Alcohol and Health

Drinking alcohol has deep historical and cultural roots. There is archaeological evidence of alcohol production and consumption dating back more than 7,000 years. The impact of alcohol on humans has been researched for many years, and even today we do not have all the answers.

Frequent drinking is a normal occurrence in our country, and it is not unusual for people to consume it from early adolescence. All celebrations, from the birth of a child to a funeral, include alcohol. One could say that rakija is a part of our national identity. While most people are familiar with the dangers of excessive alcohol intake, what constitutes an excessive amount is a matter of personal interpretation. This is one of the reasons why many people drink large amounts of alcohol with the attitude that it is normal and that they drink less than those around them. Consequently, it is no surprise that the inhabitants of Serbia are among the first in the Balkans regarding alcohol consumption.

Since my approach to habits involves balancing the enjoyment of life with the preservation of health, the purpose of this article is not to convince anyone to stop drinking or to give anything up. I want to provide you with reliable information about alcohol, describe the perspectives of experts and my own opinion based on them, so that you can make well-informed, conscious decisions about your lifestyle.

Benefits of Alcohol Intake

Since alcohol abuse has serious health and social consequences, most researchers rightfully focus on the negative and harmful effects of excessive alcohol consumption. The generally accepted view is that alcohol consumption should be avoided, and if one does drink, to drink as little and as rarely as possible. However, despite the well-known negative effects and recommendations of various organizations, alcohol is still consumed by more than half of the population in the developed world, with a tendency for numbers to rise. The question is:

Why?

The most common assumptions for the reason people drink alcohol are hedonistic (pleasure and reward), anxiolytic (stress and anxiety reduction), and addictive (once you start, it's hard to stop). I am of the opinion that besides these, there are other real or perceived benefits to alcohol intake, primarily in the field of social interactions, self-confidence, and openness to connecting with new people.

While we talk about some of the benefits of alcohol consumption, I would like to emphasize that all research indicates that the disadvantages of alcohol intake are greater and more significant than the positive effects.

Social Benefits

Alcohol, like other stimulating substances such as cocaine and amphetamines, leads to an increased secretion of endorphins. These small peptides naturally secreted in the brain have a positive impact on social understanding, communication, and maintaining long-term relationships and friendships across all primates, including humans.

Other activities that stimulate endorphins include laughing, singing, dancing, and storytelling, which are often accompanied and enhanced by alcohol consumption. For these reasons, it can be concluded that moderate alcohol consumption can have positive effects on human social behavior and life.

From my experience in working with people, the situation is similar. Practically all people who drink regularly with whom I have spoken do so for social reasons. Whether the cause of this is the improvement of social relationships that alcohol brings or the pressure exerted on them by their environment remains open to question.

A very interesting study published in 2017 examined the connection between social habits and alcohol consumption. They asked a mixed group of Britons to answer several questions, including: how often they go to a pub, whether they socialize and drink often, and whether they have "their" pub. After that, they asked them to assess feelings such as their sense of happiness, anxiety, satisfaction, relationships with people, and the like, on a scale from 1 to 7.

The data showed that people who drink moderately feel happier, more satisfied, have more trust in others, and feel better connected to their local community. Additionally, those who had "their" place and visited it regularly had an even more positive feeling toward these things.

Although the research results are interesting, the method of conducting this study is questionable because it was carried out online on a relatively small sample of 2,254 people. Additionally, the ever-relevant "chicken or egg" question remains—meaning, are people who drink more socially active because they drink, or do they drink because they are more socially active? It is expected that introverts are out of the house less often, and therefore consume alcohol less frequently, and vice versa.

Another group of scientists dealt with a similar question. They formed diverse smaller groups of people using 720 volunteers and concluded that alcohol stimulates bonding within a group. Additionally, after consuming a small amount of alcohol, people talk to each other more, express negative emotions less frequently, and share genuine laughs more often.

Health Benefits

In the past, there were various theories about the potential positive effects of moderate amounts of alcohol on human health. I found a large number of studies indicating positive effects of alcohol on heart health, but also a large number of higher-quality studies that deny this. My conclusion is that the health benefits are relatively small and highly specific, so if you decide to drink, remember that you are doing it for enjoyment and socializing, not for health.

There is evidence that the consumption of a small or moderate amount of alcohol leads to a reduced chance of death caused by various illnesses, particularly certain types of cancer. Also, there is strong evidence regarding the benefits of small or moderate amounts of alcohol in reducing the risk of kidney cancer, colon cancer, dementia, cardiovascular diseases in people with hypertension, as well as cardiomyopathy.

Disadvantages of Alcohol Intake

According to data for 2019, it is considered that alcohol contributed to the death of 2.6 million people worldwide. Among them, those aged 20–39 are the most vulnerable. Alcohol is responsible for over 200 different diseases, injuries, and health conditions, and it is classified as an addictive substance that is toxic and possesses psychoactive properties.

