By Dr. Mercola
The opioid epidemic has been making headlines in the U.S., but another public health crisis is also in the making, this time involving alcohol, according to a new study published in JAMA Psychiatry.1 In the time period spanning 2001-2002 to 2012-2013, 30 percent more Americans engaged in high-risk drinking. The study included data from nearly 80,000 Americans and found statistically significant increases in alcohol use across all sociodemographic groups.
However, increases in alcohol use, high-risk drinking and alcohol use disorder (AUD) (or alcohol dependence) were greatest among women, older adults, racial/ethnic minorities and people with lower educational level and family income. The increase "constitute[s] a public health crisis," the researchers said. "Taken together, these findings portend increases in many chronic comorbidities in which alcohol use has a substantial role."2
1 in 8 Americans May Struggle With Alcoholism
The greatest increases occurred among heavy alcohol users; the number of people diagnosed with alcoholism increased by 49 percent during the study period and is estimated to affect nearly 13 percent of Americans.3
Study author Bridget Grant of the National Institute on Alcohol Abuse and Alcoholism told International Business Times U.K., "The increases were unprecedented relative to the past two decades … [and] may have been overshadowed by increases in less prevalent drugs like marijuana and opioids, although all increases in alcohol and other substances are important."4
Overall, the number of people who reported drinking alcohol (in any amount) shot up from 65 percent to nearly 73 percent of Americans. About one-third of them engage in "high-risk drinking," which was defined as five or more standard drinks for men or four or more drinks for women at least once a week. Among women, however, this type of binge drinking increased by nearly 58 percent over the study period.5
As for why alcoholism may be on the rise, Vox noted, "Over the past few decades, alcohol has become easier to access, while addiction treatment services have remained hard to reach.
It's also likely that socioeconomic and mental health issues are playing a role, as people turn to alcohol and other drugs to essentially self-medicate all sorts of problems."6 The price of alcohol has also decreased, costing an average 4.46 percent of disposable income (based on one drink a day) in 1950 compared to 0.29 percent in 2011.7
Stanford University drug policy expert Keith Humphreys told Vox, "The price of alcohol has fallen sharply over recent decades, and that is the most compelling explanation for why the population is drinking more … Even the heaviest drinkers respond to changes in the cost of alcohol."8 Others have argued that the problem is deeper than that, pointing, perhaps, to increases in social isolation and economic troubles.
Alcohol-Related Problems Cost US $250 Billion a Year
In the U.S., the JAMA Psychiatry study authors noted, alcohol-related problems cost an estimated $250 billion a year, and that was in 2010. In an accompanying editorial, Dr. Marc A. Schuckit of the University of California, San Diego wrote:9
"It may be too early to precisely identify future costs associated with the higher rates of problematic drinking and AUDs because most do not become apparent for years after heavier drinking begins.
However, there are already signs that the changes in drinking observed since 2001-2002 may be associated with increases in alcohol-related health consequences … data already indicate increases in alcohol-related cirrhosis and in hypertension as well as a leveling off of previous decreases in cardiovascular and stroke-related deaths."
According to the U.S. Centers for Disease Control and Prevention (CDC), meanwhile, excessive drinking is responsible for 1 in 10 deaths among working-age adults aged 20 to 64 years. From 2006 to 2010 alone, excessive drinking led to about 88,000 deaths and 2.5 million years of potential life lost, each year.10
The CDC defines excessive drinking as either binge drinking (4 or more drinks during a single occasion for women or five or more drinks for men) or heavy drinking, which is eight or more drinks per week for women and 15 or more drinks for men.
What Are the Health Risks of Excessive Drinking?
Drinking alcohol can lead to a number of health risks in the short and long term. Alcohol depresses your central nervous system, which slows down the communication between your brain cells. Your limbic system, which controls emotions, is also affected. This is why alcohol consumption lowers your inhibitions. Your prefrontal cortex, a brain region associated with reasoning and judgment, also slows in response to alcohol, leading to more impulsive behavior and poor judgment.
