How much is too much? That’s the fundamental question at the heart of Alcohol Awareness Month, a time to consider the numerous negative health and safety impacts of excessive drinking.
According to the U.S. Centers for Disease Control and Prevention (CDC), more than 140,000 Americans lose their lives to excessive drinking a year – that’s more than 380 each day. These are people who are losing their lives, on average, 26 years early – basically, a third of the average American lifespan. These early deaths are mostly attributed to negative health effects from excessive drinking, such as cancer, heart disease and liver disease. However, a substantial number of deaths are also due to drunk driving.
Drinking alcohol in moderation, if at all, is one of the most important things we can do to stay healthy and reduce our risk of a variety of diseases and chronic health conditions. Moderate, responsible drinking is defined as one drink per day for women and one or two per day for men.
Some people who drink too much find it difficult or impossible to stop or cut back. Alcohol use disorder – also known as alcoholism – is a disease that requires treatment, just as any physical illness does. Excessive drinking is not a problem only for those with alcoholism, however. Many people who do not have alcohol use disorder drink too much, putting their health at risk.
How Does Alcohol Affect the Body?
Alcohol, also known as ethanol or ethyl alcohol, is found in beer, wine and liquor. When we drink alcohol, it is absorbed into our bloodstream from the small intestine and stomach. The liver works to metabolize the alcohol but can only handle a small amount at a time. This results in excess alcohol circulating throughout the body, leading to intoxication.
Alcohol’s intoxicating effects on the body are significant. It serves as a depressant to the central nervous system, affecting the brain, speech and motor reflexes. It slows the body’s response time, can blur vision and make it difficult to walk and talk. The potent effects of intoxication are why it is so dangerous to drink and drive.
Alcohol impacts people differently. Age, gender, weight and how much we have had to eat recently are all factors that affect alcohol’s interaction with our bodies. These factors impact how much alcohol it takes to reach the point of intoxication.
Drinking too much alcohol can result in dehydration, exhaustion, headaches and nausea. These are side effects that can extend to the next day, a condition commonly referred to as a hangover.
Heavy drinking’s negative effect on the body isn’t gone when the hangover goes away, however. Excessive drinking can cause lasting health problems, including:
- Heart disease: Excessive alcohol use is a leading contributor to heart disease. Heart problems related to heavy alcohol consumption include:
- High blood pressure (hypertension)
- Cardiomyopathy (stretching of the heart muscle)
- Arrhythmia (irregular heartbeat). Even one episode of heavy drinking can cause the heart to beat irregularly.
- Liver problems: These include cirrhosis (scarring) of the liver, fatty liver and alcoholic hepatitis.
- Pancreatitis: This is an inflammation of the pancreas that causes digestive problems.
- Cancer: Excessive alcohol consumption has been linked to several forms of cancer in men and women, including cancers of the breast, liver, mouth, esophagus and larynx.
- Cognitive problems: Alcohol can change how the brain works, affecting behavior and memory over time.
- Immune system problems: Excessive alcohol consumption compromises the immune system, increasing risk for illness.
- Weight gain: Alcoholic drinks contain a lot of calories and contribute to weight gain.
What is a Drink?
This may seem like a silly question, but it’s an important one. Remember, women should not have more than one drink per day and men should not have more than two. However, “a drink” is not just how much wine, beer or liquor happens to be poured in your glass or beer mug. A standard drink refers to a specific amount of alcohol – 0.6 ounces, or 14 grams.
With that metric in mind, the following servings are equal to one drink:
- A 12-ounce beer (approximately 5% alcohol content)
- A 5-ounce glass of wine (12% alcohol content)
- A 1.5 ounce shot of liquor, such as whiskey, vodka or tequila (40% alcohol content)
“It’s really important to keep these figures in mind when you are pouring a drink for yourself or are out at a restaurant or bar,” explains Dr. David Boucher, an internal medicine physician in Stephenville. “It’s not uncommon to be served a ‘tall’ beer that is 20 ounces – that’s nearly two drinks. If you get a glass of chardonnay that is two-thirds full, your wine serving is probably closer to two drinks than one.”
“Also remember that the one drink for women and two for men standard are daily limits – they should not be viewed as weekly averages,” adds Dr. Haley Banks, a family medicine doctor in Stephenville. “If I don’t drink for two days, that doesn’t mean I can safely triple my alcohol consumption on the third day.”