Health Problems

The greatest concern for health is caused by the high carcinogenicity of alcohol, which is classified into the highest Group 1 of carcinogenic substances along with asbestos, radiation, and tobacco. Alcohol increases the risk of at least seven types of cancer, including bladder cancer and breast cancer. The World Health Organization points out that alcohol exhibits carcinogenic properties regardless of the amount and frequency of consumption. We know that the negative attributes are directly related to quantity and frequency and are independent of the quality and type of beverage, because alcohol itself and the substances produced during its digestion are toxic.

There is strong evidence that alcohol increases the risk of esophageal, breast, and skin cancer even at a low intake (less than one drink per day). At moderate and high intake, it additionally increases the risk of rectal and stomach cancer.

Unlike the tobacco industry, the alcohol industry is under no obligation to inform its consumers about the carcinogenicity of its products. The scientific world has known for decades that alcohol increases the risk of cancer, but the general public is not well acquainted with this fact, and it is certainly something that needs to be addressed.

Other health problems to which a large alcohol intake contributes are numerous indeed and include: high blood pressure, heart disease, stroke, liver disease, digestive problems, and a weakening of the immune system. I could write at length about how and which problems large amounts of alcohol cause, but I think it is enough to say that it affects the entire body very poorly and leads to a series of other complications.

Psychological Problems

Alcohol is a depressant, which means it leads to a feeling of relaxation, reduced anxiety, and increased confidence. However, after the effects of alcohol wear off, they leave behind altered brain chemistry, resulting in an increase in anger, depression, and anxiety. The long-term effects of alcohol abuse include memory problems, a decline in cognitive functions, an increased risk of suicide, and an elevated chance of developing alcoholism.

Depression is the most common psychological problem occurring in people who abuse alcohol. While there is depression that is primarily caused by alcohol abuse, it has been shown that people who are already depressed are more likely to start abusing alcohol, making these two problems very closely intertwined. What we definitely know is that alcohol does not contribute to solving problems with depression; instead, it worsens them.

More than 720 thousand people worldwide commit suicide annually, with the population between 15 and 29 years old being the most affected. While the reasons for suicide vary, there is a strong link between suicide and mental disorders, primarily depression and alcoholism. The reason why alcohol so significantly increases the risk is that under the influence of alcohol, the sense of fear and control is reduced, poor decisions and judgments are made, and impulsivity and aggression are increased.

Social Problems

In addition to the medical and psychological problems caused by alcohol abuse, there is a whole range of social and individual relationship problems that cannot be ignored when trying to present the complete picture of alcohol. In the long term, alcohol contributes to unemployment, divorce, domestic violence, and homelessness.

A small study investigating the most common problems of alcoholics showed that the most frequent issues are: absenteeism from work, serious arguments with a spouse, physical assault while intoxicated, and driving under the influence.

Amount of Alcohol

How many drinks is it normal to consume during the day or week?

Different organizations and countries set different standards for what quantity of drinks is normal. These standards emerged as a product of research and the behavior of the population they are intended for.

General recommendations based on my interpretation, and drawing from the guidelines of all major organizations, are:

• For men: less than 20g of pure alcohol per day, which is about 2 drinks per day, or 14 drinks per week.
• For women: less than 10g of pure alcohol per day, which is about 1 drink per day, or 7 drinks per week.
• Individuals under the age of 21, and perhaps even 23, should not consume alcohol. There is a range of problems that specifically affect people during their developmental stage which I haven't written about in this text and to which an entire post should be dedicated.
• Pregnant and breastfeeding women should not consume alcohol due to highly negative effects on the fetus and baby. Alcohol during pregnancy can not only lead to miscarriage and stillbirth, but can also cause a number of lifelong disorders classified as Fetal Alcohol Spectrum Disorders (FASD).

Recommendations in the European Union vary from country to country. For example, for Ireland, the recommendations are up to 17 standard drinks per week for men, up to 11 standard drinks for women, and at least two days a week without alcohol. On the other hand, recommendations for France are no more than 10 standard drinks per week and no more than 2 drinks per day, with at least one day in the week without alcohol.

The classification of the American National Institute on Alcohol Abuse and Alcoholism is:

• Moderate alcohol consumption - Drinking 2 drinks per day for men and 1 drink for women.
• Binge drinking - Bringing blood alcohol concentration to 0.8 grams per liter, which typically happens after about 5 drinks for men and 4 drinks for women within a period of about 2 hours.
• Heavy alcohol use - Consuming 5 or more drinks on any day or 15 or more drinks per week for men, and 4 or more drinks on any day or 8 or more drinks per week for women.

The National Health Service of the United Kingdom recommends consuming less than 14 drinks per week spread across the week, and several alcohol-free days.

Conclusion

Alcohol can help us relax, meet new people, and navigate a new social environment more easily. The consumption of alcohol has a few health benefits, but the negative health consequences are far more pronounced. A moderate amount of alcohol is 0 to 14 drinks during the week, independent of the type of beverage. If you enjoy alcohol, that's fine, just don't overdo it.

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