of alcohol, they don't experience withdrawal symptoms when they stop drinking, nor do they report an increased tolerance for alcohol. There are several other criteria for alcohol dependence as well.

The findings are based on survey data from the National Survey on Drug Use and Health. About 138,000 participants were asked a series of questions about their drinking patterns and alcohol dependence. Researchers acknowledge that some participants could have underestimated their consumption or dependency.

But Brewer says it's important to understand that the excessive drinkers who are not alcohol dependent are unlikely to need addiction treatment. They may also respond to interventions such as increased alcohol taxes to drink less.

Copyright 2018 NPR. To see more, visit http://www.npr.org/.

ROBERT SIEGEL, HOST:

If you have a glass of wine with dinner tonight, you're in good company. If that one drink turns into three or four, well, that's not unusual, but if this happens a few times a week, you fall into a category of drinking that may surprise you. NPR's Allison Aubrey reports on a new study from the Centers for Disease Control and Prevention.

ALLISON AUBREY, BYLINE: A lot of us make the assumption that there are just two kinds of drinkers - those of us who have a glass of wine or beer with dinner and those who are alcoholics and need help, but CDC researcher Robert Brewer says, this is not an accurate picture. Most people fall into a different category.

ROBERT BREWER: The reality of the situation is that most people - most drinkers - most adults who drink - there are people who are drinking maybe a couple of times during the week and then typically drinking a large amount often on weekends.

AUBREY: And this means they're drinking too much.

BREWER: About one in three adults drink excessively.

AUBREY: And what is excessive drinking? Well, it's a lot less than you might think. Say, I have a glass of wine with dinner most nights of the week. Then on Saturday night, I go out, and I have a cocktail, a beer or maybe some more wine. By Sunday, I've had eight drinks for the week, and this is considered excessive.

BREWER: That's correct. If, as a woman, you were to consume eight or more drinks during the course of a week, yes, that would be included in the category of excessive drinking.

AUBREY: And a drink is defined as five ounces of wine, 12 ounces of beer or an ounce-and-a-half - a shot - of liquor. Now, if you're a man, two drinks a day or more than 15 per week is considered excessive. And why these cutoffs? Well, Robert Brewer says, once people habituate to this level of drinking, their risks tend to start going up, including health risks that are attributable to alcohol use over time.

BREWER: That could include cancer - breast cancer, for example - liver disease, liver cancer, heart disease.

AUBREY: So if hearing this is a bit of a wake-up call, do not jump to the conclusion that you're an alcoholic.

BREWER: Nine out of 10 people who drink too much, in fact, are not alcohol-dependent or what's sometimes commonly referred to as alcoholics.

AUBREY: This means they're not missing work days or suffering from withdrawal when they don't drink or building up a tolerance that's typical of dependency. So the bottom line here? Most drinkers are not alcoholics, but lots of us are not the moderate drinkers we thought we were.

Allison Aubrey, NPR News. Transcript provided by NPR, Copyright NPR.