Alcohol Awareness Month in Beer City – how much is too much

By Jason T. Cook, MD

Living in the vacation hotspot we lovingly know as Asheville, we often find ourselves surrounded by various forms of alcohol. Whether it’s a new brewery, a hot new restaurant serving craft cocktails, or the Thirsty Thursday dollar beer night at the Asheville Tourists baseball club, sometimes it seems like all Asheville does is drink.

It’s one thing if you visit for a week of vacation once a year, but it’s another thing altogether if it is part of your everyday life. Alcohol occupies an interesting place in our collective psyche as Americans: it is often thought to be perfectly acceptable, sometimes encouraged as a social norm, sometimes even promoted to have health benefits. One thing we do know is that America likes alcohol. It is the most commonly-used addictive substance in the United States, with over $220 billion in annual US sales.

So, is alcohol good or bad? Most physicians think that alcohol in moderation is okay for many adults, but there are millions of Americans for whom a drink is not just a casual social lubricant. Over 17 million people in the US suffer from alcohol abuse of dependence, and millions more engage in binge drinking patterns that can lead to dependence. The disease of alcoholism affects all aspects of a person’s life, causing physical and mental illnesses, ruining families, careers, and finances. Alcohol overuse causes 88,000 deaths annually, and it is the 3rd leading preventable cause of death in the US.

How much is too much? The concept of moderate drinking is often misunderstood. The general medical recommendation for alcohol moderation is no more than 14 drinks a week for men or 7 drinks a week for women, on average. It also stipulates that on any single occasion, men should limit their intake to no more than 4 drinks, and women should have no more than 3 drinks. Also, people often have different ideas about what constitutes “one drink.” Technically, a drink is defined as 12 ounces of beer or malt beverage, 5 oz of wine, or 1.5 oz of liquor. So remember, that 32 oz beer on special at the Mexican restaurant is actually almost 3 drinks, and there are in fact 5 glasses of wine in a standard 750ml bottle.

Even with that recommendation, deciding if a person drinks too much can be more complicated. Alcoholism is not just defined by how much, for how long, or what type of alcohol a person drinks, but also why they drink. Alcoholics often use drinking to attempt to treat underlying stress or other mental health problems, to numb themselves from certain unpleasant feelings, or just to satisfy an intense, unexplainable craving. Several types of validated screening questionnaires have been developed to help physicians and patients determine if someone’s drinking behavior is problematic, and we regularly use these in our offices.

If you are concerned about how alcohol is affecting your life or that of a loved one, please don’t hesitate to schedule an appointment with your primary care provider. You may also read more about alcoholism at .