Alcoholics aren’t the only ones who need to be concerned about their drinking habits. We all know someone who drinks more than they should, but justifies their habit by arguing, “At least I’m not an alcoholic” or “It’s just wine – wine is good for you!”
Even though they are not necessarily alcoholics, heavy drinkers risk a lot. Excessive alcohol consumption has been associated with a broad range of emotional, mental and physical health problems, including:
Impaired Physical Health – Research has linked habitual heavy drinking to more than 60 diseases, including:
• Liver disease (including cirrhosis)
• Brain shrinkage or dementia
• High blood pressure (which can increase the risk of stroke, kidney disease and heart failure)
• Cancer (including breast, colon, stomach, mouth, throat, esophagus and liver cancers)
• Heart disease and stroke
• Nutritional deficiencies
• Digestive problems such as gastritis and pancreatitis
• Mental health problems such as depression, anxiety and suicide
• Alcoholic neuropathy (nerve damage)
• Seizures and epilepsy
Sleep Disorders – As a depressant, even a moderate amount of alcohol can impair sleep quality. Excessive drinking may trigger sleep disorders such as sleep apnea, and can exacerbate existing sleep problems.
Accident/Injury – Alcohol is a factor in a significant number of accidents and injuries, including:
• 40 percent of fatal highway crashes, fatal falls and suicides
• 50 percent of sexual assaults and trauma injuries
• 60 percent of drownings, fatal fires and homicides
Alcohol is also a leading factor in child abuse and neglect cases and is involved in two out of three incidents of intimate partner violence.
Weakened Immunity – Over time, heavy drinking may affect the body’s ability to fight off illness and heal itself from injuries and infections such as tuberculosis, pneumonia and sexually transmitted diseases. In a recent study published in the Journal of the American College of Surgeons, patients who drank heavily had longer hospital stays after undergoing surgery and were twice as likely to return to the operating room as low-risk drinkers.
Birth Defects – No amount of alcohol is safe to drink while pregnant. Research shows that drinking alcohol during pregnancy increases the risk of fetal alcohol syndrome, miscarriage, stillbirth and other serious conditions. While many women stop drinking once they find out they are pregnant, there is also a risk of alcohol exposure during the first few weeks, before the pregnancy has been confirmed.
Risky Sex – As a result of impaired executive functioning and loss of inhibitions, heavy drinkers are more likely to engage in high-risk sex (e.g., unprotected or anonymous sex or sex with multiple partners). Studies have shown a three-fold increase in the risk of contracting a sexually transmitted disease among heavy drinkers.
Alcohol Poisoning – Heavy drinking, especially binge drinking, can cause dangerously high blood alcohol levels and lead to unconsciousness, respiratory depression, low blood pressure and body temperature, and death.
Addiction – Heavy drinkers are at increased risk of developing an alcohol addiction, especially if they have a personal or family history of addiction or mental illness. While only 2 percent of low-risk drinkers are ever diagnosed with alcohol abuse or addiction, those who routinely exceed recommended levels have a substantially higher risk of developing alcoholism (up to 50 percent), according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
Social Problems – It is often the spouse or partner of a heavy drinker who eventually seeks help or threatens to leave if their significant other refuses to get treatment. Excessive drinking takes users away from their family and friends, and makes them less present when they do spend time with loved ones. Heavy drinkers are also more likely to suffer from reduced productivity at work or unemployment.
Many people are able to drink alcohol without suffering serious consequences. They do so by remaining moderate. According to the NIAAA, low-risk drinking is considered:
• Men: four or fewer standard drinks a day and no more than 14 drinks a week
• Women: three or fewer standard drinks a day and no more than seven drinks per week
A standard drink is 5 ounces of wine, 1.5 ounces of distilled liquor or 12 ounces of beer.
Even low-risk drinking poses some risk. Each person has to assess their own risk factors, such as age, health, family history and life circumstances. The NIAAA makes clear that certain people should exercise caution or avoid drinking altogether, including those who:
• Plan to drive or operate heavy equipment
• Are pregnant or plan to become pregnant
• Have certain medical conditions, such as chronic pain, mental health disorders, long-term liver, stomach or pancreas problems, hepatitis C, and certain heart conditions
• Are taking medications that interact with alcohol
• Are responsible for the care of children or others
• Have a personal or family history of addiction
• Are under the legal drinking age
Alcohol research began as early as the 1930s, yet we’re still making new discoveries. Sometimes the unfortunate result is that the public gets mixed messages about alcohol. Some studies suggest benefits of light to moderate alcohol consumption, including a reduced risk of heart disease and stroke. And it appears the public is holding tight to these and other perceived benefits.
A study published in Psychology of Addictive Behaviors suggests that people justify their alcohol use by overlooking negative consequences and focusing on the perceived positive effects, such as courage, talkativeness, energy and improved sexual encounters.
But the benefits of drinking must be weighed against the risks. There are less harmful ways of minimizing the risk of heart disease, such as regular exercise and a healthy diet, and there are better ways to relax and improve social skills.
Although alcohol may seem like one of the least harmful drugs, it is responsible for a significant number of drug rehab admissions. Of the 1.8 million admissions to drug treatment facilities in 2008, 41.4 percent involved alcohol abuse, according to the Substance Abuse and Mental Health Services Administration. Whether an alcohol problem exists depends largely on how much the individual drinks, how often, and how it affects them and the people around them.
So what’s a person to do if they enjoy kicking back a beer or sipping a glass of wine? For most people, the occasional drink probably won’t do much damage, but stop there. The risks go up as the amount of alcohol increases, and moderation is an acquired skill. Since many people do not need to stop drinking altogether, the best approach may be cutting back enough to enjoy some of the positives while avoiding as many of the negatives as possible.
David Sack, M.D., is board certified in addiction medicine and addiction psychiatry. He is CEO of Elements Behavioral Health, a network of addiction treatment programs that include Promises rehab centers in Malibu and Los Angeles, The Ranch near Nashville, and The Recovery Place in Florida.
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Last reviewed: 2 May 2012