Alcohol: Lowering Risk

Alcohol can be a way to enhance social experiences, especially when consumed in a way that reduces the risk of harm. 

What are high-risk drinking behaviors then? High-risk drinking usually corresponds to one of two different behaviors: binge drinking and heavy drinking. 

• Binge Drinking: Defined as consuming five or more drinks for men, and four or more drinks for women within two hours. 
• Heavy Drinking: Defined as consuming more than 4 drinks on any day or more than 14 drinks per week for men and more than 3 drinks on any day or more than 7 drinks per week for women. 

Consuming less than four drinks for men or three drinks for women in one sitting may contribute to lower risk drinking but isn’t the same as moderate drinking. Moderate drinking is defined as two drinks or less for men and one drink or less for women on a given 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. 

Lower-risk drinking helps you maximize the fun and minimize the potential for harm that can occur due to alcohol intoxication (e.g., acute dehydration, legal troubles, etc.). There are ways to engage in lower-risk alcohol use.  

Lower-risk drinking involves practicing these strategies: 

• Determine the number of drinks you plan to consume before you start to drink. 
• Use counting strategies such as tallying drinks or putting bottle caps or tabs in your pockets. 
• Drink at a pace of no more than one standard drink per hour. A standard drink is equal to 12 ounces (oz) for beer at 5 percent alcohol, 5 oz. of wine at 12 percent alcohol and 1.5 oz. of liquor at 40 percent alcohol. 
• Understand it may take the liver up to one hour to process one standard drink. 
• Recognize how your height and weight will impact how much you can drink. 
• Hydrate and eating before and while you are drinking. 
• Avoid over the counter medications, prescription and substances such as marijuana, tobacco, etc. because they may interact negatively with alcohol. 
• Alternate alcohol-free drinks 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 mocktail. 
• Avoid drinking games; or, if you choose to play, setting a limit for how long you’ll take part or how much you’ll drink. 
• Reduce or avoid shots. 
• Make an exit plan and know how you will get home before going out. 
• Ask friends for help sticking to your drinking plan. 
• Know what’s in your drink. 
• Never leaving a drink unattended. 
• Understand the myth that says the more you drink the better you feel. In truth, the more alcohol you have in your system the more likely you are to experience negative effects such as nausea, vomiting, blacking out, having a hangover, etc. 

Recognizing signs and risks of intoxication

Alcohol depresses the nervous system and contributes to some of the effects that are typically experienced when drinking. Signs of intoxication include the presence or loss of: 

• Inhibitions: More talkative, over-friendly, decreased self-control, possible mood swings 
• Judgement: Behaving inappropriately or out of character, using foul language or language that may be out of character 
• Reaction Time: Glassy or unfocused eyes, slurred speech, talking or moving slowly 
• Coordination: Stumbling or swaying, dropping belongings, having trouble holding a drink, walking into things 

Even after someone stops drinking, alcohol remains in the system and these signs can become more pronounced. Occasionally, a person may consume more than planned and experience alcohol poisoning. At higher levels of consumption this can be fatal, as alcohol can decrease a person’s heart rate, their ability to breathe and relax the gag reflex, and increases their chances of choking. 

If you observe someone experiencing the following symptoms, get help immediately: 

• Semi-consciousness or unconsciousness and cannot be awakened 
• Cold, clammy, pale, or bluish skin 
• Slowed breathing (fewer than eight breaths per minute) 
• Irregular breathing (ten seconds or more between breaths) 
• Vomiting while "sleeping" or passed out, and not waking up after vomiting 

If a person has any of these symptoms, “sleeping it off” may not help and could put them at increased risk of serious injury or death. Taking action is critical and there are some steps you can take to get the person help. 

• Call 911 immediately and be prepared to provide the emergency personnel with information regarding the person’s alcohol consumption. 
• Never leave the person alone if they are unconscious. Alcohol poisoning can inhibit an individual’s gag reflex and cause them to choke on their own vomit. 
• If the person is vomiting, help them. It’s critical to make sure that you’re either helping the person sit up or are lying them down on their side so that they don’t choke on their own vomit. 

If you have additional questions or concerns about lowering your risk, there are resources available to you. You can make an appointment with a medical professional or primary care provider to learn more about how alcohol is impacting you. To learn more about where you can find medical professionals who specialize in substance use, you can visit FindTreatment.gov.