Are You Drinking Too Much? Depends on Whether You Ask the CDC, NIAAA, or Smashed.

Health and medicine explained.
Oct. 12 2012 12:44 PM

How Much Drinking Is Too Much Drinking?

Smashed is the best movie yet about our relationship with alcohol. 

People drinking at a bar.
How many drinks are OK? How many on a week night? In a weekend? In a week?

Photograph by Hemera Technologies/AbleStock/Thinkstock.

Throughout my childhood, the same 12 bottles of liquor populated our pantry, gathering dust and cobwebs, buried beneath a shifting stock of Canada Dry (my father’s favorite tipple), cereal boxes, and canned goods. Then I turned 16 and realized what the stuff in those musty old bottles was good for. By the time I was through carefully replacing the volume of what I stole with water, the contents would have frozen instantly had the bottles even been placed in the same room as the refrigerator.

Ever since those midnight raids on my parent’s rapidly diluted liquor supply, I’ve enjoyed a good drink. OK, drinks. My peak consumption years coincided with college, when my friends all lived within walking distance and my coffers did not have to be squandered on rent, food, or water bills. I won’t bore you with stock tales of academic revelry; suffice to say that my years at school were frequently punctuated by boozy adventuring and sweetly shambling courtships. It’s a minor miracle I found the time to absorb my Marx, Homer, and Jane Austen readings.

Things tapered off a bit afterward. College-level drinking doesn’t mix particularly well with waking in the morning, caring for pets (not to mention children) or, for those who indulge in the practice, operating automobiles and other assorted heavy machinery. You know, life stuff. It doesn’t do a thing for your writing ability either, contrary to popular belief, unless your editors prefer Choose Your Own Punctuation-style first drafts. (“Whatever part drink may play in the writer’s life, it must play none in his or her work,” Kingsley Amis wrote in his Memoirs; and this from the guy who wrote a book called Every Day Drinking.)

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Alcohol still plays an important part in my social life, as it does for many Americans. Most of my friends and acquaintances drink, keep a supply of booze about the house, and even get drunk, at least on the weekends. Most of us know our limits, and the limits of alcohol, better than we did in high school or college. And who doesn’t know a story of a parent, an uncle, a friend, who has struggled with alcohol, perhaps unto death?

But how many drinks are OK? How many on a week night? In a weekend? In a week? The CDC has extremely stringent answers to these questions. The agency’s definition of “heavy drinking”—an average of more than one drink a day for a woman—could make my mom, a wine-with-dinner lady, sound like Cersei Lannister. My personal experiences of doctors scolding against any overindulgence, ever—no matter the weddings, birthdays, or neighborhood dance parties—leave me feeling exasperated and not disposed to consider their opinion.

Such rigid definitions don’t seem helpful and smack of pathologizing a behavior—drinking with your friends, or even alone in moderation—that has served humanity well since our ancestors settled down for a beer and a bit of civilization. According to the CDC, 50.9 percent of Americans drink regularly (which the agency defines as more than 12 drinks per year). Overly puritanical government and medical cautions against alcohol consumption, which contrast so markedly with the experience of many, could lead drinkers to totally blow off these recommendations.

That would be a grave mistake, too, and one that has plenty of pop-cultural support, from the pages of Tucker Max’s ill-making memoirs to Katy Perry’s “Last Friday Night,” which upon completion of this sentence will be stuck in my head for at least a month. (“It's a blacked out blur, but I'm pretty sure it ruled!”) There is evidence that moderate drinking is good for you, but even more evidence that nonmoderate drinking isn’t. This is all made more difficult because definitions of moderation vary, as do every individual’s personal limits. (I had a friend in college who got spectacularly sozzeled off of two beers.)

“According to the CDC, everyone who drinks regularly and in a way that would make Julia Child proud is an at-risk drinker,” says Gabrielle Glaser, author of the forthcoming Her Best-Kept Secret, a book about drinking and American women. “I think we need to completely reframe our conversation: We need to have an open conversation about where fun is and where fun stops.”

Smashed is a movie about two people who have not considered this conversation. Kate and Charlie, played by Mary Elizabeth Winstead and Aaron Paul (he just won an Emmy for Breaking Bad), drink a lot, every day. They are about my age, their professions are familiar (she teaches, he writes), and their affection is evident. They seem to have been having a good time. But Kate, at least, has reached the point where “all the things that used to be funny aren't really funny anymore and things have gone from embarrassing to scary.”