Excessive drinking is generally classified a couple of different ways, neither of which are mutually exclusive.
- Binge drinking is when a person consumes a large amount of alcohol at one time. Five drinks for men and four for women within a two-hour period is considered binge drinking. These also represent the number of drinks, on average, that causes a person’s blood alcohol level to rise to 0.8 percent, at which point a person is considered legally intoxicated in all 50 states. Keep in mind, everyone is different and it’s possible to become legally intoxicated after fewer drinks.
- Heavy drinking, as defined by the CDC, occurs when a man has 15 or more drinks within one week and a woman has 8 or more drinks within a week.
While binge drinking and heavy drinking are harmful to our health and should be avoided, they do not necessarily indicate the medical definition of an alcohol use disorder. In fact, the CDC reports that 90% of people who are heavy drinkers and/or binge drinkers do not meet the criteria for a severe alcohol use disorder.
“Even if someone does not have alcohol use disorder, excessive drinking is still bad for you,” says Dr. John Thurmond, a Mansfield internal medicine physician. “Binge drinking and heavy drinking increase the risk for numerous chronic health problems, such as cancer. The intoxication that results from binge drinking can lead to poor judgment and decision making, injury and even death.”
Who Should Avoid Alcohol
While anyone who does drink needs to limit alcohol consumption to recommended levels, there are some who should avoid drinking altogether, including:
- Anyone under the age of 21,
- Anyone who will be driving or operating heavy machinery the same day,
- Anyone with a medical condition that alcohol may exacerbate,
- Anyone on a prescription medication that interacts with alcohol and
- Women who are pregnant or trying to become pregnant. There is no safe level of alcohol that may be consumed during pregnancy. Alcohol use during pregnancy increases the risk of birth defects and other complications.
Alcohol Use Disorder
Alcohol Use Disorder (AUD), also known as alcoholism or alcohol dependence, is classified as a chronic brain disease. Signs of AUD include compulsive alcohol consumption, a lack of control over the amount of alcohol consumed and a craving for alcohol when not drinking.
AUD can be influenced by heredity, so sometimes people have limited ability to control their desire for alcohol. If someone is dependent on alcohol, they need professional help and should not be afraid to seek it. Removing the stigma associated with AUD is one of the most important things that can be done to get more people the help they need.
While there is not a clear-cut test or exam to diagnose AUD, there are a number of characteristics people with the disorder tend to exhibit. Visit the Rethinking Drinking website, a service of the National Institutes of Health, to review a list of questions that may help you decide if you have a problem.
If you answer “yes” to two or more of their questions, you should visit with your health care provider. The more “yes” answers to these questions, the more serious the drinking issue is. Your physician can help.
“It is not uncommon for people to be unable to stop drinking on their own. Alcohol can be highly addictive for some, which is why it’s important to seek help if you are drinking too much and unable to stop,” says Dr. Lester Ong, an internal medicine physician in Stephenville. “There is no shame in seeking help.”
Common treatments for AUD include behavioral treatments, prescription medication and mutual support groups. These include groups such as Alcoholics Anonymous, which provide peer support to help people quit drinking.
Youth and Alcohol
Among the many things parents worry about for their children are the dangers of alcohol. Alcohol is the most used drug among American youth. According to the CDC’s 2019 Youth Risk Behavior Survey, 29% of high school students drank alcohol in the last 30 days and 14% binge drank.
Even more alarming, 17% of high school students reported riding with a driver who had been drinking. As concerning as these numbers are, the percentage of youth drinking and binge drinking has declined over the last decade, which is encouraging.
It is important parents talk with their teens about the dangers of alcohol and the reasons to avoid it. “The most important thing we can do as parents is to set a good example – our kids are always watching and learning from us,” says Dr. Allan DeVilleneuve, a Plano pediatrician.
Ask for Help
If you’ve noticed your alcohol consumption has increased over time and you are exceeding one or two drinks a day, that’s a warning sign that it is time to slow down – or stop. Some people arrive at that realization and are able to stop just fine on their own. Others need more help. If you think you may drink too much and are having a hard time cutting back, make an appointment to visit with your physician today. He or she is there to help you.
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
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