Is it drinks consumed or how much goes into your bloodstream?

Say you have two people, one drinks a pint of beer on an empty stomach and feels tipsy. The other drinks 3 pints with a big meal and feels equally tipsy. Is there a difference in terms of alcohol complications with this pattern in the long run? In other words are recommended limits about absolute unit intake or is it more how much gets through food absorption into your bloodstream? Another way to view it is am I less likely to suffer with health related problems if I drink on an empty stomach and feel more tipsy than someone who drinks more on a full stomach?