Of course, many of us lose the ability to accurately count when it comes to how much we’ve consumed. And so the idea of moderate daily drinking has a big flaw from the start, even before you look at what research has been done to support the habit.
Still, it’s possible to look at the pros and cons of alcohol with eyes wide open, and then we can each make up our own minds. So let’s take a tour in this month’s newsletter through some of the varied research about the health consequences of drinking — from its effects on car wrecks to our waist lines — and then we can decide for ourselves.
That’s just a little less than the number of people who live in the Washington, D.C., Capitol Hill neighborhood, or slightly more than the combined undergraduate enrollments of the universities of Virginiaand Maryland. Imagine the outcry if such large groups of people vanished suddenly.
Officials try to ensure motorists learn the hazards of intoxicated driving, requiring, at least once every eight years or so when they renew their licenses, that they familiarize themselves with basics on blood alcohol levels and impaired operation of a vehicle.
With vehicular carnage on the upswing, these discussions focused on “average” motorists clearly aren’t making the case.
Now is the time, when we’re all sober readers, to realize how irrational it is to think you’ll be fine if you’ve had “just a few” before getting behind the wheel. How often have you seen happy people at a bar assure each other they’re OK, based on information that safety experts employ on “average” drivers?
Boozers may argue they’re safe for the road, imagining they have a blood alcohol concentration (BAC) not exceeding legal norms.
Think again. Alcohol impairment, much less intoxication, is highly individual, dependent on factors including the type of liquor you’re drinking, your weight, whether you’re drinking on a full or empty stomach, and the speed at which you’re imbibing. To even begin to guestimate, based largely on weight, if you’re exceeding legal BAC limits — typically .08 percent or more — requires a complicated chart (click here to see an example). But how likely is it, really, that you’ll use such a resource during a night on the town?
Further, age is a factor in drinking and driving. Both the young and old may have cognitive aspects, in development or degeneration, that become a bad mix with drinking and how it impairs judgment, especially about safety and risks. Drivers of all ages also may worsen alcohol’s harms on the road, compounding its detrimental effects with other distractions, including drowsiness and especially with cell phones. Please don’t text while driving, get wrapped up in phone calls, or otherwise take your full attention off the road with your smart phone, or any other computer screen or device, or by listening to a too-loud broadcast or recording in your vehicle.
“Along with marijuana, prescription drugs are also commonly linked to drugged driving crashes. A 2010 nationwide study of deadly crashes found that about 47 percent of drivers who tested positive for drugs had used a prescription drug, compared to 37 percent of those had used marijuana and about 10 percent of those who had used cocaine. The most common prescription drugs found were pain relievers. However, the study didn’t distinguish between medically supervised and illicit use of the prescription drugs.”
Alcohol also contributes to injuries and deaths in those two groups when they drink and move around the roads: The National Highway Traffic Safety Administration (NHTSA) found that a third of pedestrians killed in vehicular crashes in 2016 exceeded the legal alcohol limit for drivers. That toll of nearly 2,000 inebriated victims also represents an increase of 300 more people versus 2014. Experts say that drinkers emerge from bars and parties, guessing that they’re better off staggering home on foot. But they’re too drunk to heed signs and barriers. They stumble into traffic, often in the late of night and unable to take appropriate precautions.
As for bicyclists, NHTSA says that “alcohol was a factor in 29 percent of traffic crashes in which the bicyclist (or driver) had blood alcohol concentrations (BACs) of .08 … or higher, the illegal alcohol level in all states.”
The legal, financial, and emotional costs of alcohol-related vehicular wrecks resulting in injuries and deaths can be staggering, as we at our law firm see too often in our practice. Instead, in any cost-benefit analysis, a taxi called or a ride-share service hailed on an app looks brilliant, as does securing in advance the help of Samaritans who will act as designated drivers.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) points out that, “Alcohol beverages supply calories but few nutrients and may contribute to unwanted weight gain. If you need to lose weight, looking at your drinking may be a good place to start.”
