How To Know If You Have A Drinking Problem

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How To Know If You Have A Drinking Problem

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KEY TAKEAWAYS

You know you have a drinking problem if you consume:

More than 5 alcoholic drinks per day or 15 per week as a man
More than 4 drinks per day or 8 per week as a woman [1].

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What Is Considered A Drinking Problem, According To...

DSM V

The diagnostic and statistical manual of mental disorders (DSM V) defines that out of the 11 criteria for alcoholism:

2-3 indicates mild alcohol use disorder
4-5 indicates moderate alcohol use disorder
6 + indicates severe alcohol use disorder

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The 11 criteria for alcohol use disorder are:

Have you drank for longer or consumed more than you intended to?
Have you thought about stopping drinking or cutting down on alcohol but been unable to?
Have you spent a lot of time drinking, or being sick and getting over the aftereffects of drinking?
Have you wanted to drink alcohol so badly that you could not focus on anything else?
Have you found that drinking or the after-effects of drinking have made you unable to complete tasks at work or at home?
Have you continued to drink alcohol even if it has caused arguments with friends or family members?
Have you prioritised drinking alcohol over hobbies and other interests?
Have you engaged in drunk driving, operating machinery, or unsafe sex more than once?
Have you continued to drink alcohol even if it caused depression, anxiety or memory blackouts?
Have you found that you have to drink more to achieve the same effects of alcohol?
Have you experienced withdrawal symptoms after drinking alcohol; including nausea, restlessness, sweating or a rapid heart rate? [2]

Alcoholics Anonymous

Alcoholics Anonymous defines a drinking problem as the physical desire to consume alcohol beyond the capacity to control it; as well as the inability not to give in to cravings for alcohol [3].

NIAAA

The NIAAA defines a drinking problem as consuming:

more than 5 drinks per day or 15 per week as a man,
more than 4 drinks per day or 8 per week as a woman [4].

WHO

WHO states that moderate alcohol consumption is less than:

1.5 litres of wine per week
3.5 litres of beer per week
450ml of spirits per week [5]

Any consumption over these levels is classed as a drinking problem.

CDC

The CDC define alcohol use disorder as:

Consuming more than 14 drinks a week for a man,
Consuming more than 7 drinks a week for a woman, over the last year [6].

How To Tell If Someone Has A Drinking Problem

Drinking Pattern & Intake Level

Drinking patterns and intake levels that indicate potential alcohol addiction include:

Drinking to intoxication - 3 or more days per week
Binge drinking - 3 or more days per week [7]

Physical Symptoms

Physical withdrawal symptoms, such as nausea, vomiting, and shakiness occur in all casual drinking patterns, but symptoms that indicate a drinking problem include:

Delirium tremens
Seizures
Auditory and visual hallucinations

Behavioural & Emotional Symptoms

Secrecy or denial about drinking problem - 67% of alcoholics either completely deny or downplay alcohol abuse [8]
Impulsivity - drinking problems disrupt neurotransmitter levels that induce and magnify impulsive behaviour [9]
Anger - chronic alcoholics are in the 98th percentile for anger [10]
Obsessing over the next drink
Only attending social events where drinking will occur
Being unable to stop drinking before intoxication, illness or memory blackouts occur

Work

A 1-litre increase in alcohol consumption leads to a 13% increase in sickness absences; with absenteeism and poor work performance also being clear indicators of a drinking problem [11].

Financial issues

Credit card debt - acquiring new credit cards
Borrowing money from payday loans or loan sharks
Impulsive spending - gambling, shopping whilst drunk and purchasing unnecessary items

Relationship Issues

Arguments - public arguments, not speaking to partner for long periods of time
Secrecy - hiding drinking behaviours
Shifting the blame - accusing partner of causing drinking

Health Problems

Jaundice - 60% of alcoholic hepatitis sufferers [12]
Ascites - 30% of alcohol-induced cirrhosis sufferers [13]
Sclera discolouration - 38% of alcoholic liver failure sufferers [14]

Trauma/Accidents/Hospitalisation

More than 1 in 10 visits to A&E departments are due to alcohol-related illnesses, including:

Road traffic accidents
Falls or broken bones
Losing driving license due to drink driving [15]

This manifests in the body as more frequent visible bruises or cuts.