Esquire describes Smashed as a “hipster Days of Wine and Roses,” a hammy 1962 film about another white, middle-class, hard-drinking couple. But that’s not right. Days of Wine and Roses covers the arc of a relationship that is grim from the beginning. (Jack Lemmon downs a pint of bourbon, by himself, on their first date. That’s a warning sign, ladies.) Smashed has no equivalent of Lemmon thrashing around in a sanatorium, straightjacketed and screaming with delirium tremens. The depiction of his addiction is so hideous that even many hardened drinkers can easily distance themselves from it: I’d never wind up like that. The other, far more relatable, pole can be seen in films from The Thin Man—“Would you bring me five more Martinis?”—to Animal House, which depict the sociable, fun side of alcohol with few, if any, hints of its dangers. Who hasn’t gotten drunk and silly with their friends?

“That line between moderate drinking and problematic drinking is not something that is cut and dry; it evolves for people,” says historian Lori Rotskoff, author of Love on the Rocks: Men, Women, and Alcohol in Post-World War II America. “Carving out that middle ground is something that gets negotiated culturally, and film presents a really good opportunity [for measuring] these anxieties.”

Smashed does a better job than any film I’ve seen of addressing our culture’s schizophrenic relationship with drinking. It covers a year or so in the life of the couple (at a trim 85 minutes, it’s a little too short) and the increasing obviousness of their problem. Unlike Days of Wine and Roses—which can feel like a two-hour PSA with unusually fine acting—Smashed offers an understandable explanation for the couple’s dangerous drinking. The film gives fair play to booze: Kate and Charlie imbibe because they have a lot of fun while doing it. So they do it all the time. Lacking any control mechanisms, or dialogue about their habits, they seem to think they can live like Bluto. They are hazily unaware of the warning signs.

But there are a lot of them. Within the first 20 minutes of the movie, Kate, who drinks more desperately than her husband, exhibits five of the National Institute on Alcohol Abuse and Alcoholism’s (NIAAA) eleven “symptoms of an alcohol use disorder.” (Their ReThinking Drinking website provides an interactive tool for gauging levels of alcohol abuse, and its rationing standards are a bit laxer than those of the CDC.) She pisses the bed, drinks in the morning, keeps a flask in her car, vomits in class from a hangover, drives drunk, smokes crack while hammered, and awakes twice in unfamiliar locales.

Definitions of alcoholism and alcohol abuse shift over time, as Rotskoff argues, but the behaviors named above should send anyone’s klaxons blaring. The NIAAA’s list of warning signs is useful; any one of them should be an indicator for moderation at the least. Smashed depicts a relationship to alcohol that is clearly having deleterious effects on every aspect of Kate’s life.

The principal cultural value of Smashed is that it tacks a course apart from the two usual depictions of drinking: hilariously screwed-up or dead drunk in a ditch. Instead, it shows us a woman who is slipping from one to the other, and a man who may not be drinking to the same extent but is still letting his perpetual buzz erode his ability to live well.

A recent NIAAA study, covering 43,000 American adults, suggests that most people who like getting drunk on the weekends are unlikely to succumb to the kind of alcohol dependence exhibited by Kate. “Many heavy drinkers do not have alcohol dependence. For example, even in people who have 5 or more drinks a day (the equivalent of a bottle of wine) the rate of developing dependence is less than 7 percent per year,” the study’s summary reads.

But, as Kate’s arc demonstrates, many people do become dependent, and of those some suffer from what NIAAA calls “recurrent or chronic” abuse. And while Charlie may be a “time-limited” abuser (the exact details of his drinking are unclear, as Kate is really the film’s focus), even his less dramatic intake costs him a lot. Endangering your relationship with the one you love, not to mention the woman herself, seems like a pretty solid metric for the slide from recreational to problematic.  

Smashed doesn’t parse out these details and it still presents Alcoholics Anonymous as the best way to get sober, just like Days of Wine and Roses did (although the higher power business is not mentioned). But it still far more relatable than its predecessor or, say, Leaving Las Vegas, and that’s important: The film can provide an impetus for important conversations about drinking in our social lives and in our society. Drinking is often fun, as I discovered on those raids of my parent’s liquor cabinet, but Smashed is an important corrective to the temptation to see it as an uncomplicated pleasure. Alcohol can have its place in life, but there are plenty of places it doesn’t belong. And your car, the shower, and your relationship are among them.

Jake Blumgart is a reporter and researcher based in Philadelphia. Follow him on Twitter.

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