This pamphlet will help answer these questions:

How does alcohol affect my body? Do I have a drinking problem? How do I get help?

It's a good idea to know the warning signs of problem drinking. If you or someone you know has a drinking problem, seek help.

Alcohol's Effect on the Body

Alcohol slows down your body. The more you drink, the more it slows your body's response to your brain. This affects thinking, talking, seeing, walking, driving, and doing day-to-day tasks.

Light to moderate drinking rarely causes harm (see box). Heavy drinking, though, can cause problems. It may damage the liver or cause cirrhosis, which can lead to liver failure and death. It may damage the heart muscle and other organs. It also may increase the risk of some cancers.

Alcohol use is linked with:

• About one half of fatal car crashes
• Two thirds of drownings
• One half of fires
• One half of severe falls
• Violence (including domestic violence)
• Suicide
• Damage to the fetus and newborn that lasts a lifetime

How Much Is Too Much? "Too much" means different amounts for different people. Here is one way to find out whether you are a light, moderate, or heavy drinker. Light: On average, less than one drink a day Moderate: One or two drinks a day Heavy: More than two drinks a day Keep in mind that how often you drink is as important as how much you drink. You may not drink often, but if you drink too much at one time (binge), you still may have a problem. A drink is defined as 12 grams of alcohol. That includes a: 12-oz bottle of beer or wine cooler 5-oz glass of wine 1–1 1/2-oz glass of liquor

Special Concerns for Women

For some women, alcohol use could increase their risk for:

• Certain cancers (breast, for instance)
• Osteoporosis
• Early menopause
• Irregular periods
• Infertility
• Miscarriage in pregnant women
• Having a baby with fetal alcohol syndrome

What Is Problem Drinking?

Drinking becomes problem drinking when it harms your health, behavior, or relationships. Problem drinking sometimes is called alcoholism. The amount of alcohol that creates problems differs with each person. It depends on a person's weight, age, health, and family, medical, and emotional background.

You may not know if you have a drinking problem. Here are some signs:

• Drinking alone when you feel angry or sad
• Drinking in a pattern (every day or every week at the same time)
• Planning activities around drinking
• Drinking to relieve pain or stress
• Drinking more than you meant to or after you told yourself you wouldn't
• Drinking to get drunk
• Thinking a lot about drinking
• Showing a personality change when you drink

The box on the reverse side gives a short test used by experts to assess alcohol use versus abuse. If you are still unsure, check with your doctor.

How Can I Get Help?

The T-ACE Questions Here's a test—called the T-ACE—used to assess problem drinking: T  How many drinks does it take to make you feel high (Tolerance)? A  Have people Annoyed you by criticizing your drinking? C  Have you felt you ought to Cut down on your drinking? E  Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (Eye opener)? If your answer to the tolerance question is more than two drinks, give yourself a score of 2. Score 1 for each yes answer to any of the other questions. A total score of 2 or more may mean that you have a drinking problem. Talk to your doctor about your drinking habits. He or she can give you more information and refer you for counseling or treatment. Modified from Sokol RJ, Martier SS, Ager JW. The T-ACE Questions: practical prenatal detection of risk-drinking. Am J Obstet Gynecol 1989;160:865

Problem drinkers can get help. If a woman has a drinking problem, she has some choices for treatment. Addiction to alcohol cannot be cured, but it can be treated with success. Alcoholism need not be a lifelong problem.

Treatment options include:

Stopping drinking and safely getting alcohol out of your system with the help of a doctor Taking medication to help prevent relapse Counseling—including for friends and family members—to help cope with the stress of problem drinking Group therapy led by professionals or people who have drinking problems

There are groups that help people with problem drinking. One group is Alcoholics Anonymous (AA). The phone book will list local chapters.

Finally...

Some women may wonder if they have a drinking problem. It's a good idea to know the warning signs of problem drinking. If you or someone you know has a drinking problem, seek help.

Glossary

Cirrhosis: A disease caused by loss of liver cells, which are replaced by scar tissue that impairs liver function.

Fetal Alcohol Syndrome: A pattern of physical, mental, and behavioral problems in the baby that are thought to be due to alcohol abuse by the mother during pregnancy.

Infertility: A condition in which a couple has been unable to get pregnant after 12 months without the use of any form of birth control.

Menopause: The process in a woman's life when ovaries stop functioning and menstruation stops.

Miscarriage: The spontaneous loss of a pregnancy before the fetus can survive outside the uterus.

Osteoporosis: A condition in which the bones become so fragile that they break more easily.

This Patient Education Pamphlet was developed under the direction of the Committee on Patient Education of the American College of Obstetricians and Gynecologists. Designed as an aid to patients, it sets forth current information and opinions on subjects related to women's health. The average readability level of the series, based on the Fry formula, is grade 6–8. The Suitability Assessment of Materials (SAM) instrument rates the pamphlets as "superior." To ensure the information is current and accurate, the pamphlets are reviewed every 18 months. The information in this pamphlet does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice may be appropriate.

Copyright © February 2000 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

ISSN 1074-8601

Requests for authorization to make photocopies should be directed to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923.

To reorder Patient Education Pamphlets in packs of 50, please call 1-800-762-2264, ext 830, or order online at www.acog.org.

The American College of Obstetricians and Gynecologists
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PO Box 96920
Washington, DC 20090-6920

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