Health Effects of Alcohol

Alcohol has a negative effect on health, both in the short and long term. In the short term, your decision-making and reactions are impaired, making you more likely to crash your car, get into a fight, or suffer a fall. In the long term, alcohol use increases the risk of liver disease, heart disease, stroke, several types of cancers and other health issues.

Short-term effects

• Increased risk of unplanned pregnancy and STDs

• Injuries and fatalities from falls, vehicle collisions, and other types of accidents

• Exposure to violence, including homicide and sexual assaults

• Death due to alcohol poisoning from very high blood-alcohol levels

• Nausea, vomiting, dehydration, headache, sleep difficulties

Binge drinking is defined as consuming 5 or more drinks (in men) and 4 or more drinks (in women) on any given occasion. Some people indulge in binge drinking only occasionally and they do not have an alcohol use disorder. However, binge drinking can have many harmful effects even when a person doesn’t have an alcohol addiction.

Binge drinking is associated with an increased risk of unintended pregnancy. ^{[1] [2]}

Binge drinkers are also more likely to engage in unplanned sex, which increases the risk of contracting HIV and other sexually transmitted diseases.

Binge drinkers experience increased risks of assault, getting into fights, and suffering physical injuries, putting them at risk of serious health complications. Alcohol is frequently a contributing factor in fatal non-traffic accidents, such as homicides, accidental injuries, and suicide. ^[3]

Alcohol can increase the risk of stillbirths and miscarriages in pregnant women. Drinking during pregnancy can lead to fetal alcohol spectrum disorders (FASDs). These is no specific medical test to diagnose FASDs, and so doctors look for a combination of distinctive facial features, below-average height or weight, and central nervous system issues in deciding whether it may be present. Physical and mental issues in the child can vary in severity, but may include coordination issues, learning difficulties, attention difficulties, speech and language problems, vision and hearing impairment, poor sleeping as a child, and issues with the heart, bones, and kidneys. ^[4]

Alcohol is also a contributing factor in road accidents, which is why most legislators around the world have introduced some forms of restriction on driving while under the influence. One study ^[5] in New Zealand found that young people who drink and drive have a 2.6 times higher rate of traffic accidents compared to those who did not drink.

Alcohol poisoning is a major cause of death in the United States. ^[6] Between the years 2015 and 2019, excessive alcohol use was responsible for 140,000 deaths each year. That is 380 deaths every day attributed to alcohol use.

Adult males above the age of 35 years are most frequently involved in alcohol-related deaths. The majority of alcohol-associated deaths are from the health effects of alcohol, including liver disease, heart disease, and various types of cancers.

In addition, alcohol-impaired driving claimed over 13,000 lives in 2021, with alcohol being implicated in nearly 1 in 3 driving fatalities. Also, around 1 in 4 people who died from suicide had alcohol use disorder and a high blood alcohol concentration at the time of their death. ^[7]

Long-term effects

• Liver damage

• Pancreatitis

• High blood pressure

• Weakening of the immune system

• Pneumonia

• Sepsis

• Chronic inflammation

• Stroke

• Heart failure

• Infertility

• Cancer

• Anxiety

• Brain damage

Alcohol and Immunity

Heavy drinking weakens the immune system. ^[8] It is associated with an increased risk of pneumonia, sepsis, and other immune-related issues. Heavy alcohol use also slows down tissue repair and increases the risk of experiencing complications from surgery.

Alcohol and Chronic Inflammation

Research has shown an association between alcohol and chronic inflammation. ^[9] Alcohol causes LPS (lipopolysaccharide) translocation across the gut. LPS is a bacterial toxin. In healthy people, the intestinal barrier prevents LPS from leaving the gut to enter the circulation. The body detoxifies LPS using complex multi-organ interactions, with the liver in particular playing an important role. Studies have found that people with alcohol-related liver disease have higher levels of circulating LPS. Drinking alcohol reduces the ability of the body to detoxify.

Alcohol and Liver Disease

Alcoholic liver disease is a common health complication in heavy drinkers. The liver is the organ that metabolizes (processes) ethanol. Therefore, it is no surprise that the liver is exposed to the highest levels of tissue damage in people with alcohol use disorders. Excessive drinking causes different types of lesions on the liver, including inflammation, fat accumulation, scar tissue development, and remodeling of tissue. Beyond quitting drinking alcohol and liver transplants, there are few options available for treating the condition. ^[10]

Alcohol and Cancer

Alcohol is associated with an increased risk of many types of cancers, including breast, liver, esophageal, pancreatic, colon, and others. In the case of breast cancer, for example, more than 100 studies have demonstrated a link between alcohol consumption and the disease. While we know alcohol plays a multifactorial role in the development of cancers, the precise mechanisms are not yet fully understood. ^[11]

