"This leaves many drinkers mistakenly assuming that a moderate average level of consumption is safe, regardless of drinking pattern," said Rudolf Moos, professor emeritus of psychiatry and behavioral sciences at Stanford University School of Medicine, in a statement.
Moos is the coauthor of a recent study that found many moderate drinkers above age 30 actually end up binging on the weekend -- defined as five or more drinks in a row or within a short period of time.
People who binged were about five times more likely to experience multiple alcohol problems, such as "getting hurt, emotional or psychological problems from alcohol, having to use more alcohol to get the same effect, and experiencing effects of alcohol at work, school or caring for children," said study coauthor Charles Holahan, professor of psychology at the University of Texas at Austin, in an email.
"What this means is that an individual whose total consumption is seven drinks on Saturday night presents a greater risk profile than someone whose total consumption is a daily drink with dinner, even though their average drinking level is the same," Holahan said.
Adult binge drinking
Most past research on binge drinking has focused on the younger generation, typically teens and college students. Consuming multiple drinks at one sitting is widespread
in this population segment. But statistics show a good many adults over 30 are binge drinkers, and the problem is on the rise
, especially among women and adults over 65.
Yet levels of binge drinking among adults may escape "public health scrutiny, because it occurs among individuals who drink at a moderate average level," Holahan said. "At present, binge drinking among moderate drinkers is largely undetected in primary care settings."
Women are especially sensitive to the effects of alcohol, according to the National Institute on Alcohol Abuse and Alcoholism
. Alcohol-related problems appear sooner and at lower drinking levels than
in men, the NIAA said.
Women are more susceptible to alcohol-related brain damage
and heart disease than men, and studies
show women who have one drink a day increase their risk of breast cancer
by 5% to 9% compared with women who abstain.
For both men and women over 65 years of age, the increase "is of particular concern because many older adults use medications that can interact with alcohol, have health conditions that can be exacerbated by alcohol, and may be more susceptible to alcohol-related falls and other accidental injuries," the NIAA stated.
An 'overlooked' pattern
The new study, published in the American Journal of Preventative Medicine
, used survey data collected as part of the Midlife Development in the United States study
, which has been following a national sample of Americans between the ages of 25 and 74 since 1995.
The study analyzed nearly 1,300 drinkers over nine years and found most cases of binge drinking — and of multiple alcohol problems — occurred among individuals who were average moderate drinkers.
"An average moderate drinker of, for example, one drink a day might achieve that average by a daily drink with dinner or seven drinks on Saturday night," Holahan said.
While that behavior would not necessarily lead to alcoholism, Holahan said, the study found drinking an average of more than one drink a day for women and two drinks a day for men -- or five or more drinks on the same occasion -- was linked to alcohol problems nine years later.
"These findings point to a need for alcohol interventions targeting moderate average level drinkers in addition to conventional strategies focusing on the higher risk, but smaller, population of habitually high-level drinkers," Holahan said.
Is your drinking a problem?
How do you know if your use of alcohol has become a problem? One telltale sign is when drinking is beginning to interfere with your ability to go through your daily life, experts say.
"Alcohol use disorder is defined as compulsively using alcohol despite having negative consequences from your use, such as an impact on your relationships, your ability to function in your job or in whatever roles you have in your community," Dr. Sarah Wakeman, medical director of the Substance Use Disorders Initiative at Mass General Brigham told CNN in a prior interview
Be wary if you continue drinking despite negative impacts on your physical or mental health. And it doesn't have to be calling in sick or working with a hangover, Dr. Leena Mittal, chief of the women's mental health division in the department of psychiatry at Brigham and Women's Hospital in Boston, told CNN previously.
"Don't forget relationships. Are you having more disagreements? Are people in your life expressing concern or noting that you're different? Hiding your drinking, or lying about it, these too are concerning behaviors," Mittal said.
Here's a red flag: You're pouring big drinks without realizing it. Current American Heart Association guidelines call for no more than two standard drinks a day for men and one for women and anyone 65 and older.
What is a standard drink? It's 12 ounces of regular beer, 4 ounces of regular wine or 1.5 ounces of liquor, according to US standards.
"Yet people may be pouring a huge goblet of wine and not realize that it's actually two or three servings of wine and not just one," Wakeman said.
"We know that millions of Americans drink above those levels, even in pre-pandemic times," Wakeman said. "In 2019, some 66 million Americans had episodes where they were drinking higher than those recommended limits."