Is it Okay to have that drink?

Health & Wellness

Over the past few years my news feed has contained an array of headlines suggesting that any alcohol use is a health risk. When considering risk it is important to keep in mind the complexities. For example, if you are told that  you are at a 2% risk for a specific negative consequence, and the research states that one or more factors double your risk, the risk would be 4%, which for many is still a relatively small level of risk.  In addition, the warnings of negative consequences associated with alcohol use, or any other practice, need to be carefully understood.  For example, if alcohol use shortens life span relevant questions remain: by how much (there is a big difference between having our life spanned shortened by two weeks as opposed to two years);  what are the risks associated with different amounts of alcohol use; are there protective factors that would lower your risk despite use; and are there exacerbating factors that would increase your risk. Finally, the quality of the research and the verification of findings by multiple  researchers make a huge difference.  Is there just one study supporting a finding or are there multiple studies in a variety of settings by different researchers supporting the same conclusions?  Are the studies well done methodologically or are there significant weaknesses?  All these factors, plus others, need to be considered before reaching definitive conclusions. 

Recently, I had the good fortune to listen to a podcast on the subject  (1) which featured a New York Times reporter, Susan Dominus (2) who has recently delved into understanding the risks associated with alcohol use. This podcast also included an interview with Dr. Tim Stockwell, who has examined in detail the data associated with the risks of alcohol use.  Dr. Stockwell has a long career studying alcohol use and in 2023 published his findings ( a meta analysis, which is an examination of multiple studies on a topic and involves drawing conclusions based on all of the available data) on the risks associated with alcohol use. Dr. Stockwell’s research rejects the earlier conclusion that alcohol, specifically red wine, may have some beneficial health effects, and concludes that there is risk of increased mortality (death from any cause) from alcohol use.  Stockwell attributes his work in this area to the ideas and work of Kaye Middleton Fillmore, who initially challenged the conclusions that alcohol use had protective benefits and found notable methodological flaws in the earlier research showing the benefits of alcohol use (4). 

However, Dr. Stockwell tempers his conclusions by noting that the degree of risk varies significantly depending on the extent of alcohol use, how much one drinks.  A summary of his findings suggest that an average of 2 drinks a week is associated with a less than one week decrease in life expectancy, while 7 drinks a week is associated with a decrease in life expectancy to 2 and a half months, and 5 or more drinks a day reduces life expectancy by 2 years or more. Moreover, there appear to be differences between men and women, with women having higher risks of increased mortality (dying from any cause) then men at the same levels of alcohol use (5).

In discussing these findings the NYT reporter, Susan Dominus, draws out the complexities of risk further, and even raises the possibility that there might be social benefits from having a drink, e.g., a chance to connect and socialize with coworkers. However, Dominus does not minimize the risks associated with alcohol use and makes the point that there is a distinction between an individual choice, and the broader social implications of increased risk of mortality associated with alcohol. 

While it is difficult to draw a definitive conclusion about alcohol use several things appear clear. First, there is no evidence supporting any health benefit connected to alcohol use. Second, heavier use, more than 2 drinks a day for women and 3 for men clearly can have notable health risks (this conclusion is advanced by Stockwell and others). Third, that lower levels of use, 2 or 3 drinks a week, is likely a minor risk at best. However, as Dominus points out, alcohol use can increase risks in specific situations. Therefore, those who are occasional or social drinkers need to be mindful of this reality.  For example,  even small amounts of alcohol can impair functioning. While you are likely not at risk of a DUI if you drive home from dinner after one drink, you may have slight impairments in judgment and physical coordination that increase your risk of an accident.

In addition to encouraging all of us to be mindful of our alcohol use, it is also important that we work to be careful and thoughtful consumers of the latest scientific claims, particularly when they are translated into headlines.  The complexities of the research may often indicate that the bullet point conclusions are not as simple and clear as we might first think.  Scientific knowledge is hopefully always evolving.  Thus, we need to keep in mind that today’s rather definitive claims may be subject to revision.  

  1. The Daily Podcast, July 5th 2024 titled: “How bad is alcohol for you, really?”.  See https://www.nytimes.com/2024/07/05/podcasts/the-daily/alcohol-health-risks.html for a transcript of the podcast or check the Daily podcast for an audio version.
  2. Susan Dominus wrote an article, in the New York Times, that led to the podcast on the Daily. See:   A related NYT article by Alice Callahan offers a brief overview of the issues: https://www.nytimes.com/2024/02/17/well/eat/red-wine-heart-health.html
  3. Tim Stockwell has had a long career researching and reporting on the risks associated with alcohol use. A good overview of his work is available in a youtube video, noted below, but he also has a long list of publications.  The research referenced in this blog is from his (and his colleagues)  2023 meta analysis (a study of multiple studies on a given topic)  the risks of alcohol use that was based on nearly 5 millions subjects. 
  4. Kaye Middleton Fillmore’s research identified serious flaws in earlier research, specifically how earlier research showing the protective benefits of alcohol use included former drinkers (many of whom had health issues) in their non-drinker groups. When these individuals were removed from the studies the protective benefits of alcohol use disappeared. Examples of Fillmore’s work include:
  5. See CDC data on the comparative risks of alcohol use for men and women: https://www.cdc.gov/alcohol/fact-sheets/womens-health.htm
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