In my last blog post, I took the New York Times to task for incorrectly suggesting that new research demonstrates a connection between alcohol consumption and the rise of cancer in younger adults. And then just a few days after I wrote that, a patient asked me my thoughts on the health risks of alcohol. So I thought I’d dedicate a post to the topic.
Let’s start with a simple fact: alcohol is toxic to the human body. There is now a lot of research to suggest that even moderate alcohol consumption may play a role in the development of some cancers and in neurological disease. It’s also well established that alcohol consumption is tied to an increased risk for atrial fibrillation, a common type of heart arrhythmia that can increase the risk of having a stroke. And the longstanding belief that moderate alcohol consumption is protective against cardiovascular disease has not held up under closer scrutiny. No, one glass of red wine per night will not cut your risk for a heart attack, and wine consumption is not the reason that countries like France, Italy, and Greece have lower rates of heart disease than we Americans do.
Add to this the long established fact that heavy alcohol consumption is terrible for the body, and substantially increases the risk for liver, cardiac, and brain disease, and we can reasonably conclude that alcohol is bad for humans. Period, full stop. And looked at purely as a substance examined in isolation, this is a correct conclusion. However…
Human lives are too rich, varied, and complex for medical scientists to ever fully capture. And while it’s become unambiguous that alcohol, even in moderation, has some negative health consequences, it has also become clear in the past few years that loneliness and social isolation are also terrible for human health, increasing the risk for virtually every known ailment from depression and suicidality to cancer, diabetes, and heart disease. Of course, no human being needs (or should feel they need) alcohol to avoid loneliness and social isolation. Nonetheless, it remains a fact that alcohol is one of the great “social lubricants” of humanity.
How many friendships have blossomed over a drink? How many romances have been kindled? How many pregnancies have occurred and families been formed? How many stressed out workers have felt the camaraderie of blowing off some steam with a colleague at the bar after a tough day at the office?
I’m not saying that alcohol is necessary for good times and human happiness – many people have rich, robust social lives without ever touching a drink. I am saying that friendship, love, family, and community are key aspects to human wellness and flourishing, and that for many people an occasional drink does play a role in helping to facilitate these areas of life. No medical researcher can accurately track these “downstream” benefits.
Please understand that what I’m offering here is merely my opinion as an experienced observer of the human condition – another doctor may well have a different opinion on this than I do. It’s not that I believe the researchers in the ivory tower who find detrimental effects of alcohol on human health are wrong; it’s just that they may have a more myopic view of the picture than somebody like myself, who works all day with actual patients who are navigating the infinite complexities of life.
So while I’m certainly willing to keep my mind open and change my view as more becomes know, for now here is where I come down on the question of alcohol consumption:
If you drink heavily (which for the moment I’ll define as more than two drinks per day most days), try to stop, or at least cut back drastically. You are doing major harm to your health.
If you don’t drink, there’s no need to start. It isn’t going to do anything positive for your health.
If you drink in moderation (say 1-2 drinks, a few times per week), I would leave it to your judgment as to whether to continue or not. You are probably doing a small amount of harm to your body by taking in a toxic substance several times per week. But on the flip side, there are real health benefits to connecting with friends, your spouse or partner, your colleagues, and the other folks in your life. If a drink now and then helps you to better flourish in these areas, my gut feeling is that the benefits of that probably outweigh, or at least neutralize, the risks of the alcohol. And that’s just from a “how long and how disease free are you going to live?” point of view, and doesn’t even take into account the vitally important, and very subjective, question of what constitutes a happy life.
Finally, let me add the historical perspective that I often bring into my commentary (remember: I was a history major way back in college).
Humans have been consuming alcohol for a damned long time. The ancient Greeks and Romans were obsessed with wine, and in the parts of the world that are descended from the Greco-Roman empire (e.g. Italy, Spain, Portugal, etc), wine consumption has long been, and continues to be, an integral part of the culture. In colonial times here in America, beer and rum were consumed regularly by all segments of the population (our second president John Adams, for example, drank a tankard of hard cider every morning for breakfast). Adolf Hitler’s first attempt to seize power occurred in a beer hall, for the obvious reason that that’s where one could find large groups of German men to try to rally, and his eventual greatest rival, Winston Churchill, was a notorious boozer who nonetheless lived to age 90 and managed to accomplish a few things along the way.
Despite all of this alcohol consumption, diseases like Alzheimer’s dementia, type 2 diabetes, cancer, and heart disease remained relatively rare until the 20th century, and not only because people died younger back in the day, or because without our modern technology these problems were not always diagnosed.
The point being that alcohol indeed has the ability to harm health, but it’s simply not credible to believe that moderate alcohol consumption is a death sentence. And while there may be some benefits to giving up alcohol altogether, most Americans who are seeking to improve their health will probably get a lot more mileage by focusing on other areas, such as adopting good diet, sleep, and exercise habits. Like so much else with medical science, it’s a good idea to interpret the data through a lens of common sense.
