Alcohol has known negative effects on physical and mental health, and recent research has emphasized that the rule “the less, the better” is true when discussing how much alcohol is too much.[1][2][3][4] This article will explore the different types of alcohol, addiction risks, and known effects on health.
- Alcohol has many negative effects on physical and mental health, which are more pronounced for people who drink heavily and often.
- Recent research suggests that even light or moderate drinking can be harmful to your health, increasing the risk for heart problems, liver problems, and certain cancers.
- Limiting or restricting your alcohol use can improve your physical and mental health dramatically, leading to better sleep, more energy, and a lower chance of chronic health problems and early mortality.
Understanding alcohol
Alcoholic beverages are consumed around the world by adults for social, cultural, and recreational purposes. Historically, light or moderate drinking has not been acknowledged as posing a significant risk to public health. In recent years, however, more research has emerged that suggests even low levels of alcohol use can negatively impact health.[3][4]
Due to this recent research, more health agencies and officials in the U.S. and abroad are emphasizing increased caution with alcohol use. Suggestions have been made to revise dietary guidelines and public health recommendations to adopt the mantra, “less is better” when it comes to alcohol use. The reasons for these revised drinking guidelines include studies that show that even light drinking can increase the risk for cancer, cardiovascular problems, and early mortality.[4]
Alcohol statistics
Alcohol use is common in most countries around the world, but is particularly prevalent in the United States, countries in the European Union, and other developed nations. The countries with the lowest levels of alcohol consumption include those in the Middle East, Asia, and North Africa. Recent data has shown decreases in drinking among young people in recent years, possibly in part due to changing health recommendations and increased awareness of health risks.[5][6]
Here are some statistics about alcohol use around the world:[5][6]
- Males are more likely than females to have alcohol use disorder.
- European countries have the highest rates of alcohol consumption in the world.
- 7 of the 10 countries with the highest alcohol consumption are in the EU.
- Middle East and North African countries with high Muslim populations have the lowest levels of alcohol consumption per capita.
- Globally, 56% of the population aged 15 and over abstain from drinking.
- Globally, alcohol is the 7th leading cause of early death and disability.
- Globally, alcohol is the number one leading cause of early death and disability in ages 15-49.
- Globally, alcohol consumption contributes to 5% of morbidity and mortality.
A brief history of alcohol use
Alcohol use trends change over time according to shifts in culture, economic activity, and current health policies and guidelines. For example, there wasn’t an official health warning against drinking while pregnant until 1981 in the U.S., and a minimum drinking age wasn’t set until 1988.[7]
Over the past twenty years, more research and funding have been prioritized to better understand the health impacts of alcohol use, especially in the low to moderate range of consumption. Recent studies suggest that, contrary to prior beliefs, even small and infrequent amounts of alcohol can have negative effects on health. Perhaps because of this research, alcohol consumption does appear to be decreasing in the US and abroad, especially among young people.[3][4][6][7]
The effects of alcohol use
There are many negative effects of alcohol use on the body and brain, including impacts on major organs, the brain, endocrine, and immune systems. These include both short and long-term effects that can result in several serious health conditions, some of which can be fatal.[1][2][3] In fact, alcohol is a leading cause of disability and death around the world, and has particularly negative effects on the heart, liver, and risk of cancer.[5][6] Alcohol use can also affect mental health, leading to undesired changes in mood, thinking, and behavior.
Physical effects
The physical effects of alcohol can be far-reaching, affecting nearly every organ and system within the body. While heavy and frequent use of alcohol results in the most serious health consequences, new research suggests even light drinking can increase the risk for health problems.[3][4]
Here are some of the negative ways that alcohol can negatively impact physical health:[1][2][4][5]
- Liver: Alcohol is metabolized through the liver, and heavy use can lead to liver diseases, inflammation, and cirrhosis.
- Pancreas: Alcohol can lead to inflammation of the pancreas, known as pancreatitis.
- Heart: Alcohol use can weaken the heart, leading to cardiomyopathy and increasing the risk for high blood pressure, irregular heartbeat, and heart disease or stroke.
- Gastrointestinal system: Drinking can alter the microbiome, increasing the risk for colorectal cancers, inflammation, and bleeding.
- Lungs: Alcohol use is associated with an increased risk for respiratory illnesses and disorders like pneumonia, respiratory syncytial virus (RSV), and tuberculosis.
- Brain: Alcohol interferes with the brain’s executive functions, leading to impaired information processing, reasoning, decision making, and impulse control. Heavy use of alcohol can also lead to shrinkage of the brain and permanent damage.
- Nervous system: Alcohol interferes with the functioning of the peripheral nervous system and can lead to peripheral neuropathy, which leads to pain, burning, and numbness in the limbs.
