Drink?: The New Science of Alcohol and Health

We have a huge blind spot for the steep social costs of our most harmful drug. It's not just alcoholics whose health is at risk. Moderate drinking also entails risks of cancer, high blood pressure and strokes. Intoxication also harms others. Domestic violence and date rape are just two of the violent crimes that are typically alcohol- related. Drinking and driving accounts for about one in three traffic fatalities.The reason we tolerate the harm is because alcohol use also has benefits. Professor David Nutt is a leading global authority on alcohol abuse. No prohibitionist, Nutt writes that alcohol is a social drug for a social animal; it "lubricates our interactions with others... is a major part of how we bond...our celebration rituals revolve around alcohol." There is some evidence that drinking can enhance creativity.That's why he concludes that alcohol is both the drug with the most benefits andthe most harmful addictive substance to society.The main reason alcohol is the most harmful drug is that so many people use it: about four out of five in western countries. Between one to two in 10 are problem drinkers. The top 10 percent of American drinkers consume an average of 74 drinks per week, which is over 10 drinks per day.Nutt asserts that "no level of alcohol consumption is safe." Not long ago red wine was reputedly good for the heart. But in 2018 Lancet concluded that, on balance, any protection from drinking would be more than canceled out by the negative effects. The supposed protective effect of resveratrol, found in red wine, has not been sustained in human research, though men get a lowering of ischemic heart disease from consuming half a glass of wine per week.We better understand the effects of alcohol today than we did a decade or two ago. For example, recent research shows that alcohol use is associated with at least eight cancers. We also know that alcohol acts on many different neurotransmitter systems in the brain. That's why severe alcohol intoxication can lead to coma and even death. In addition, the parts of the brain dealing with judgment are very sensitive to alcohol.In the US, an estimated 88,000 people (approxi- mately 62,000 men and 26,000 women) die from alcohol-related causes annually, making alcohol the third leading preventable cause of death in the United States, behind tobacco and poor diet and physical inactivity.The health risks are dose-related. For example, the incidence of cancer rises with consumption. When it comes to the heart, "Even light to moderate drinking raises your risk of an irregular heartbeat, cardiac arrythmia, which may make you feel faint and short of breath.The risk of stroke is both dose dependent and cumulative."When it comes to the brain, "The leading preventable causes of dementia are head injury and the damage alcohol does to the brain. At least one in five cases of dementia is probably due to alcohol. Women may experience brain damage at lower levels of alcohol intake than men." Though there is contradictory evidence about moderate consump- tion, it is "absolutely certain that heavy drinking (adversely) affects the brain."In the USA, DUI is commonly defined as 0.08% BAC. The per se .08 level was a compromise arrived at after long debate with the powerful industries that make, sell and serve alcoholic beverages who wanted a higher legal limit.The limit in much of Europe is .05, while it's .02 in at least four countries and .00 in four more. One explanation is that business interests have more influence on government in the US than in Europe. "Reducing the limit to 0.05 percent would reduce the accident risk by half, even though it wouldn’t halve the amount people can drink."One mostly ignored harm from drinking is fetal alcohol spectrum disorder. While the most severe cases on the spectrum are readily diagnosed, the less severe cases are far more frequent but usually undiagnosed. Less obvious symptoms can appear years after birth, and can include hyperactivity and behavior disorder. The global rate of FASD is 8 per 1,000, while Down syndrome is 1 per 1,000. “There is no known safe level of alcohol use during pregnancy or when trying to get pregnant," says the CDC. "More than 1 in 9 pregnant women in the US drink alcohol while pregnant, and about 4 percent binge drink." Those numbers are increasing.Some people drink before bedtime, but it's not advisable because it disrupts sleep after the first few hours. In addition, drinking before sleep increases snoring, which can lead tosleep apnea.Since most people drink, the challenge is how to drink sensibly to reduce the risks.The author shares strategies to help people who aren't dependent get the maximum benefits with the minimum harm. One strategy is to decide before a social event how much you will drink, instead of deciding in the moment after judgment is impaired.Abstention may be the best strategy, however, for drinkers who are alcohol dependent, who have certain other health problems, or are pregnant.When it comes to children, the earlier a child starts to drink, the greater likelihood of developing an alcohol problem later in life. Our priority should be to teach teens who start drinking how to be safe in the shortterm, and how to protect their health in the longterm. A few more interesting facts:▪︎ People who are hangover resistant are more likely to become alcoholics.▪︎ "New research suggests alcohol may cause your immune system to attack your body."▪︎ "Alcohol is also the leading preventable cause of hypertension."▪︎ Many patients with cirrhosis consider themselves social drinkers, though they tend to consume quite a bit.▪︎ "Alcohol consumption, even at moderate levels (5-10 drinks a week), is associated with adverse brain outcomes."▪︎ It is clear that "heavy drinking increases the risk of type 2 diabetes" by damaging the pancreas. "Alcohol is the most common reason why people get pancreatitis."▪︎ "Close to half of all people who commit suicide are intoxicated...you have a seven-times-increased risk for a suicide attempt soon after drinking alcohol, and this increases to 37 times after heavy use of alcohol."▪︎ "Studies suggest that the likelihood of becoming alcoholic for an adult diagnosed with ADHD is five to ten times higher than in the general population."▪︎ It is well establihed that heavy drinkers are less fertile. "It lowers libido and increases the likelihood of impotence."▪︎ "Both men and women get more sensitive to alcohol as they get older."▪︎ “Excessive drinking costs the US economy more than $220 billion—or about $1.90 per drink, according to the Centers for Disease Control and Prevention."▪︎ " Alcoholism does run in families. If your parent has had or has alcoholism, your own risk is three to four times higher."▪︎ "The number of older people dependent on alcohol or who drink heavily has risen fast. It’s...also what happens when people retire and find themselves with disposable income and with more time to drink and no reason to put on the brakes." Retiring overseas is a risk factor. "The social life of the expat may be based around drinking, and booze is often cheaper too."This book is an informative update on the science about drinking. It offers good advice about reducing the risks while retaining the benefits. -30-

