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A beer or a glass of wine is a common way many Americans choose to wind down at the end of a day. How much is too much? How do you know when you've crossed the line to alcohol use disorder (AUD)?

Drinking “in moderation” means having no more than one drink a day if you're a woman, and no more than two if you're a man. One drink equals:

• 1.5 ounces of liquor (like whisky, rum, or tequila)
• 5 ounces of wine
• 12 ounces of beer

Another way to look at your drinking habits is to think about how much you have during an average week. For women, "heavy" or "at risk" drinking means more than seven drinks per week, or more than three in any day. For men, it's more than 14 drinks in a week, or more than four in a day.

Alcohol Use Disorder
Risky drinking may be a sign of a medical condition called alcohol use disorder. It's a chronic disease that affects your brain. An estimated 16 million people -- adults and adolescents -- in the U.S. have it. Sometimes genes passed down to you from your parents can put you at risk. Your environment or psychological makeup also play a role.

There are many signs that someone may have AUD. Some of the signals include:

• An uncontrollable urge to drink
• Lack of control over how much you drink
• Negative thoughts when you're not drinking alcohol
• Drinking in risky situations
• Drinking that interferes with fulfilling obligations
• Continuing to drink even though it causes problems or makes them worsen
• Stopping or doing less of important activities because of alcohol

There are mild, moderate, and severe forms of AUD, which depend on how many symptoms you have. You're more likely to have AUD if one or more of the following is true:

• You can't relax or fall asleep without drinking.
• You need a drink in the morning to get going.
• To be social, you have to drink.
• Alcohol serves as your escape from feelings.
• After drinking, you drive.
• You mix alcohol and medications.
• You drink when you're pregnant or caring for small children.
• When loved ones ask how much you drink, you don't tell the truth.
• You hurt people or become angry when you drink.
• It's tough for you to remember what you did when you were drinking.
• Your responsibilities suffer because of your drinking.
• Drinking has caused you legal problems.
• You tried to stop drinking but failed.
• You can't stop thinking about drinking.
• To feel the effects of alcohol, you have to drink more and more.
• You have withdrawal symptoms after you stop drinking for too long, like shakiness, nausea, trouble sleeping, or seizures.

The more of these that describe you, the more severe your AUD is likely to be.

Effects of AUD
Even if your case is mild, it can have a serious impact on your physical and mental health. Often, AUD causes other problems that you try to avoid by drinking. That creates a negative cycle.

In the short term, AUD can cause:

• Memory loss
• Hangovers
• Blackouts

Long-term effects include:

• Stomach problems
• Heart problems
• Cancer
• Brain damage
• Permanent memory loss
• Pancreatitis
• High blood pressure
• Cirrhosis, or scarring on your liver

You're also more likely to take dangerous risks. That raises your chances of being injured or dying from:

• Car accidents
• Homicide
• Suicide
• Drowning

AUD affects those around you, too. Your drinking may damage relationships with loved ones because of anger problems, violence, neglect, and abuse. Women who are pregnant risk having a miscarriage. Their baby is more likely to have fetal alcohol syndrome and a higher chance of dying from SIDS (Sudden Infant Death Syndrome).

Are you wondering whether your drinking is on the high side of normal or if it's crossed the line into a problem? Think back on the past year. If any of the following scenarios seem familar, it might be time to make some changes.

You Drink More Than Planned
You've had times when you ended up drinking more than you thought you would, or for longer than you were going to. It may not seem like a big deal if it only happens once in a while, but that shows you have trouble controlling yourself while drinking. And it's an early warning sign.

You Spend a Lot of Time on Drinking
We're not talking about just the time with a glass (or can, or bottle) in your hand. There's also getting the alcohol, feeling sick after you drink, and recovering from the effects later. Keep track of all your activities in a daily diary or schedule planner for a few weeks, and take an honest look at how it adds up.

Your Tolerance Has Gone Up
"The usual" doesn't have as much of an effect on you anymore. You need to drink much more than before to get the buzz you want. Your brain adapts to alcohol over time and can become less sensitive to its effects.

You Crave Alcohol
There are times when you want a drink so badly, you can't think about anything else until you get one. That strong need or urge can be triggered by people, places, things, or times of day that remind you of drinking. Certain emotions or physical sensations can also trigger a craving. When you have a drinking problem, your brain reacts to these triggers differently than a social drinker's does.

