Alcohol Use Disorder: Heavy Drinking Vs Binge Drinking

Reviewed by Dr. Joshua Lee, MD, Chief Medical Officer, Board-Certified in Addiction Medicine.

There are many terms to describe how people misuse alcohol. While these terms seem to mean the same thing, each has a different clinical meaning. 

Recognizing the differences between some common types of problem drinking can help you better understand your drinking habits, think through any changes you’d like to make to those habits, and get support if it is needed.

What Is Alcohol Use Disorder (AUD)?

AUD is a medical diagnosis made by a healthcare professional. The diagnosis indicates that someone has a disorder that makes it difficult for them to control their drinking or stop drinking entirely.

AUD is diagnosed as either mild, moderate, or severe. The severity is determined by the number of symptoms a person has based on criteria outlined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).  The DSM-5 is published by the American Psychiatric Association. It helps assess and diagnose mental health conditions. 

If someone meets 2 of the 11 criteria of AUD during a 12-month period, they are diagnosed with the condition.

Problems such as alcohol misuse, alcohol addiction, alcohol dependence, and what has historically been called “alcoholism” are all included within the broader AUD diagnosis.

It’s estimated some 15 million Americans have AUD, although the number may be higher as AUD is likely underdiagnosed (1,2). Treatments are available for all levels of AUD. Medication like naltrexone can be effective. Counseling, therapy, support groups,  or a combination of these treatments can also be effective.

Oar Health offers an online alcohol use assessment which will enable you, with a doctor's help, to learn whether you have AUD and if so, the severity of your AUD.

Symptoms of AUD

To determine whether you have AUD, a healthcare professional will ask if you’ve experienced any of the following within the past 12 months:

• Had times when you ended up drinking more, or longer, than you intended
• More than once wanted to cut down or stop drinking, or tried to, but couldn’t
• Spent a lot of time drinking, being sick, or getting over other alcohol aftereffects
• Wanted a drink so badly you couldn’t think of anything else
• Found that drinking, or being sick from drinking, often interfered with taking care of your home or family, or caused job troubles or school problems
• Continued to drink even though it was causing trouble with your family or friends
• Given up or cut back on activities that were important or interesting to you, or gave you pleasure, so you could drink
• More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unprotected sex)
• Continued to drink even though it was making you feel depressed or anxious or adding to another health problem, or after having had a memory blackout
• Had to drink much more than you once did to get the effect you want, or found that your usual number of drinks had much less effect than before
• Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, a seizure, or sensed things that were not there

Mild alcohol use disorder (AUD): presence of 2 to 3 symptoms

Moderate alcohol use disorder (AUD): presence of 4 to 5 symptoms

Severe alcohol use disorder (AUD): presence of 6 or more symptoms

What Is Heavy Drinking?

Heavy drinking is not an official medical term. You cannot be diagnosed as a “heavy drinker.” 

However, public health officials in the United States have established standard definitions of heavy drinking for men and women to guide people’s understanding of their alcohol consumption habits (3). 

For men, heavy drinking is consuming 15 drinks or more per week. For women, heavy drinking is defined as consuming 8 drinks or more per week.

If your drinking habits meet the definition of heavy drinking, you may or may not have alcohol use disorder (AUD). 

The frequency of your heavy drinking, and how the drinks you consume are spread out during the week, are just two elements that might go into determining how much of a problem alcohol is having on your life and overall health.

What Is Binge Drinking?

Similar to heavy drinking, binge drinking isn’t a diagnosable medical condition, but there is a standard definition public health officials use to determine when someone is binge drinking.

Binge drinking is defined as alcohol consumption on one occasion that brings the blood alcohol concentration (BAC) level to 0.08% or more. 

In men, this usually corresponds to 5 or more drinks in about 2 hours, and in women, 4 or more drinks within about 2 hours.

An occasional instance of binge drinking, while not good for your short-term health, is likely not an indicator that you have alcohol use disorder (AUD). 

Rather, a regular pattern of binge drinking can indicate alcohol misuse and is a good reason to consult a medical professional about your drinking habits.

How Much Alcohol Is Considered OK To Drink?

In the United States, moderate drinking is considered safe for your health. According to the U.S. Departments of Health and Human Services and Agriculture’s Dietary Guidelines for Americans 2020-2025, moderate drinking is defined as:

Men: 2 standard drinks or fewer per day

Women: 1 standard drink or fewer per day

In the United States, a standard drink is defined as:

• 12 ounces of a regular beer that’s approximately 5% alcohol by volume
• 5 ounces of wine that’s about 12% alcohol by volume
• 1.5 ounces of a distilled spirit that is about 40% alcohol by volume

How Do I Know If I Have An Alcohol Problem?

Of course, your overall alcohol consumption is an important factor in determining whether you have an alcohol problem that needs treatment.

But other criteria beyond how many drinks you consume, and in what time frame, must be taken into account, along with the impact alcohol is having on your life.

For example, if your drinking habits negatively impact relationships with family or friends, cause problems at work or school, or lead to physical and mental health issues, you likely have an alcohol problem.

If any of these apply to you, treatment is available.

Frequently Asked Questions

Are alcohol use disorder (AUD), heavy drinking, and binge drinking the same thing?

No. AUD is a medical diagnosis given to someone who cannot control their drinking or cannot stop drinking entirely. For men, heavy drinking is defined as consuming 15 drinks or more per week, while for women it is defined as 8 drinks or more per week. Binge drinking is alcohol consumption on one occasion that brings the blood alcohol concentration (BAC) level to 0.08% or more. Heavy drinking and binge drinking may or may not indicate AUD.

What’s a safe amount to drink?

In the United States, moderate drinking is considered safe for your health. For men, that is up to 2 drinks per day, while for women, moderate drinking is 1 drink per day.

Is the amount you drink the only factor in determining whether you have an alcohol problem?

It’s an important one, but in determining how much of a problem you have with alcohol, a healthcare provider will also consider how drinking alcohol is affecting your life and your overall health.

Are You Drinking Too Much?

Is drinking affecting your job? Is alcohol harming your health or relationships? Does your drinking worry you? Ever tried to drink less but failed?

If any of this sounds familiar, Oar Health might be right for you. Oar Health offers medication FDA-approved for the treatment of alcohol problems. A daily pill to drink less or quit.

Qualify For Treatment

Reviewed by Dr. Joshua Lee, MD, Chief Medical Officer, Board-Certified in Addiction Medicine.

Dr. Lee is a nationally recognized addiction medicine expert and Professor at NYU Grossman School of Medicine. He leads groundbreaking research on naltrexone and buprenorphine for alcohol and opioid use disorders, with a focus on real-world impact in primary care and justice-involved populations.