- Immune system: Alcohol weakens the immune system, increasing the risk for infections, autoimmune disorders, and cancers.
- Endocrine system: Alcohol can interfere with hormone production and regulation in the body, increasing the risk for thyroid conditions and other hormone-related disorders and imbalances.
- Musculoskeletal system: Alcohol increases the risk of muscle wasting (myopathy), fractures, gout, and bone density problems.
- Physical appearance: Heavy, sustained alcohol use can lead to physical blemishes that are often mild but can develop into serious conditions if left untreated.
Psychological effects
Alcohol is a psychoactive substance, which means it alters a person’s cognition, mood, and behavior. The short-term effects of alcohol intoxication include impaired judgment, reasoning, and decision-making skills. Many people who use alcohol report feeling less inhibited and more impulsive when they drink, leading to poor decisions that can have lasting consequences. Some people who drink develop alcohol dependency, which is characterized by a cycle of compulsive use that can be difficult to break without treatment.[1][2][3]
Alcohol is also a known depressant and can have negative effects on a person’s mood. Many people with depression who abuse alcohol report a worsening of their symptoms over time. Others describe noticing that they become more irritable after drinking, and this can persist or worsen the next day. Alcohol is known to negatively impact sleep, which is essential for mood, cognitive functioning, and mental well-being, and can compound the negative effects on mental health over time.[2][3]
Alcohol addiction
Alcohol use disorder (AUD) and addiction encompass various harmful drinking behaviors, including alcohol abuse, alcohol dependence, and alcohol addiction (alcoholism). Warning signs of alcohol use disorder are related to patterns of drinking, the continuance of alcohol consumption despite negative consequences, and the presence of withdrawal symptoms.[10]
The consumption of an increasing volume of alcohol, particularly if more alcohol is consumed than was intended, or if the individual finds it difficult or impossible to stop drinking, may indicate a problem. Often, those with alcohol use disorder develop a tolerance to alcohol, requiring more and more to have the same effects.[10]
Other symptoms of alcoholism may include:[10]
- Alcohol-related accidents.
- Saying or doing things that hurt others or yourself.
- Mood swings.
- Impaired ability to work.
- Depression or anxiety.
Another indicator is if there is an intense craving for alcohol, and a large proportion of time is spent on obtaining alcohol, drinking it, and recovering from a drinking session.
The presence of withdrawal symptoms, if alcohol is not consumed, is also an indicator of alcohol use disorder.
Why alcohol affects people differently
Like all substances, alcohol’s effects can vary from person to person. The variable effects of alcohol consumption can be explained by several factors, including a person’s sex, age, size, and genetics, which all influence how alcohol is metabolized. The metabolization of alcohol describes the body’s process of breaking down the ethanol in alcohol, which is responsible for its intoxicating effects, as well as many health problems linked to alcohol use.
For example, women have less water in their bodies than men, which is why they don’t metabolize alcohol as well as men. This is why the drinking guidelines suggest only one drink per day for women vs two for men, regardless of their size. The body's ability to metabolize alcohol also decreases with age, which is why alcohol may affect older adults more.[1]
Race can also be a factor, with approximately 30-45% of East Asians lacking an enzyme needed to break down alcohol. This helps to explain what is commonly called “Asian flush”, or the experience of feeling flushed, sick, and dizzy when consuming small amounts of alcohol. This genetic difference also leads to an increased risk of alcohol-related health problems like cancer in this population, even in low to moderate amounts.[1]
Do different types of alcohol affect you differently?
Different types of alcohol can have variable effects, which may be due to the alcohol content, fermentation processes, and additives present. For example, some types of alcohol have higher sugar contents or contain certain natural compounds that can affect how the body metabolizes alcohol. One of the main reasons different types of alcohol can have variable effects is because of the ethanol content they contain.[1][3]
Types of alcohol
The most common types of alcohol people consume are liquor, beer, and wine. Within each of these three categories, several variations can contain different amounts of ethanol, which is how the alcohol content is calculated. For example, 1.5 fluid ounces of liquor contains the same amount of alcohol as 5 fluid ounces of wine or 12 fluid ounces of beer. A standard cocktail may contain 1-4 servings of alcohol, leading a person to become more intoxicated than if they had a glass of wine or beer.[1][3]
What is a standard drink measure?
A standard drink is measured by the amount of pure ethanol in a beverage, which varies depending on the type of alcohol being consumed. Generally, a standard drink contains 14 grams or .6 fluid ounces of pure ethanol, which equates to approximately:[3]
- 12 ounces of regular beer.
- 5 ounces of regular wine.
- 1.5 ounces of liquor.
