What Is At-Risk Alcohol Drinking?

Heavy Drinking or Binge Drinking

Man With Cocktail
How Much Alcohol Is Risky?. © PhotoXpress.com

How do you know if you are drinking too much or too often? The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has conducted research to see who is most at risk of abusing alcohol.

What Are the Recommended Levels?

According to the NIAAA, these are the guidelines for "heavy" or "at-risk" drinking:

  • Five or More Drinks for Men - Five or more drinks during any one drinking session, or more than 14 drinks a week, is considered risky.
  • Four or More Drinks for Women - Four drinks or more during a day, or more than seven drinks a week, is considered heavy drinking for women.

If you drink less than the above-recommended amounts, your level of drinking is considered in the "low risk" category. According to research by the NIAAA, only 2% of people who drink at those levels are at risk for developing alcohol abuse disorders or alcoholism.

Think Everyone Drinks a Lot?

You may be thinking, "No one drinks that small amount of alcohol. Anyone who drinks, drinks more than that!" But, it's not true that "everyone" drinks a lot.

A National Institute of Health survey of 43,000 people over age 18 found that less than 3 out of 10 people drink at at-risk levels. The survey found that:

  • 37% always drink at low-risk levels
  • 35% do not drink at all
  • 28% drink at heavy or at-risk levels

At Risk For What?

If you exceed the guidelines, however, your risk of developing alcohol abuse or alcohol dependence increases significantly.

Generally, about 25% of people who drink at higher than the recommended guidelines will develop alcohol problems.

Drinking too much not only puts you at risk of developing an alcohol use disorder, it increases the risk of harm in other areas of your life.

Injuries. Drinking more than the recommended guidelines can put you at risk for being injured or killed.

For example, alcohol is a factor in 60% of all fatal burn injuries, drownings, and homicides.

Alcohol plays a role in 50% of all severe trauma injuries and sexual assaults, as well as being a factor in 40% of all fatal motor vehicle crashes, fatal falls, and suicides.

Health Problems. The number of health problems that excessive alcohol consumption can cause is long and varied. Heavy drinking can increase the risk of several types of cancer, liver disease, heart disease, stroke, depression, sleep disorders, and sexually transmitted diseases (from unsafe sex).

Drinking too much can also make managing other health problems and conditions more difficult, such as diabetes, high blood pressure, and others.

Birth Defects. Drinking during pregnancy can cause a wide range of brain damage and other serious problems for newborns. It is unknown if any amount of alcohol during pregnancy is safe for the unborn baby, therefore it is recommended that pregnant women drink no alcohol.

Drinking Frequency Counts, Too

The risk also increases if you binge drink or drink heavily on a frequent basis, according to National Institutes of Health research.

If you drink heavily only one day a month, your chances of having an alcohol use disorder are about 20%. But if you exceed the guidelines once a week, the chances jump to 33%.

For those who drink heavily twice a week, the chances of developing a problem are 50% - one in every two people. These percentages were found in a study of the drinking patterns of more than 43,000 U.S. adults.

Could You Have a Problem?

If you go out with friends or co-workers during the week and drink five or more drinks (four for women) and you also drink heavily one night during the weekend, there is a 50-50 chance that you will develop an alcohol use disorder, if you don't have one already.

You might want to take this quiz to see if your drinking level might already fall into the definitions of alcohol abuse or alcohol dependence. You may want to seek help in cutting down your alcohol consumption or trying to quit.


National Institute on Alcohol Abuse and Alcoholism. "What's a Standard Drink (PDF)." Updated 2005.

National Institute on Alcohol Abuse and Alcoholism. "Rethinking Drinking: Alcohol and Your Health." February 2009.

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