Questionnaire

What should be the legal age for drinking?

Frequently Asked Questions (FAQs)

 

 Welcome to the Frequently Asked Questions section!

 

Here are some commonly asked questions about alcohol use. Click on the links below to get answers to your questions:

 

 

Q. What is alcohol?

A. Ethyl alcohol, or ethanol, is an intoxicating ingredient found in beer, wine, and liquor. Alcohol is produced by the fermentation of yeast, sugars, and starches.

 

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Q. How does alcohol affect a person?

A. Alcohol affects every organ in the body. It is a central nervous system depressant that is rapidly absorbed from the stomach and small intestine into the bloodstream. Alcohol is metabolized in the liver by enzymes; however, the liver can only metabolize a small amount of alcohol at a time, leaving the excess alcohol to circulate throughout the body. The intensity of the effect of alcohol on the body is directly related to the amount consumed.

 

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Q. Why do some people react differently to alcohol than others?

A. Individual reactions to alcohol vary, and are influenced by many factors; such as:

  • Age
  • Gender
  • Race or ethnicity
  • Physical condition (weight, fitness level, etc)
  • Amount of food consumed before drinking
  • How quickly the alcohol was consumed
  • Use of drugs or prescription medicines
  • Family history of alcohol problems

 

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Q. What is a standard drink?

A. In different countries, health educators and researchers employ different definitions of a standard unit or drink because of differences in the typical serving sizes in that country.

In the program Alcohol e-Help, a standard drink is equal to 10 grams or 12.5 ml of pure alcohol. Generally, this amount of pure alcohol is found in

• 250 ml of beer.

• 100 ml of wine.

• 30 ml distilled spirits or liquor (e.g., gin, rum, vodka, or whiskey).

 

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Q. Is beer or wine safer to drink than liquor?

A. No. One 250 ml beer has about the same amount of alcohol as one 100 ml glass of wine, or 30 ml distilled spirit. It is the amount of alcohol consumed that affects a person most, not the type of alcoholic drink.

 

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Q. What are caffeinated alcoholic beverages (CABs)?

A. Caffeinated alcoholic beverages (CABs) are premixed beverages that combine alcohol, caffeine, and other stimulants. They may be malt- or distilled spirits-based and usually have higher alcohol content than beer (e.g., 5%–12% on average for CABs compared to 4%–5% for beer). The caffeine content in these beverages is usually not reported.

 

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Q. What does moderate drinking mean?

A. There is no one definition of moderate drinking, but generally the term is used to describe a lower-risk pattern of drinking. Here it is defined as having no more than 1 drink per day for women and no more than 2 drinks per day for men. This definition is referring to the amount consumed on any single day and is not intended as an average over several days.

 

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Q. Is it safe to drink alcohol and drive?

A. No. Alcohol use slows reaction time and impairs judgment and coordination, which are all skills needed to drive a car safely. The more alcohol consumed, the greater the impairment.

 

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Q. What does it mean to be above the legal limit for drinking?

A. The legal limit for drinking is the alcohol level above which an individual is subject to legal penalties (e.g., arrest or loss of a driver's license)

  • Legal limits are measured using either a blood alcohol test or a breathanalyzer.
  • Legal limits are typically defined by state law, and may vary based on individual characteristics, such as age and occupation. In India, the legal limit is 0.03 mg%.

Note: Legal limits do not define a level below which it is safe to operate a vehicle or engage in some other activity. Impairment due to alcohol use begins to occur at levels well below the legal limit.

 

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Q. How do I know if it’s okay to drink?

A. The current guidelines recommend that if you choose to drink alcoholic beverages, do not exceed 1 standard drink per day for women or 2 standard drinks per day for men. According to the guidelines, people who should not drink alcoholic beverages at all include the following:

  • Children and adolescents.
  • Individuals of any age who cannot limit their drinking to low level.
  • Women who may become pregnant or who are pregnant.
  • Individuals who plan to drive, operate machinery, or take part in other activities that require attention, skill, or coordination.
  • Individuals taking prescription or over-the-counter medications that can interact with alcohol.
  • Individuals with certain medical conditions.
  • Persons recovering from alcoholism.

 

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Q. What do you mean by heavy drinking?

A. For men, heavy drinking is typically defined as consuming an average of more than 2 drinks per day. For women, heavy drinking is typically defined as consuming an average of more than 1 drink per day.

 

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Q. What is binge drinking?

A. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) binge drinking is defined as a pattern of alcohol consumption that brings the blood alcohol concentration (BAC) level to 0.08% or more. This pattern of drinking usually corresponds to 5 or more drinks on a single occasion for men or 4 or more drinks on a single occasion for women, generally within about 2 hours.

