Whether it's wine with dinner or drinks at a party, many of us enjoy indulging in alcoholic beverages from time to time. But when does it move from moderate social drinking to something more serious? How can you tell if you're drinking too much? And what should you do if you think you or your loved one has a problem with alcohol?

How much is too much?
According to the World Health Organization's guidelines for low risk drinking, men should consume 14 standard drinks or less per week, and women 9 standard drinks or less.  A standard drink equals 13.6 grams of alcohol, or the equivalent of one 5oz (143 mL) glass of wine, one 12oz (341 mL)  beer, or a 1.5 oz (43 mL) glass of spirits.

"If you drink more than that, that might be problematic drinking," says Dr. Tony George, Professor and Chair in Addiction Psychiatry and Head of the Division of Addiction Psychiatry at the University of Toronto. "So that can be a red flag to you."

Additionally, Dr. George says rather than just basing whether you have a problem on numbers, you should also examine whether your drinking habits are having a negative effect on your personal, work or social life to assess whether you should be quitting or cutting down. Have you driven while impaired? Do you find you are repeatedly late for work or school or calling in sick because of alcohol? Are you arguing with loved ones about your drinking, or developing health issues? These are all warning signs that your drinking is out of control.

Another quick way to gauge whether you have a problem is by using the internationally recognized CAGE Assessment tool, developed by  Dr. John A. Ewing, founding director of the Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill.

This short four-question survey is used by physicians to screen patients for problems with alcohol:

Do you feel the need to Cut down on your drinking?
Have you felt Annoyed by people criticizing your drinking?
Have you felt bad or Guilty about your drinking?
Have you felt the need for an Eye-opener drink, first thing in the morning?

"If you answer yes to two of four those four questions, you have a 90 per cent probability of having an alcohol problem," says Dr. George.

Page 1 of 2 - on page 2: find out what to do if your loved one has a problem.
Should I feel guilty about having a drink (or two) in the afternoon?
According to Dr. George, as long as you are practising responsible drinking, an alcoholic beverage in the afternoon isn't a particular cause for concern.

"There are plenty of people who drink when they get home from work, one or two drinks, who never have a problem," he says. "The key is moderation, and recognizing when the situation may be spinning out of control."

The CAMH has several recommendations for moderate drinking practices, which can help to reduce your risk of problems with alcohol. First, keep track of  all of your drinks every day, so that you are aware of how much alcohol you are actually consuming. Pace yourself on days where you choose to drink by waiting between drinks, diluting drinks with mix, alternating alcoholic beverages with non-alcoholic beverages and eating snacks while you drink. Stay alert to your drinking and set personal limits, and learn to say 'no' when you are offered drinks without feeling guilty or succumbing to peer pressure.

Also, find balance by spending time on other things that you enjoy that don't involve alcohol, such as seeing movies, meeting friends and participating in clubs and activities.

What should I do if I think I or my loved one has a problem with alcohol?
If you believe you may have a problem with alcohol dependency, Dr. George recommends you talk to your family physician for help. If you are thinking of quitting drinking, it might be helpful to make a list of reasons why you are drinking and why you'd like to quit, and participation in self-help support groups like Alcoholics Anonymous can be an effective way find the support you need to keep on track.

If you are concerned about a loved one's drinking, the first step is to talk to them about it. A caring non-confrontational conversation can help your loved one see how their behaviour is affecting those around them, and can help motivate them to get the help they need. If you do not feel comfortable talking to the person, you can also get help from a professional in your community.

Educate yourself on alcohol abuse, and be aware of the resources available for you and your loved one in your community. Also, you don't have to go it alone — groups like Al-Anon and Alateen are available specifically to help support family members of those struggling with alcohol.

For more information:
The Centre for Addiction and Mental Health
Low-risk Drinking Guidelines
Alcohol Help Center
Al-Anon/Alateen

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