Lena Savoie
Alcohol consumption has been linked to a wide range of health issues and is considered a toxic, psychoactive, and dependence-producing substance. While there is no guaranteed safe amount of alcohol for anyone, heavy drinking is generally considered to be when a woman has four or more drinks or a man has five or more in about two hours, causing the blood alcohol concentration (BAC) to reach the legal driving limit of 0.08%. Binge drinking, which is a form of alcohol misuse, is associated with more than half of alcohol-related deaths in the US and increases the risk of falls, burns, car crashes, memory blackouts, medication interactions, assaults, drownings, and overdose deaths. High-intensity drinking is defined as consuming two or more times the sex-specific thresholds for binge drinking, which is ten or more standard drinks for males and eight or more for females.
| Characteristics | Values |
|---|---|
| High-intensity drinking for males | 10 or more standard drinks |
| High-intensity drinking for females | 8 or more standard drinks |
| Binge drinking for males | 5 or more drinks in about 2 hours |
| Binge drinking for females | 4 or more drinks in about 2 hours |
| Blood alcohol concentration (BAC) at legal driving limit | 0.08% |
| BAC level at which a person may lapse into a coma | 0.30% |
| BAC level at which a person may result in death | 0.40% |
| Number of people who die from alcohol-related cancers each year in the US | More than 20,000 |
| Number of people at risk of developing alcohol-attributable cancer in the WHO European Region | Over 200 million |
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What You'll Learn
Binge drinking
According to the 2023 National Survey on Drug Use and Health (NSDUH), about 61.4 million, or 21.7%, of people in the United States aged 12 and older reported binge drinking in the past month. While rates of binge drinking among young people are decreasing, they remain high, with 28.7% of 18 to 25-year-olds reporting binge drinking in 2023. Binge drinking among older adults is also a concern, with about 12% of adults aged 65 and older reporting binge drinking in the same year.
High-intensity drinking is a form of binge drinking that involves consuming two or more times the sex-specific thresholds, which is 10 or more standard drinks for males and eight or more for females. It is associated with an increased risk of harm and adverse health effects.
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Alcohol poisoning
Alcohol Misuse
Alcohol misuse refers to drinking in a manner, situation, amount, or frequency that could cause harm to oneself or others. This includes binge drinking and heavy alcohol use. Alcohol misuse increases the risk of developing Alcohol Use Disorder (AUD) over time.
Binge Drinking
Binge drinking is defined as a pattern of drinking that brings Blood Alcohol Concentration (BAC) to 0.08% or higher. For a typical adult, this corresponds to consuming five or more drinks (male) or four or more drinks (female) in about two hours. Binge drinking causes more than half of the alcohol-related deaths in the United States and increases the risk of falls, burns, car crashes, memory blackouts, medication interactions, assaults, drownings, and overdose deaths.
Heavy Drinking
Heavy drinking markedly increases the likelihood of AUD and other alcohol-related harms. Heavy drinking thresholds are lower for women because alcohol distributes itself evenly in body water, and women have proportionally less water in their bodies than men. Therefore, a woman's BAC will be higher than a man's after consuming the same amount of alcohol, putting her at greater risk.
High-Intensity Drinking
High-intensity drinking is defined as consuming two or more times the binge-drinking thresholds for women and men. For men, this is 10 or more standard drinks, and for women, it is eight or more standard drinks.
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High-intensity drinking
Research has shown that a significant percentage of teens and young adults engage in high-intensity drinking. For example, approximately 10% of US 12th-grade high school students reported consuming 10 or more drinks in a row in the past two weeks, with an additional 4-5% consuming 15 or more drinks. These rates are even higher among college students, with 12.4% consuming 10 or more drinks and 5.1% consuming 15 or more drinks.
The Monitoring the Future survey defines high-intensity drinking among adolescents as consuming 10 or more drinks for 8th, 10th, and 12th graders, and 15 or more drinks for 12th graders only. It is important to note that any amount of alcohol consumption can be associated with harm, and the level of harm increases with the amount consumed. Excessive alcohol use can lead to various health issues, including high blood pressure, heart disease, liver disease, digestive problems, a weaker immune system, mental health conditions, memory problems, and an increased risk of several types of cancer, including breast cancer.
