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What is alcoholism?

Alcoholism, or alcohol use disorder (AUD), is a chronic and progressive illness characterized by:

Loss of control over drinking.

Increasing urge to drink (tolerance).

Withdrawal symptoms when not consuming.

Continuing to drink despite negative medical, family, work, or social consequences.

It is not simply drinking heavily on one occasion, but a sustained and compulsive pattern that interferes with daily life.

What is not alcoholism?

The following are not alcoholism:

Moderate, occasional drinking within recommended limits.

A single episode of drunkenness without dependence.

Controlled drinking that does not have repercussions on health or social and work life.

What is social drinking?

Social drinking refers to drinking alcohol in social settings (dinners, gatherings, celebrations) occasionally and in moderation.
Characteristics:

There is no compulsion or daily need.

Consumption is adjusted to the environment and is usually limited.

It does not interfere with health, work, or relationships.

A standard drink

International guidelines (WHO, CDC, NIAAA) define a standard drink as an amount that provides ~14 g of pure alcohol:

Beer: 12 oz (≈ 355 ml) at 5% ABV.

Wine: 5 oz (≈ 150 ml) at 12% ABV.

Distilled spirits (whiskey, rum, vodka, tequila): 1.5 oz (≈ 45 ml) at 40% ABV.

Low-risk drinking (recommended dose)

Men: Up to 2 standard drinks per day, maximum 14 per week.

Example: 24 oz (≈ 710 ml) of beer or 10 oz (≈ 300 ml) of wine or 3 oz (≈ 90 ml) of liquor.

Women: Up to 1 standard drink per day, maximum 7 per week.

Example: 12 oz (≈ 355 ml) of beer or 5 oz (≈ 150 ml) of wine or 1.5 oz (≈ 45 ml) of liquor.

Where do we cross the line?

At-risk drinking: When low-risk limits are routinely exceeded.

Binge drinking:

Men: ≥ 5 drinks (~60 g of pure alcohol) in 2 hours.

Women: ≥ 4 drinks (~48 g of pure alcohol) in 2 hours.

Alcoholism: Compulsive drinking, dependence, tolerance, withdrawal, and sustained negative consequences.

Comparison table

Category Definition Example in ml/oz Consequences

Social drinking Occasional, moderate, in social settings, without compulsive drinking 1–2 glasses of wine (150–300 ml / 5–10 oz) at dinner Generally safe
Risky drinking Repeatedly exceeding recommended limits >14 drinks/week in men, >7 in women Increased cardiovascular, liver, and neurological risk
Alcoholism Chronic disorder with dependence, tolerance, and withdrawal Variable, with compulsive pattern Severe organic, social, and psychological damage

Conclusion

Alcoholism is not defined solely by quantity, but by loss of control and dependence. Drinking in moderation and within the recommendations can be considered social or low-risk drinking, while consistently exceeding limits or binge drinking marks the difference between an occasional habit and a disease.

Raul Ayala MD