Hi Doc:

Lots of people drink over the holidays, but I think my friend may be overdoing it. I suspect she has an alcohol problem because she sometimes doesn't remember what happened the night before when she was drinking. She has said herself that she might have an issue with drinking. What is considered heavy drinking versus normal drinking and where can she go for help?

Cpl. Red Merlot

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Dear Cpl. Merlot,

I've reached out to an expert to answer your questions: Dr. John Shehan, a psychiatrist and head of the Addiction Medicine Intensive Outpatient Program at the U.S. Army Medical Center Darnall-Hood at Fort Hood in Texas.

Here's what Dr. Shehan said.

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Thanks for asking a question that I frequently get: How do you define having a good time versus risky drinking?

I've discussed the effects alcohol can have on your body and how easily it can impair you in this forum before.

First of all, it's important to realize it's tricky to identify an alcohol use disorder in your battle buddy—that's when they overuse alcohol to the point of being dependent on it

Moreover, it is very important to catch an alcohol use disorder early on because it can cause relationship problems, legal problems, and long-term health issues. Also, people who drink can be at risk for sexual assaults or for family issues

A 2018 Department of Defense survey found that nearly 10% of service members were categorized as heavy drinkers, and 6.2% reported one or more serious consequences from their drinking.

Alcohol use disorder is very common, but identification can be difficult because it is hard to tease out problem drinking from having fun.

Knowing limits are an important first step for your friend and for everyone who drinks.

Government guidelines recommend not drinking more than 14 alcoholic drinks in a week for men and no more than four drinks in a sitting.

For women and men over 65, it's seven drinks in a week, or no more than three drinks in a sitting because they're more affected by alcohol from a health standpoint.

People who exceed these limits are considered heavy drinkers.

Binge drinking is defined as five or more alcoholic drinks for males or four or more alcoholic drinks for females at the same time or within a couple of hours of each other on at least one day in the past month.

These guidelines are in place because if you drink more than this on a regular basis you can cause serious physical harm to your body and be at risk of developing alcohol use disorder.

Even though alcohol is legal, it is a highly toxic substance. I have seen young soldiers with serious liver, heart, and stomach problems that are life-threatening, all from drinking too much alcohol.In addition, alcohol can affect your cognitive skills and impact your nervous system.

Basically, think of alcohol as a poison, one that can kill you quickly or over time. Alcohol is the third leading cause of preventable death in the United States and contributes to over 60 different diseases.

Take the Audit-C Questionnaire if You're Worried

The 3-question AUDIT-C questionnaire is a quick way to know if you might be at risk of having an alcohol use disorder.

Any service member can walk into any embedded behavioral health clinic or ask to speak to a substance use disorder clinical care provider to get evaluated and treated.

Remember, being a true battle buddy may mean having courageous conversations with your friend about addressing her alcohol problem.

At the end of the day, you may be helping your friend get her life on the right track.

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Cpl. Merlot,

I hope Dr. Shehan's answers have helped you decide on next steps with your friend. You are being a good buddy, and we wish you both well. As the doc says, "Happy holidays and remind your friend that stopping drinking alcohol is the first step in a successful military career."