 

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Q. What is the difference between alcoholism and alcohol abuse?

A. Alcohol abuse is a pattern of drinking that result in harm to one’s health, interpersonal relationships, or ability to work.

Manifestations of alcohol abuse include the following:

  • Failure to fulfill major responsibilities at work, school, or home.
  • Drinking in dangerous situations, such as drinking while driving or operating machinery.
  • Legal problems related to alcohol, such as being arrested for drinking while driving or for physically hurting someone while drunk.
  • Continued drinking despite ongoing relationship problems that are caused or worsened by drinking.
  • Long-term alcohol abuse can turn into alcohol dependence.

 

Dependency on alcohol, also known as alcohol addiction and alcoholism4, is a chronic disease. The signs and symptoms of alcohol dependence include: 

  • A strong craving for alcohol
  • Continued use despite repeated physical, psychological, or interpersonal problems
  • The inability to limit drinking
  • The inability to limit drinking
  • Need for significantly increased amounts of alcohol to achieve intoxication or desired effect; or markedly diminished effect with continued use of the same amount of alcohol
  • A great deal of time spent in activities necessary to obtain, to use, or to recover from the effects of drinking
  • Important alternative pleasures or interests given up or reduced because of drinking

 

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Q. What does it mean to get drunk?

A. “Getting drunk” or intoxicated is the result of consuming excessive amounts of alcohol. Binge drinking typically results in acute intoxication

Alcohol intoxication can be harmful for a variety of reasons, including:

  • Impaired brain function resulting in poor judgment, reduced reaction time, loss of balance and motor skills, or slurred speech.
  • Dilation of blood vessels causing a feeling of warmth but resulting in rapid loss of body heat.
  • Increased risk of certain cancers, stroke, and liver diseases (e.g., cirrhosis), particularly when excessive amounts of alcohol are consumed over extended periods of time.
  • Damage to a developing fetus if consumed by pregnant women.
  • Increased risk of motor-vehicle traffic crashes, violence, and other injuries.
  • Coma and death can occur if alcohol is consumed rapidly and in large amounts.

 

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Q. How do I know if I have a drinking problem?

A. Drinking is a problem if it causes trouble in your relationships, in school, in social activities, or in how you think and feel. If you are concerned that either you or someone in your family might have a drinking problem, consult your personal health care provider.

 

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Q. What can I do if I or someone I know has a drinking problem?

A. Consult your professional health care provider if you feel you or someone you know has a drinking problem.

 

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Q. What health problems are associated with excessive alcohol use?

A. Excessive drinking both in the form of heavy drinking or binge drinking, is associated with numerous health problems, including:

  • Chronic diseases such as liver cirrhosis (damage to liver cells); pancreatitis (inflammation of the pancreas); various cancers, including liver, mouth, throat, larynx (the voice box), and esophagus; high blood pressure; and psychological disorders
  • Unintentional injuries, such as motor-vehicle traffic crashes, falls, drowning, burns and firearm injuries
  • Violence, such as child maltreatment, homicide, and suicide
  • Harm to a developing fetus if a woman drinks while pregnant, such as fetal alcohol spectrum disorders
  • Sudden infant death syndrome (SIDS)
  • Alcohol abuse or dependence

 

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Q. I’m young. Is drinking bad for my health?

A. Yes, studies have shown that alcohol use by youth and young adults increases the risk of both fatal and nonfatal injuries9, 10, 11. Research has also shown that youth who use alcohol before age 15 are five times more likely to become alcohol dependent than adults who begin drinking at age 2112. Other consequences of youth alcohol use include increased risky sexual behaviors, poor school performance, and increased risk of suicide and homicide13, 14, 15.

 

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Q. Is it okay to drink when pregnant?

A. No. There is no safe level of alcohol use during pregnancy. Women who are pregnant or plan on becoming pregnant should refrain from drinking alcohol. Several conditions, including Fetal Alcohol Spectrum Disorders have been linked to alcohol use during pregnancy. Women of child bearing age should also avoid binge drinking to reduce the risk of unintended pregnancy and potential exposure of a developing fetus to alcohol.

 

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Q. I am not dependent on Alcohol. Can I experience problems?

