One in four adults reported drinking more during the pandemic, according to an American Psychological Association survey. Alcohol consumption among adults increased 14% from 2019 to 2020, according to a study published in JAMA Network Open in September 2020. The research also revealed instances of heavy drinking increased among women. On top of that, Nielsen reports alcohol sales, outside of bars and restaurants, grew more than 20% during the pandemic.  “Living through the pandemic has been an experiment in people’s resiliency when cut off from many of their everyday activities and human interactions,” says Dr. Sarita Salzberg, MD, MPH, a primary care physician board-certified in family and addiction medicine with virtual health platform PlushCare. “During this time, many tried to cope in new ways, including by drinking more than usual.” Along with the stress and uncertainty of the pandemic, Dr. Akhil Anand, MD, a psychiatrist at Cleveland Clinic, says loneliness, isolation, and grief are other reasons people may be drinking more.  But when it comes to drinking, how much is too much? And how do you know if you’re drinking too much? We asked experts to explain—here’s what they had to say.

What’s considered drinking too much?

Drinking in moderation is defined as two or fewer drinks per day for adult men and no more than one for women, according to the Dietary Guidelines for Americans. Pregnant women and anyone under age 21, people with certain medical conditions, or anyone who is recovering from alcohol abuse shouldn’t drink at all.   “Consistently drinking more than these amounts can be classified as drinking too much,” explains Dr. Indra Cidambi, MD, medical director and founder of Center for Network Therapy. Men and women have physiological differences, which is why recommended alcohol quantities differ for them, she says. Women often feel intoxicated more quickly than men, since their bodies contain less water, more fatty tissues, and lower levels of specific enzymes that break down substances.  “There is no magic number or drinks or way to define what it means to drink too much,” adds Dr. Salzberg. Metabolism, tolerance, and how someone is impacted by alcohol play a role, too, and she says the terms “drinking too much” and “alcoholic” often carry a negative stigma.

8 signs you’re drinking too much

There are several signs that your drinking behaviors may be becoming excessive and threatening your overall health and wellbeing. Here’s an overview: 

It interferes with your daily life

When drinking affects your job or family responsibilities, daily habits, or causes financial distress, you may need to seek help. 

It affects your relationships

This includes instances when friends or family are commenting on your drinking habits. Also, when drinking is causing relationship strife, or you’re losing meaningful relationships.

It leads to risky behaviors

You may be engaging in high-risk activities or behaviors, such as driving while intoxicated. 

You regularly blackout

If you regularly drink so much that you experience blackouts, it’s likely you’re drinking too much. Severe hangovers are another sign. 

You’re using alcohol to cope or relax

Another sign of drinking too much is when you use alcohol as a coping mechanism or a way to relax, and you continue drinking even if it makes you feel depressed or anxious.

You need to drink more for the same effects

The need to drink more than in the past to feel the same effects increases your alcohol tolerance, which may lead to excessive drinking. 

You have withdrawals when you don’t drink

Symptoms of withdrawal include shakiness, sweating, tremors, headaches, anxiety, irritability, and insomnia, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). 

You can’t control your drinking

Regularly thinking about drinking, trying to stop or cut back, or setting drinking limits for yourself and then breaking these rules may mean you need help with your drinking. 

How excessive drinking affects your health

Drinking too much alcohol is linked to a number of mental and physical health conditions, Dr. Anand says, “Alcohol is the only substance that I can think that literally damages every single organ system in our body.”  It can increase the risk for certain cancer, impaired liver function, affect fertility, and cause changes in testosterone and estrogen levels, he adds.  Substance abuse and relapse triggers include anxiety, isolation, depression, boredom, and financial and relationship stress, Cidambi says.  “The pandemic, unfortunately, has created a perfect storm by delivering multiple triggers at the same time,” she says. “When someone indulges in heavy drinking over an extended period of time, the body becomes chemically dependent on alcohol.”  Then, when you try to stop drinking, you’ll likely experience withdrawal symptoms. Alcohol withdrawal can be dangerous, possibly causing seizures or stroke, Cidambi says. 

What to do if you’re drinking too much

Think you’re drinking too much? A good place to start is calling SAMHSA’s National Helpline at 1-800-662-HELP. Salzberg also suggests talking to your primary care physician, who can determine if additional or more treatment would be beneficial.  Treatments for alcohol dependence may include medication, therapy, or self-help groups, like Alcoholics Anonymous or Narcotics Anonymous, Cidambi says.  Other ways to manage your drinking, she says, include: 

Keep track of your drinking by writing it down or using an app like DrinkControl or AlcoDroid Alcohol TrackerSet a number of drinks to consume per week or per dayAvoid keeping alcohol in your home Have alcohol-free days 

“If you find that you consistently flout these self-established rules, you may need help,” Dr. Cidambi says.  Never feel shame for asking for an expert’s opinion about your drinking and healthy ways to cope if it’s a concern, Dr. Salzberg adds.  “It’s important to keep in mind that living through the pandemic has been extremely difficult for all of us,” she says. “We are all trying to cope and doing our best in a hard situation.” Next, read about what “recovering” means as it relates to alcohol. 

Sources

Dr. Akhil Anand, MD, psychiatrist, Cleveland ClinicDr. Indra Cidambi, MD, medical director and founder, Center for Network TherapyDr. Sarita Salzberg, MD, MPH, primary care physician board-certified in family and addiction medicine, PlushCareAlcoholics Anonymous (AA)American Psychological Association:One year on: Unhealthy weight gains, increased drinking reported by Americans coping with pandemic stressCenters for Disease Control and Prevention (CDC): Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020CDC:Dietary Guidelines for Alcohol JAMA Network Open:Changes in Adult Alcohol Use and Consequences During the COVID-19 Pandemic in the USNarcotics Anonymous (NA) Nielsen: Rebalancing the ‘COVID-19 effect’ on alcohol sales Substance Abuse and Mental Health Services Administration (SAMHSA): Alcohol Use Facts and Resources SAMHSA: National Helpline Drinking Too Much Alcohol  8 Signs You re Drinking Too Much - 61