What is considered moderate drinking? Is it bad for you?

Drinking too much alcohol too frequently is unhealthy and can lead to liver disease, weight gain, and alcohol use disorder (AUD). Alcohol consumption may also play a role in certain mental health conditions, like depression and dementia, including Alzheimer’s disease. (1, 2, 3, 4, 5). 

But what about moderate drinking? You might wonder if there’s a healthy way to drink, how much alcohol consumption is considered moderate, and how much is too much. 

The internet is full of misinformation about the risks of alcohol intake. And the truth is, everyone may be affected by alcohol differently. But here’s what the experts have to say about drinking in moderation — the good, the bad, and the ugly — and your health. 

How many drinks a week is considered moderate drinking?

According to the National Institute on Alcohol Abuse & Alcoholism (NIAAA), moderate drinking is defined differently for men and women. For men, moderate drinking is consuming two or fewer drinks per day on average (or up to 14 drinks in a week). Drinking one or fewer drinks per day on average (up to seven alcoholic beverages per week) is considered moderate drinking for women. Heavy drinking for men is more than 14 drinks per week, or more than four in one day; for women it's more than seven drinks per week, or more than three in one day.  (6)

Standards for alcohol content in a single drink often differ culturally from country to country. In the United States, a standard alcoholic beverage usually contains 4 grams of alcohol, which is typical for 12 ounces (355 mL) of regular beer, 5 ounces (150 mL) of wine, or 1.5 ounces (45 mL) of a cocktail or spirit. (7)

However, in 2020, the advisory committee for the Dietary Guidelines for Americans recommended lowering the daily limit to one drink per day for both men and women. According to experts, that one drink should be no more than 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor. (8)

Is moderate drinking safe?

When it comes to your health, drinking alcohol can be a balancing act. Expert opinions on safety and levels of alcohol consumption have generally varied over the years, with some studies even citing the potential benefits of an occasional cocktail or glass of wine. 

However, according to a 2021 study at Oxford University, there is no safe level of alcohol consumption — especially for brain health and mental wellness. (9) And yet, moderate drinking may help some people avoid alcohol dependence. Research from 2018 suggests that only about 2% of people who drink in moderation develop AUD and dependence. (10) 

Effects of moderate drinking

Drinking alcohol in excess can negatively impact your health, including almost every part of your body. High alcohol consumption is not considered safe, and has the potential to damage vital organs, as well as affect your behavior and mood. 

But what about moderate drinking? You might think having a few drinks regularly is harmless, but even consuming alcohol in moderation carries some risks. 

Depression, anxiety, and mental health 

Though complex, alcohol consumption and developing mental health conditions — especially anxiety and depression — may be closely associated. (11) 

Many people living with depression and anxiety turn to drinking alcohol for temporary relief in coping with symptoms or episodes. However, this behavior may cause a cycle of worsening mental health in some people. (12, 13) 

Because alcohol consumption — and especially heavy drinking — is often connected to mental health conditions like anxiety and depression, addressing drinking and alcohol abuse can often lead to major improvements in managing mental wellness. (14)

Weight gain 

Excessive weight and obesity can both pose serious health risks. Though studies officially link any level of alcohol consumption to weight gain, alcohol contains about 7 calories per gram and is considered the second-most calorically rich nutrient after fat. (15) Ounce for ounce, beer contains about as many calories as sodas and other soft drinks high in sugar, and red wine contains about twice as much. (16, 17, 18)

Moderate drinking vs. heavy drinking

Moderate drinking and heavy drinking have some key differences to be aware of, as defined by the Centers for Disease Control and Prevention (CDC). (19) 

Drinking in moderation vs. abstinence

Abstinence from alcohol is the only true way to avoid health risks associated with drinking. Here’s the difference between alcohol abstinence and drinking in moderation. 

Men vs. women: Does moderate drinking differ?

Moderate drinking differs between men and women, according to health authorities like the CDC and NIAAA. The effects of alcohol consumption can also differ greatly based on a person’s physical composition, regardless of sex or gender identity. 

