Defining Risk Drinking

Many efforts to prevent alcoholrelated harm are aimed at reducing risk drinking. This article outlines the many conceptual and methodological challenges to defining risk drinking. It summarizes recent evidence regarding associations of various aspects of alcohol consumption with chronic and acute alcoholrelated harms, including mortality, morbidity, injury, and alcohol use disorders, and summarizes the study designs most appropriate to defining risk thresholds for these types of harm. In addition, it presents an international overview of lowrisk drinking guidelines from more than 20 countries, illustrating the wide range of interpretations of the scientific evidence related to risk drinking. This article also explores the impact of drink size on defining risk drinking and describes variation in what is considered to be a standard drink across populations. Actual and standard drink sizes differ in the United States, and this discrepancy affects definitions of risk drinking and prevention efforts. KEY WORDS: Alcohol consumption; alcohol use disorder; alcoholrelated harm; alcohol and other drug use (AOD) use harm reduction; harm minimization; prevention of harm from AOD use; problematic AOD use; prevention of problematic AOD use; AOD induced risk; attributable risk; risk thresholds; morbidity; AOD risk mortality; AOD risk injury; standard drink; amount of AOD use; responsible AOD use Preventing alcoholrelated harm does not necessarily require that risk drinking be defined. At th