The likelihood of a fatal motor vehicle injury increases by 1.74% for every 0.02% increase in blood alcohol concentration [16].

Negative Consequences

30-50% of alcoholics demonstrate:

Denial or downplaying alcohol consumption
Attributing job loss, losing driving license or lack of money to issues other than alcohol use (cognitive distortion) [17]

Coping Mechanism

Alcohol becomes a habitual coping mechanism when used repeatedly as self-medication for stress, anxiety and depression.

Alcohol use becomes a drinking problem when it stops being one of many coping mechanisms used, and becomes the only way to cope.

Avoiding Responsibility

A problem drinker typically avoids responsibility by:

Blaming others for excessive drinking
Claiming to have 'bad luck' instead of accepting responsibility for the consequences of drinking
Blaming past trauma - childhood trauma, divorce or physical injury

Legal Trouble

Shoplifting alcohol or items to exchange for alcohol
Stealing money to pay for alcohol - taking money from parents' wallet or stealing card
Drink driving - points or loss of license
Assault on others whilst intoxicated - leading to prison time

Family/Friends Concerned

Friends and family members notice:

Unstable moods
Poor judgement
Slurred speech
Memory problems
Having to take on financial, household or childcare responsibilities [18]

Isolation

Isolation due to a drinking problem is shown by a combination of:

Drinking alone
Poor self-care
Relief when plans are cancelled
Not engaging in conversation during social events
Eating less food

Although drinking alone can be attributed to being introverted, repeatedly voluntarily isolating indicates alcohol use disorder.

When It Looks Like A Drinking Problem, But Isn't

Drinking Patterns That Are Not Problematic Drinking

Social Drinking

Unlike those with a drinking problem, social drinkers:

Drink for enjoyment rather than seeking to avoid withdrawal symptoms
Know drinking limits and do not exceed them
Do not drink drive

Binge Drinking

Unlike those with a drinking problem, binge drinkers:

Drink socially and for enjoyment
Only exceed limits on less than 5 days per month [19]
Do not drink drive

Header	Non Drinkers	Social Drinking	Binge Drinking	Chronic Alcoholism
Amount Consumed	0 drinks	1/2 drinks per day [20]	4/5 drinks in 2 hours [21]	4/5 drinks per day [22]
Consumption Frequency	Never	Only at social events	At least 1 day per month [23]	5 or more days per month [19]
Alcohol Cravings?	No	No	Yes	Yes
Needing Alcohol To Socialise	No	Yes	No	No
Relationship Problems	No	No	Yes	Yes
Liver Issues	No	No	Yes	Yes
Legal Issues	No	No	Yes	Yes
Unusual Changes In Routine	No	No	No	Yes
Overreacting To Questions About Drinking	No	No	No	Yes
Reduced Exercise Or Healthy Diet	No	No	No	Yes

Conditions Mistaken For A Drinking Problem

Dementia

Dementia may be confused with a drinking problem due to:

Memory loss
Difficulty concentrating
Changes in mood
Anxiety

Conversely, alcoholism includes these factors, where dementia does not:

Withdrawal symptoms - nausea, vomiting and shakiness
Inability to stop drinking - unsuccessful detoxes or tapering off alcohol use

Auto-Brewery Syndrome

Auto-brewery syndrome may be confused with a drinking problem due to:

Slurred speech
Dizziness
Loss of motor function

Unlike auto-brewery syndrome, alcoholism shows a sharp increase in alcohol use, as well as prioritising alcohol above all other responsibilities.

Tourette's Syndrome

Tourette's syndrome may be confused with a drinking problem due to:

Repeating specific words or phrases
Swearing
Jerking the head or limbs
Grimacing

Unlike Tourette's syndrome, alcoholics do not always outwardly show physical signs of drinking, especially if they are actively trying to avoid detection.