The author outlines exactly how alcohol affects our health. Additionally, he offers sensible guidelines on how to reduce alcohol intake.

This is a 5-star book, easily. And I'm a teetotaler. I was curious as to what David Nutt had to say, as I had heard of him causing controversy by advocating for other drugs, but not alcohol. I think it's important for people to know the facts if they are going to drink. But I see by looking at the reviews on this book that even a scary, fact-filled book like this will not change fervent drinkers' minds. And it is a very scary book. I thought I knew most facts about the dangers, but Nutt goes into great detail about how alcohol affects every part of the body, what's involved in hangovers, fetal alcohol syndrome, and the types of cancers related to its use. He explains the drugs used for treatment of alcoholics. I am tired of people telling me a little red wine is good for the heart. Nutt makes sense in saying not enough study has been done on that (it may be lifestyle, instead) and if alcohol hurts all other organs, what good is it if it helps the heart? That made total sense. He has plenty of insightful examples, which makes the book a fast and interesting read. It's not dry and dull. His expertise is obvious. His credentials are impressive. I do take issue with him that society must celebrate all of its important days with alcohol, from birth to death, and also as a way to meet people. He mentions bars a lot as local meeting spots, so he hopes to help people who imbibe to do it responsibly. I've never been in a bar or tavern, and I don't have a problem meeting plenty of good people. The crowd I'm around does not drink. I belong to a friendly church with social activities. Yes, I've taught Sunday School and many kids' programs, great experiences. I belong to a Christian writers' group. I have ministered on a jail team for 15 years as a volunteer assistant chaplain, as well, and had plenty of experiences with hundreds of alcoholics, all of whom started out as social drinkers. I have not seen drug treatments working well with these people. They continue to come into jail, despite attending numerous programs. We call them "frequent flyers." One drug replacing another drug (alcohol) is not a real treatment. It's only a bandaid solution. Nutt did mention that a person must really want to change if he's an alcoholic. That is true. But it's also true that once started down the path of social drinking, it's extremely difficult to quit. I would not encourage anyone to drink, period. It's just better not to start! I believe any real change must come from a relationship with Jesus Christ, who forgives our sins and makes us whole. He is the Healer.

I wish I could have read this before taking my first drink. If everyone did, it could spare incalculable suffering. The author, who both owns a wine bar and is a physician who studies the effects of alcohol, is perfectly qualified to provide an objective appraisal of this ubiquitous drug. As he makes very clear, it is indeed a drug, and should be used with appropriate caution. In his efforts to avoid sounding too preachy, he even includes a chapter on its social benefits. But this is positioned near the end. That and the implied question of why a drug is necessary for socializing in the first place square with his unmistakeable, two-fisted message: we are conditioned to enjoy alcohol by tradition and setting, but must learn to respect it. The explanation of the clinical effects of increasing blood levels is central and sufficient to justify reading this. I finally have an explanation for those flashes of light while trying to sleep after one too many drinks! If you care about your body and especially if you have children to raise, get this clear-headed book about how drinking really affects you.

Well written and to the point. Author doesn't guilt trip, moralize, or lecture. He presents the science behind alcohol consumption. My only warning is that after reading the book you may never want to drink again, or, if you do, you'll feel really bad about yourself afterwards.

It's amazing we live in a backwards society where you feel you have to apologize for not accepting a cancer inducing drug that overall across many factors is the most damaging drug there is. David objectively explores the many areas of this insidious toxin and as someone who has found freedom from this addictive substance his book solidified my decision. Being free of the shackles of this poison suits me, it's my choice, other people's choice to imbibe booze is nothing to do with me, but David lays out the facts in a really clear and scientific way. Bravo to a fantastic book

This book proves that it is indeed possible to balance a controversy and find based on it your personal way of dealing with a situation. Unfortunately, it also shows again how politicians, lobbyists, and economic leaders are only serve their personal gain (and this is NOT UK-specific!!!). The essence of this book should be a mandatory part of every school education, and I am saying that but also favoring quality drinks in reasonable proportions.

Me ha gustado mucho el libro, explica muy bien el cómo actúa el alcohol en el cuerpo y los efectos que produce.Ayuda a saber más sobre una bebida tan socialmente aceptada, siento que es algo valioso para muchos.

Mailer the book is great for information about the dangers of alcohol, I find it slightly odd that he owns a wine bar. He also doesn't mention the failure that was prohibition in America. All in all however it was a good informative read.

Highly recommended if you want to know what the most 'acceptable' drug does to you.