Alcohol misuse

The Learning and Wellbeing Team

Large studies suggest that as many as 31% of college students report misusing alcohol but just 6% show signs of alcohol dependence. According to the Center for Disease Control in the United States, the consumption of alcohol that puts individuals at increased risk for adverse health and social consequences is considered alcohol misuse. In practice, that means either (a) more than 4 drinks per day for men or more than 3 drinks per day for women, or (b) more than 14 drinks per week for men or more than 7 drinks per week for women), or both.

Alcohol dependence and alcohol tolerance are different from alcohol misuse. Everyone has experienced some degree of tolerance. When you first started drinking, you likely noticed how even just one drink would make you light-headed and tipsy. One drink was enough to give you a buzz. Maybe even make you drunk.  With time, you don’t get the same effect with one drink. You need a second drink and then a third to get the same effect. That experience, which most of us have had, is a good example of how tolerance works. 

Alcohol dependence is about not being able to stop. Lots of people who drink say that they can stop whenever they want to. But doing something is different than saying it. The best test of whether or not you are showing the signs of alcohol dependence is to stop drinking for 15 days. If you cannot avoid drinking for 15 days (and two weekends), you may have the beginnings of a bad habit that might turn out to be dependence. But only a doctor or substance abuse specialist will be able to determine whether or not these difficulties are, in fact, evidence of alcohol dependence. People with alcohol dependence often need to drink more and more alcohol to get the same effect and will likely experience withdrawal symptoms after they stop.  Symptoms of withdrawal can include any of the following: insomnia, irritability, changing moods, depression, anxiety, aches and pains, cravings, fatigue and nausea. Keep in mind you don’t need to have all of those symptoms. Symptoms of withdrawal can be characterized by just a few. 

Why this matters:

Even without dependence or withdrawal symptoms, the excessive consumption of alcohol can be devastating. Research has shown that about 10% of college students are injured every year because of drinking, 12% are hit or assaulted by drinking students, and 2% of students are the victims of alcohol-related sexual assault or date rape. Other studies show that the long-term use of alcohol will increase your risk for a range of health problems, including heart problems and even cancer. 

Think you can stop?

A study of binge drinking in college students showed that heavy drinking during college and university was related to alcohol abuse later on in life. What may seem like something you just do while you are in college or university, for some will become a lifelong addiction.  

How screening tests work:

Screening tests, whether for alcohol use disorder, depression or anxiety are NOT designed to substance abuse or to diagnose mental illness. In fact, they cannot. Only a mental health professional, such as a physician, psychiatrist, or psychologist, can make a diagnosis. 

Screening tests are an important tool that can help a physician, psychiatrist, or psychologist reach a decision about whether or not you have a mental disorder or illness.  But, the results of a screening test are not enough. To be diagnosed with a mental illness you must experience (a) some kind of distress or elevated symptoms (e.g., some sadness, inattentiveness, anxiety, etc.), (b) which last for a number of weeks (or more), which (c) cause you some impairment (i.e., these symptoms get in the way of you living your life. It is a complicated and sometimes difficult decision, which is why the results of a screening test are never enough on their own to diagnose a mental illness. 

The test says I have symptoms of alcohol misuse no diagnosis. What now?

Many, many more people will experience difficulties controlling their consumption of substances, such as alcohol, and would like to reduce their consumption. Here are two effective strategies to reduce your consumption. 

1.  Control your own intake.  Many students will go to parties with their own alcohol in their own bottle of alcohol that is only partially filled. This will allow you to start limiting what you will drink.  Know one really needs to know how much you have had. If you show up with just a mostly empty bottle of liquor, you can always lie and tell them you started early. This is also a good strategy to make sure that no one messes with your drinks. 

2. Slow down your drinking. One other way to reduce your consumption is to switch back and forth between alcohol and any other non-alcohol drink (e.g., pop, juices, mineral water). This will not only slow down your consumption but also give you an opportunity to rethink how much you have had already had to drink and whether or not you want to drink more.  

3. Avoid the strong stuff. Switching from alcohol to beer or wine that has a lower alcohol level (e.g., 3%) can also reduce you consumption dramatically.  

4. Take a drinking holiday. Prove to yourself (and your friends) that you are in control by taking a break from drinking. There are lots of ways to do this. You could limit your self to drinking to just 2 nights during the week (and limit your consumption). Each month you could take a week and a weekend off entirely once a month. Go to a party and decide not to drink alcohol. 

Yes, these are really, really hard to do. But, all of this is easier if you and your friends decide to do this together.  

1. National Institute on Alcohol Abuse and Alcoholism. Helping patients who drink too much: a clinician’s guide, updated 2005 edition. Rockville: National Institutes of Health; 2005 [cited 2008 Dec 5]. Available from: 

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