Gray Area Drinking

Gray area drinking is a term that describes the realm between a healthy level of alcohol consumption and a diagnosis of alcohol use disorder (the clinical term for alcoholism).

While gray area drinking is not an official diagnosis, the term accurately expresses a growing problem with immoderate drinking since coronavirus and its aftermath brought sweeping changes across the world.

The extra stressors triggered by the pandemic over the past two years have led to sharp increase in alcoholism in the United States. 2019 data from SAMHSA’s annual National Survey on Drug Use and Health (NSDUH) shows that 14.5 million people in the U.S. had alcohol use disorder. The most current data from NSDUH 2020 showed that more than 28 million people are now grappling with alcohol use disorder.

What is Gray Area Drinking?

Gray area drinking, like any gray areas in life, is not robustly defined and the boundaries are unclear. The zone sits somewhere between moderate drinking and the rock bottom of alcoholism. CDC defines moderate drinking as no more than one standard drink for women each day, and no more than two standard drinks for a man each day. 

A relatively new term and not a clinical descriptor, gray area drinking describes all those who consume more than moderate quantities of alcohol but who do not meet the criteria for alcohol dependence or alcohol use disorder. 

Gray area drinkers, then, are not physically dependent on alcohol. People falling in the gray area of alcohol consumption typically drink because they want to consume alcohol, not because they need to stave off withdrawal symptoms brought about by the absence of alcohol – this occurs when you become alcohol-dependent. 

Since someone drinking relatively moderate levels of alcohol will not identify as having AUD, it is highly unlikely they will attend peer-support meetings like those of AA (Alcoholics Anonymous). It is equally unlikely that gray area drinkers will be looking to engage with addiction treatment – after all, they could theoretically stop drinking any time they want to. 

So, if you find you are stuck between what most people consider light social drinking and the classic markers of alcoholism, you could be a gray area drinker. Even if your alcohol consumption is not causing visible harm, if you drink more often than once in a while, you could already be on the spectrum of gray area drinking. 

One of the inbuilt difficulties of identifying gray area drinking is the lack of symptoms that might otherwise sound alarm bells. How much alcohol is considered too much, though? 

Well, the following organizations are responsible for the two main sets of drinking guidelines in the United States: 

• NIAAA (National Institute on Alcohol Abuse and Alcoholism)
• DGA (Dietary Guidelines for Americans)

According to NIAAA, low-risk drinking is defined as follows: 

• Men drinking no more than 14 standard drinks weekly and no more than 4 standard drinks daily.
• Women drinking no more than 7 standard drinks weekly and no more than 3 standard drinks daily.

Per the updated DGA 2020-2025, moderate drinking is defined as follows: 

• Men drinking no more than 2 standard drinks daily.
• Women drinking no more than 1 standard drinks daily.

Both sets of guidelines consider a standard drink to be any of the following: 

• Beer with 5% alcohol content (12oz)
• Wine with 12% alcohol content (5oz)
• Distilled spirits with 40% alcohol content (1.5oz)

Beyond this level of moderate drinking, NIAAA defines heavy drinking as follows: 

• Men drinking more than 14 standard drinks weekly and more than 4 standard drinks daily.
• Women drinking more than 7 standard drinks weekly and more than 3 standard drinks daily. 

Per NIAAA, binge drinking is defined as: 

• Men drinking more than 5 standard drinks within 2 hours.
• Men drinking more than 4 standard drinks within 2 hours.

Alcohol use disorder is diagnosed according to APA’s benchmark diagnostic tool, DSM-5-TR (the most edition of Diagnostic and Statistical Manual of Mental Disorders) as follows: 

• Mild AUD: 2 to 3 criteria
• Moderate AUD: 4 to 5 criteria
• Severe AUD: 6 or more criteria

If you feel you are caught somewhere between the alcohol consumption levels outlined above and full-blown alcoholism, you could be in the gray zone.

Who is at Risk for Gray Area Drinking?

Anyone can be at risk of gray area drinking, just as anyone could develop alcohol use disorder. 

Try this gray area drinking test. If you experience any of the following scenarios regularly, you might already be in the gray area of drinking: 

1. You frequently drink alcohol when you’re alone
2. You rely on alcohol as a form of escapism
3. You drink several alcoholic drinks in one sitting
4. You find that you need more alcohol to deliver the same rewards
5. You worry about your drinking habits
6. You suffer from hangxiety

1) You frequently drink alcohol when you’re alone

Drinking alone is one of the brightest red flags for a growing alcohol problem. If you make excuses for drinking alone or lie about solo sessions, this is even more troubling. 

