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Symptoms

By Mayo Clinic staff

Alcoholism signs and symptoms include those below. You may:

  • Be unable to limit the amount of alcohol you drink
  • Feel a strong need or compulsion to drink
  • Develop tolerance to alcohol so that you need more to feel its effects
  • Drink alone or hide your drinking
  • Experience physical withdrawal symptoms — such as nausea, sweating and shaking — when you don't drink
  • Not remember conversations or commitments, sometimes referred to as a "black out"
  • Make a ritual of having drinks at certain times and become annoyed when this ritual is disturbed or questioned
  • Be irritable when your usual drinking time nears, especially if alcohol isn't available
  • Keep alcohol in unlikely places at home, at work or in your car
  • Gulp drinks, order doubles or become drunk intentionally to feel good, or drink to feel "normal"
  • Have legal problems or problems with relationships, employment or finances due to drinking
  • Lose interest in activities and hobbies that used to bring you pleasure

If you binge drink or have other problems with alcohol, you may have many of the signs and symptoms above, although you may not feel as much of a compulsion to drink compared with someone who has alcoholism. Also, you may not have physical withdrawal symptoms when you don't drink. But this pattern of drinking can still cause serious problems and lead to alcoholism. As with alcoholism, you may not be able to quit problem drinking without help.

What is considered one drink?
One standard drink is:

  • 12 ounces (355 milliliters) of regular beer (about 5 percent alcohol)
  • 8 to 9 ounces (237 to 266 milliliters) of malt liquor (about 7 percent alcohol)
  • 5 ounces (148 milliliters) of wine (about 12 percent alcohol)
  • 1.5 ounces (44 milliliters) of 80-proof hard liquor (about 40 percent alcohol)

What about my drinking?
If you've ever wondered whether your drinking crosses the line into problem drinking or alcoholism, ask yourself these questions:

  • If you're a man, do you ever have five or more drinks in a day?
  • If you're a woman, do you ever have four or more drinks in a day?
  • Do you ever need a drink to get you started in the morning?
  • Do you feel guilty about your drinking?
  • Do you think you need to cut back on how much you drink?
  • Are you annoyed when other people comment on or criticize your drinking habits?

If you answered yes to even one of these questions, you may have a problem with alcohol.

When to see a doctor
If you feel that you sometimes drink too much or your family is concerned about your drinking, talk with your doctor. See your doctor even if you don't think you have alcoholism, but you're concerned about your drinking or it's causing problems in your life. Other ways to get help include talking with a mental health provider or seeking help from a support group such as Alcoholics Anonymous.

Because denial is common, you may not feel like you have a problem with drinking or that you need help to stop. You might not recognize how much you drink or how many problems in your life are related to alcohol use. Listen to family members, friends or co-workers when they ask you to examine your drinking habits or to seek help.

References
  1. Saitz R, et al. Screening for unhealthy use of alcohol and other drugs. http://www.uptodate.com/ index. Accessed June 2, 2012.
  2. Hoffman RS, et al. Management of moderate and severe alcohol withdrawal syndromes. http://www.uptodate.com/index. Accessed June 2, 2012.
  3. Alcohol and public health: Frequently asked questions. Centers for Disease Control and Prevention. http://www.cdc.gov/alcohol/faqs.htm. Accessed March 29, 2010.
  4. Gold MS, et al. Psychosocial treatment of alcohol abuse and dependence. http://www.uptodate.com/index. Accessed June 2, 2012.
  5. Esser MB, et al. Binge drinking intensity. American Journal of Preventive Medicine. 2012;42:625.
  6. Johnson BA, et al. Pharmacotherapy for alcohol abuse and dependence. http://www.uptodate.com/index. Accessed June 2, 20127.
  7. Substance-related disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed June 2, 2012.
  8. Harmful interactions: Mixing alcohol with medicines. National Institute on Alcohol Abuse and Alcoholism. http://www.niaaa.nih.gov/publications/brochures-and-fact-sheets. Accessed June 3, 2012.
  9. Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. June 14, 2012.
  10. Overview of alcohol consumption. National Institute on Alcohol Abuse and Alcoholism. http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption. Accessed June 2, 2012.
  11. Underage drinking. National Institute on Alcohol Abuse and Alcoholism. http://www.niaaa.nih.gov/alcohol-health/special-populations-co-occurring-disorders/underage-drinking. Accessed June 2, 2012.
  12. Alcohol use disorders. National Institute on Alcohol Abuse and Alcoholism. http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders. Accessed June 2, 2012.
  13. Fetal alcohol exposure. National Institute on Alcohol Abuse and Alcoholism. http://www.niaaa.nih.gov/alcohol-health/fetal-alcohol-exposure. Accessed June 2, 2012.
  14. Beyond hangovers: Understanding alcohol's impact on your health. http://pubs.niaaa.nih.gov/publications/Hangovers/beyondHangovers.pdf. Accessed June 2, 2012.
  15. College drinking. National Institute on Alcohol Abuse and Alcoholism. Accessed http://www.niaaa.nih.gov/alcohol-health/special-populations-co-occurring-disorders/college-drinking. June 2, 2012.
  16. Breast cancer. American Cancer Society. http://www.cancer.org/Cancer/BreastCancer/DetailedGuide/breast-cancer-risk-factors. Accessed June 12, 2012.
  17. Public policy statement on the definition of alcoholism. American Society of Addiction Medicine. http://www.asam.org/advocacy/find-a-policy-statement/view-policy-statement/public-policy-statements/2011/12/15/the-definition-of-alcoholism-(ncadd-asam). Accessed June 25, 2012.
  18. Schneekloth TD (expert opinion). Mayo Clinic, Rochester, Minn. June 23, 2012.
  19. Thiamin. The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/nutritional_disorders/vitamin_deficiency_dependency_and_toxicity/thiamin.html. Accessed August 1, 2012.
DS00340 Aug. 9, 2012

© 1998-2013 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

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