Multiple Sclerosis

Multiple sclerosis (MS) may be confused with a drinking problem due to:

Difficulty pronouncing words - MS affects how the tongue and lips move
Difficulty controlling volume - MS causes a weakened diaphragm
Not remembering words
Not understanding what is being said
Muscle spasms

Alcoholics experience full body or hand tremors, rather than muscle spasms seen in MS sufferers.

Self-Tests To Evaluate If You Have A Drinking Problem

CAGE Questionnaire

The CAGE questionnaire asks about:

Criticism from others about drinking habits
Guilt caused by drinking
Drinking in the morning as the cure for a hangover

Answering yes to two or more, out of four questions indicates a 91% sensitivity to alcoholism [24].

AUDIT Questionnaire

The AUDIT questionnaire asks about:

Injuries to the person and others as a result of alcohol use
Whether others are concerned about drinking levels
Feelings of guilt and remorse after drinking

The questionnaire asks 10 questions and defines the scores as:

0-7 meaning low risk of alcoholism
8-5 meaning increasing risk of alcoholism
16-19 meaning higher risk of alcoholism
20 or more meaning possible alcohol dependence [25].

Alcohol Screening Test (AST)

An aspartate aminotransferase screening test [AST] level of 4 times above the normal range [8-33 U/L], indicates liver disease or chronic hepatitis as a result of alcohol abuse [26] [27].

Severity Of Alcohol Dependence Questionnaire

The severity of alcohol dependence questionnaire asks about:

Experiencing sweating, hand or whole body shaking
Avoiding meeting people first thing in the morning

The questionnaire asks the alcoholic to quantify alcohol use as either a quarter, half or full bottle of spirits per day [28].

MAST - Michigan Alcohol Screening Test

The MAST has questions asking:

Whether alcohol has caused hallucinations, shakiness or delirium tremens
Whether drinking has caused problems with friends and family members, colleagues or the police
If others have commented on alcohol use

The MAST has 22 questions with yes or no answers, with scores over 6 indicating problem drinking [29].

Am I An Alcoholic Checklist

Abbeycare's Am I an Alcoholic checklist asks about:

Experiencing withdrawal symptoms
Whether social life is motivated by drinking
Missing obligations due to alcohol use

The checklist has 10 questions, with mostly A's indicating problem drinking, mostly B's indicating some alcohol abuse and mostly C's indicating controlled drinking [30].

(Hear how comedian Darren Connell realised he had a drinking problem in our first episode of Listen Up!)

