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When is “One More Drink” Too Much?

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In July 2011, The American College of Obstetricians and Gynecologists released a Committee Opinion that all women should be screened for alcohol use at least once a year, and within the first trimester of pregnancy.

These recommendations reflect an increase in problem drinking among women. So what does that mean, exactly? How do you know if you’re a “problem drinker”? Well, if a woman drinks more than 7 drinks in a week, or more than 3 drinks on one occasion, she may be at risk of developing a drinking problem.

Of course, there’s always debate over what constitutes “a drink.” (“Hey,” you might think, “I only had one drink: a 23-ounce Hurricane!”) For these purposes, a drink can be defined as a 12-ounce beer, a 5-ounce glass of wine or a 1.5-ounce shot of liquor (straight-up or in a mixed drink).

Why do women have different guidelines from men? First of all, our bodies are clearly made up differently. Women’s bodies contain less water than men’s bodies, pound for pound, which causes our bodies to react differently to alcohol. Because alcohol breaks up in body water, blood alcohol becomes less concentrated in a man’s body than in a woman’s. This, in addition to the fact that the average woman weighs less than the average man, explains why a woman, for the most part, physically can’t handle as much alcohol as a man.

Still, the majority of American women over age 18 do drink alcohol. A survey reported by the National Institute on Alcohol Abuse and Alcoholism found that almost 29 percent of adult women in the U.S. reported drinking 4 or more drinks on a single occasion in a 12-month period. Overall, 42 percent drank 12 or more drinks over the past year.

But is drinking a bad thing? Not necessarily. Two large studies published in 2010 confirmed that light drinking can actually be good for the heart, lowering the risk of cardiovascular disease. For women, however, this equates to a single drink per day, still within the limits of low-risk drinking. Regardless of the potential cardiac benefits, the results of these studies do not serve as a recommendation for women to drink. On the contrary, drinking can have detrimental effects on other organs, which can outweigh the potential health benefits.

In young women, for example, moderate drinking can increase the risk of breast cancer. Excessive drinking, which is never advised, can increase risk of many severe health problems, including but not limited to cirrhosis of the liver, hepatitis, osteoporosis, high blood pressure, mental illness and different types of cancers.

Particularly in women of childbearing age, the risks are high, especially when binge drinking becomes a habit. Heavy drinking can decrease fertility and lead to menstrual disorders. If a woman does become pregnant, alcohol consumption during pregnancy can cause brain damage to the baby, along with other possible birth defects.

The World Health Organization developed a 10-question test to help identify problem drinking. This test, known as the Alcohol Use Disorders Identification Test (or AUDIT), can be found here. Any score over 8 suggests that some intervention may be advisable.

While drinking can be enjoyable in certain circumstances and within limits, understanding how much is enough can help keep everyone safe.

Well Woman and Prenatal Visits Should Include Alcohol Abuse Screening

New York City Department of Health and Mental Hygiene

Women and Alcohol, National Institute on Alcohol Abuse and Alcoholism

Rethinking Drinking, National Institute on Alcohol Abuse and Alcoholism



Reviewed July 21, 2011
by Michele Blacksberg R.N.
Edited by Jody Smith

Add a Comment1 Comments

According to the American Medical Association and the World Health Organization Alcoholism is a disease. An alcoholic can't ever have one drink. The first drink triggers their alcoholism, which is a craving for more and more drinks.
They say "one drink is to many and a thousand is never enough". I work in the rehab industry here http://www.addict-help.com. Millions of people die every year from alcohol related events. If you or someone you know has a drinking problem, get help, please.

February 19, 2015 - 1:16pm
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