People who are assigned female at birth tend to develop drinking-related health issues at lower levels of alcohol consumption, in comparison to those assigned male at birth. A woman’s body may absorb up to 30% more alcohol than a man’s. (20)

The science behind this difference is linked to four reasons, including: 

1. Water content: Women tend to hold less water in their bodies than men. 

2. Weight: Metabolizing alcohol is directly connected to your body weight. In general, women weigh less than men and have less tissue in their bodies to absorb alcohol. 

3. Chemical composition: Compared to men, women have lower levels of alcohol dehydrogenase (AHD), a chemical found in the liver that aids the body in breaking down and metabolizing toxins like alcohol. Because of this, alcohol tends to remain in a woman’s system longer than in men’s.

4. Hormones: Hormonal differences between women and men may also play a role in how alcohol affects the body. (21) Limited studies indicated that blood-alcohol concentrations in women are at their highest just before menstruation and at their lowest on the first day after menstruation. 

Can you drink moderately on naltrexone?

Yes, it is considered safe to drink moderately while taking naltrexone. However, you won’t feel the pleasurable “buzz” normally associated with drinking alcohol. Naltrexone specifically blocks alcohol’s euphoric effects and feelings in order to help people lessen addictive behaviors around drinking and stay sober or in recovery. Over time, your cravings for alcohol will diminish while taking naltrexone. 

However, it’s important to keep in mind that naltrexone will not prevent you from becoming inebriated or drunk from alcohol. Just because you can’t feel the typical “high” from alcohol while taking naltrexone, it does not mean you should drive or perform other dangerous activities while under the influence of alcohol. 

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FAQ about moderate drinking

Finding information about the risks and benefits of moderate drinking can be tricky. Here’s a helpful FAQ on consuming alcohol in moderation. 

Can an alcoholic ever drink again in moderation?

For years, the answer to whether people with alcohol dependence and AUD could ever drink again in moderation was presumed to be a firm “no.” But today, programs like Moderation Management may offer people living with AUD a way to drink moderately or taper off into abstinence. 

Moderate drinking is possible for people who have issues with alcohol. However, many of those who can successfully drink in moderation likely do not have a disorder like AUD or alcohol dependence. Rather, they may have been “problem drinkers,” such as binge drinkers, or simply heavy drinkers who want or need to cut back. (22)

People who have had problems with alcohol in the past may want to consult a doctor or therapist for help regulating their behaviors around drinking. 

Can a binge drinker moderate alcohol consumption?

Yes. With dedication and the will to change, anyone can work hard to adjust their behaviors to live a healthier lifestyle. However, people who binge drink may be more likely to develop AUD and dependence, which typically requires professional help and guidance. (23)

If you think you or a loved one may have developed a dependence or AUD from binge drinking, consider reaching out to a physician or therapist for help. 

Does moderate drinking cause dementia?

According to current research, developing dementia is most strongly associated with heavy alcohol use, especially as people age. Moderate drinking has not been clinically linked to dementia yet, but that doesn’t mean it can’t have an effect on your brain’s health. (24, 25)

Does moderate drinking cause cancer?

Yes. According to the National Cancer Institute, alcohol consumption at any level is linked to developing cancer, especially mouth, throat, and voice box cancers. Alcohol consumption is also connected to esophageal, liver, breast, and colorectal cancers. There is also growing evidence that drinking alcohol may be associated with an increased risk for melanoma, prostate, and pancreatic cancers. (26) 

What happens when a moderate drinker stops drinking?

When you stop drinking alcohol entirely, even as a moderate drinker, you allow your body and mind a chance to heal. However, it may take some time before you feel like yourself again. 

The immediate benefits of alcohol abstinence include avoiding certain downfalls associated with drinking, such as: 

- hangovers and alcohol poisoning

- violence, injuries, and accidents

- high-risk sexual behaviors

- miscarriage and stillbirth for women

In the long term, you can expect vast improvements in your physical health, including:

- a healthier heart and cardiovascular system 

- decreased risk of certain cancers 

- an improved immune system and fewer everyday illnesses 

- recovered liver function and decreased liver damage from conditions like fatty liver and alcoholic hepatitis 

You will likely also experience more robust mental health benefits when you quit drinking, like:

- improved relationships with friends, family, and coworkers 

- reduced stress levels 

- better sleep quality 

- improved mood 

- lessened symptoms of anxiety and depression 

- more energy

- better focus and concentration