By Robert Matylewicz, DO, ABAM, Medical Director at The Ranch PA The term “moderate drinking” gets thrown around a lot these days. Seems like every time you turn the corner, there’s a new study proclaiming alcohol’s health benefits or warning of its dangers. Just like any substance that has potential for abuse and addiction, it’s a tricky topic when you’re weighing benefits versus risks.
What Recent Research Says About Moderate Drinking
Some research shows that there are legitimate health benefits of light to moderate alcohol use. A few include: ● Lowering the risk of diabetes: A Danish study of over 70,000 people found that women and men who drank moderately had a 32% and 27% lower risk (respectively) of developing diabetes compared to people who drank less than one day each week. ● Protecting some cognitive functioning in old age: A handful of studies, like this one, have found moderate drinking offers some protective benefits to cognitive health in older adults. ● Helping prevent cardiovascular conditions: Some research has found that people who drink red wine in moderation may experience cardiovascular benefits from its resveratrol and antioxidants components, helping prevent coronary artery disease and protecting against high cholesterol by increasing levels of high-density lipoprotein (HDL) cholesterol, aka “the good cholesterol.” There’s also evidence of health risks associated with moderate drinking and one large meta-analysis that refutes the benefits claimed in other studies. ● Increased risk for brain damage and decline in verbal skills: A study by University of Oxford researchers followed participants for 30 years and found that compared to non-drinkers, people who drank 5-6 drinks a week had a quicker decline in verbal fluency (a measure of executive function in the brain). It also found people who consumed 11 drinks or more a week increased their risk of certain types of brain damage including hippocampal atrophy, which impacts functions like spatial navigation and memory. ● Greater risk of cancer: A 2012 study published in the American Journal of Public Health found that just one or two drinks a day significantly increased the risk of some cancers like oropharyngeal cancer and breast cancer, especially in women. ● No long-term health benefits: When a meta-analysis of 87 studies on alcohol use and morbidity corrected for what they determined to be design flaws and biases in previous studies touting the health benefits of alcohol use, they found no indication that moderate drinking had long-term positive effects.
Why Moderate Drinking Is a Slippery Slope
If you’re drinking on occasion and it’s not interfering with your work, school or family life, then there’s not a lot of cause for concern. The reason why moderate drinking is such a slippery slope is because if you’re genetically predisposed to addiction when you drink. Even by moderate standards, you’re basically throwing the gauntlet down and challenging the brain’s reward system. If you’re not genetically predisposed to addiction, you’re still putting yourself at risk for a substance use disorder if you go over that “moderate” line occasionally. Repeated misuse of alcohol or other drugs can start rewiring the brain, strengthening positive associations with those substances, and that can lead to psychological and physical dependence. Many people start self-medicating their depression or anxiety with alcohol, often without knowing they have a mental health issue. A couple of drinks to take the edge off can quickly progress into an alcohol use disorder when there’s an underlying mental health condition. The other challenge is that some people who see themselves as moderate drinkers are actually binge drinkers. If you drink moderately for the most part, but also kick back more than four or five drinks a night a couple of weekends a month or at bars and celebrations, you’ve crossed the line into binge drinking. The data shows this happens about four times a month for one in six U.S. adults. In my experience, it’s people who binge drink who come into treatment with issues, like DUIs, blackouts, unprotected sex with strangers and other alcohol-related problems.
Do the Benefits of Moderate Drinking Outweigh the Risks?
Here’s the thing about alcohol. People who don’t have a problem with it don’t need to pay attention to how much they drink. They’re “naturally” light or moderate drinkers. They have one or two drinks on occasion, maybe three once in a blue moon. When you need to be vigilant about your alcohol consumption to ensure it fits the definition of moderate drinking, it’s time to take a closer look at your behaviors. For people who are truly social drinkers and don’t even feel the need to dig around to see if their drinking patterns are problematic, the benefits of having red wine or alcohol as outlined by these studies can likely be achieved without developing high-risk patterns. It’s when we get into areas like occasional binge drinking, a genetic propensity for addiction and masked mental health disorders where I would argue that it’s very clear that any benefits of moderate drinking do not outweigh the risks.