The Health Risks of Alcohol

On August 24, 2018, the Lancet published a paper based on a study from the University of Washington,concluding that there is no safe level of drinking alcohol. The Lancet is a renowned English and international medical journal.  The study shows that in 2016, nearly 3 million deaths globally were attributed to alcohol use, including 12 percent of deaths in males between the ages of 15 and 49.

"The health risks associated with alcohol are massive," said Dr. Emmanuela Gakidou of the Institute for Health Metrics and Evaluation at the University of Washington and the senior author of the study. "Our findings are consistent with other recent research, which found clear and convincing correlations between drinking and premature death, cancer, and cardiovascular problems. Zero alcohol consumption minimizes the overall risk of health loss." Gakidou is a professor of health metrics sciences at the UW School of Medicine, and of global health at the UW School of Public Health.

The study does not distinguish between beer, wine, and hard liquor due to a lack of evidence when estimating the disease burden, Gakidou said. However, researchers used data on all alcohol-related deaths generally and related health outcomes to determine their conclusions.

Alcohol use patterns vary widely by country and by sex, the average consumption per drinker, and the attributable disease burden. Globally, more than 2 billion people were current drinkers in 2016; 63% were male.  Alcohol use was less in countries with large numbers of Muslims, as Islam forbids and discourages drinking.  

The study looked at deaths and overall poor health attributable to alcohol for 23 health outcomes, such as communicable and non-communicable diseases and injuries, including:

• Cardiovascular diseases: atrial fibrillation and flutter, hemorrhagic stroke, ischemic stroke, hypertensive heart disease, ischemic heart disease, and alcoholic cardiomyopathy;
• Cancers: breast, colorectal, liver, esophageal, larynx, lip and oral cavity, and nasal;
• Other non-communicable diseases: cirrhosis of the liver due to alcohol use, diabetes, epilepsy, pancreatitis, and alcohol use disorders;
• Communicable diseases: lower respiratory infections and tuberculosis;
• Intentional injuries: interpersonal violence and self-harm;
• Unintentional injuries: exposure to mechanical forces; poisonings; fire, heat, and hot substances; drowning; and other unintentional injuries; and
• Transportation-related injuries.

"We now understand that alcohol is one of the major causes of death in the world today," said Lancet Editor Richard Horton. " We need to act urgently to prevent these millions of deaths. The myth that one or two drinks a day are good for you is just that -- a myth. This study shatters that myth."

The take home message from this study is complicated.  Companies providing beer, wine and hard liquor are enormously large and powerful, permeating the world of sports, dining and agriculture. Cutting down on alcohol use means resisting pressures from many directions – advertising, friends, social events, and habits.  If you want to abstain, and can go 3-4 days without alcohol, you are probably not seriously addicted and can make the shift. You may decide to have a single drink on special occasions, such as your birthday, but be sober at other events.   If you have been a regular drinker and have great difficulty abstaining a day or two, you should see your doctor to discuss the possible use of temporary drugs to help you through the transition to sobriety.  In either case, you should start going to AA meetings, both for help and to meet other non-drinkers.  You will get a sponsor who will help your transition.  Don’t worry if you don’t believe in a God – the group itself, or nature, can function as your higher power.  

Sadja Greenwood, MD, MPH    back issues on this blog