Being able to have a few drinks without feeling any effects may seem like a good thing. In fact, if you need to drink increasing amounts of alcohol to feel an effect, it could be a sign you have a problem with alcohol.

You do not need to drink every day to have a problem with alcohol. Heavy drinking is defined by how much alcohol you have in a day or in a week.

You may be at risk if you:

• Are a man and have more than 4 drinks in a day or more than 14 drinks in a week.
• Are a woman and have more than 3 drinks in a day or more than 7 drinks in a week.

Drinking this amount or more is considered heavy drinking. This is true even if you only do it on weekends. Heavy drinking can put you at risk for health problems such as heart disease, stroke, liver disease, sleep problems, and some types of cancer.

You may think that drinking problems have to start early in life. In fact, some people develop problems with drinking at a later age.

One reason is that people become more sensitive to alcohol as they get older. Or they may take medicines that make the effects of alcohol stronger. Some older adults may start to drink more because they are bored or feel lonely or depressed.

Even if you never drank that much when you were young, you can have problems with drinking as you get older.

What is a healthy range of drinking for men and women age 65 years or older? Experts recommend no more than 3 drinks in a single day or no more than a total of 7 drinks a week. A drink is defined as 12 fluid ounces (355 mL) of beer, 5 fluid ounces (148 mL) of wine, or 1½ fluid ounces (45 mL) of liquor.

Problem drinking is not about what you drink, but how it affects your life. For example, if you can answer "yes" to any two of the following statements, drinking may be causing you problems.

• There are times when you drink more or longer than you planned to.
• You have not been able to cut down or stop drinking on your own, even though you have tried or you want to.
• You spend a lot of time drinking, being sick from drinking, or getting over the effects of drinking.
• Your urge to drink is so strong, you cannot think about anything else.
• As a result of drinking, you do not do what you are expected to do at home, work, or school. Or, you keep getting sick because of drinking.
• You continue to drink, even though alcohol is causing problems with your family or friends.
• You spend less time on or no longer take part in activities that used to be important or that you enjoyed. Instead, you use that time to drink.
• Your drinking has led to situations that you or someone else could have been injured, such as driving while drunk or having unsafe sex.
• Your drinking makes you anxious, depressed, forgetful, or causes other health problems, but you keep drinking.
• You need to drink more than you did before to get the same effect from alcohol. Or, the number of drinks you are used to having now have less effect than before.
• When the effects of alcohol wear off, you have symptoms of withdrawal. These include, tremors, sweating, nausea, or insomnia. You may even have had a seizure or hallucinations (sensing things that are not there).

People with long-term (chronic) pain sometimes use alcohol to help manage pain. There are several reasons why this may not be a good choice.

• Alcohol and pain relievers do not mix. Drinking while taking pain relievers may increase your risk of liver problems, stomach bleeding, or other problems.
• It increases your risk for alcohol problems. Most people need to drink more than a moderate amount to relieve pain. Also, as you develop a tolerance for alcohol, you will need to drink more to get the same pain relief. Drinking at that level increases your risk for alcohol problems.
• Long-term (chronic) alcohol use can increase pain. If you have withdrawal symptoms from alcohol, you may feel more sensitive to pain. Also, heavy drinking over a long time can actually cause a certain type of nerve pain.

If you are drunk, nothing will help make you sober except time. Your body needs time to break down the alcohol in your system. The caffeine in coffee may help you stay awake. However, it will not improve your coordination or decision-making skills. These can be impaired for several hours after you stop drinking. This is why it is never safe to drive after you have been drinking, no matter how many cups of coffee you have.

Carvalho AF, Heilig M, Perez A, Probst C, Rehm J. Alcohol use disorders. Lancet. 2019;394(10200):781-792. PMID: 31478502 pubmed.ncbi.nlm.nih.gov/31478502/.

National Institute on Alcohol Abuse and Alcoholism website. Overview of alcohol consumption. www.niaaa.nih.gov/alcohols-effects-health/overview-alcohol-consumption. Accessed September 30, 2022.

National Institute on Alcohol Abuse and Alcoholism website. Rethinking drinking. www.rethinkingdrinking.niaaa.nih.gov/. Accessed September 30, 2022.

National Institute on Alcohol Abuse and Alcoholism website. Using alcohol to relieve your pain: what are the risks? www.niaaa.nih.gov/publications/brochures-and-fact-sheets/using-alcohol-to-relieve-your-pain. Updated May 2021. Accessed September 30, 2022.

O'Connor PG. Alcohol use disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 30.

US Preventive Services Task Force, Curry SJ, Krist AH, et al. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;320(18):1899-1909. PMID: 30422199 pubmed.ncbi.nlm.nih.gov/30422199/.

Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.