How to Reduce Your Risk of Alcohol Use Disorder: What Research Shows

Alcohol use disorder (AUD) doesn’t happen overnight. It develops gradually, often so slowly that people don’t realize it’s happening until they’re deep in it.

If Dry January has made you think about your relationship with alcohol—even just a little—this is worth understanding: what increases the risk of developing AUD, what decreases it, and how to make intentional choices going forward.

This isn’t about diagnosing anyone. It’s about prevention—understanding how drinking patterns evolve so you can make informed decisions about yours.

What is alcohol use disorder?

AUD exists on a spectrum, from mild to severe. It’s characterized by difficulty controlling alcohol use despite negative consequences. The DSM-5 identifies 11 criteria; the more you meet, the more severe the disorder.

Some criteria include:

• Drinking more or longer than intended
• Wanting to cut down but not being able to
• Spending significant time drinking or recovering
• Cravings
• Drinking interfering with responsibilities
• Continuing despite relationship problems
• Giving up activities to drink
• Drinking in dangerous situations
• Needing more alcohol for the same effect (tolerance)
• Withdrawal symptoms when not drinking

Meeting 2-3 criteria indicates mild AUD; 4-5 is moderate; 6+ is severe. Many people who wouldn’t consider themselves “alcoholics” actually meet criteria for mild AUD.

Risk factors you can’t control

Some risk factors for AUD are outside your control:

Genetics: Having a family history of AUD significantly increases risk. If a parent or sibling has struggled with alcohol, your risk is 3-4 times higher than average.

Mental health conditions: Anxiety, depression, ADHD, PTSD, and other mental health conditions increase AUD risk. The conditions often lead to self-medication with alcohol.

Early exposure: Starting to drink before age 15 substantially increases lifetime risk of developing AUD compared to starting at 21 or older.

Trauma history: Experiencing trauma, especially in childhood, increases vulnerability to substance use disorders.

You can’t change these factors. But you can be aware of them—and be more intentional about your drinking if you have them.

Risk factors you can influence

Other risk factors are within your control:

Drinking patterns

How much you drink matters. Heavy drinking (more than 4 drinks per day for men, 3 for women) significantly increases AUD risk. Binge drinking (5+ drinks on one occasion for men, 4+ for women) also elevates risk, even if overall consumption is moderate.

How often you drink matters. Daily drinking creates more opportunity for dependence than occasional drinking. The more frequently alcohol is present, the more your brain adapts to it.

Drinking alone matters. Social drinking tends to be self-limiting. Drinking alone removes social constraints and is associated with higher AUD risk.

Why you drink

Drinking for effect (to feel different) is riskier than drinking for taste or social reasons. If you’re drinking specifically to reduce stress, manage emotions, or feel better, that’s a higher-risk pattern than drinking because you enjoy wine with dinner.

Using alcohol to cope with difficult emotions is a warning sign. The more you rely on alcohol for emotional regulation, the more your brain comes to depend on it.

Environment

Easy access increases risk. Having alcohol readily available at home makes it easier to drink habitually.

Social environment matters. Spending time with heavy drinkers normalizes heavy drinking and creates pressure to match their consumption.

What Dry January reveals about your risk

Dry January is actually a useful risk assessment tool. How you experience this month tells you something:

Lower risk indicators:

• The month has been challenging but manageable
• Cravings exist but don’t dominate
• You’re noticing benefits and feeling better
• Social situations are awkward but navigable
• You haven’t seriously considered giving up

Higher risk indicators:

• The month has been extremely difficult, more than expected
• Cravings are intense and persistent
• You’ve experienced physical withdrawal symptoms
• You’ve had significant mood changes (worse, not better)
• You’ve broken the commitment multiple times
• You’re counting down to February 1st intensely

Neither set of indicators is a diagnosis. But they give you information about where you might be on the spectrum.

