Having a drink with friends after work, a glass of wine with dinner or a few beers over the weekend is, for most people, part of “normal” life. Sometimes, though, casual or social drinking can develop into “problematic” drinking where life doesn’t feel right unless alcohol is involved. And, it can be tricky to know when drinking has crossed the line from normal to not-so-normal. Problem drinking that becomes severe is diagnosed as alcohol use disorder (AUD) — a chronic relapsing disease where alcohol use is compulsive, and the drinker has lost control over their alcohol intake and feels bad when not drinking. When you start drinking to avoid feeling bad, or to cope with stress, your drinking may be getting out of hand. It’s important to know the early signs of problematic drinking so that you can take steps to cut back. Recognizing an alcohol problem is the first step toward managing it. Here are some early signs that you may be developing an alcohol problem. #1 “Heavy” drinking becomes “excessive” drinking – Even if you are a moderate to heavy drinker, the fact that you are able to maintain your grades in college or sustain a successful career means that you’re fine, right? Not necessarily. Excessive drinking can lead to alcohol abuse and dependency, which can progress to alcoholism and related health problems. What qualifies as excessive drinking? Drinking is considered excessive when, if you’re a man, you consume four drinks a day on one occasion or more than 15 per week. If you’re a woman, you are drinking excessively if you are consuming more than three drinks per day or on one occasion or more than eight drinks per week. #2 Episodes of binge drinking – Excessive drinking may manifest as a pattern of binge drinking where you don’t necessarily drink every day, but when you do drink, you consume several drinks at one sitting — often drinking more than you intended. For men, an episode of binge drinking is defined as five or more drinks consumed within two hours. For women, it is four or more drinks consumed within two hours. #3 Cognitive impairments, losing train of thought – Are you forgetting things or having trouble multitasking at work? According to a recent research study, poor concentration and attention deficits are linked to binge drinking, as well as to drug use. Impairments in processing and using information that helps with decision-making and planning tasks are linked to a person’s frequency of alcohol use. Memory loss — forgetting things you said or did while drinking — is also a warning sign of problems with alcohol. #4 You’ve had a few close calls while drinking – If you have gotten yourself into situations while drinking that put you in danger (i.e., driving under the influence, having unsafe sex, swimming, using machinery, taking a drink while also taking prescription medications or walking in a dangerous area), this is a sign that your alcohol consumption is interfering with your better judgment. #5 Resolutions to cut down on drinking don’t work – Have you tried more than once to stop drinking, or at least to cut down on the amount you drink, but couldn’t stick to it? Perhaps you stopped drinking when pregnant or at the request of a spouse, only to resume old drinking patterns after a short period of abstinence or in times of stress. #6 It takes more alcohol to get the same buzz – If you have to drink more than you used to in order to get the effect you want, this is a sign that you have developed physical tolerance to alcohol. The next stage is physical dependency, which you need to guard against. #7 You’ve started having some health problems – Are you noticing that you feel depressed or anxious more often or are experiencing health problems? If you are getting sick a lot, having trouble sleeping or often feel down, these can be the aftereffects of consuming alcohol. Withdrawal symptoms can also include upset stomach, sweating, restlessness, shakiness, a racing heart or even seizures. #8 You’ve changed your activities – If you have given up or cut back on activities that used to be important or enjoyable to you, it is important to figure out if this is because of alcohol. Are you canceling events because you felt too sick to attend due to a drinking binge? Or, have you stopped engaging in certain activities in favor of drinking? If you have experienced some of these early warning signs of an alcohol problem, it is time to stop and take stock of things. Unless you make big changes in your drinking behavior or get treatment for an alcohol use disorder, your drinking is on the way to interfering with your job or school, relationships, health and quality of life. It’s best to recognize it early so you can take action before things start to fall apart. Sources: Alcoholism and Alcohol Abuse. Recognizing the Signs and Symptoms of a Drinking Problem. HelpGuide.org. Alcohol Use Disorder. National Institute on Alcohol Abuse and Alcoholism. Losing train of thought or it’s hard to multi-task? You may be having one drink too many. Efrat Aharonovich, et al. Mailman School of Public Health, Columbia University. Addiction, 2017.