What Is At-Risk Alcohol Drinking?

Heavy Drinking or Binge Drinking

Man With Cocktail


How do you know if you are drinking too much or too often? What does it mean if you drank a bottle of wine last night? 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, guidelines for "heavy" or "at-risk" drinking are as follows:

  • 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 a major national survey conducted by the NIAAA, only 2% of people who drink at those levels are at risk for developing alcohol abuse disorders or alcoholism.

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

According to the NIAAA survey:

  • Less than 30% of people drink at at-risk levels
  • 37% always drink at low-risk levels
  • 35% do not drink at all.
  • 28% of people drink at heavy or at-risk levels

The Risks

If you exceed the guidelines, 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.

  • If you drink heavily only one day a month, your chances of having an alcohol use disorder are about 20%.
  • If you exceed the guidelines once a week, the chances jump to 33%.
  • If you drink heavily twice a week, the chances of developing a problem are 50%—one in every two people.

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


Drinking more than the recommended guidelines can put you at risk of 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 the following

  • Several types of cancer
  • Liver disease
  • Heart disease
  • Stroke
  • Depression
  • Sleep disorders
  • 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 birth defects 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 avoid alcohol.

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.

If this pattern sounds familiar, it's a good idea to try to cut down your alcohol consumption or try to quit. You might also want to take this quiz to see if your drinking level might already fall into the definitions of alcohol abuse or alcohol dependence.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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