Alcohol and Pancreatitis

Pancreatitis is an inflammation of the pancreas. This organ plays an important role in alcohol metabolism in the body, and as a result, pancreatic complications can occur in people with alcohol issues. Alcoholic pancreatitis occurs more frequently in heavier drinkers, but some heavy drinkers may not have any identifiable symptoms of the condition, thereby delaying diagnosis and treatment. ^[12]

Alcohol and Cardiovascular Disease

Alcohol is linked to hypertension (increased blood pressure), which itself is associated with a wide range of health conditions. Researchers have proposed a number of possible methods by which alcohol can result in elevated blood pressure, including damage to the blood vessels and imbalances in the central nervous system. It has been established that alcohol has a larger effect on systolic blood pressure versus diastolic blood pressure. ^[13]

Alcohol consumption is associated with an increased risk of stroke. One meta-analysis found that people who consume more than 60 grams of alcohol per day are more likely to experience a stroke, while those with light to moderate drinking patterns have a reduced risk of stroke. ^[14] However, other studies have shown that moderate alcohol consumption of 1-2 drinks per day is associated with a higher risk of stroke compared to no drinking. ^[15]

It can be difficult to separate fact from fiction when it comes to the link between alcohol and heart disease. Some studies have shown moderate alcohol intake has a protective effect on the heart. However, more research is needed. At present, we don’t know if it is moderate alcohol intake (a glass of red wine a day) or related factors that have the protective effect. For instance, it’s possible that red wine drinkers are more educated and have a higher socioeconomic status, giving them greater access to heart-healthy foods and physical activity opportunities such as gym memberships.

What we do know is that heavy drinking is linked to a number of poor cardiovascular outcomes, including high blood pressure, heart disease, heart failure, and stroke. People with alcohol use disorders are at risk of developing asymptomatic alcoholic cardiomyopathy (ACM), a disorder of the heart muscle, which can progress to heart failure. Unless alcohol consumption is completely eliminated, there is an almost 50% mortality rate within four years in people with this condition. ^[16]

Chronic alcohol consumption is also linked to arrhythmias (heart rhythm problems), which includes the heart beating too fast, too slow, or irregularly. Studies in particular point towards tachycardias (a resting heart rate of more than 100 beats per minute) being a concern in heavy drinkers. There is also some evidence that heavy drinking increases the risk of sudden death from fatal arrhythmia. ^[17]

Alcohol and Brain Damage

Alcohol consumption is associated with brain damage. Studies have shown that people with alcohol use disorders have a smaller brain volume compared to those who don’t drink excessively. This difference in brain volume is most severe in the frontal cortex, the area of the brain responsible for motor tasks, creativity, abstract thinking, judgment, and socially appropriate behavior. In fact, there is evidence to suggest that neurodegeneration caused by excessive alcohol consumption can make a person more impulsive and less able to resist the temptations of harmful substances. ^[18]

Alcohol and Mental Health Conditions

Alcohol use disorders and anxiety are commonly present together. The exact way in which the two are linked is not yet fully understood, but a number of pathways have been proposed. It could be that alcohol consumption causes anxiety. It’s also possible that people with anxiety are drawn to alcohol in order to self-medicate. Then there is the possibility that a third unknown factor could lead to both alcohol use disorder and anxiety. More research is required to understand the precise reasons behind the comorbidity. However, we do know that in people with mental health conditions such as anxiety and depression and alcohol use disorder, dual diagnosis addiction treatment that addresses both conditions simultaneously is necessary. ^[19]

Notably, one specific anxiety disorder that has been linked to alcohol use disorders is post-traumatic stress disorder (PTSD). People experiencing PTSD often use alcohol to self-medicate. But using too much alcohol makes it harder to cope with the stress and trauma of distressing memories. Alcohol intoxication also worsens certain PTSD symptoms like feeling numb or having no emotions. ^[20]

Alcohol and Fertility

Alcohol is associated with fertility problems in both males and females. Increasing alcohol consumption is linked to worsening semen quality in men. One study examined 100 males with alcohol use disorders, and only 12% of these individuals had normal semen parameters. Among the heavier drinkers in the group (those consuming 80 grams per day or more), none had normal semen parameters. This suggests a dose–related relationship between alcohol and male fertility. Women who have 2 or more drinks per day experience more infertility issues, and this effect is even more pronounced in older women. ^[21]

Alcohol and Pregnancy

Women of childbearing age should refrain from behaviors such as binge drinking, because it puts them at risk of unintended pregnancy due to risky sexual behaviors under the influence of alcohol.

Pregnant women or women who are planning a pregnancy soon should avoid drinking alcohol. There is no safe drinking limit during pregnancy. Several medical conditions, such as fetal alcohol syndrome (FAS), have been directly linked to alcohol use during pregnancy. FAS is a condition in which babies exposed to alcohol during the mother’s pregnancy suffer growth problems and irreversible brain damage.

Moderate alcohol consumption (1 drink per day) is not known to be harmful while breastfeeding (especially if waiting 2 hours after drinking), but avoiding alcohol is the safest option for new mothers.

Last updated: February 28, 2024