Alcohol and Other Substance Use

Home Healthcare Alcohol and Other Substance Use

Alcohol Use and Your Health

Drinking too much can harm your health. Excessive alcohol use led to more than 140,000 deaths and 3.6 million years of potential life lost (YPLL) each year in the United States from 2015 – 2019, shortening the lives of those who died by an average of 26 years.1 Further, excessive drinking was responsible for 1 in 10 deaths among working-age adults aged 20-64 years.2 The economic costs of excessive alcohol consumption in 2010 were estimated at $249 billion, or $2.05 a drink.3

What is a standard drink?

US standard drink= 12oz beer (5% ABV), 8 oz malt liquor (7% ABV),5oz wine (12% ABV),1.5oz 80-proof (40% ABV) distilled spirit

In the United States, a standard drink contains 0.6 ounces (14.0 grams or 1.2 tablespoons) of pure alcohol. Generally, this amount of pure alcohol is found in

  • 12-ounces of beer (5% alcohol content).
  • 8-ounces of malt liquor (7% alcohol content).
  • 5-ounces of wine (12% alcohol content).
  • 1.5-ounces of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey).4

What is excessive drinking?

Excessive drinking includes binge drinking, heavy drinking, and any drinking by pregnant women or people younger than age 21.

  • Binge drinking, the most common form of excessive drinking, is defined as consuming
    • For women, 4 or more drinks during a single occasion.
    • For men, 5 or more drinks during a single occasion.
  • Heavy drinking is defined as consuming
    • For women, 8 or more drinks per week.
    • For men, 15 or more drinks per week.

Most people who drink excessively are not alcoholics or alcohol dependent.5

What is moderate drinking?

Drinking in Moderation: 1 drink or less in a day for women; 2 drinks or less in a day for men; or nondrinking

The Dietary Guidelines for Americans recommends that adults of legal drinking age can choose not to drink, or to drink in moderation by limiting intake to 2 drinks or less in a day for men or 1 drink or less in a day for women, on days when alcohol is consumed.4 The Guidelines also do not recommend that individuals who do not drink alcohol start drinking for any reason and that if adults of legal drinking age choose to drink alcoholic beverages, drinking less is better for health than drinking more.4

There are some people who should not drink any alcohol, including those who are:

  • Younger than age 21.
  • Pregnant or may be pregnant.
  • Driving, planning to drive, or participating in other activities requiring skill, coordination, and alertness.
  • Taking certain prescription or over-the-counter medications that can interact with alcohol.
  • Suffering from certain medical conditions.
  • Recovering from alcoholism or are unable to control the amount they drink.4

By adhering to the Dietary Guidelines, you can reduce the risk of harm to yourself or others.

Short-Term Health Risks

Excessive alcohol use has immediate effects that increase the risk of many harmful health conditions. These are most often the result of binge drinking and include the following:

  • Injuries, such as motor vehicle crashes, falls, drownings, and burns.6,7
  • Violence, including homicide, suicide, sexual assault, and intimate partner violence.6-10
  • Alcohol poisoning, a medical emergency that results from high blood alcohol levels.11
  • Risky sexual behaviors, including unprotected sex or sex with multiple partners. These behaviors can result in unintended pregnancy or sexually transmitted diseases, including HIV.12,13
  • Miscarriage and stillbirth or fetal alcohol spectrum disorders (FASDs) among pregnant women.6,12,14,15

Long-Term Health Risks

Over time, excessive alcohol use can lead to the development of chronic diseases and other serious problems including:

  • High blood pressure, heart disease, stroke, liver disease, and digestive problems.6,16
  • Cancer of the breast, mouth, throat, esophagus, voice box, liver, colon, and rectum.6,17
  • Weakening of the immune system, increasing the chances of getting sick.6,16
  • Learning and memory problems, including dementia and poor school performance.6,18
  • Mental health problems, including depression and anxiety.6,19
  • Social problems, including family problems, job-related problems, and unemployment.6,20,21
  • Alcohol use disorders, or alcohol dependence.5

By not drinking too much, you can reduce the risk of these short- and long-term health risks.