You Give Up Other Activities
What is it that you do for fun, besides drink alcohol? Think about the activities you used to enjoy, the issues that were important to you, and the ways you used to spend your free time. Has drinking edged those things out of your life, or prevented you from doing them?

You're Dropping the Ball on Life
Can you think of more than a few times when you came to work with a hangover, missed deadlines, or got behind on schoolwork because of your drinking? When your alcohol use, including being sick from drinking, often prevents you from keeping up with responsibilities at home, work, or school, it's a problem.

It Causes Friction in Relationships

You care about your loved ones, but you can't imagine your life without alcohol. Your drinking has led to trouble with your family or friends, or made problems worse, yet you continue to drink. This doesn't make you a bad person, but it does make it more urgent that you look for help to change your habits and get your relationships back on track.

You Have Withdrawal
As the effects of alcohol wear off, you may have trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating. Alcohol changes your brain chemistry, and when you drink heavily over a long period of time, your brain tries to adapt. If you suddenly stop drinking, your brain has to adjust again, causing these withdrawal symptoms.

You Could've Been Hurt
While you're drunk, your brain doesn't grasp the short-term and big-picture results that could come from poor decisions and getting into risky situations like driving, swimming, fighting, having unsafe sex, or walking in a dangerous area. Even if nothing bad has happened -- yet -- this is a warning sign.

Drinking Is Making You Sick
Do you continue to drink even though you know it's causing health problems, or making those problems worse? Alcohol can damage your liver, heart, brain, pancreas, and immune system. And it can raise your odds of getting certain cancers. Although you realize it's harming you, a physical or emotional dependence on alcohol can make quitting hard.

You've Gotten Into Legal Trouble
If you've been arrested or had other run-ins with the law more than once because of your alcohol use, it's getting serious. You might be dealing with the fallout from this for years. But it's not too late to do something about it.

You Want to Stop but Can't
Maybe you've been concerned enough that you've already thought about or actually tried to cut down on your drinking -- and it didn't happen. Alcohol masks unhappy emotions, so those feelings may come back when you quit drinking, making it harder to stick to your goal. If you try to abstain, but then obsess over alcohol or switch to another drug or behavior, that's a red flag.

What to Do
Any of these things could signal an alcohol problem. Don't feel bad, but do consider cutting back on drinking -- or quitting altogether. Talk to your doctor, a therapist, or a counselor. The more things you said "yes" to, the more important it is that you take action or seek help from a health professional.

When you have alcohol use disorder (AUD), you might lose control over when and how much you drink, feel bad when you aren’t drinking, or keep using alcohol even when it starts to cause problems in your life.

People who drink heavily or binge drink regularly are more likely to have alcohol use disorder. Heavy drinking is more than four drinks in a day or more than 14 in a week for men. Women are considered heavy drinkers when they have more than three drinks in a day or more than seven in a week.

But there’s no specific number of drinks per day that mean you have the condition. The diagnosis depends on how alcohol affects your life.

Your answers to some questions about your alcohol use can help you decide if you have a problem.

Screening Test for Alcohol Use Disorder

In the past year, have you:

• Had times when you drank more or for longer than you meant to?
• Tried (or wanted to try) multiple times to cut back or stop drinking, but you couldn’t?
• Spent a lot of time drinking or getting over the effects of alcohol?
• Felt a strong need, urge, or craving to drink?
• Found that drinking or its effects kept you from doing work, going to school, or taking care of your family?
• Continued to drink even when it caused tension with family and friends?
• Skipped out on or decreased activities you enjoy so you could drink?
• More than once found yourself doing risky things during or after drinking, like driving or having unsafe sex?
• Kept drinking even though it made you blackout, feel sad or anxious, or made another health problem worse?
• Had to drink more than you once did to get the same effects?
• Felt withdrawal symptoms from alcohol, like insomnia, shakiness, nausea, or a racing heart?

If you answered yes to any of these, you may have alcohol use disorder.

See a Health Care Professional
They can do a formal assessment to see if you have alcohol use disorder.

They'll ask you questions about your drinking habits, like how much you drink, how often, whether it’s affected your relationships or work, and if you’ve ever done risky things after you’ve had alcohol. They may have you fill out a questionnaire about your drinking habits. Questions about your symptoms, thoughts, feelings, and behaviors help check on your mental health.

The health care professional may ask if they can speak with your family members or friends, too. (They won’t give out any information about you without your consent.)

A physical exam can show signs that alcohol is affecting your health, such as a mild tremor, an enlarged, tender liver, changing blood pressure, or a fast heartbeat.

