Many people with alcohol problems cannot tell when their drinking is out of control. An important first step is to be aware of how much you are drinking and how your alcohol use may be harming your life and those around you.

One drink is defined as a 12-ounce can or bottle of beer, a 5-ounce glass of wine, a wine cooler, or 1 cocktail or shot of hard liquor. Think about:

• How often you have any alcoholic drinks at all
• How many drinks you have when you do drink
• How any drinking you are doing is affecting your life or the people around you

Here are some ways to drink responsibly, as long as you do NOT have a drinking problem.

Healthy men up to age 65 should limit themselves to:

• No more than 4 drinks in 1day
• No more than 14 drinks in aweek

Healthy women up to age 65 should limit themselves to:

• No more than 3 drink in 1 day
• No more than 7 drinks in a week

Healthywomen of all agesand healthymen over age 65 should limit themselves to:

• No more than 3 drinks in 1 day
• No more than 7 drinks in aweek

You can use the AUDIT-C questionnaire to help you decide if your drinking is risky.

People with risky drinking patterns are drinking more than is considered medically safe. People who are risky drinkers have a higher risk of going on to abuse alcohol and become dependent on alcohol.

Some habits of risky drinkers are drinking:

• Many times per month, or even per week
• 3 - 4 drinks, or more, on a typical day
• 5 or more drinks on one occasion monthly, or even weekly

Your health care provider will advise you to cut down or even quit, and can help you begin to do this.

Alcohol abuseis a type of drinking that may affect how your life is going. If youhave any of these problems, you may be abusing alcohol.

• You did not do what you were expected to do (at home, work, or school) as a result of drinking.
• Your drinking caused you or someone else to be injured, or could have caused injury.
• You have had run-ins with the law.
• You have had trouble or conflict with your family, friends, or coworkers.

You may also have early signs of alcohol dependence.

Some signs of alcohol dependence are that you:

• Need to drink more to get the same effect from alcohol
• Have not been able to cut down or stop
• Have symptoms of withdrawal when you try to quit or cut down. Some of these aretremors, sweating, nausea, or insomnia.
• Have not been able to stop drinking once you have started
• Continue to drink, even though alcohol is causingemotional or physicalproblems, or problems with your family, friends, or job
• Spenda lot of time drinking,thinking about drinking, or recovering from drinking
• Spend less time on otheractivities that used to be important or that you enjoyed

If you or others are concerned about your drinking,make an appointment with your health care provider to talk about your drinking. Your health care provider can help guide you to the best treatment.

Some other resources include:

• Alcoholics Anonymous (AA) -- www.aa.org
• National Clearinghouse for Alcohol and Drug Information -- www.ncadi.samhsa.gov

Bush K,Kivlahan DR,McDonellMB,FihnSD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998; 158(16):1789-1795.

In the clinic. Alcohol use. Ann Intern Med. 2009 Mar 3;150(5).