Alcohol: The Good, the Bad, the Ugly

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Alcohol is both good and bad. Makes some happy, others sad. It amplifies joy, or exacerbates decline. It alienates, it coalesces. It de-stresses, stresses, calms and kills. But you know what? You are the variable. So, then is moderation sexy? Explore your prescription.

What goes up must come down.  There is no top without a bottom.  Two sides to every coin.  No front without a back.  A lid without a pot.  My cliche list is endless.  So, I will stop torturing you.

Just know, most arise from kernels of truth.

Alcohol is good and bad.  Makes some happy.  Others sad.  Amplifies joy.  Or, exacerbates decline.  It alienates.  It coalesces.  De-stresses and stresses.  It calms.  It kills.

You are the variable.  As is the dose.

Is ‘Moderation’ sexy? 

For those whose health benefits from moderate drinking exceed their drawbacks, it is.  Like most things, there are no absolutes or guarantees. No one size-fits-all.

According to the 2015-2020 Dietary Guidelines for Americans, moderate alcohol consumption reflects up to 1 drink per day for women and up to 2 drinks per day for men.  A standard one alcoholic drink-equivalent being defined as such (1):

14 grams (0.6 fl oz.) of pure alcohol =    12 fluid oz beer (5% alcohol)

                                                          =     5  fluid oz wine (12% alcohol)

                                                          =    1.5 fluid oz of 80 proof distilled spirits (40% alcohol)

The health advantages are triggered less by ‘what’ and more by ‘how’ you drink.  Consuming the weekly total in two days (aka binge drinking) will be more damaging than following the previously mentioned guidelines.

 

The Good

Alcohol influences multiple organ systems.  In moderation, it may benefit the heart and cardiovascular circuitry by reducing heart rate and blood pressure, lowering the risk of heart disease (and death from it) as well as stroke.  A report by the Harvard T. H. Chan School of Public Health claims “more than 100 prospective studies show an inverse association between moderate drinking and risk of heart attack, ischemic (clot-caused) stroke, peripheral vascular disease, sudden cardiac death, and death from all cardiovascular causes.  The effect is fairly consistent, corresponding to 25 percent to 40 percent reduction in risk.” (2)

In this volume, it is linked to improving HDL levels (the ‘good cholesterol’) which protects the heart when elevated.  Optimizes insulin control which reduces the risk of diabetes.  Decreases gallstone formation.  Positively impacts clotting to avoid strokes and heart attacks.  By putting certain imbibers at ease, it might also lessen social isolation and serve to diminish stress.

It is important to realize that not everyone responds this way.  Or, is eligible for this prescription.

  

The Bad

Heavy, binge or excessive drinking can be destructive.  The hazards abound with ever-increasing intake.  The liver getting chronically inflamed may lead to alcoholic hepatitis with ultimate progression to scarring (aka cirrhosis) and liver failure warranting transplant.  Since alcohol is a central nervous system depressant, the effects can prompt poor judgement, memory loss, sleep disturbances, or loss of coordination.  In so doing, you put yourself in harm’s way.

If consumed while on certain medications or in a smoker, then the results can be magnified.  The evidence is convincing that breast cancer chances increase along with other cancers.  Gastrointestinal issues may develop.  Heart muscle may get injured.  The adverse impact on an unborn baby presents on a wide, unknowing spectrum (ranging from stillbirth and miscarriages to birth defects).    

Abuse and misuse of alcohol play a vital role in creating a future that could be filled with doctors of differing specialty.  Genetics play a part, so family history of alcoholism is useful information.  Environmental factors can be compounding triggers.  

  

The Ugly

Heavy drinking is a major cause of preventable death and chronic disease.  Addiction initiates a cascade of untoward events.  If reasoning and decision-making are impaired, then violence, sexual assault and risky sexual behaviors may morph into reality (e.g. unprotected sex exposing self to infections).  Drowning, falls, motor vehicle fatality and disability enter the mix.  Toxic levels can accelerate ER visits.  Mental health deteriorates, in some instances, to dementia or worsening cognition often accompanied by depression and anxiety.  

The National Institute on Alcohol Abuse and Alcoholism statistics are sobering:

  • Fourth leading cause of preventable death in the U.S. 

        ~88,000 (62,000 male, 28,000 female) die annually from alcohol-related causes

  • In 2014, 31% of all driving fatalities secondary to alcohol impairment 
  • In 2010, alcohol misuse cost U.S. $249.0 billion with 75% due to binge drinking
  • In 2012, more than 10% of U.S. kids live with a parent with alcohol problems
  • Research shows alcohol use during teen years can interfere with normal brain development, increase alcohol misuse disorders, contribute to injuries, sexual assault and even deaths (including car crashes)
  • In 2009, alcohol-related liver disease was primary cause of almost 1 in 3 liver transplants
  • Drinking alcohol increases risk of cancers of mouth, esophagus, pharynx, larynx, liver and breast
  • 3.5% all cancer deaths in the U.S. alcohol related in 2009 (3)

 

Self-medicating is a rampant issue that is not limited to alcohol.  It is an unhealthy means to cope and numb out from feeling any pain.  Unfortunately, life is riddled with moments of joy co-existing with periods of suffering.  Using healthy methods to approach these experiences will allow you to grow, better navigate to the other side, maintain jobs, romantic relationships, successful friendships and improved performance, in general.  These aid longevity.  

The current opioid epidemic can be applied to many substances: illegal or prescription as well as alcohol.  Ask yourself:  Do I need to take this every day to function?  If yes, then you might be self-medicating.  Requiring such substances on a daily basis to operate indicates a problem.  An inability to maintain a job, friendships or romantic relationships along with participation in activities of daily living - like basic hygiene - reflects a major impedance to successful living and suspicion for abuse.  

Whether you fit into the ‘moderation’ category is an invaluable discussion you should have with your doctor.  Family history and underlying illness should especially give you pause.  It is not recommended for you if contemplating pregnancy or already are pregnant, are underage, on medicines that interact with it, are an alcoholic in recovery and definitely not if performing an activity that could harm others and requires precision and command of instruments or machinery (e.g. driving, conducting surgery).  Additionally, if you don’t drink, then you are encouraged not to start.

SOURCES:

(1)  2015-2020 Dietary Guidelines for Americans: https://health.gov/dietaryguidelines/2015/guidelines/appendix-9/#table-a9-1

(2)  Harvard T.H. Chan School of Public Health:  https://www.hsph.harvard.edu/nutritionsource/alcohol-full-story/

(3)  National Cancer Institute:  https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet