How do you know if someone’s drinking is a problem? Short answer: “If you are talking or concerned about it.” What do I mean?
The only reason a person would be worried about another person’s drinking is because that other person’s behaviors change when they drink. Their behavioral changes are called drinking behaviors.
Drinking behaviors occur when a person consumes more alcohol, thus more ethyl alcohol chemicals, than their liver can metabolize. When this happens, the ethyl alcohol chemicals interrupt the chemical portion of the brain’s cell-to-cell communications. This suppresses normal neural network functioning responsible for judgment, memory, pleasure/reward, emotions, breathing…. In other words, it changes a person’s thoughts, feelings, and behaviors.
Contrary to popular belief, it’s not just the drinking pattern of alcoholism that causes these behavioral changes, although alcoholism is certainly one. Binge drinking, heavy social drinking, and alcohol abuse (terms now grouped together as alcohol misuse and/or alcohol use disorders) also cause drinking behaviors. Some of the drinking behaviors include:
- crazy, convoluted accusations and illogical arguments
- verbal, physical and/or emotional abuse
- bullying; neglect
- driving while impaired
- domestic violence.
Why Does Knowing Whether a Person’s Drinking is a Problem Matter
Short answer: “There is a direct impact – a second-hand effect – on the people confronted and/or coping with drinking behaviors.” These second-hand effects include:
- being on the receiving end of drinking-related verbal, physical or emotional abuse; neglect; bullying and believing it’s the “real” person coming out, not understanding the behaviors are the consequence of chemical changes in the brain
- being seriously injured by an impaired driver
- feelings of anxiousness, hopelessness, walking on egg shells because of the uncertainty, worry, fear, anger, concern triggered when in the sphere of an impaired person’s drinking behaviors
- being on the receiving end of domestic violence or a sexual assault by a person whose brain functioning has changed under the influence of alcohol.
Moms, dads, husbands, wives, brothers, sisters, children, grandchildren, grandparents, boyfriends, and girlfriends exposed to and/or coping with these sorts of drinking behaviors experience physical, emotional and quality of life impacts because the drinking behaviors trigger their stress response system. When this system is repeatedly activated, their stress becomes toxic, and they experience many of the following stress-related symptoms:
- stomach ailments
- anxiety, depression, frequent or wild mood swings
- chronic neck and/or shoulder pain
- frequent headaches, migraines
- chest pain, palpitations, rapid pulse
- increased anger, frustration, hostility
- feeling overloaded, overwhelmed, helpless, hopeless
I call this second-hand effect secondhand drinking (SHD). For more on this, check out “The Fight-or-Flight Stress Response – Secondhand Drinking Connection.
Now… back to the original question, “How do you know if drinking is problem?” If you’ve agreed with my short answer, “You’re talking about and/or concerned about it,” then you’ve seen some of the drinking behaviors I mentioned above. And that is your answer. Drinking really is a problem because it’s not “normal” to change behaviors when drinking. And that’s because staying within low-risk or moderate drinking limits typically keeps a person from exhibiting drinking behaviors.
Definition of “Moderate” or “Low-Risk” Drinking Limits
For Women: No more than 7 standard drinks in a week, nor 3 of the 7 in a day
For Men: No more than 14 standard drinks in a week, nor 4 of the 14 in a day.
A standard drink is defined as 5 ounces of table wine, 12 ounces of beer or 1.5 ounces of liquor (e.g., vodka). Often “drinks” served at parties or in bars or restaurants contain more than one standard drink.
What Knowing Low-Risk Drinking Limits Can Do For You
1. Helps you understand when your loved one’s brain is likely changed by the ethyl alcohol chemicals in alcoholic beverages, thus their behavioral changes are not their “normal” (unless that’s how they behave when they’re not drinking).
2. Helps you avoid the unnecessary, unproductive and down right destructive exchanges that can occur when you try to make sense out of the actions and behaviors of someone who has exceeded low-risk drinking limits — especially the “per day” limit.
This 2nd reason can be especially important and makes more sense when you understand the next section.
Blood Alcohol Content Explained
Alcohol is not digested like other foods and liquids. It bypasses the digestive system and enters the bloodstream through the walls of the small intestine. Because alcohol dissolves in water, the bloodstream carries it throughout the body (which is 60-70%) water, where it is absorbed into body tissue high in water concentration (like the brain) and highly vascularized (meaning, lots of blood vessels – like the brain).
The ethyl alcohol chemicals in alcoholic beverages are metabolized by specific enzymes produced in the liver. This is the process by which ethyl alcohol chemicals leave the body. The liver can only metabolize a certain amount of ethyl alcohol per hour, which means it leaves the bloodstream more slowly than it enters. Because the brain controls everything we think, feel, say and do, ethyl alcohol chemicals “sitting” in the brain until the liver can metabolize them changes the chemical portion of the brain’s electro-chemical signaling process (in other words, how brain cells talk to one another, aka neural networks). This in turn changes neural networks (cell-to-cell communications) responsible for a person’s thoughts, feelings, and behaviors.
A very GENERAL rule of thumb is that it takes about one hour for the liver to metabolize one standard drink. A standard drink is defined as 5 ounces of table wine, 12 ounces of beer or 1.5 ounces of hard liquor. Using this very GENERAL rule of thumb, it will take four hours to metabolize four standard drinks — even if the drinks were consumed back-to-back, and it’s been over an hour.
BUT, no two people will necessarily metabolize alcohol in the same manner. Drink for drink, people who weigh less, for example, will have more alcohol concentration in their system than someone who weighs more. People who have lower amounts of the liver enzymes that metabolize ethyl alcohol chemicals will take longer to metabolize the same amount of alcohol as someone else. Additionally, genetics, whether taking medications, having a mental disorder, and stage of brain development will also have an influence on how one person’s liver metabolizes and/or their brain responds to ethyl alcohol chemicals. [See related post for more on this stage of brain development concept, “Underage Drinking – How Teens Can Become Alcoholics Before Age 21.”]
The key message is the liver can only metabolize a certain amount of alcohol per hour. Until the alcohol is metabolized, a person still has ethyl alcohol chemicals in their bloodstream, which means their brain’s electro-chemical signaling processes are still being changed. Hence a person’s decision-making capabilities are being changed, as well. In this manner, a person who’s had too much to drink may actually “choose” to drink and drive, or to keep drinking because “they feel fine,” or engage in any number of other destructive behaviors because of the convoluted “thinking” caused by ethyl alcohol chemicals’ impacts on electro-chemical signaling processes.
Knowing that it is a person’s exceeding low-risk drinking limits – especially the per day limits – that is causing the drinking behaviors is what can help you avoid a whole lot of endless, pointless talk or angst about nothing you have any control over — namely, the drinking behaviors. When a person drinks more than their brain and body can processes, they affect the very areas of their brain needed to think straight and act responsibly.
By keeping this in mind, you will know that as a person exceeds low-risk drinking limits, there is…
- no point in having a ‘serious’ discussion,
- no point getting into a fight about their drinking behaviors, and
- definitely every reason not to get in the car with them (yes, a woman consuming 3 or a man consuming 4 drinks in a two hour period will likely register a .08 BAC).
For more information on drinking patterns…
check out NIAAA’s website, “Rethinking Drinking.” Another resource to check out is the World Health Organization’s Alcohol Use Disorders Test (AUDIT). To see how a clinician might interpret the test results, check out the WHO AUDIT PDF, pgs. 19-20.