By Lori Hooley RN, Ben Bearnot MD, and Jim Morrill MD
For all of recorded history, alcohol has been a part of American culture and many cultures around the world, well known for making us feel good during celebratory moments and helping us find relaxation during challenging times. However, alcohol also carries serious risks. Heavy alcohol use can not only harm the person drinking, but can also take a devastating toll on family and friends. In honor of Alcohol Awareness Month, we would like to take a moment to address some common questions that we as health care providers receive from many of our patients regarding alcohol use.
How do you know whether you or a family member’s alcohol intake is healthy or unhealthy?
Moderate alcohol use for healthy adults generally means up to one drink a day for women and up to two drinks a day for men. One drink is measured as: 12 fluid ounces (355 milliliters) of beer, 5 fluid ounces (148 milliliters) of wine, or 1.5 fluid ounces (44 milliliters) of hard liquor (80 proof). Heavy or high-risk drinking is defined as more than three drinks a day or more than seven drinks a week for women and men older than 65, and more than four drinks on any day or more than 14 drinks a week for men younger than 65. Binge drinking is defined as four or more drinks within two hours for women and five or more drinks within two hours for men.
What are the effects of alcohol on the brain and body?
Drinking alcohol at any level has physiological and psychological effects, including effects on mood, perception, judgment, balance, blood pressure (lower during drinking, higher after drinking), and the function of muscles and nerves. However, excessive drinking as defined above can increase your risk of serious health problems, including:
– Certain cancers, including breast cancer and cancers of the mouth, throat, esophagus and liver.
– Pancreatitis (painful inflammation of the pancreas).
– Heart muscle damage (alcoholic cardiomyopathy) leading to heart failure
– High blood pressure
– Chronic liver disease
– Depression, including suicidal thoughts
– Accidental serious injury or death
– Brain damage and other problems in an unborn child
– Risk of acute alcohol withdrawal syndrome
How can you tell if someone has an alcohol use disorder?
Substance use disorders—including alcohol use disorder—can involve one or more of the “3 C’s”:
• Cravings (thoughts, feelings, people, places, things that bring on an urge to use the substance);
• Control issues (using more/longer than planned, unsuccessful attempts to cut down or quit, or increasing time spent obtaining, using, or recovering from use); or
• Consequences (failure to fulfill major obligations at work, school, or home).
People with alcohol use disorder almost always develop tolerance (a progressive need to drink more to have the same effect) and withdrawal (physical effects of abruptly stopping drinking), which can involve elevated blood pressure and severe mental status changes and often requires hospitalization.
Are there treatments for risky alcohol use or alcohol use disorder?
There can be shame associated with seeking treatment, but alcohol use disorder is a treatable medical condition. And treatment works! Millions of people across the country are in long term recovery. The route to recovery can involve counseling, such as behavioral therapy, and medications (such as Naltrexone or Acamprosate) that have been proven in studies to reduce the desire to drink. Some people need inpatient medical detoxification to stop drinking safely. Mutual support groups such as Alcoholics Anonymous, which patients can access outside the medical system and are a crucial lifeline to many people in recovery, can help people stop drinking, manage relapses, find fellowship, and cope with necessary lifestyle changes.
Where can I go for further information?
Your Primary Care Physician will be able to answer any questions you may have regarding healthy or unhealthy alcohol use. They will be able to assist in recognizing, treating, or managing alcohol use disorder. You can also find more information online from the U.S. Centers for Disease Control and Prevention (Alcohol Portal | CDC), National Institute on Alcohol Abuse and Alcoholism (Alcohol’s Effects on Health | National Institute on Alcohol Abuse and Alcoholism (NIAAA) (nih.gov)), or Alcohol Addiction Centers (What is Alcoholism? – Learn About Alcohol Addiction).