Drinking Too Much: How to Recognize the Signs and Make Changes

Drinking too much isn't always obvious. Understanding what "too much" actually means helps you evaluate your own drinking patterns honestly.

What You'll Discover:

• What "drinking too much" actually means in measurable terms.

• How to recognize the signs in your own behavior.

• Health risks associated with excessive drinking.

• Why people who drink too much often don't realize it.

• Options for reducing your alcohol consumption.

• How medication can help you drink less.

According to the Centers for Disease Control and Prevention, excessive alcohol use is responsible for more than 140,000 deaths in the United States each year. Yet many people who drink too much don't recognize it because their drinking doesn't match the stereotype of "alcoholism." Understanding what excessive drinking actually looks like helps you assess your own patterns.

What Does "Drinking Too Much" Actually Mean?

The first thing to know is that "too much" has specific definitions that may surprise you.

Heavy drinking is defined by the CDC as:

• Women: 8 or more drinks per week

• Men: 15 or more drinks per week

Binge drinking is defined as:

• Women: 4 or more drinks within about 2 hours

• Men: 5 or more drinks within about 2 hours

A standard drink contains:

• 12 ounces of regular beer (5% alcohol)

• 5 ounces of wine (12% alcohol)

• 1.5 ounces of distilled spirits (40% alcohol)

Something to consider is that many poured drinks exceed these standard amounts. A large glass of wine might be 8 or 9 ounces, which is nearly two standard drinks. A strong cocktail can contain two or three standard drinks. When people count "glasses" rather than standard drinks, they often underestimate their actual consumption.

So, how common is drinking too much? The short answer is more common than most people think. According to the National Institute on Alcohol Abuse and Alcoholism, approximately 29 million adults in the United States had alcohol use disorder in 2022. Many more drink at levels that exceed recommended guidelines without meeting the criteria for a disorder.

Signs You May Be Drinking Too Much

Recognizing excessive drinking in yourself isn't always straightforward. Several signs indicate your drinking may have crossed into problematic territory.

Quantity-based signs:

• Exceeding 14 drinks per week (men) or 7 drinks per week (women) regularly

• Frequently having 5 or more drinks in one sitting

• Needing more alcohol than before to feel the same effects

Behavioral signs:

• Drinking more than you intended when you sit down

• Failed attempts to cut back or control your drinking

• Drinking alone or hiding how much you drink

• Canceling plans or avoiding activities to drink instead

• Continuing to drink despite problems it causes

Physical signs:

• Hangovers that affect your work or responsibilities

• Sleep problems related to drinking

• Weight changes

• Memory gaps during drinking episodes

• Feeling shaky, anxious, or unwell when you haven't had a drink

Psychological signs:

• Thinking about drinking frequently

• Using alcohol to cope with stress, anxiety, or sadness

• Feeling defensive when someone mentions your drinking

• Regretting things you did while drinking

If it seems like several of these apply to you, that's worth taking seriously. You don't need to check every box to have a drinking problem worth addressing.

For a more detailed assessment, see our article on do I have a drinking problem.

Health Risks of Drinking Too Much

Excessive drinking affects virtually every system in your body. The risks increase with the amount and frequency of consumption.

Liver damage - The liver processes most of the alcohol you consume. Heavy drinking can cause fatty liver, hepatitis, and eventually cirrhosis. Early-stage liver damage often produces no symptoms.

Cardiovascular effects - Regular heavy drinking raises blood pressure, increases stroke risk, and can weaken the heart muscle.

Cancer risk - According to the World Health Organization, alcohol is a Group 1 carcinogen. It increases risk of mouth, throat, esophagus, liver, breast, and colorectal cancers.

Brain effects - Heavy drinking affects memory, cognitive function, and can cause brain shrinkage. Research shows that people who drink four or more drinks daily have significantly increased risk of hippocampal shrinkage.

Mental health - While alcohol may temporarily reduce anxiety, chronic heavy drinking typically worsens anxiety and depression over time.

Immune function - Excessive drinking weakens the immune system, making you more susceptible to infections.

The good news is that many of these effects are reversible if you reduce your drinking. Liver damage in the early stages can heal. Blood pressure often normalizes. Brain function improves.

Why People Who Drink Too Much Often Don't Realize It

Many people drink at problematic levels without recognizing it. Several factors contribute to this.

Social normalization - If everyone in your social circle drinks heavily, your consumption seems normal by comparison. Heavy drinking is so common in many circles that it's invisible.

Gradual increase - Tolerance builds slowly. The amount that once got you buzzed no longer does, so you drink more. This escalation often happens without conscious awareness.

Functional status - If you're holding down a job, maintaining relationships, and meeting responsibilities, you may assume your drinking is fine. But "functioning" doesn't mean "not at risk."

Stereotypes - The image of an "alcoholic" as someone who drinks from morning to night and has lost everything doesn't match most people who drink too much. Most people with alcohol problems are still functioning in their daily lives.

Minimization - It's psychologically uncomfortable to recognize a problem. The mind tends to minimize evidence that would require difficult changes.

For that reason, measuring your actual consumption in standard drinks over a week or two can be revealing. Many people are surprised by the number.

Options for Drinking Less

If you recognize that you're drinking too much, options exist for making changes.

Set specific limits - Define exactly how much you'll drink per occasion and per week. Write it down. Tell someone. Vague intentions to "drink less" rarely work.

Track your consumption - Record every drink for 2 to 4 weeks. The act of tracking often naturally reduces consumption.

Change your environment - Remove alcohol from your home. Avoid situations where you tend to drink heavily. Change routines associated with drinking.

Build accountability - Tell someone about your goal. Regular check-ins provide motivation to stay on track.

Address triggers - Identify what prompts you to drink (stress, boredom, social anxiety, certain times of day) and develop specific strategies for each.

Consider medication - Naltrexone is an FDA-approved medication that reduces cravings and makes drinking less rewarding. It can significantly help people drink less.

Our article on tips for quitting alcohol provides additional practical strategies.

How Medication Can Help

Naltrexone addresses the biological drivers of excessive drinking, making it easier to drink less without relying solely on willpower.

How it works:

The medication blocks opioid receptors in the brain. When you drink with naltrexone in your system, you don't get the same pleasurable "buzz." Over time, this breaks the association between alcohol and reward, reducing cravings.

What to expect:

• Easier to stop after one or two drinks

• Reduced cravings between drinking occasions

• Alcohol gradually becomes less interesting

• Less mental energy spent fighting the urge to drink more

Naltrexone is taken as a daily 50mg tablet. It doesn't make you sick if you drink and doesn't require complete abstinence. Research shows that people taking naltrexone have significantly fewer heavy drinking days compared to those using willpower alone.

All that said, medication works best when combined with behavioral changes and some form of support. Programs like Choose Your Horizon combine naltrexone with coaching to address both biological and behavioral aspects of drinking.

Our article on how naltrexone helps you regain control explains the medication in more detail.

Taking the Next Step

Drinking too much is common, often unrecognized, and carries real health risks. But it's also addressable. Understanding what "too much" actually means, recognizing the signs in your own behavior, and knowing your options puts you in a position to make informed decisions.

If you want to explore whether medication could help you drink less, take the online Alcohol Use Assessment to see if naltrexone might be right for you.