A. It must be remembered that Alcoholism or Alcohol dependence is only one of many alcohol problems. Using Alcohol in excessive amounts regularly can be just as harmful. A person can ‘abuse’ alcohol without actually being an alcoholic--that is, he or she may drink too much and too often but still not be dependent on alcohol. These problems can be: not being able to meet occupational or social responsibilities; driving under the influence and consequent arrests and accidents; and many alcohol-related medical diseases. Under certain situations, even social drinking is dangerous--for example, when driving, during pregnancy, or if you are taking certain medications, which can interact adversely with alcohol.

 

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Q. Is beer safer to drink than IMFL (such as whisky or gin or rum)?

A. Remember, both beer and IMFL are alcoholic beverages, which differ in terms of concentration of alcohol. In other words if you have consumed half a bottle of typical Indian beer, it is equivalent to consuming about one, 30-ml. drink of whisky. Thus, the amount of alcohol you have consumed affects you the most, not the type of alcoholic beverage.

 

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Q. Is it true that one should have snacks while drinking?

A. When people drink on an empty stomach, there's no food to slow the absorption of alcohol. As a result, the alcohol gets absorbed faster and people get intoxicated more rapidly. On the other hand, drinking alcohol with food allows alcohol absorption and thus its effects to rise gradually. Thus, it is always safer to consume alcohol along with food as opposed to drinking on an empty stomach. But as we have said earlier, it is always better not to drink at all.

 

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Q. Should I mix my alcohol with water or with soda?

A. All aerated drinks (such as those containing soda) increase the rate with which alcohol is absorbed. Thus mixing alcohol with soda will lead to faster absorption and intoxication. In addition, soda will also be more irritating to the lining of the stomach and hence, will have more risk of gastritis. Thus, if one chooses to drink, a non-aerated beverage is safer than an aerated one.

 

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Q. Someone I know has an alcohol problem, but is unwilling to get help. What can I do about it?

A. This can be a challenging situation. Usually it is not a good idea to force someone to get help. However, we don't need to wait for someone to experience extreme adverse consequence before helping them. Following steps can be suggested to help a problem-drinker get treatment:

  • Stop covering up. Very often we make excuses to others or try to protect the alcoholics from the results of their drinking. This should be avoided as in such situations we inadvertently end up helping the person continue his behavior and experiencing the adverse consequences.
  • Choose appropriate time. Usually a good time to talk to the person is shortly after he has experienced an alcohol-related problem – such as a serious family argument or an accident. However, avoid a time when the person is under intoxication, instead talk when he is sober.
  • Give specific examples. Tell the person that you are worried about his drinking. Cite the recent examples of the situations in which the person’s drinking has lead to problems. It is important to avoid giving a lengthy sermon on all possible consequences of drinking, rather be specific to talk to about only the problems person has suffered.
  • Be ready with a plan. It would help if you have already collected information in advance about available treatment services in your neighborhood. If the person is willing to get help, immediately seek an appointment or accompany the person to a treatment agency.
  • Get help from others. If the person is still unwilling to get help, ask someone more influential to talk to him using the steps just described.

 

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Q. What is a safe level of drinking?

A. The internet is full of information on ‘safe levels’ of drinking. It must be remembered however, that most such recommendations are available for primarily people from the western countries. For a country like India, we still do not have enough data to recommend the safe level of drinking. In Indian setting, it is safe to say that NOT DRINKING AT ALL IS THE SAFEST OPTION. Research conducted in western countries suggests that for most adults, moderate alcohol use, up to two drinks per day for men and one drink per day for women and older people, is associated with much fewer problems than drinking in excess amounts. One drink is equal to approximately ½ a bottle of regular beer, or ¼ bottle of strong beer or 30 ml. of distilled spirits (i.e., Indian Made Foreign Liquor) such as whisky, rum, gin or vodka.

Certain people for whom any level of drinking is absolute no-no:

  • Pregnant Women
  • Those who are driving or operating heavy machinery
  • Those who are on certain medications (ask your doctor)
  • Those who have some medical conditions that can be worsened by drinking (ask your doctor)
  • Those who are Recovering from alcohol problems
  • People younger than the prescribed limit as per local laws.

 

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Q. Are the effects of alcohol in women different than that from men?

A. While we do believe in gender equality, the fact remains that alcohol affects women differently as compared to men. After drinking the same amount of alcohol, women generally get more intoxicated than men do, even if both of them have same body weight. The primary reason behind it is the lesser amount of water in the women’s bodies. Because of this, the same amount of alcohol becomes more highly concentrated in a woman's body than in a man's. Additionally, long term use of alcohol affects women more adversely and many medical problems, such as damage to the various organs like brain, heart, and liver, develop earlier in women than in men.

 

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Q. I often read that small amount of alcohol consumption daily is good for health. Specifically people say that it prevents heart diseases. Is it true?

