Alcohol in some form or another has made headlines off and on throughout the years for its supposed health benefits. But what really is the truth on the matter?

In simplest terms, drinking less is better for health than drinking more. If an adult of legal drinking age does choose to drink, drinking in moderation is recommended. What exactly is considered “moderation?” For men, that is considered two “standard” drinks or less in a day. For women, that is considered one “standard” drink or less in a day. There are also certain populations that should not consume any amount of alcohol, including:

• Individuals under age 21, the minimum legal drinking age in our country
• Individuals who are pregnant or may be pregnant
• Individuals with medical conditions what may be made worse by drinking
• Individuals taking medications that may interact with alcohol
• Individuals planning to drive a vehicle or operate machinery
• Individuals who are unable to control the amount of alcohol they consume

Now, let’s define what a “standard” drink is. A standard drink is any beverage containing 14 grams of pure alcohol, or 0.6 fluid ounces. Here are standard drink equivalents:

• Beer – one 12 ounce serving of “regular” beer containing 5% alcohol
• Hard seltzer or other malt beverages – one 8-10 ounce serving containing 7% alcohol
• Wine – one 5 ounce serving of wine containing 12% alcohol
• Hard liquor or spirits – one 1.5 ounce shot containing 40% alcohol

In other terms, a 12 ounce hard seltzer actually contains 1-1/2 standard drinks and a 16 ounce beer contains 1-1/3 standard drinks. A regular wine bottle, which is 750mL, is five standard drinks.

Why is alcohol consumption a big deal, anyway? It’s because of a variety of both short-term and long-term consequences that can come with alcohol use.

Short-term consequences

First, heavy alcohol consumption can lead to blackouts, or gaps in a person’s memory of events that took place when intoxicated. Second, alcohol is associated with a large number of injuries and fatalities. Approximately 31% of all motor vehicle traffic fatalities involve alcohol. Approximately 25% of suicides involve alcohol. Alcohol is a factor in most fatal falls and half of fatal drownings. Alcohol is a contributor to a large percentage of emergency department visits and is associated with a significant number of sexual assaults.

Long-term consequences

Heavy and/or chronic consumption of alcohol can directly cause certain health problems and exacerbate other chronic health problems. Alcohol use is associated with damage in the following organs:

• Liver – causing fatty liver, fibrosis, cirrhosis, alcohol-associated hepatitis and liver cancer
• Pancreas – causing acute or chronic inflammation of the pancreas, called pancreatitis
• Gastrointestinal – causing stomach inflammation, bleeding ulcers, alterations in the gut’s microbiome and colon cancer
• Heart – causing abnormal heart rhythms, high blood pressure, heart disease, cardiomyopathy and heart failure
• Brain – causing memory impairment and stroke
• Lungs – causing pneumonia or acute respiratory distress syndrome
• Muscle – causing muscle inflammation and muscle wasting
• Bone – causing reduced bone density and impaired ability to repair broken bones

There is strong evidence that alcohol consumption can increase risk of certain types of cancer. This includes head and neck cancers (oral cavity, pharyngeal and laryngeal cancers), esophageal cancer, liver cancer, breast cancer and colon cancer. In women, even one drink a day can increase risk of breast cancer by 5 to 15% compared to women who don’t drink at all.

The immune system is weakened by drinking as well, both in the short and long term. Drinking heavily on a single occasion slows the immune system for up to 24 hours after consumption. Chronic heavy drinking makes people more likely to contract serious infectious diseases.

Now that we know what a standard drink is and what is considered “moderate” drinking, let’s discuss alcohol misuse. Alcohol misuse includes both binge drinking and heavy drinking. Binge drinking is consumption of four or more drinks for a woman and five or more drinks for a man in a single occasion. Heavy drinking is four or more drinks on any day or eight or more drinks per week for women, and five or more drinks on any day or 15 or more drinks per week for men. Alcohol misuse can lead to damage in organs and cause serious and permanent health issues. It can also lead to tolerance to alcohol, or in other words, a condition where it takes more and more alcohol to feel intoxicated. Those with tolerance to higher amounts of alcohol are in turn at increased risk for alcohol use disorder.

Alcohol use disorder (AUD) is an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. AUD has also been referred to as “alcohol abuse,” “alcohol dependence” or “alcoholism.” People struggling with AUD continue drinking despite suffering from negative effects of alcohol consumption on relationships with family and friends, negative effects on work, legal ramifications from drinking, and having alcohol-related problems with their health. Below are symptoms used by doctors to diagnose AUD:

In the past year, have you:

• Had times when you ended up drinking more, or longer, than you intended?
• More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
• Spent a lot of time drinking, being sick from drinking, or getting over other aftereffects?
• Wanted a drink so badly you couldn’t think of anything else?
• Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
• Continued to drink even though it was causing trouble with your family or friends?
• Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
• More than once gotten into situations while or after drinking that increased your chances of getting hurt?
• Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had an alcohol-related memory blackout?
• Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
• Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, dysphoria (feeling uneasy or unhappy), malaise (general sense of being unwell), feeling low, or a seizure? Or sensed things that were not there?

AUD severity is based on the presence of the number of symptoms above.

• Mild: presence of 2-3 symptoms
• Moderate: presence of 4-5 symptoms
• Severe: presence of 6 or more symptoms

If you think that you or a loved one may be having difficulty with AUD, know that help exists. Treatment approaches that have been shown to be effective are available. These include behavioral therapy, medications and mutual support groups. Talking with your healthcare provider, family and friends as well as researching the various options can help you decide what may be best for you. What works for one person will not necessarily work for everyone. Effective behavioral treatments include cognitive behavioral therapy, dialectical behavior therapy, motivational enhancement, family counseling, or a combination of these. They are also available in a variety of treatment settings, including outpatient, intensive outpatient, residential or intensive inpatient levels. Three prescription medications approved for use in treating AUD – naltrexone, acamprosate and disulfiram. They work in different ways to help an individual cut back or abstain from alcohol use. Mutual support groups that exist include Alcoholics Anonymous, Narcotics Anonymous, other 12 step programs, Recovery Dharma, faith leaders (priests, chaplains, pastors, etc) or other support groups.

If you find yourself concerned about your or a loved one’s relationship with alcohol, please know that help is available and effective and quitting doesn’t need to be done alone. Listed below are some helpful resources that can provide information. And remember, an effective treatment approach varies from person to person, so please call us at (970) 625-1100 to schedule a visit with your healthcare provider to create an individualized plan.

Alcoholics Anonymous – https://www.aa.org

Narcotics Anonymous – https://na.org

Recovery Dharma – https://recoverydharma.org

Rethinking Drinking: Alcohol and your Health – https://rethinkingdrinking.niaaa.nih.gov

NIAAA Alcohol Treatment Navigator –  https://alcoholtreatment.niaaa.nih.gov

Written by Megan Patrick, DO