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Is moderate drinking good for your health?

Alcohol is the most widely used drug in the world, including in the United States.

About 70 percent of adults in the United States report past-year alcohol consumption, with over 37 million drinkers reporting binge drinking (defined for women as four or more drinks per occasion, and five or more drinks per occasion for men) at least once a week. The prevalence of past-year drinking has increased in the past two decades, from 65.4 percent in 2001 to 2002 to 72.7 percent in 2012 to 2013.

Partially because it is such a commonly used substance, heavily marketed and glamorized in pop culture, Americans’ comfort with and acceptance of alcohol is high.

Should it be?

I research alcohol use and the associations between drinking and a wide range of problems. While the rising opioid epidemic has been receiving a lot of attention in the past five years, it is important to remember that alcohol is involved in a greater number of deaths and physical and social problems. Backed by a strong industry, alcohol’s dangers may be underplayed and its benefits exaggerated. A study to examine the health benefits of moderate alcohol consumption, jointly funded by the National Institutes of Health and the alcohol industry, was recently halted for reasons including possible conflicts of interests. Now is a good time to review some things we do know about alcohol.

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Is moderate drinking good for your health?

In the past two decades, the idea that moderate drinking may actually confer health benefits has taken hold, backed up by some preliminary evidence. This led to the often-mentioned notion in the popular press that a glass of red wine a day reduces the risk of cardiovascular disease and diabetes.

There was one major flaw in many of the studies used to back up the claim that a glass of red wine is good for health. They compared moderate drinkers to non-drinkers – rather than comparing lighter to heavier drinkers. There is a phenomenon called the “sick quitter paradox,” however, that could affect study findings. “Sick quitter” means that non-drinkers tend to be less healthy than low-level drinkers, and that many people choose to not drink for health reasons. Therefore, some non-drinkers may be less healthy than moderate drinkers for reasons unrelated to alcohol.

The question as to whether moderate drinking is beneficial remains open. The National Institutes of Health recently sought to initiate a large randomized control trial, the gold standard for understanding causal relationships, to look into the benefits of moderate drinking.

This trial was designed to pick up the heart benefits of consuming one drink a day, but it was not designed to be able to detect the negative consequences of moderate alcohol use, such as increases in breast cancer. Many in the alcohol research community wondered what the recommendations from this study would be, since there are so many well-established problems with drinking even at moderate levels that likely outweigh any potential benefits.