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Nearly one-third of American adults are 鈥渆xcessive鈥� drinkers, but only 10% of them have alcohol use disorder (alcoholism). Those numbers, , shine a new light on alcohol consumption in America.

鈥淭his study shows that, contrary to popular opinion, most people who drink too much are not alcohol dependent or alcoholics,鈥� said Dr. Robert Brewer, Alcohol Program Lead at the Centers for Disease Control and Prevention (CDC) and one of the report鈥檚 authors, .

The term excessive drinking covers several different groups.

• Binge drinkers: men who have more than five drinks on one occasion or women who have more than four drinks
• Heavy drinkers: men who have more than 15 drinks in a week or women who have more than eight drinks
• Women who drink during pregnancy
• Anyone under age 21 who drinks

Alcoholism, now formally known as , is a medical condition that applies to individuals who have strong cravings for alcohol, can鈥檛 control their drinking, show withdrawal symptoms if they stop drinking, and continue to drink despite health or other alcohol-related problems.

The new study, done by researchers with the CDC and the , found that about 70% of all American adults drink alcohol at least now and then, about 30% report excessive drinking, and 3.5% have alcohol use disorder. It is higher among heavy drinkers (10%) and binge drinkers, ranging from 4% among those who report binge drinking once or twice a month to 30% among those who binge drink 10 times or more in a month.

Almost alcoholic

The knowledge that only 10% of heavy drinkers are alcoholic may be reassuring, but that doesn鈥檛 mean the other 90% aren鈥檛 have problems with drinking. I spoke with Joseph Nowinski, PhD, coauthor of . In the book, Nowinski, a clinical psychologist in private practice, and coauthor Robert Doyle, MD, a psychiatrist at Harvard-affiliated Massachusetts General Hospital, describe how drinking negatively affects up to one third of drinkers who aren鈥檛 classified as having alcohol use disorder.

鈥淭here are many people in the almost alcoholic zone who are having alcohol-related problems with their health, their relationships and social lives, and even their work, but who don鈥檛 connect the dots between these problems and their drinking,鈥� says Nowinski. 鈥淭hese people dismiss the possibility of being an alcoholic鈥攁nd they truly don鈥檛 qualify under current definitions鈥攂ut may need to take a step back to look at how drinking is affecting their lives.鈥�

You can find out where you fall on the by taking the that Nowinski and Doyle developed for their book. If your score is 9 or above, the suggestions and solutions in Almost Alcoholic may be helpful.

Patterns matter

The National Institute on Alcohol Abuse and Alcoholism categories low-risk drinking as 14 or fewer drinks a week for men and 7 or fewer drinks a week for women. But how those drinks are spread out over the week matter. A woman who has a drink a day is different from one who has three drinks on Friday and four on Saturday.

A drink a day, especially with a meal, has been linked to lower risks for heart disease, diabetes, and a host of other conditions. But seven drinks in a day can lead to an inflammatory response that tips health in the other direction.

鈥淭his may be important as we approach the holiday season and festivities invite heavier alcohol consumption,鈥� says Doyle.