Wondering if you drink too much? This can be a tough question to answer. And who even knows or decides what’s too much? Is it drinking a couple Scotch on the rocks most evenings? Is it buying a 24-pack of beer on Fridays and finishing it by Sunday night but not drinking the rest of the week? And does it even matter?

To answer that last question, the simple answer is, “Yes.” Yes, because drinking too much can actually change your brain – the way it works and its overall health. This can result in changed thoughts, feelings and behaviors – behaviors that harm the drinker and their friends, family members and total strangers.

What’s the Brain Have to Do With This?

The brain is the organ that controls everything we think, feel, say and do – everything!

It does this through what’s called an electro-chemical signaling process. This process is also called neural networks or neural circuitry.  This process is how individual brain cells (neurons) “talk” to one another and then to and from other neurons throughout the body via the nervous system.

There are various components to this “talking.” Neurons, neurotransmitters, receptors, branchlike extensions, synapses are some examples. But for the purpose of this article, I’ll focus in on the neurotransmitters and the receptors. These are the chemical portions of this electro-chemical signaling process.

Different neurons send different messages with different chemicals.  For example, dopamine neurotransmitters and receptors carry messages of pleasure as the reward for having done something so a person wants to repeat that something to get the pleasurable feeling again.

The ethyl alcohol chemicals in alcoholic beverages work on these dopamine-reliant pleasure/reward neural networks. They trigger a surge in dopamine, which is what makes the brain experience that pleasurable feeling for having an alcoholic beverage. It is also what makes the brain want to repeat this experience, causing them to want to drink again.

And it is this initial change to dopamine-reliant neural networks that can result in what’s called an alcohol use disorder – meaning drinking too much. There’s a LOT more involved than what this simple statement implies, as you’d imagine. But suffice it to say it’s the chemical, structural and behavioral changes brought on by drinking too much that changes a person’s brain functioning and thus their thoughts, feelings and behaviors. These are called Drinking Behaviors (see image to the right).

Then How Much is Too Much?

There’s been a great deal of research in this area in the last 15-20 years thanks to advances in imaging technologies that allow scientists and medical professionals to study the live human brain in action and over time. And it is this research that now answers the question, “Who even knows and decides what’s too much?”

Leaders in this research and reporting on it are the National Institute on Alcohol Abuse and Alcoholism (NIAAA),  World Health Organization (WHO),  Centers for Disease Control (CDC), and the U.S. Surgeon General’s Report on Alcohol, Drugs, and Health, to name a few. In other words, there’s a lot of research behind what I share next to explain that drinking is not just “normal” or “alcoholic.”

Drinking Patterns Explained

There is a range of drinking patterns. They include alcohol use, mild AUD, moderate AUD and severe AUD.

Alcohol use, aka low-risk drinking limits, normal drinking, “social” drinking or casual drinking

• For women: no more than 7 standard drinks a week, with no more than 3 of those 7 on any one day
• For men: no more than 14 standard drinks a week, with no more than 4 of those 14 on any one day
• A standard drink means the amount of ethyl alcohol chemicals in the alcoholic beverage is the same. Common standard drinks include: 5 ounces of table wine, 12 ounces of regular beer and 1.5 ounces of 80 proof spirits. Common cocktails often contain more than 1 standard drink.
  

  NIDA’s illustrates common “standard” drinks – meaning the alcohol type and volume shown contain the same amount of ethyl alcohol.

Mild Alcohol Use Disorder (AUD) – aka binge drinking, heavy drinking

This includes: binge drinking (drinking 4 or more standard drinks on an occasion for women and 5 or more on an occasion for men) and heavy drinking (drinking 2 or more on a day for women and 3 or more for men).

Moderate Alcohol Use Disorder – aka alcohol abuse

This includes routine binge drinking and/or heavy drinking.

Severe Alcohol Use Disorder – aka Alcoholism

There is no typical drinking pattern identified with severe alcohol use disorder. It happens, however, when a person’s moderate AUD chemically and structurally changes their brain, making their brain more vulnerable to the key risk factors for developing severe AUD. These risk factors include genetics, childhood trauma (aka ACEs), mental illness (aka mental health disorder), early use (drinking during before the brain is fully developed), and social environment (e.g., home, school, peer groups, community).

So What’s the Deal With Sharing All of These AUD Levels?

As long as people stay at the low-risk drinking limits (aka alcohol use), there is generally not a problem. Why?

Because generally the liver can manage to metabolize these ethyl chemicals so that they can leave the body. When a person exceeds these low-risk limits, the liver has a hard time metabolizing the ethyl alcohol chemicals in a timely manner, so the chemicals continue to circulate throughout the body and brain.

Wondering if you drink too much? How does a person “choose” to drink and drive?

This excess of ethyl alcohol chemicals is what changes the way brain cells “talk” to one another, which is what changes a person’s thoughts, feelings, and behaviors. It’s how a person can “choose” to drink and drive, for example.

It’s important to understand alcohol use disorders are developmental, meaning a person can avoid, stop or change them at any time. The “how” and “why” of this is beyond the scope of this article. Rather this article serves as a basic overview of AUDs in order to help you answer the question, “Do I drink too much? This next section can also help with that answer.

Below is an assessment tool for alcohol use disorders created by the World Health Organization. It’s referred to as AUDIT (Alcohol Use Disorders Identification Test). The World Health Organization recommends that a trained professional conduct this questionnaire.  When a professional uses this evaluation, for example, they would explain what a standard drink is and is able to interpret answers accurately.  Therefore, in the absence of having a trained professional conducting it, the scoring guidelines and results must be considered tentative—NOT definitive.  It is important to not draw any firm conclusions.

What If You Think You May Be Drinking Too Much

After completing the AUDIT, you may discover that you need assistance with an alcohol use disorder.  There are many options, and no one-size-fits all. Two resources for what assistance may entail are from the National Institute on Drug Addiction (NIDA) – and by the way, alcohol is considered a drug. They are:

• “Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition),” https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
• “Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide,” https://www.drugabuse.gov/publications/principles-adolescent-substance-use-disorder-treatment-research-based-guide/principles-adolescent-substance-use-disorder-treatment 

And as always…

Feel free to email me at lisaf@breakingthecycles.com to arrange a free Zoom or phone call to talk about your specific questions. You may also want to read by latest book, 10th Anniversary Edition If You Loved Me, You’d Stop! What you really need to know when your loved one drinks too much. The first half covers alcohol use disorders – what they are, how a person develops them and how they can be changed or treated. The second half is all about helping the family member or friend experiencing secondhand drinking – what that looks like and what they can do to improve their own lives (which often results in their loved one making the decision to address their drinking problem). It’s available in paperback, Kindle and other eReader formats. [eReader formats allow you to immediately access the book and read it without anyone knowing ?.]

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Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com

Lisa Frederiksen is the author of hundreds of articles and 12 books, including her latest, "10th Anniversary Edition If You Loved Me, You'd Stop! What you really need to know when your loved one drinks too much,” and "Loved One In Treatment? Now What!” She is a national keynote speaker with over 30 years speaking experience, consultant and founder of BreakingTheCycles.com. Lisa has spent the last 19+ years studying and simplifying breakthrough research on the brain, substance use and other mental health disorders, secondhand drinking, toxic stress, trauma/ACEs and related topics.

Latest posts by Lisa Frederiksen (see all)

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