2) You rely on alcohol as a form of escapism

If you are drinking alcohol to self-medicate symptoms of depression or anxiety, this is an ineffective and self-defeating strategy, as well as a prime marker for abusive patterns of drinking already deep into the gray area. 

The more you start relying on alcohol as a coping mechanism for mental health issues, the more you are likely to inflame those issues. Instead, seek treatment for the underlying condition from a qualified mental healthcare professional. 

3) You drink several alcoholic drinks in one sitting

If you frequently drink more than a standard drink in one sitting, this can lead to more habitually consuming excessive quantities of alcohol. 

While binge drinking does not necessarily lead to alcohol use disorder, it will increase your chances of developing AUD. If you engage in binge drinking, you are already at the darker end of the gray zone. 

4) You find that you need more alcohol to deliver the same rewards

The more alcohol you drink, the more your body becomes accustomed to the substance. Sustained alcohol consumption leads to tolerance building. This means you’ll require more alcohol to achieve the same effects. 

Tolerance and withdrawal are both indicative of physical dependence. If you feel you need to drink more alcohol than before, you should start seriously questioning your consumption. 

5) You worry about your drinking habits

If you have started to question or regret your drinking habits, you could already be at risk of gray area drinking. 

6) You suffer from hangxiety

Hangxiety is a term used to describe the anxiety that follows heavy alcohol consumption. 

If you find yourself increasingly troubled by anxiety accompanying hangovers, you could be firmly in the gray area of drinking and potentially already on your way to developing a more serious problem with alcohol. 

When to Seek Help for Gray Area Drinking

Ask yourself the following questions and respond honestly. They can help you determine whether or not you are a gray area drinker. 

• Alcohol is a central part of your life. You couldn’t imagine meeting friends or going for a meal without having a couple of alcoholic drinks. How central is alcohol to your life?
• Even if your alcohol consumption has not triggered any adverse outcomes in your life, do you often worry about the amount you drink?
• Have you tried and fail to moderate your alcohol consumption or to quit drinking completely?
• Do you drink alcohol to cope with stress, depression, or anxiety?
• How often do you engage in binge drinking?

Your responses to the above questions may give you further cause for concern. Speak with your healthcare provider about those concerns. 

Ultimately, if you do not feel in complete control of your alcohol consumption and if you feel unable to quit drinking, you are likely in the gray area of drinking. 

Here are a few of the primary benefits of drinking in line with guidelines for moderation: 

• Improved sleep
• Weight loss and improved overall diet
• Reduced incidence of hangxiety
• Sharper clarity and focus
• Weight loss
• Stronger interpersonal relationships
• More productivity
• Increased energy levels
• More robust immune system
• Overall health improvements

And here’s what to do if you need help regulating your alcohol consumption or quitting alcohol completely…

Treatment for Alcoholism at California Detox 

Maybe you want to engage with addiction treatment before gray area drinking gives way to alcohol use disorder. Perhaps you are already dependent on alcohol and want to regain your life. Whatever your experience with alcohol, we can help you recalibrate your life here at California Detox in Southern California. 

All addictions are unique with alcoholism presenting along a spectrum. As such, we provide treatment programs at all levels on American Society of Addiction Medicine’s continuum of care, including: 

• Inpatient programs (residential rehab)
• PHPs (partial hospitalization programs)
• IOPs (intensive outpatient programs)
• Remote rehab programs
• Dual diagnosis treatment programs

Before you engage with a treatment program at California Detox, you will need to detox. Take advantage of our supervised medical detox program to flush all alcohol from your system, preparing yourself physically for ongoing inpatient or outpatient treatment. 

All treatment programs draw from these evidence-based interventions:

• Medication-assisted treatment
• Group counseling
• Individual counseling
• Psychotherapy (CBT or DBT)
• Family therapy
• Holistic therapy

When you complete your treatment program here at California Detox, you’ll have a firm foundation from which to embrace sober living and a life outside the gray area of drinking. 

All you need to do is reach out to admissions today. The friendly team is waiting for your call at 949.390.5377.