The term "standard drink" (SD) is used to compare the amount of alcohol in different strength drinks. Whether you drink beer, wine or spirits, one standard drink contains approximately the same amount of alcohol.
Knowing how many standard drinks you have on a regular basis is helpful in assessing the severity of your drinking problem - if you have one. This information can also be helpful if you reach the point where you decide to take control of your drinking and want to drink within medically safe limits.
For questionnaires which analyse your personal drinking pattern, go to Self-Assessment.
LOW RISK DRINKING LEVELS
In New Zealand, low risk drinking guidelines have been established by the Alcohol Advisory Council (ALAC) as follows:
For Males: 21 SDs per week, no more than 6 SDs per day.
For Females: 14 SDs per week, no more than 4 SDs per day.
In Australia, new guidelines have been adopted which recommend a maximum of 14 standard drinks a week for both males and females.
In New Zealand's binge drinking culture, this might not seem like a lot. But the reality is that many people drink a lot more than this for years on end with little knowledge or awareness of the damage they may be doing. The fact that you are not aware of any problems by the age of 40 for instance, even though you perhaps drink a bottle of wine a day does not mean that damage is not occurring. Even at these low risk levels, there is evidence that the executive functions of the frontal lobe of the brain, which affects decision making ability, may be diminished.
GENDER DIFFERENCES IN METABOLISING ALCOHOL
There are two reasons that the "safe level" for women is less than the "safe level" for men.
1) Alcohol is not absorbed into fat cells, and generally a woman will have more fatty tissue (on the breasts and buttocks) than a man of the exact same weight. Because the alcohol does not go into the fatty tissues, more of it stays in the bloodstream leading directly to the brain. The result is that women may become intoxicated more quickly.
2) Women also generally have less of the enzyme in their stomach that metabolises alcohol than men do, and so alcohol is broken down more slowly in females; once again more of it gets directly to the brain than in the average male, and women become intoxicated more quickly.
ORGAN DAMAGE CAUSED BY ALCOHOL
In small amounts alcohol, especially red wine, appears to have some positive health benefits.However when it is metabolized in the body, it creates acetaldehyde which is poisonous. When you drink too much alcohol, prolonged exposure to acetaldehyde begins to damage different organs in the body, including the liver and brain. When you feel like vomiting after drinking too much, your body is doing its best to get rid of this poison.
Medical experts have determined how much alcohol the average adult can consume before it begins to cause damage. These amounts are known as "safe drinking levels". When you drink more than the recommended safe levels, this overloads the ability of the liver to metabolise and get rid of the alcohol. There is then too much alcohol running around in the body and this places stress on the liver and other organs in the body. In particular it slowly leads to the beginning of cellular brain damage and shrinkage of the cerebral cortex.
While some of these areas of the brain may recover when drinking stops or returns to safe levels, other areas do not. In other words, with prolonged exposure to alcohol, some damage is permanent.
Medical experts believe the following amounts are safe for adults to drink. However pregnant women should not drink at all because of the risk to the foetus, and teenagers should always be aware of the potential impact of any substance use (including alcohol) on the development of neural pathways in the brain (see Factors which Contribute to the Development of Dependence).
AM I AN ALCOHOLIC?
The typical stereotype that many people have of an "alcoholic" is someone living in the streets with a bottle in their hand - perhaps a bottle of methylated spirits. The word alcoholic is related to the medical perspective of substance use which suggests that alcoholism is a disease from which there is no recovery. From this perspective the only appropriate "treatment" is complete abstinence, which is the basis of the approach underlying Alcoholics Anonymous.
While it would probably be fair enough to call a person drinking every day and living in the streets an alcoholic, the reality is that people can become dependent on alcohol long before they end up sleeping on a park bench.
LEVELS OF DEPENDENCE
In order to assess the severity of someone's alcohol or dug use, most countries in the West now use diagnostic criteria based on the observation of various behaviours which describe substance abuse and substance dependence. There are four criteria for abuse and seven for dependence.
Using this process to assess substance dependence, it is possible to be:
mildly dependent (meeting 3 criteria)
moderately dependent (meeting 4 or 5 criteria) or
severely dependent (meeting 6 or 7 criteria).
Those who adhere to the medical model might not be comfortable with this approach as the medical perspective suggests that you either have the disease (of alcoholism) or you don't. Clinically it seems clear that levels of dependence vary considerably. However from the medical perspective, if you have the disease of alcoholism in the early stages (mild dependence), unless you stop drinking completely, the disease will progress until you become severely dependent.
In general, A&D counsellors and addiction specialists these days might be reluctant to apply the word alcoholic to a client as it means such different things to different people. It is more useful to say how many criteria the client meets, and then everyone who uses this approach knows exactly how serious the client's problem is.
The word alcoholic might then be reserved for those clients who meet 6 or 7 criteria, are therefore at the more severe end of the spectrum of dependence, and who, despite numerous attempts to cut back or stop, have relapsed many times.
To see whether you meet any of the criteria for dependence, click on SELF-ASSESSMENT.
