Distributed January 30, 2003
Op-Ed Editor: Mark Nickel
David C. Lewis, M.D.
Should you drink for your health?
A new study in The New England Journal of Medicine reports on the health benefits of moderate alcohol consumption. However, that study does not mean alcohol is a health food for everyone.
As a physician, I’m always on the lookout for disease prevention, so I am encouraged by a recent authoritative report on the benefits of moderate alcohol consumption. In January, The New England Journal of Medicine published a study of more than 38,000 male health professionals which concluded that the moderate and regular consumption of alcohol at least three or four times a week is associated with a significant decrease in the risk of myocardial infarction, the leading cause of death in the United States.
Because the study results were reported widely, many of the 90 million drinkers and countless nondrinkers in the country are now asking about their own levels of drinking or abstinence. Has alcohol become a health food?
Not so fast.
The new study is important but not conclusive for everyone. It reviewed the histories of men ages 40 to 75, telling us nothing about younger and older men or about women – i.e., half of the U.S. population.
It is stating the obvious to say that drinking is not always beneficial. As a physician, I have seen well over a thousand individuals compromise their health and happiness through drinking. Nationally, upward of 18 million people have experienced significant problems with alcohol use. Therefore, we need to balance the health benefits of drinking against the risks.
Some guidance can be gleaned from The New England Journal’s editorial, which accompanied the publication of the study. It cautioned physicians about the downside of advising patients to drink, commenting that not many physicians would “use the therapy that might reduce the rate of myocardial infarction by 25 to 50 percent, but that would result in thousands of additional deaths per year due to cancer, motor vehicle accidents and liver disease.” The editorial further states that “there is insufficient information to encourage patients who do not drink alcohol to start.” I agree and can elaborate further.
A number of people should not drink at all. Pregnant women and children should not drink. Those for whom drinking worsens an existing medical or psychiatric illness shouldn’t drink; nor should those whose drinking precipitates negative reactions by mixing alcohol with prescribed or over-the-counter medications. Obviously, drinking and driving don’t mix. Even with moderate alcohol intake, driving skills can be impaired.
People who have had alcohol problems in the past, particularly those with the disease of alcoholism, certainly shouldn’t drink. Finally, those with a strong family history of alcohol problems should drink only with caution and be aware that they are at greater risk than the general population for developing harmful drinking patterns or alcoholism. Such a risk would most certainly offset any protective health benefits discovered in the study.
The wide dissemination of the results of this study is commendable. Yet a common concern of addiction medicine specialists and people who are recovering from alcoholism or the harmful effects of alcohol is that any publicity about the health benefits of drinking will be used as a rationalization by problem drinkers to keep on drinking, or for alcoholics who have achieved sobriety to resume their earlier drinking practices. I don’t share their concern. This isn’t the first study to have found that alcohol can be protective against heart attacks, yet alcohol treatment programs have not been deluged by clients in relapse who have resumed drinking “for their health.”
Should you drink for your health?
The lifesaving benefits of drinking still require further investigation. Let’s accept this important scientific study for what it is worth. Use good judgment about your own drinking habits. Talk with your doctor. Although many physicians are ill prepared to give advice on this subject, some are in a position to help you find an answer.
The bottom line is that if you are an individual who is free of the many risks of drinking and who drinks moderately on a regular basis, you may be enhancing your health. But drinking isn’t for everyone.