References

[1] National Institute on Alcohol Abuse and Alcoholism. “Understanding Alcohol Drinking Patterns | National Institute on Alcohol Abuse and Alcoholism (NIAAA).” NIH Gov, 2024. “For men, consuming five or more drinks on any day or 15 or more per week; For women, consuming four or more on any day or eight or more drinks per week.”
[2] National Institute on Alcohol Abuse and Alcoholism. “Alcohol Use Disorder: A Comparison between DSM–IV and DSM–5 | National Institute on Alcohol Abuse and Alcoholism (NIAAA).” NIH Gov, 2021. “The presence of at least 2 of these symptoms indicates Alcohol Use Disorder (AUD). The severity of the AUD is defined as: [table].”
[3] Alcoholics Anonymous Org UK. “The Big Question.” Alcoholics Anonymous, 7 June 2024. Accessed 6 Mar. 2025. “If you are unsure whether you need AA, try answering the questions below. See how you do. Remember, it takes courage to face up to the fact that you have a problem. Answer YES or NO to the following questions.”
[4] National Institute on Alcohol Abuse and Alcoholism. “Understanding Alcohol Drinking Patterns | National Institute on Alcohol Abuse and Alcoholism (NIAAA).” NIH Gov, 2024. “NIAAA defines heavy drinking as follows: For men, consuming five or more drinks on any day or 15 or more per week. For women, consuming four or more on any day or eight or more drinks per week.”
[5] World Health Organization. “No Level of Alcohol Consumption Is Safe for Our Health.” World Health Organisation, 4 Jan. 2023. ““Moderate” alcohol consumption – less than 1.5 litres of wine or less than 3.5 litres of beer or less than 450 millilitres of spirits per week.”
[6] CDC. “NHIS - Adult Alcohol Use - Glossary.” CDC Gov, 10 May 2019. "Current heavier drinker – More than 7 drinks per week for women; more than 14 drinks per week for men, on average over the past year."
[7] Wetterling, T. “DRINKING PATTERN and ALCOHOL-RELATED MEDICAL DISORDERS.” Alcohol and Alcoholism, vol. 34, no. 3, 1 May 1999, pp. 330–336. “Frequent heavy drinkers showed a trend to more alcohol-related medical disorders than alcoholics with a different drinking pattern, although they were younger and their estimated life-time alcohol intake was comparable to that of continuous drinkers. Thus, the drinking pattern, particularly frequent inebriation, has an influence on the occurrence of alcohol-related disorders.”
[8] Schuckit, Marc A., et al. “Characteristics Associated with Denial of Problem Drinking among Two Generations of Individuals with Alcohol Use Disorders.” Drug and Alcohol Dependence, vol. 217, no. 1, Dec. 2020, p. 108274. “Table 1.”
[9] Dick, Danielle M., et al. “Understanding the Construct of Impulsivity and Its Relationship to Alcohol Use Disorders.” Addiction Biology, vol. 15, no. 2, Apr. 2010, pp. 217–226. “Thus, not only can alcohol act acutely to induce or magnify impulsive behavior, but it can also act chronically to increase the likelihood of impulsivity via the adaptive burden of what is termed allostasis.”
[10] Walitzer, Kimberly S., et al. “Alcohol-Adapted Anger Management Treatment: A Randomized Controlled Trial of an Innovative Therapy for Alcohol Dependence.” Journal of Substance Abuse Treatment, vol. 59, Dec. 2015, pp. 83–93. “Anger was associated with heavier drinking, and this group began at the 98th percentile on trait anger.”
[11] Norström, Thor. “Per Capita Alcohol Consumption and Sickness Absence.” Addiction, vol. 101, no. 10, Oct. 2006, pp. 1421–1427. Accessed 21 Mar. 2019. “13% increase in sickness absence.”
[12] Basra, Gurjot. “Symptoms and Signs of Acute Alcoholic Hepatitis.” World Journal of Hepatology, vol. 3, no. 5, 2011, p. 118. “[Table 1] Jaundice 60.”
[13] Marsano, Luis S, et al. “Diagnosis and Treatment of Alcoholic Liver Disease and Its Complications.” Alcohol Research & Health, vol. 27, no. 3, 2024, p. 247. “It is estimated that 3 of every 10 patients who have cirrhosis without complications will develop ascites within the next 5 years.”
[14] Konstantin Kazankov, et al. “A Novel Smartphone Scleral‐Image Based Tool for Assessing Jaundice in Decompensated Cirrhosis Patients.” Journal of Gastroenterology and Hepatology, vol. 38, no. 2, 4 Jan. 2023, pp. 330–336. “[Table 2] rho = 0.38, P < 0.001.”
[15] NHS. “Risks - Alcohol Misuse.” NHS, 4 Oct. 2022. “Accidents and injury – more than 1 in 10 visits to accident and emergency (A&E) departments are because of alcohol-related illnesses.”
