Cut off: How much booze is too much?


During the holidays, people were chug-a-lugging along, drinking eggnog with rum, eating fruit cake with more rum, sipping wine, and downing martinis. Most people know their limits. Amateurs, however, haven't learned their limit. Over-drinkers, meanwhile, treat their limit as a minimum: like a night club that requires a two-drink minimum. So how does one know when enough is enough?

Barbra Streisand and Donna Sommers sang a duet, "Enough Is Enough." I don't know how Streisand can hold such a long note without passing out, and I also don't know how some people can drink so much without passing out.

When I was a medical student, I learned a quick screening test to detect alcohol abuse in a person. It is called the CAGE questionnaire, and it has nothing to do with Nicolas Cage or with a Go-Go disco.

To make it interesting, let's do it like a cheerleader. Give me a "C"! "Have you had to cut back on your drinking?" Give me an "A"! "Have you been annoyed by other people criticizing your drinking?" Give me a "G"! "Have you felt guilty about your drinking?" Give me an "E"! "Do you have eye-openers, i.e. a drink in the morning?"

If you answer "yes" to two to four of the questions, you might have a drinking problem. However, I have learned that there is a lot of flexibility in the answers. I asked one person about "A," and he said, "Oh, no. No one ever complains about my drinking. My wife drinks more than I do." To "G," another person answered, "Sure I have felt guilty about my drinking– because I can't keep up with my friends."

For "C," I have heard this too many times, "Yes, I've cut back from 12 beers a day to eight."

Quantity of alcohol is hard to decipher in the medical office. Unless I actually see my patients drinking in public, I am never quite sure how much they are drinking. When I worked in D.C., it took me three months to learn that a favorite malt liquor can have as much alcohol as three and a half beers.

I had a patient who said he had three martinis a day in tumblers. Someone served me a martini in a tiny little glass, and I said, "How cute. It is so small." He said, "This is how the standard martini glass should be." Today, the martini glasses are huge like those seen on "Bewitched" when Samantha and Endora sip drinks in the clouds.

For many people, beer and wine are not considered to be alcoholic drinks. Time after time, I hear some people with alcohol addictions say, "I can't be an alcoholic. I only drink beer." One of my friends has a father who is dying of alcoholic cirrhosis, so he traded in his vodka for saki because he doesn't consider saki an alcoholic drink.

A 12-ounce beer, a four-ounce glass of wine, and a one-ounce shot of 80-proof liquor all have the same quantity of alcohol.

The good thing about a bottle of beer is it is pre-measured. You can count out your "bottles of beer on the wall." I have no idea how many ounces of wine I am served in a restaurant, and mixed drinks forget it!

The bottom line about alcohol: if you have health problems, social problems, relationship problems, and/or emotional problems due to drinking alcohol, you have a drinking problem. Enough is enough depends on how alcohol affects you and others.