Know Your Limits: Are you – or is he – among the rising number of service members abusing alcohol?

What’s a normal night of social drinking – two, three, four drinks?

According to the National Institute on Alcohol Abuse and Alcoholism, binge drinking for women is three drinks or more in a single day and no more than seven drinks per week. For men, it’s four drinks or more on a single day and no more than 14 drinks per week.

“There’s been talk that drinking at that level once a week or more often is a link to dependence,” said Katharine Bradley, MD and senior investigator at Group Health Research Institute. “We know what levels of drinking lead to problems and people really need to keep their drinking below that.”

That’s because studies show that these are the levels at which physical health risks increase, Bradley said. Women’s levels are much lower because both liver damage and breast cancer risk increases with lower levels of alcohol use, she said. But many of us don’t realize at what level the danger starts.

“I think that we as a culture and we as a public health community have not done a good job educating people about the levels of consumption that lead to dependence,” she said.

Bradley and other health professionals recently led a webinarfor the Defense Centers of Excellencethat focused on the increasing levels of alcohol abuse among service members. 

According to DCOE, risky, hazardous and heavy drinking is increasing among veterans and service members. A 2008 study of service members found heavy alcohol use rates increased from 15 percent in 1998 to 20 percent in 2008.

Among the general population, alcohol dependence rates are high among both men and women in their 20s, Bradley said. About 21 percent of men ages 18-29 have an alcohol use disorder; about 10 percent of women in that age group meet the criteria for alcohol abuse, she said.

“The prevalence of alcohol dependence is incredibly high in their 20s,” Bradley said. “I’d say we have societal denial about this issue. It’s challenging for people. They think (drinking above recommended limits is) so common.”

Bradley said there’s no single cause for the rise in alcohol use, but she suspects that for service members it’s often an attempt to self-medicate for PTSD.

“We know that untreated PTSD leads people to drink to try to manage their symptoms,” she said.

Spouses can identify and curtail drinking problems among service members, Bradley said. If you suspect your spouse may be suffering from PTSD, encourage him to get screened so he can receive treatment. If you know you also drink above those recommended limits, get help.

“There’s increasing evidence that if the spouse also drinks, combined couples therapy has been shown to be more effective,” Bradley said. “It’s joining together and especially realizing you might need to stop drinking too to support your partner and getting alcohol out of the house.”

In addition to knowing those binge drinking limits, here are more signs to watch out for:

Withdrawal symptoms

A marked increase in the amount he drinks/diminished effects for the same amount

Drinking larger amounts over longer time periods than intended/lack of control over how much he drinks

Persistent desire or unsuccessful efforts to cut down on drinking

Spending a great deal of time in activities focused on alcohol

Important social, occupational or recreational activities are reduced or given up so he can drink

Continued alcohol use despite persistent psychological or physical problems

Failing to fulfill major obligations due to drinking

Recurrent use of alcohol in dangerous situations or despite legal problems

Continued use despite social or interpersonal problems

If your spouse fears documentation of his alcohol use, look outside the military health system, Bradley said. Programs like Alcoholics Anonymousand new prescription drugs can help combat alcohol abuse, she said.

But not getting help is much more likely to damage his career than ignoring the problem, Bradley said.

“The notion that getting help is going to get in the way, it’s far more often that not getting help gets in the way,” she said.

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