Let’s be honest, too: It isn’t just that a 1.5-ounce shot of Kahlua carries 150 calories, or a 4-ounce glass of red wine has 80 calories, or that a 4-ounce margarita is a 168-calorie drink, it’s that most of us don’t consume just one drink at a sitting — and we typically graze as we do. It’s wine and cheese, and more, right? Suddenly, the liquor calories double, and they’re compounded by wagyu sliders, cheese-slathered nachos, and sour crème-topped, twice-cooked potato skins, or whatever. It’s also likely that if you’re in a bar or at a bash, you’re not taking a vigorous walk, or working out hard at the gym, or otherwise reducing your calorie intake. By the way, you’re unlikely to save many calories, and critics say you’ll skimp on flavor (and the intoxicating effects, if that’s what you’re seeking) by trying “light” beers.
There’s another aspect of drinking, though, where medical research is less cheery: That new Global Burden of Diseases study, published in the “Lancet” and analyzing alcohol use and its health effects in 195 countries from 1990 to 2016, underscored, as the Washington Post reported, that, despite “numerous peer-reviewed studies [with] evidence that people who have a drink or two a day are less likely to have heart disease than people who abstain or drink excessively … many other health risks offset and overwhelm the health benefits. That includes the risk of breast cancer, larynx cancer, stroke, cirrhosis, tuberculosis, interpersonal violence, self-harm and transportation accidents.”
Let’s put all the caveats in place: Diet and nutrition research, including studies of alcohol, are difficult to run, and their results must be closely parsed. It can be difficult for researchers in alcohol-use studies to figure how their results may be skewed by participation of study subjects who may be healthier or sicker, and, thus, less or more inclined to drink. How might research results be affected by the education level of study subjects or their mental health, including if they suffer conditions like depression? While medical scientists may try to control for age, race, gender, and other key factors, there many other variables to consider, often far too many in these types of works to allow them to say that X is the direct cause of Y, as studies have shown how cigarettes cause cancer. Instead, experts underscore, alcohol studies report observations and associations.
“For each set of 100,000 people who have one drink a day per year, 918 can expect to experience one of the 23 alcohol-related problems in any year. Of those who drink nothing, 914 can expect to experience a problem. This means that 99,082 are unaffected, and 914 will have an issue no matter what. Only 4 in 100,000 people who consume a drink a day may have a problem caused by the drinking, according to this study. At two drinks per day, the number experiencing a problem increased to 977. Even at five drinks per day, which most agree is too much, the vast majority of people are unaffected.”
Still, the evidence grows about alcohol’s role in raising patients’ risks for cancer. Long history has demonstrated this is especially true with liver cancer and other conditions of this vital organ, which acts as the body’s filtering and chemical manufacturing plant.
But when it comes to your well-being and drinking, here’s some other folks to listen to, hard and well: Your spouse, family, and closest friends. Maybe your religious advisor. These who know you best and care about you most may need to tell you a truth — that you have a problem with alcohol. You’re not alone.
Although boozing took a dive from the 1970s to the 1990s, it soared thereafter, according to researchers who examined Americans’ drinking through a regularly conducted national survey with more than 36,000 respondents. They were screened to ensure they were representative, with researchers taking special pains to ensure accurate data on women, blacks, Latinos, and Asian Americans.
In the 2002-2013 study time, Americans’ overall drinking increased by 11 percent, with roughly 75 percent of all respondents reporting that they had consumed alcohol within the last year. It jumped 30 percent for Asian Americans and 22.4 percent for seniors.
There was worse news when it came to high-risk drinking, defined as women who reported consuming at least four or more drinks per day every week and men who downed five or more drinks each day every week. High-risk drinking leaped by 29.9 percent overall — but it jumped by 58 percent among women and 65 percent among seniors.
As for alcohol dependence and abuse, the most severe category that most of us commonly would call alcoholism, it increased 65.9 percent among the poor (those earning less than $20,000 annually), 83.7 percent among women, and 92.8 percent among African Americans.