No specific lab tests diagnose alcohol use disorder. But your doctor can test your blood to check how well your liver works, since heavy drinking can affect it.

Get Help
If you’re diagnosed with AUD, treatment can range from individual or group counseling, to medications, to an outpatient alcohol program, to an inpatient stay. No matter how severe the problem may seem, treatment can make a difference.

Don't wait. It’s best to find help as early as possible.

When you’re concerned that someone you love drinks too heavily, it can be hard to know what to do. You may not know what to say or how they'll react if you bring it up.

Regardless of why you're hesitating, when at least one of these things are true, you're not wrong for wanting to talk about it:

• You worry about how much or how often your loved one drinks.
• You make excuses for how they act when they drink.
• You’ve been hurt or embarrassed by your loved one when they were drinking.
• The amount of money they spend on alcohol concerns you.
• You bail your loved one out when their drinking keeps them from responsibilities.
• Their behavior when they drink makes you nervous.
• You’ve called or thought about calling the police because of your loved one’s drinking.

You can’t fix the problem or change their behavior. But you can present your concerns in such a way that they might see things more clearly and get the help they need.

What Helps
Study up. Find out as much as you can about the effects of alcohol and the signs of alcohol misuse so you have facts on hand.

Time your talk right. A conversation when they’ve been drinking or are stressed is likely to trigger a lot of emotions that could get out of hand. Choose a time when you’re both well-rested and clearheaded.

Focus on results. Explain how their drinking could be affecting their health and how it will continue to cause harm. Express your concern for their well-being as someone who cares for them.

Remember that it will take them time to change.

Expect pushback. They may be defensive and deny the problem. Try not to take it personally. Think of it as planting a seed that will blossom into new, healthy habits.

Prepare a plan. Have some concrete next steps for them to choose from, in case they're ready to get help. Look for local Alcoholics Anonymous meetings, find counselors that fit their insurance plan, and research treatment facilities. Offer to give them a ride if they need one.

Seek support. Confronting someone about their heavy drinking can be hard on you, too. Talk to a trusted friend, counselor, or spiritual leader about what you’re going through.

You can also find groups of folks who are in the same situation as you are. Organizations like Al-Anon, Nar-Anon, and Alateen have networks all over the country and online to support those dealing with a loved one’s heavy drinking.

Stay connected. Continue to do things you enjoy together. Encourage their hobbies and healthy friendships.

Be ready to stay the course and support them as they work on themselves and seek treatment.

What Doesn't
Don’t lecture, shame, or threaten. If you blame them or come on strong, it can backfire. You may have better luck with a more caring approach.

Try not to judge or use emotion to steer the conversation. Remember that you aren’t their therapist or counselor. It’s not your job to diagnose or treat them.

Stop covering their tracks. It can be hard to step aside when you see someone doing self-destructive things. But when you make excuses or cover their dropped responsibilities, it keeps them from seeing the consequences of their actions. Of course, if they or others are in serious, immediate danger, call 911.

Don’t let it consume you. You may care deeply and want very much to help, but be sure you’re taking a step back from time to time. Don't let negative feelings get to you. Their drinking isn't your fault.

Taking care of your emotional and mental health can help you better help them.

The Surrey Hypnotherapy Clinic TM

For professional, caring and confidential help, adviice, therapy or treatment for, or about, any of the above issues or topics, or similar, just contact Peter, preferably by e-mail, to arrange an appointment for your free initial consultation.

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If you would like to find out more about how Surrey Hypnotherapist Peter Back might be able to help you, or if you are simply looking for the best help, advice, therapy or treatment for GAD Anxiety, from a highly qualified and experienced Psychoanalyst, Psychotherapist, Hypnotherapist or Hypnotist, just contact Peter by e-mail, at the Surrey Hypnotherapy Clinic, Woking, to arrange an appointment to learn more about Hypnosis and Peter's own unique form of specialist, evidence based, Hypnotherapy and Psychotherapy.

Acknowledgements

https://www.webmd.com/mental-health/addiction/alcohol-use-disorder-18/slideshow-signs-alcohol-problem?ecd=wnl_spr_051419&ctr=wnl-spr-051419_nsl-LeadModule_cta&mb=szBqbSo37LsIj7dh4siksBXFE73IOX1clc2LqLaF0NE%3d

https://en.wikipedia.org/wiki/Alcoholism

https://www.nhs.uk/conditions/alcohol-misuse/

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