Alcohol and Other Substance Use 

Drinking alcohol while using opioids increases the risk of overdose and death

Polysubstance use is when two or more substances are used together or within a short time period, either intentionally or unintentionally. Polysubstance use involving alcohol includes drinking and using other substances such as marijuana, opioids, heroin or other illicit drugs, or medications not as prescribed. Whether intentional or not, using alcohol and other substances is unsafe because the effects may be stronger and more unpredictable than one drug alone, and even deadly. 

Polysubstance use involving alcohol can increase the chance of health risks including:  

  • Overdose. 
  • Injury. 
  • Violence. 
  • Risky sexual behavior. 
  • Chronic disease. 
  • Alcohol or other substance use disorders. 

Alcohol can increase overdose risk. 

Using alcohol and certain other substances, including other depressants like opioids or benzodiazepines, together or within a couple of hours of drinking can result in: 

  • Difficulty or stopping breathing. 
  • Damage to the brain, heart, and other organs. 
  • Death. 

Drinking alcohol with medications can also cause health problems or death. Always check with your healthcare provider before drinking while taking prescription medicine. 

How common are overdoses involving alcohol in the United States? 

  • About 1 in 5 emergency department visits associated with the misuse of prescription medicines also involved alcohol in 2016. 
  • About 1 in 7 opioid-related deaths involved drinking alcohol within a few hours of using an opioid in 2017. The proportion of opioid overdose deaths involving alcohol varied by state, ranging from 7% to 29%. 
  • Opioid overdose deaths where alcohol contributed to the death increased 41% from 2019 to 2020. 

What factors are associated with higher rates of polysubstance use involving alcohol? 

1 in 4 people who binge drink also report other substance use in the past month.

  • Being male, younger in age, non-Hispanic Black, or having a lower household income. 
  • Individual-level binge drinking. People who binge drink are four times more likely to use other substances than people who do not drink. 
  • Frequent binge drinking. Other substance uses increases as the frequency of binge drinking increases. 
  • State-level binge drinking. States with higher binge drinking rates also have higher rates of opioid overdose deaths involving alcohol. 
Harms involving the use of alcohol and other substances can be prevented. 

You can: 

  • Avoid using alcohol when using other substances. 
  • Choose not to drink or limit alcohol use. If you are an adult of legal drinking age and choose to drink alcohol, adhere to the Dietary Guidelines for Americans on moderate alcohol use (Up to one drink in a day for women and up to 2 drinks in a day for men). 
  • Talk with your healthcare provider about your drinking and discuss the medications that you are taking to prevent adverse reactions with prescribed medicines. 
  • Take a quick assessment to check your drinking. 
  • Support effective community strategies to prevent excessive alcohol use, such as increasing alcohol taxes, regulating the number of places that sell alcohol in your community, or others recommended by the Community Preventive Services Task Force. 

States and communities can: 

  • Use comprehensive and effective approaches to reduce the availability and affordability of alcohol such as by regulating the density of alcohol outlets through zoning and licensing, increasing alcohol taxes, or other strategies recommended by the Community Preventive Services Task Force. These strategies can be used with other strategies to reduce overdoses, such as strengthening prescription drug monitoring programs. 
  • Enforce existing laws and regulations about alcohol sales and service. 
  • Develop and strengthen community coalitions that build partnerships between schools, faith-based organizations, law enforcement, healthcare providers, public health agencies, and local, tribal, and state leaders to reduce alcohol and other substance use and its impacts. 
  • Routinely monitor and report the prevalence, frequency, and intensity of binge drinking (whether people binge drink, how often they do so, and the number of drinks they consume) and other substance use. 
  • Routinely assess alcohol in toxicology testing in acute care settings and among decedents. 

Alcohol Use During Pregnancy

Pregnant woman refusing wine

There is no known safe amount of alcohol use during pregnancy or while trying to get pregnant. There is also no safe time for alcohol use during pregnancy. All types of alcohol are equally harmful, including all wines and beer.

FASDs are preventable if a baby is not exposed to alcohol before birth.