Evidence-based prevention strategies

If you want to reduce your risk of developing AUD (or keep mild patterns from progressing), here’s what works:

Maintain drink-free periods

Taking regular breaks from alcohol—whether Dry January annually, alcohol-free weekdays, or other patterns—helps prevent tolerance from building and keeps your relationship with alcohol from deepening unconsciously.

This is exactly what you’re doing now. Consider making it a recurring practice.

Set and keep limits

Decide in advance how much you’ll drink and stick to it. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines low-risk drinking as:

• For women: No more than 3 drinks on any single day AND no more than 7 per week
• For men: No more than 4 drinks on any single day AND no more than 14 per week

These aren’t “safe” limits—they’re “low risk.” Even within these limits, some risk exists.

Monitor your why

Pay attention to why you’re drinking. If you notice you’re increasingly drinking to cope with stress, emotions, or problems—rather than for pleasure or social connection—that’s a pattern to interrupt.

Address underlying issues

If you have anxiety, depression, or other mental health conditions, getting proper treatment reduces the need to self-medicate with alcohol. Many people’s drinking decreases significantly once underlying conditions are addressed.

Be honest about family history

If AUD runs in your family, take that seriously. This doesn’t mean you can’t drink—but it means you have less margin for error. Patterns that might be fine for someone without family history could be riskier for you.

Maintain alternative coping mechanisms

The more tools you have for managing stress, processing emotions, and creating enjoyment, the less you need alcohol for these functions. Dry January is a good opportunity to develop these tools.

After Dry January: Making a Plan

As January ends, think about what you want going forward:

Questions to consider:

• What have I learned about my relationship with alcohol?
• Are there patterns I want to change?
• What safeguards would help me drink more intentionally?
• Do I have risk factors that warrant extra caution?

Options to consider:

• Return to previous drinking with more awareness
• Set specific limits (drinks per day, per week, per occasion)
• Establish alcohol-free days or weeks
• Extend Dry January for longer
• Significantly reduce or stop drinking
• Seek professional support for underlying issues

There’s no single right answer. The goal is intentional decision-making based on honest self-assessment.

When to seek professional support

Consider talking to a healthcare provider or mental health professional if:

• Dry January revealed concerning patterns
• You have multiple risk factors for AUD
• You’ve tried to moderate and struggled
• Underlying mental health issues are driving your drinking
• You’re not sure where you fall on the spectrum and want assessment

Early intervention works better than waiting until things are clearly problematic. If you’re questioning your relationship with alcohol, that question alone is worth exploring.

At Brightside, we help people understand and address their relationship with alcohol, especially when it intersects with anxiety, depression, or other mental health concerns. Take a free assessment to learn more about whether support might help.

Common questions

How do I know if I have alcohol use disorder?

AUD is diagnosed based on specific criteria (difficulty controlling use, cravings, tolerance, withdrawal, negative consequences). Only a healthcare provider can diagnose AUD, but if you’re concerned about your drinking, that concern is worth exploring professionally—you don’t need to be sure before seeking an assessment.

Does having a family history of alcoholism mean I’ll become an alcoholic?

No. Family history increases risk but doesn’t determine outcome. Being aware of your family history allows you to be more intentional about your drinking patterns, monitor yourself more carefully, and seek help earlier if patterns become concerning.

Can I prevent AUD if I’m already drinking regularly?

Yes—prevention applies at any stage. Moderating consumption, maintaining drink-free periods, addressing underlying mental health issues, and staying honest about your patterns can all reduce the risk of progression.

What’s the difference between heavy drinking and alcohol use disorder?

Heavy drinking describes a pattern of consumption (exceeding low-risk guidelines). AUD describes a condition characterized by impaired control over drinking. Heavy drinking increases risk of developing AUD, but not everyone who drinks heavily has AUD. However, the line can blur over time.

Is it possible to go from unhealthy drinking patterns to healthy ones?

For some people, yes—especially if patterns haven’t progressed too far. For others, moderation is difficult or impossible, and abstinence works better. This varies by individual. If you’ve tried moderation and struggled, that’s information about what approach might work for you.