The following are guidelines published by the Australian National Health and Medical Research Council about what constitutes safe drinking, and addresses drinking once alcohol related brain impairment (ARBI) has been identified.

Low, Medium and High Risk

One standard drink (10 grams of alcohol) is in:
2 x 258ml glasses of light beer
1 x 258ml glass of regular beer
1 x 100ml small glass of table wine
1 x 30ml nip of spirits
1 x 63ml fortified wine

ARBI and Alcohol Consumption

Alcohol consumption ranges from light (social drinkers) to heavy consumption. Decline in cognitive functioning related to alcohol use is gradual, and depends upon the amount of alcohol consumed, and for how long.

The degree of brain impairment resulting from alcohol consumption depends on many factors, including the amount and pattern of consumption, age, sex, nutrition and individual differences. ARBI may be mild, moderate, severe, or very severe.

Months or years of drinking results in the development of tolerance to alcohol. Tolerance refers to the ability to consume increasing amounts of alcohol without showing gross signs of intoxication. Tolerance can be mistaken as a sign of resistance to the adverse consequences of drinking. Tolerance is, however, an indicator of serious changes produced by alcohol. Tolerance allows individuals to maintain higher blood alcohol concentrations without appearing intoxicated, while many aspects of brain functioning and vital organs are vulnerable to injury.

Most people do not present with identifiable symptoms of ARBI until aged in their early thirties. Younger people who have similar symptoms may have brain impairment from another cause or combination of causes - for example, dual addiction to other substances or traumatic brain injury.

Fetal Alcohol Spectrum Disorders and Learning disabilities can be additional complicating factors in diagnosis.

It is important to note that younger people are at greater risk of incurring a traumatic head injury as a result of alcohol use.

Drinking after ARBI has been identified

People with ARBI who continue to drink have an increased risk of assaults, falls, car accidents and trauma which can exacerbate existing brain impairment. There is increasing evidence to suggest that the effects of alcohol on an already injured brain can be dramatic and unpredictable.
The potentially serious consequences of continued alcohol consumption for individuals with ARBI needs recognition when decisions about further consumption are to be made.