[16] Taylor, Benjamin, and Jürgen Rehm. “The Relationship between Alcohol Consumption and Fatal Motor Vehicle Injury: High Risk at Low Alcohol Levels.” Alcoholism: Clinical and Experimental Research, vol. 36, no. 10, 7 May 2012, pp. 1827–1834. “Which estimated that the odds of fatal motor vehicle injury increased by 1.74 (95% CI: 1.43 – 2.14) for every 0.02 % increase in BAC.”
[17] Schuckit, Marc A., et al. “Characteristics Associated with Denial of Problem Drinking among Two Generations of Individuals with Alcohol Use Disorders.” Drug and Alcohol Dependence, vol. 217, no. 1, Dec. 2020, p. 108274. “About 30% to >50% of individuals with AUDs or other SUDs evidence denial.”
[18] NI Direct. “When Alcohol Affects Family Life | Nidirect.” NI Direct, 13 Oct. 2017. “The drinker is usually torn between wanting alcohol and not wanting the harm that always seems to follow. They often blame others when they drink too much. The spouse or partner is often fearful and feels hurt, shame and a sense of failure. Many spouses try to hide the drinker’s problem-drinking by taking on extra responsibilities.”
[19] National Institute on Alcohol Abuse and Alcoholism. “Understanding Alcohol Drinking Patterns | National Institute on Alcohol Abuse and Alcoholism (NIAAA).” NIH Gov, 2024. “SAMHSA defines heavy alcohol use as binge drinking on five or more days in the past month.”
[20] National Institute on Alcohol Abuse and Alcoholism. “Understanding Alcohol Drinking Patterns | National Institute on Alcohol Abuse and Alcoholism (NIAAA).” NIH Gov, 2024. “According to the Dietary Guidelines for Americans 2020-2025, adults of legal drinking age can choose not to drink or to limit their intake to two drinks or less in a day for men and one drink or less in a day for women, when alcohol is consumed.”
[21] National Institute on Alcohol Abuse and Alcoholism. “Understanding Alcohol Drinking Patterns | National Institute on Alcohol Abuse and Alcoholism (NIAAA).” NIH Gov, 2024. “For a typical adult, this pattern corresponds to consuming five or more drinks (male), or four or more drinks (female), in about two hours.”
[22] National Institute on Alcohol Abuse and Alcoholism. “Understanding Alcohol Drinking Patterns | National Institute on Alcohol Abuse and Alcoholism (NIAAA).” NIH Gov, 2024. “NIAAA defines heavy drinking as follows: For men, consuming five or more drinks on any day or 15 or more per week; For women, consuming four or more on any day or eight or more drinks per week. SAMHSA defines heavy alcohol use as binge drinking on five or more days in the past month.”
[23] National Institute on Alcohol Abuse and Alcoholism. “Understanding Alcohol Drinking Patterns | National Institute on Alcohol Abuse and Alcoholism (NIAAA).” NIH Gov, 2024. “On at least one day in the past month.”
[24] Ewing, John. “CAGE Questions for Alcohol Use.” MDCalc. “CAGE Questions for Alcohol Use.”
[25] UK Gov. "Alcohol use disorders identification test (AUDIT)." UK Gov Assets Publishing Service. "AUDIT is a comprehensive 10 question alcohol harm screening tool. It was developed by the World Health Organisation (WHO) and modified for use in the UK and has been used in a variety of health and social care settings."
[26] UCSF Health Org. “Aspartate Aminotransferase (AST) Blood Test.” UCSF Health Org, University of California San Francisco Health. “The normal range is 8 to 33 U/L.”
[27] Lab Tests Online UK. “Aspartate Aminotransferase (AST) Test.” Lab Tests Online Org UK. “Moderately high levels, often less than 4 times the upper limit of normal (ULN) are seen in the slowly developing variety of liver disease, chronic hepatitis, as well as alcohol abuse, cholestasis and heart, kidney or skeletal muscle damage.”
[28] SMART! Innovations In Drug Services. "SEVERITY OF ALCOHOL DEPENDENCE QUESTIONAIRE (SADQ-C)." July 2015. "I drank more than a quarter of a bottle of spirits in a day (OR 1 bottle of wine OR 7 beers)."
[29] Orgeon Gov. "Michigan Alcohol Screening Test (MAST)."
[30] Laura Morris, Abbeycare. “Am I an Alcoholic Checklist - Abbeycare Clinics.” Abbeycare, 2019. Accessed 6 Mar. 2025. “Question #1. Have you had times when you drank more alcohol or drank for a longer period than you planned?”

About the author

Harriet Garfoot

Harriet Garfoot BA, MA has an Undergraduate degree in Education Studies and English, and a Master's degree in English Literature, from Bishop Grosseteste University. Harriet writes on stress & mental health, and is a member of the Burney Society. Content reviewed by Laura Morris (Clinical Lead).

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Last Updated: April 2, 2025