Millions of bright, capable, accomplished folks — of all ages — can’t see themselves and their drinking habits clearly enough to know if the alcohol consumption has tipped over from occasional to moderate to heavy to abusive. The experts at NIAAA report this:
“A few mild symptoms — which you might not see as trouble signs — can signal the start of a drinking problem. It helps to know the signs, so you can make a change early. If heavy drinking continues, then over time, the number and severity of symptoms can grow and add up to an ‘alcohol use disorder.’ Doctors diagnose an alcohol use disorder when a patient’s drinking causes distress or harm.”
“Drinking too much can harm your health. Excessive alcohol use led to approximately 88,000 deaths and 2.5 million years of potential life lost each year in the United States from 2006 – 2010, shortening the lives of those who died by an average of 30 years. Further, excessive drinking was responsible for 1 in 10 deaths among working-age adults aged 20-64 years. The economic costs of excessive alcohol consumption in 2010 were estimated at $249 billion.”
Treatment for alcoholism has a history, and experts say it can be effective. “The good news,” reports the NIAAA, “is that no matter how severe the problem may seem, most people with an alcohol use disorder can benefit from some form of treatment. Research shows that about one-third of people who are treated for alcohol problems have no further symptoms one year later. Many others substantially reduce their drinking and report fewer alcohol-related problems.”
Let’s focus on what alcohol does to your judgment. NIAA says that:
“Even mild-to-moderate drinking can adversely affect cognitive functioning, i.e., mental activities that involve acquiring, storing, retrieving, and using information. Persistent cognitive impairment can contribute to poor job performance in adult alcoholics and can interfere with learning and academic achievement in adolescents with an established pattern of chronic heavy drinking. A small but significant proportion of the heaviest drinkers may develop devastating, irreversible brain-damage syndromes, such as Wernicke-Korsakoff syndrome, a disorder in which the patient is incapable of remembering new information for more than a few seconds.”
Stupid drinking, according to some reports, also is leading to a newer budget-busting problem: Drunken online shopping. It’s not as silly or small matter as many might think, according to one online site’s survey, which found:
“Nearly half of American adults admit to regularly shopping while drunk — and it appears to be getting worse. Americans spent an average of $448 per person in drunk purchases in 2017, nearly double what they did in 2016 …. That would equate to billions of dollars on drunk shopping per year nationwide, the authors said. Men are responsible for more drunk spending than women: $564 versus $282. Generation X spent the most on drunk purchases, averaging $738 last year — more than triple the amount ($206) that millennials spent.”
While intoxicated, shoppers buy shoes, clothes, gifts — and they hit online gambling sites. Some take on bigger financial transactions while tipsy, dealing with banking, investment, and retirement matters online.
If your favorite internet retailer or enterprise is pokey on Monday mornings, it may be because, as the experts recommend, newly sober consumers can take advantage of online businesses’ generous returns policies to cancel out their drunken dealings.
Some finance gurus recommend that drinkers with bad online habits consider downloading apps like DrnkPay, which connects to debit cards and limits user purchases if they have spent a certain amount at a bar in a given night; or Cold Turkey, which, even if it gets deleted, can be set to block selected apps and websites.
Booze and sex may be even more risky as STD cases soar
As young people return to school this fall, educators and public health officials may need to deal with intoxication and risky sexual behaviors with even greater urgency — not just because of the #MeToo movement and the increased national awareness about protecting girls and women from untoward sexual advances and assault.
The CDC also is reporting that sexually transmitted diseases, especially among the young, is soaring. As USA Today reported:
“New cases of chlamydia, gonorrhea and syphilis spiked nearly 10 percent in 2017, continuing a four-year trend of rising sexually transmitted diseases fueled by a lack of awareness and changing sexual behavior. …The [CDC] said 2.29 million new cases of these three common yet treatable sexually transmitted diseases were diagnosed in 2017. The number of new STD cases continued a ‘steep, sustained increase’ since 2013, the CDC reported.”
The rise in cases is at record levels, but the federal budget has not increased STD program funding since 2013, leaving health departments scrambling to address the problem with fewer resources.”