A. Research conducted in western countries has shown that moderate drinkers are less likely to die from one form of heart disease than are people who do not drink any alcohol or who drink more. None of these studies however have been conducted in India. It must be remembered that there are considerably differences in this part of the world as compared to the western world; our bodies, our lifestyle, our climate, our eating habits are different. Thus, something which has been applicable in the western countries cannot be imported directly in our settings. Thus, a nondrinker should not start drinking solely to benefit his heart. Whatever benefits you may get from small amount of drinking, can also be accrued by suitable lifestyle changes such as exercise and eating low-fat foods. However, if you do choose to drink, drink in moderation. Heavy drinking can actually increase the risk of many diseases including heart diseases.

 

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Q. Someone I know is dependent on Alcohol. Should I just lock him up so that he is unable to drink? I have heard that if an alcoholic does not drink for a few days, he can quit drinking permanently.

A. If a person is dependent on Alcohol, he should never be forcibly made to stop drinking. In dependent individuals stopping alcohol suddenly may lead to withdrawal symptoms which can be dangerous and even fatal. Correct way of stopping alcohol is always to consult a trained doctor, who would advise to stop drinking and then prescribe certain medications to control the dangerous withdrawal symptoms.

 

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Bibliography

 

1.United States Department of Agriculture and United States Department of Health and Human Services. In: Dietary Guidelines for Americans. Chapter 9 – Alcoholic Beverages. Washington, DC: US Government Printing Office; 2005, p. 43–46. Available at http://www.health.gov/DIETARYGUIDELINES/dga2005/document/html/chapter9.htm. Accessed March 28, 2008.

 

2.National Highway Traffic Safety Administration. Available at http://www.nhtsa.dot.gov/. Accessed March 28, 2008.

 

3.National Institute of Alcohol Abuse and Alcoholism. NIAAA council approves definition of binge drinking  [PDF–1.6Mb] NIAAA Newsletter 2004;3:3.

 

4.Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV), published by the American Psychiatric Association, Washington D.C., 1994.

 

5.Centers for Disease Control and Prevention. Fetal Alcohol Spectrum Disorders. Available at http://www.cdc.gov/ncbddd/fas/default.htm. Accessed March 31, 2008.

 

6.Substance Abuse and Mental Health Services Administration. Available at http://www.samhsa.gov/treatment/treatment_public_i.aspx. Accessed March 28, 2008.

 

7.Bonnie RJ and O’Connell ME, editors. National Research Council and Institute of Medicine, Reducing Underage Drinking: A Collective Responsibility. Committee on Developing a Strategy to Reduce and Prevent Underage Drinking. Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press, 2004.

 

8.U.S. Department of Health and Human Services. The Surgeon General's Call to Action to Prevent and Reduce Underage Drinking. Rockville, MD: U.S. Department of Health and Human Services; 2007. Available at http://www.surgeongeneral.gov/topics/underagedrinking/. Accessed March 28, 2008.

 

9.Hingson RW, Heeren T, Jamanka A, Howland J. Age of onset and unintentional injury involvement after drinking. JAMA 2000;284(12):1527–1533.

 

10.Hingson RW, Heeren T, Winter M, Wechsler H. Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18–24: Changes from 1998 to 2001. Annu Rev Public Health 2005;26:259–79.

 

11.Levy DT, Mallonee S, Miller TR, Smith GS, Spicer RS, Romano EO, Fisher DA. Alcohol involvement in burn, submersion, spinal cord, and brain injuries. Medical Science Monitor 2004;10(1):CR17–24.

 

12.Office of Applied Studies. The NSDUH Report: Alcohol Dependence or Abuse and Age at First Use. Rockville, MD: Substance Abuse and Mental Health Services Administration, October 2004. 

 

13.Substance Abuse and Mental Health Services Administration. A Comprehensive Plan for Preventing and Reducing Underage Drinking. Washington, DC: 2006.  

 

14.Centers for Disease Control and Prevention (CDC). Alcohol-Related Disease Impact (ARDI). Atlanta, GA: CDC. Available at http://www.cdc.gov/alcohol/ardi.htm. Accessed March 28, 2008.

 

15.Miller JW, Naimi TS, Brewer RD, Jones SE. Binge drinking and associated health risk behaviors among high school students. Pediatrics 2007;119:76–85.

 

16.Department of Health and Human Services. U.S. Surgeon General Releases Advisory on Alcohol Use in Pregnancy; urges women who are pregnant or who may become pregnant to abstain from alcohol. Released Monday, February 21, 2005.