Why Alcohol is Dangerous

Alcohol in the mother’s blood passes to the baby through the umbilical cord. Alcohol use during pregnancy can cause miscarriage, stillbirth, and a range of lifelong physical, behavioral, and intellectual disabilities. These disabilities are known as fetal alcohol spectrum disorders (FASDs). Children with FASDs might have the following characteristics and behaviors:

Polysubstance Use in Pregnancy
Use of multiple substances in pregnancy is common

Pensive woman sitting indoors lost on thoughts side view face
Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum)
  • Small head size
  • Shorter-than-average height
  • Low body weight
  • Poor coordination
  • Hyperactive behavior
  • Difficulty with attention
  • Poor memory
  • Difficulty in school (especially with math)
  • Learning disabilities
  • Speech and language delays
  • Intellectual disability or low IQ
  • Poor reasoning and judgment skills
  • Sleep and sucking problems as a baby
  • Vision or hearing problems
  • Problems with the heart, kidney, or bones

Learn more about FASDs »

How Much Alcohol is Dangerous

There is no known safe amount of alcohol use during pregnancy.

When Alcohol is Dangerous

There is no safe time for alcohol use during pregnancy. Alcohol can cause problems for the baby throughout pregnancy, including before a woman knows she is pregnant. Alcohol use in the first three months of pregnancy can cause the baby to have abnormal facial features. Growth and central nervous system problems (e.g., low birthweight, behavioral problems) can occur from alcohol use anytime during pregnancy. The baby’s brain is developing throughout pregnancy and can be affected by exposure to alcohol at any time.

It is never too late to stop alcohol use during pregnancy. Stopping alcohol use will improve the baby’s health and well-being.

Excessive Alcohol Use is a Risk to Men’s Health

Men are more likely than women to drink excessively. Excessive drinking is associated with significant risks to men’s health and safety, and the risks increase with the amount of alcohol consumed. Men are also more likely than women to take other risks (such as misusing other substances, having multiple sex partners, or not wearing a seat belt), that when combined with alcohol, further increase their risk of illness, injury or death.

father with arm around son

Adult Men Drink More than Women

  • Almost 59% of adult men report drinking alcohol in the past 30 days compared with 47% of adult women.
  • Men are almost two times more likely to binge drink than women. Approximately 22% of men report binge drinking and on average do so 5 times a month, consuming 8 drinks per binge.
  • In 2019, 7% of men had an alcohol use disorder compared with 4% of women.

Alcohol is Associated with Injury, Violence, and Other Harms

  • Men have higher rates of alcohol-related hospitalizations than women.
  • More than three-quarters of deaths from excessive drinking are among males, totaling more than 97,000 deaths each year in the U.S.
  • Among drivers in fatal motor vehicle traffic crashes, men are 50% more likely to have been intoxicated (i.e., a blood alcohol concentration of 0.08% or greater) compared with women.
  • Excessive alcohol consumption increases aggression and may increase the risk of physically assaulting another person. Alcohol is a key risk factor for sexual violence perpetration.
  • Males are more than three times as likely to die by suicide than females, and more likely to have been drinking prior to suicide.
  • Alcohol use is one of the most important preventable risk factors for cancer. Alcohol use increases the risk of cancer of the mouth, throat, esophagus, liver, and colon, which are more common among men. Drinking alcohol also increases the risk of prostate cancer.

Alcohol May Affect Men’s Sexual and Reproductive Health

  • Excessive alcohol use can interfere with testicular function and male hormone production resulting in erectile dysfunction and infertility.
  • Alcohol use by men also increases the chances of engaging in risky sexual activity including unprotected sex, sex with multiple partners, or sex with a partner at risk for sexually transmitted infections.

Men can reduce the amount of alcohol they drink to reduce their risk of health problems and other harms.

The Alcohol Use and Your Health Fact Sheet addresses a number of additional health conditions associated with excessive alcohol use that affect both men and women.

Disclosure: Most of this information was obtained from the  website and brought to you by 

Dr. Yvette Fletcher-Prince, MD, DNP, APRN