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Alcohol tolerance
Factors that influence alcohol tolerance include:
- Body size and weight: Large-bodied people will require more alcohol to reach insobriety than lightly built people. Body weight and adult weight vary with ethnicity.
- Biochemistry: The prevalence of high levels of alcohol dehydrogenase, a group of enzymes responsible for the breakdown of alcohol, in an individual increases alcohol tolerance.
- Socio-economic and cultural differences: Differences in tolerance levels are also influenced by factors such as diet, average body weight, and patterns of consumption.
- Setting: People develop higher alcohol tolerance when they regularly consume alcohol in the same setting. Conversely, drinking in a new location or with different people may lower one's alcohol tolerance.
Tolerance can foster higher levels of drinking, which can have negative health effects. While those who have developed tolerance may not feel the effects of alcohol as readily, they are still doing damage to their liver and may become dependent on alcohol.
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Alcohol and cancer
Alcohol consumption is linked to a heightened risk of several types of cancer. Alcohol misuse, including binge drinking and heavy alcohol use, increases the risk of alcohol use disorder (AUD) and other alcohol-related harms. Binge drinking is defined as consuming four or more drinks by women and five or more drinks by men in about two hours, and it causes more than half of the alcohol-related deaths in the US. High-intensity drinking is the consumption of two or more times the binge-drinking thresholds.
The International Agency for Research on Cancer (IARC) has classified alcohol as a Group 1 carcinogen (cancer-causing substance) due to sufficient evidence that it causes cancers of the oral cavity, pharynx, larynx, oesophagus, and liver in people. Alcohol can disrupt cell cycles, increase chronic inflammation, and damage DNA, which is the cell's "instruction manual" that controls its growth and function. When DNA is damaged, a cell can grow out of control and become cancerous. Alcohol also increases the absorption of carcinogens from tobacco and other sources, such as diethyl nitrosamine (found in tobacco smoke, cured and fried foods, cheddar cheese, agricultural chemicals, pharmaceuticals, and cosmetics).
Additionally, alcohol can increase hormone levels, including estrogen, which plays a role in breast cancer development. Even light drinking can increase a woman's risk of breast cancer by 5% to 15% compared to non-drinkers. Alcohol consumption has also been associated with an increased risk of mouth and throat cancers. Studies suggest that drinking three or more alcoholic drinks per day increases the risk of stomach and pancreatic cancers and may also increase the risk of prostate cancer.
According to the US Dietary Guidelines, adults can choose not to drink or limit their intake to two drinks or less in a day for men and one drink or less in a day for women. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines heavy drinking as having four or more drinks on any day or eight or more drinks per week for women and five or more drinks on any day or 15 or more drinks per week for men. Doctors can advise patients on drinking patterns and offer behavioural counselling to those who drink excessively.
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Frequently asked questions
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), drinking patterns that are considered "heavy" include:
- 4 or more drinks for women and 5 or more drinks for men in about 2 hours. This meets the definition of binge drinking.
- 10 or more standard drinks for males and 8 or more for females, which is considered high-intensity drinking.
Excessive alcohol consumption can lead to immediate and long-term health effects, including:
- High blood pressure
- Heart disease
- Liver disease
- Digestive problems
- Weakened immune system
- Mental health issues such as depression and anxiety
- Memory problems, including dementia
- Increased risk of several types of cancer, including breast cancer
- Alcohol poisoning
- Overdose when mixed with other drugs
- Alcohol dependence or Alcohol Use Disorder (AUD)
The U.S. Dietary Guidelines recommend limiting alcohol intake to 1 drink or less per day for women and 2 drinks or less per day for men. It's important to note that the less alcohol consumed, the lower the risk of alcohol-related health issues. Some individuals, such as those under the legal drinking age, pregnant women, or individuals with certain medical conditions, should avoid alcohol completely.
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