Risks of heavy alcohol consumption
Heavy alcohol consumption is typically defined as having four or more drinks for women, or five or more drinks for men. Over the course of a week, heavy drinking is defined as 8 or more drinks per week for women and 15 or more drinks per week for men. The risks of heavy drinking are serious and include negative effects on physical health, mental health, and social health.[1][2][3]
Here are some of the risks associated with heavy drinking:[1][2][3][6]
- Increased risk for alcohol use disorder.
- Increased risk for dependence and alcohol withdrawal, which can be fatal.
- Increased risk for depression and suicide.
- Increased risk for liver, heart, pancreatic, and brain damage.
- Increased risk for social problems.
- Increased risk for chronic health problems and disabilities.
- Increased risk for alcohol poisoning and overdose.
- Increased risk of cancer.
- Increased risk for mortality and early death.
Drinking in moderation
Current dietary guidelines for moderate drinking are one drink or less per day for women or two for men. Recent research has shown that drinking within these levels still carries an increased risk for health problems, and suggestions have been made to lower these guidelines.[3][4] The most common recommendation made by health officials and agencies around the world is that ‘less is best, and safest is none’ when it comes to alcohol consumption.[3]
There has been some research that shows that occasional light drinking is fairly low-risk and unlikely to lead to major health problems and complications. There was also a large study done of over 135,000 individuals that found that low-risk drinkers were often those who consumed only wine and who drank only with meals.[4]
Who should avoid alcohol?
Certain individuals should avoid alcohol or significantly restrict their consumption because of increased risk for health or mental health complications. Individuals who should consider abstaining from alcohol include:[1][3]
- Minors under the legal drinking age.
- Women who are pregnant or trying to become pregnant.
- Women who are breastfeeding.
- People with a history of alcohol or drug addiction.
- People who have previously experienced alcohol dependence or withdrawal.
- People who are taking psychoactive medications, especially CNS depressants such as benzodiazepines and barbiturates.
- People who have an existing diagnosis of depression.
- People prescribed or taking medications that interact with alcohol.
- People with compromised immune systems.
- People with underlying health issues like diabetes, heart disease, or hypertension.
- People who experience a ‘flush’ response when drinking alcohol.
- People who are driving or operating heavy machinery or equipment.
Mixing alcohol and other substances
Mixing alcohol with other substances, including prescribed medications, is risky and can increase the risk for alcohol-related health complications. Always talk with your doctor or prescriber about any medications you are taking to receive advice about whether or not it is safe to consume alcohol. Mixing alcohol with other illicit substances is also risky and can affect the way the body absorbs or metabolizes the drug, as well as change the effects of the drug.[8]
Alcohol and stimulants
Many people report combining alcohol with stimulants, which is dangerous. Alcohol is a CNS depressant, meaning these two substances have opposite effects on the central nervous system. Drinking while taking a stimulant can have several negative effects on your body, brain, and behavior, including:[9]
- Increased risk for overconsumption and alcohol intoxication or poisoning.
- Cognitive impairments, including problems with attention, judgment, and memory.
- Increased impulsivity and drug-seeking behaviors.
- Increased heart rate and blood pressure, causing strain on the cardiovascular system.
- Cellular stress and degeneration.
- Potentiation of stimulant effects, leading to toxicity.
- Increased risk of certain cancers.
Alcohol and sedatives or depressants
Drinking alcohol in combination with other CNS depressants like sedatives, benzodiazepines, or opioids is very dangerous. Because these drugs slow the activity of the nervous system, combining them can increase the risk of fatal overdose. Vital statistics show that one in five overdoses involving an opioid or benzodiazepine involves alcohol. The primary risk associated with drinking in combination with another CNS depressant is the risk for respiratory depression, which can be fatal.[8]
Alcohol and antidepressants
Alcohol can affect the way that antidepressants work, making them less effective. Heavy and frequent use of alcohol can also increase depressive symptoms and the risk for suicide, as well as leading people to become less consistent with treatment.[8]
Alcohol and other medications
Alcohol can interact with medications by altering the metabolism of a medication, increasing or decreasing the body’s efficiency of metabolizing alcohol, or altering the effects of the medication. Alcohol can interact negatively with a huge number of medications, so a complete list is not possible. Here are some of the commonly used medications that have known negative interactions with alcohol:[8]
- Benzodiazepines.
- Stimulants (such as those used for the treatment of ADHD).
- Sleep medications.
- Antidepressants.
- Opioid pain relievers.
- NSAID drugs (the most widely available types include aspirin, naproxen, and ibuprofen).
- Acetaminophen (Tylenol).
- Anticoagulants (blood thinners).
- Antimicrobial medications.
Alternatives to alcohol
Replacing alcoholic beverages with non-alcoholic beverages is a good way to begin to limit or restrict your consumption. Non-alcoholic beers, wines, and ‘mocktails’ may be a good option for regular drinkers who want an alternative with a similar taste profile. Other options include juices, teas, seltzers, and other enjoyable beverages.
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