How much drinking is too much? Alcohol, low-risk drinking and signs you're drinking too much

You pour a glass of wine and wonder, just for a second, whether this is your second or your third tonight. Or a friend mentions they've stopped drinking for a month, and you notice you'd find that hard. Questions about our own drinking tend to arrive quietly like this. If you'd like support, we offer alcohol addiction counselling in Kitchener-Waterloo, in person or online anywhere in Ontario.

This article explains what Canada's current guidance says about alcohol and health, what counts as a standard drink, and why the answer to "how much is too much?" is about more than a number. It also covers how drinking can affect your mood, sleep and relationships, and when it might help to talk to someone.

What counts as a standard drink in Canada?

Before you can compare your own habits with any guidance, it helps to know what one drink actually is. In Canada, a standard drink contains about 13.45 grams of pure alcohol. That's roughly:

• a 341 ml (12 oz) bottle of beer, cider or cooler at 5% alcohol
• a 142 ml (5 oz) glass of wine at 12% alcohol
• a 43 ml (1.5 oz) shot of spirits at 40% alcohol

Many drinks are bigger than this. A large glass of wine poured at home, a tall can of craft beer at 7%, or a mixed drink with a double shot can each count as two standard drinks or more. Counting standard drinks rather than glasses often changes the picture.

Canada's Guidance on Alcohol and Health

In 2023, the Canadian Centre on Substance Use and Addiction released Canada's Guidance on Alcohol and Health. It replaced the older drinking guidelines with a simpler message: when it comes to alcohol, less is better.

The guidance describes risk across a range of drinks per week:

Zero drinks a week. No alcohol-related health risk, and benefits such as better sleep and health overall.

One to two standard drinks a week. Low risk. You'll likely avoid alcohol-related harm to yourself or others.

Three to six standard drinks a week. Moderate risk. Your risk of developing several types of cancer, including breast and colon cancer, increases.

Seven or more standard drinks a week. Increasingly high risk. Your risk of heart disease and stroke rises too, and the risk keeps climbing with each additional drink.

The guidance also suggests not having more than two drinks on any one day, and says there's no safe amount of alcohol during pregnancy.

The low-risk alcohol question: why less is better

For many years, people heard that a drink a day might be good for the heart. The newer evidence doesn't support that, and the guidance no longer recommends drinking for health benefits. That doesn't mean everyone who drinks more than two drinks a week is in trouble. It means that every drink carries some risk, and reducing how much you drink lowers that risk, wherever you're starting from.

How alcohol affects your health

Alcohol affects almost every part of the body. Over time, regular drinking is linked to a higher risk of cancer, heart disease, stroke and liver disease. Alcohol is a known cause of cancer, which many people are surprised to learn.

The effects aren't only long term. Even moderate drinking can disrupt sleep, leaving you tired and less able to cope the next day. It can raise blood pressure, affect your weight, and make injuries and accidents more likely.

Binge drinking and heavy drinking

How you drink matters as well as how much. Having several drinks on one occasion, often called binge drinking, carries its own risks even if your weekly total looks moderate. Someone who doesn't drink during the week but has six or seven drinks on a Saturday night is taking on more risk than the weekly number suggests.

Heavy drinking over time increases the risk of physical health problems and of developing a dependence on alcohol. If drinking a lot in one sitting is a pattern for you, our next article looks at how to stop binge drinking and what tends to help.

Am I drinking too much? Questions to ask yourself

Numbers are useful, but they can't tell the whole story. Some people drink within the guidance and still feel alcohol has too much hold on them. Others drink a little over and have no trouble cutting back. You might notice it helps to ask yourself a few honest questions:

• Do you often drink more than you planned to?
• Have you tried to cut back and found it harder than you expected?
• Do you look forward to a drink as the main way to relax or cope?
• Does alcohol affect your sleep, work, or how you feel the next day?
• Has someone close to you said they're worried about your drinking?
• Do you feel uneasy at the idea of a week without a drink?

If you answered yes to some of these, it doesn't mean you have an addiction. It does suggest that your relationship with alcohol might be worth a closer look.

When alcohol use becomes a drinking problem

There isn't a single line that separates everyday alcohol use from problem drinking. It's usually a gradual shift: drinking more often, needing a little more to feel the same effect, or relying on alcohol to get through certain moments. Some people call this grey area drinking, where things aren't falling apart but alcohol is taking up more space than you'd like.

This often shows up in small ways first, such as skipping plans because you're hungover, or keeping a closer eye on whether there'll be a drink at an event. If you're wondering whether things have gone further, our article on the signs of alcohol addiction describes the patterns to watch for.

Alcohol, mood and mental health

Many people drink to take the edge off stress or anxiety. In the moment, it can work. But alcohol is a depressant, and as it wears off, anxiety and low mood often return stronger. Over time, drinking to cope can make your mental health harder to manage, not easier, and can strain your relationships too.

If you notice that you drink more when you're stressed, lonely or low, that pattern is worth paying attention to. It's often a sign that alcohol is doing an emotional job, and that the feelings underneath need care.

Cutting back on alcohol

If you'd like to drink less, small, concrete changes tend to work better than big promises. Some people find these helpful:

Count your drinks. Track standard drinks for a couple of weeks so you know your real starting point.

Plan alcohol-free days. Choose a few days a week when you don't drink at all.

Slow down. Alternate each drink with water, and choose smaller sizes or lower-strength options.

Notice your triggers. Pay attention to the times, places and feelings that lead you to drink.

If you've been drinking heavily or every day, talk to a doctor before you stop suddenly, because withdrawal can be medically serious.

When excessive drinking needs support

You don't need to wait until drinking causes a crisis to ask for help. In therapy, we can look at your drinking with you without judgement: what it gives you, what it costs you, and what you'd like to change. Some people want to stop, others want to drink less, and both are reasonable goals.

Counselling can sit alongside medical treatment, peer support or other kinds of help. Whatever the starting point, the aim is the same: a relationship with alcohol that supports your health and your life rather than working against them.

If you're in crisis, you can call or text 9-8-8 any time. If anyone is in immediate danger, call 911.