At higher doses, your cerebellum, which plays a role in muscle activity, will also be impacted, leading to dizziness and loss of balance. The acute health risks that follow are most often associated with binge drinking:11
- Injuries, including motor vehicle accidents, falls, drownings and burns
- Violence, including homicide, suicide, sexual assault and intimate partner violence
- Alcohol poisoning, which can shut down areas of your brain that control basic life-support functions like breathing and heart rate, leading to death.
- Risky sexual behaviors
In the long term, alcohol consumption promotes weight gain and fatty liver disease. It also disrupts your gut microbes,12 which can have a significant impact on your physical health and mental well-being. It's well-known that altering the balance of bacteria in your digestive tract can weaken your immune system, making you more prone to inflammation and disease. In addition, excessive alcohol use increases your risk of chronic disease and other health problems, such as the following noted by the CDC:
✓ Poor school or work performance
✓ Liver disease
✓ Digestive problems
✓ Cancer (breast, mouth, throat, esophagus, liver and colon)
✓ Learning and memory problems, including dementia
✓ Mental health problems, including depression and anxiety
✓ Social problems, including lost productivity, family problems and unemployment
✓ Alcohol dependence, or alcoholism
Most People Who Drink Excessively Are Not Alcoholics
Some people may think that, because they're not suffering from alcoholism, they're not risking their health from heavy drinking. But, according to the CDC, 90 percent of people who drink excessively do not have an alcohol use disorder.13 This does not mean that their health isn't being damaged by excessive drinking, however. What's the difference? In the case of alcohol use disorder (alcoholism), it's a chronic disease that severely affects your life.
People with alcohol use disorder may be unable to limit their drinking or crave a drink so badly that it overwhelms their thoughts. AUD can also lead to problems with your work or personal life, but despite this those affected tend to continue drinking unless they receive professional help.
You may also find that you need to drink more and more to get the same effects. Dr. Lorenzo Leggio, a National Institutes of Health (NIH) researcher, said in a news release, "People shouldn't wait for a physical problem like liver disease [to get help] … The sooner you act can help prevent medical consequences."14 George Koob, Ph.D., director of NIH's National Institute on Alcohol Abuse and Alcoholism, shared additional insights into how to identify a drinking problem:
"Addiction has 3 major problems: You lose your ability to feel good, you get more stressed, and you have a hard time making proper decisions … That's a recipe for disaster … A good indicator is that something is out of whack. Is your personal life deteriorating because of your drinking?
Are people starting to shun you? If you're feeling generally miserable, that's a warning sign … You don't have to hit bottom. You'll save yourself a lot of damage socially, professionally, and probably in your own body if you attend to an alcohol problem a lot earlier."
Exercise Can Help You Reduce Alcohol Intake While Buffering Some of the Health Damage
If you want to cut back on drinking, exercise is essential. When you drink, it chemically alters your brain to release dopamine, a chemical your brain associates with rewarding behaviors. When you exercise, this same reward chemical is released, which means you can a similar "buzz" from working out to that you can get from alcohol. In one study, hamsters that ran the most consumed less alcohol, while less active hamsters had greater cravings for and consumption of alcohol.15
In addition, exercise may help to mitigate some of the risks of alcohol consumption. Longtime drinkers who exercise regularly have less damaged white matter in their brains compared to those who rarely or never exercise.16 The white matter is considered the "wiring" of your brain's communication system and is known to decline in quality with age and heavy alcohol consumption.
Even among chronic drinkers, those who exercise five hours a week have the same rate of mortality as those who never drink alcohol, in large part by counteracting the inflammation caused by alcohol. Those who got at least 2.5 hours a week of moderately intense exercise also significantly reduced the biological impact of their drinking.17
While this doesn't mean exercise can negate all the negative effects of alcohol — those who drank excessively (20 or more standard drinks for women and 28 or more for men a week) did not gain the protective effects — it's certainly a useful strategy to consider (and one you should be doing regardless of your drinking habits).
What Else May Help You to Avoid Problematic Drinking?'
