Alcohol and Health: Unpacking the Good, Bad, and Ugly

Alcohol is a very personalized substance. Its impact on health changes with time and circumstance. Many people drink casually during fun occasions while others use it as a coping mechanism. Alcohol can be complicated as it is a positive in some situations and a negative in others. The benefits and consequences are deeply rooted in the dosage and reasons for use. In this article, we’ll unpack the impact of alcohol on health: the good, bad, and ugly.

Alcohol Dosage

Often times words such as “moderate intake”, “heavy alcohol use”, and “one drink” are thrown around. Unfortunately, these words have no legal definition, leaving them up for interpretation by the masses. Through our research, we found that the generally accepted guidelines for “one drink”, and light, moderate, and heavy alcohol consumption are as follows:

• One Drink: In the U.S. one drink is considered to be 12 ounces of beer, 5 ounces of wine, or 1½ ounces of hard liquor¹
• Light Consumption: 1-3 drinks per week for men and women
• Moderate Consumption: 1-3 drinks per day for men, 1 drink per day for women
• Heavy Consumption: 5 or more drinks per day, or 15 or more per week for men, 4 or more drinks per day, or 8 or more per week for women

Alcohol and Health: The Good

The benefit of alcohol consumption is a heavily studied topic. Although more research is needed to make definitive claims, there is evidence of health benefits related to light and moderate alcohol consumption.

Several studies have discovered that consuming light to moderate amounts of alcohol is linked to a 25% to 40% decrease in the risk of various health conditions, including heart attacks, strokes, peripheral vascular disease, sudden cardiac death, and deaths related to cardiovascular diseases.² These benefits extend to elderly individuals and those at high risk of heart attack, stroke, and death including those with type 2 diabetes and hypertension. Biologically, these benefits make sense as ethanol raises high-density lipoprotein (HDL) cholesterol which is associated with lower rates of heart disease.

Research suggests that light to moderate alcohol consumption can also have positive effects on other aspects of physical health. Many studies have found increased insulin sensitivity and reduced fasting insulin secretion leading to reduced risk of type 2 diabetes.³ Lower mortality rates, reduced risk of dementia, reduced risk of developing brittle bones, and lowered stress levels have all been associated with light to moderate alcohol consumption.

Alcohol and Health: The Bad

The health benefits of light to moderate alcohol intake plummet once alcohol use becomes excessive. Increasing alcohol to that which is considered heavy consumption has been found to increase the risk of hypertension⁴, abnormal heart rhythms, stroke, heart attack, and death. It can also cause inflammation of the liver (alcohol hepatitis) and can lead to scarring or cirrhosis of the liver.

The negative effects of alcohol are heavily dependent on drinking patterns. Several studies have found that participants who drink 5-6 drinks per day are at a significantly higher risk of myocardial infarction (heart attack) than those who drink the same amount throughout the week.⁵ A women’s health study found that women who drank 1 drink per day for 4-5 days a week had lower death rates from any cause compared to women who consumed the same amount in 1-2 days.⁶ The key is to keep the total amount of alcohol consumed per day within the range of what is considered light to moderate consumption.

Alcohol and Health: The Ugly

This is where alcohol becomes more personalized. Our reaction to alcohol is dependent on how our body processes and metabolizes alcohol intake. There is a generally accepted classification system related to our reactions to alcohol. For example, there are “angry drunks, “chatty drunks”, “life of the party drunks”, “emotional drunks”, “drunks that blow chunks”, the list of individual responses to alcohol is infinite.

Alcohol consumption can turn ugly very quickly due to alcohol’s effect on the central nervous system. Alcohol crosses the blood-brain barrier altering the brain chemistry and halting proper brain functions. It inhibits the part of the brain that is responsible for judgment and decision-making. For some, this leads to lowered inhibition and increased impulsivity leading to poor decisions.

The weight of these poor decisions is highly dependent on the individual consumer. The majority of people choose to follow alcohol consumption with unhealthy food choices they normally would not make if they were sober. For others, alcohol’s effect on the central nervous system can lead to lashing out, heavy aggression and violence sometimes leading to life-altering or life-ending physical altercations. In the worst cases, alcohol consumption leads to the decision to drive. In 2023 there were approximately 10,500 drunk driving deaths in the United States.⁷ Roughly 28 people per day or 1 person every 51 minutes dies as the result of drunk driving.

Unpacking the Good, Bad, and Ugly

Alcohol, when consumed in moderation, has several health benefits. If you’re over the age of 21, feel free to relax and have a few drinks throughout the week. If you begin feeling like your light-moderate alcohol consumption is transitioning into heavy consumption, work on dialing it back. If needed, abstain from alcohol for 2-6 weeks. This will lower your tolerance and make it so that you do not need to drink as much in order to feel its effects.

If you are prone to making bad decisions when drinking, it is very important that you stay away from alcohol altogether. No one pictures themselves as the person who would kill someone else as the result of poor decision-making while under the influence. However, the fact is, it happens and it could very well happen to you. One night of drinking is never worth the consequence of another person’s life accompanied by a life in prison following their death.

Alcohol can be a very enjoyable and beneficial thing in life. Just make sure to be responsible and conscientious of your choices and your volume of intake.

Supporting Research

1. Dietary guidelines for Americans 2020-2025. U.S. Department of Agriculture. https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf ↩︎
2. Goldberg IJ, Mosca L, Piano MR, Fisher EA. Wine and your heart: a science advisory for healthcare professionals from the Nutrition Committee, Council on Epidemiology and Prevention, and Council on Cardiovascular Nursing of the American Heart Association. Circulation. 2001 Jan 23;103(3):472-5. ↩︎
3. Bonnet F, Disse E, Laville M, Mari A, Hojlund K, Anderwald CH, Piatti P, Balkau B; RISC Study Group. Moderate alcohol consumption is associated with improved insulin sensitivity, reduced basal insulin secretion rate and lower fasting glucagon concentration in healthy women. Diabetologia. 2012 Dec;55(12):3228-37. doi: 10.1007/s00125-012-2701-3. Epub 2012 Aug 31. PMID: 22935962. ↩︎
4. Understanding the Silent Killer: A Revolutionary Guide to Hypertension. Human Health Co. (2024e, May 5). https://humanhealthco.com/understanding-the-silent-killer-a-revolutionary-guide-to-hypertension/ ↩︎
5. Mukamal KJ, Conigrave KM, Mittleman MA, Camargo Jr CA, Stampfer MJ, Willett WC, Rimm EB. Roles of drinking pattern and type of alcohol consumed in coronary heart disease in men. New England Journal of Medicine. 2003 Jan 9;348(2):109-18. ↩︎
6. Mostofsky E, Mukamal KJ, Giovannucci EL, Stampfer MJ, Rimm EB. Key findings on alcohol consumption and a variety of health outcomes from the Nurses’ Health Study. American journal of public health. 2016 Sep;106(9):1586-91. ↩︎
7. Alcohol related deaths per year, State & More: 2023 analysis. NCDAS. (2024, May 3). https://drugabusestatistics.org/alcohol-related-deaths/ ↩︎