If you believe you have an AUD, seek professional help. In some cases, having a direct conversation with family and friends about the problem may help motivate the person to quit (i.e., stage an intervention). If you drink excessively and would like to cut back, you can try keeping track of how much you drink and setting limits on how much (or little) to consume. You should also avoid places, activities and even people who may tempt you to drink, and seek out new positive hobbies and friendships to replace them.18
If and when you do drink alcohol, sip your drink slowly and consume a glass of water afterward. It's a good idea to eat something along with the alcoholic beverage, as if your stomach is empty, it will speed the alcohol's rate of absorption into your body. It may also cause more severe stomach irritation. When you feel buzzed, it's a sign that your body's detoxification pathways are becoming overwhelmed. Take a break from drinking, or quit for the day entirely, to allow your body to metabolize the alcohol effectively.
If you have a habit of binge drinking, simple text-message reminders may also help you cut back. Young adults in one study received a series of text messages asking about weekend plans for drinking and expressing concern if excessive levels were mentioned.
The texts also suggested setting goals to limit or reduce alcohol consumption. Those who received the text interventions had a 12 percent reduced incidence of binge drinking.19 Even if you don't have a formal text message intervention available, you can try a similar program with a group of friends.
Is Moderate Drinking Good for You?
Whether or not moderate alcohol consumption can be safe and even healthy is controversial, with studies showing somewhat mixed results. For instance, research shows people who have one to two drinks a day may have a significantly reduced risk of death from heart disease and "all causes" compared to those who never drink alcohol.20 On the other hand, alcohol consumption may be associated with an increased risk of cancer, even at moderate levels of intake.
I generally define "moderate" alcohol intake (which is allowed in the beginner phase of my nutrition plan) as a 5-ounce glass of wine, a 12-ounce beer or 1 ounce of hard liquor, with a meal, per day. As you progress further in the nutrition plan, I do recommend eliminating all forms of alcohol. I also recommend using the following "pre-tox" to help lessen the damage alcohol may do to your body if you know you're going to be having a few drinks:
1. N-acetyl cysteine (NAC)
NAC is a form of the amino acid cysteine. It is known to help increase glutathione and reduce the acetaldehyde toxicity21 that causes many hangover symptoms. Try taking NAC (at least 200 milligrams) 30 minutes before you drink to help lessen the alcohol's toxic effects.
If you're wondering just how powerful NAC can be, consider that, like alcohol, one way that Tylenol causes damage to your liver is by depleting glutathione. If you keep your glutathione levels up, the damage from the acetaminophen may be largely preventable. This is why anyone who overdoses on Tylenol receives large doses of NAC in the emergency room — to increase glutathione.
2. B Vitamins
NAC is thought to work even better when combined with thiamine, or vitamin B1.22 Vitamin B6 may also help to lessen hangover symptoms. Since alcohol depletes B vitamin in your body, and the B vitamins are required to help eliminate it from your body, a B-vitamin supplement taken beforehand, as well as the next day, may help.
3. Milk Thistle
Milk thistle contains silymarin and silybin, antioxidants that are known to help protect your liver from toxins, including the effects of alcohol. Not only has silymarin been found to increase glutathione, but it also may help to regenerate liver cells.23 A milk thistle supplement may be most useful when taken regularly, especially if you know you'll be having cocktails on more than one occasion.
4. Vitamin C
Alcohol may deplete your body of vitamin C, which is important for reducing alcohol-induced oxidative stress in your liver. Interestingly, one animal study showed vitamin C was even more protective to the liver than silymarin (milk thistle) after exposure to alcohol.24
Making sure you're getting enough vitamin C, via supplements or food (or both), is another trick to use prior to indulging in alcoholic beverages. Vitamin C is such a powerful detoxifier that if you take large doses prior to receiving dental anesthesia, the anesthesia will be significantly weakened and may not work.
Magnesium is another nutrient depleted by alcohol, and it's one that many are already deficient in. Plus, magnesium has anti-inflammatory properties that may help to reduce some hangover symptoms. If you don't eat a lot of magnesium-rich foods, taking a magnesium supplement before an evening involving drinking may be helpful.