We know we shouldn’t drink too much. But what is too much – and why exactly is it bad for us? Might some alcohol actually be good for our health? Where should we draw the line?

'Safe' Drinking

In January 2016 the Chief Medical Officers in the UK revised their guidelines on alcohol consumption. 

To keep health risks from alcohol to a low level they advise that both men and women should:

• Drink a maximum of 14 units of alcohol per week
• Spread consumption over a number of days, rather than concentrated into one or two days  
• Have a number of alcohol free days per week

14 units a week is about a bottle and half of wine or five pints of export type lager. 

Fortunately food slows down alcohol absorption, so it is safer to drink alcohol with meals. 

If you drink regularly, your body starts to build up a tolerance to alcohol. So you need to consume more alcohol to get the same effects. This can lead to drinking harmful levels. The Department of Health recommends at least 2 alcohol free days per week. 

If you’re alcohol intolerant (for example your skin flushes after drinking) the only way to prevent this is to avoid alcohol altogether. 

What happens when we drink more than is safe? 

If we drink more than a ‘safe’ amount there seem to be three main health risks: 

Drink related accidents and injuries 

In 2016 an estimated 9,050 people were killed or injured when at least one driver was over the drink-drive limit. This is 5% of all reported road casualties and is the highest number since 2012. The alcohol limit for drivers in England and Wales is 80mg of alcohol per 100ml of blood.

Liver disease: 

One of the best known examples is probably the footballer George Best, who died aged just 59. 

Prolonged alcohol misuse can reduce the liver’s ability to remake its cells, which can lead to permanent liver damage. The symptoms of liver disease can also take many years to appear. By that time, it may be too late as your liver may be so badly damaged. Often, alcohol-related liver disease is misdiagnosed for other conditions. So, it is better to be safe than sorry. 

The risk threshold for developing liver disease is 30g ethanol/day, almost 4 units per day. So drinking half a bottle of wine in an evening, for instance, means you’re already drinking above the risk threshold for developing liver disease. And the harmful effects of alcohol can increase as you get older.

Pancreatitis (inflammation of the pancreas)

This is another condition frequently associated with alcohol consumption. Symptoms include serious stomach pains and vomiting. A recent analysis of six different studies showed the threshold for this condition was more than four units per day.

Cancer 

There is a link between alcohol and seven different types of cancer. According to Cancer Research UK, drinking alcohol causes 11,900 cases of cancer a year.  

Not everyone who drinks alcohol will develop cancer, however, drinking alcohol increases the risk of developing cancer compared to people who don’t.  

The types of cancers most associated with alcohol are: 

• mouth cancer
• pharyngeal (upper throat)
• oesophageal (food pipe)
• laryngeal (voice box)
• breast cancer
• bowel cancer
• liver cancer  

Each cancer is associated with a different part of the body the alcohol passes through. Compared with drinking a safe level, the most significant risk is for mouth and throat cancers.

Cancer Research UK advises: 

• It’s alcohol itself that causes damage - what type of alcohol you drink doesn’t matter

• Whatever your drinking habits, cutting down will reduce your risk  

Alcohol-related hospital admissions

In 2016/17, there were an estimated 337,000 alcohol-related hospital admissions, 17% higher than 2006/07.

A range of health risks 

Drinking more than a recommended safe level increases your risk of accident, liver disease and cancer. Alcohol is also a diuretic which can lead to dehydration and associated medical problems. It can interfere with your sleep patterns.  And the sugar content of alcohol can lead to weight problems and increase the risk of diabetes. 

But are there any possible health benefits if you stick to the recommended safe levels? 

Beneficial effects of alcohol: 

Cardiovascular disease: Some studies have suggested that light to moderate alcohol consumption (2-4 units per day) is associated with a reduced risk of heart disease and stroke. However, a 2018 report in The Lancet suggested that this lower risk among moderate drinkers is for non-fatal heart attacks only. 

A 2017 review in the BMJ noted that, while moderate drinkers were less likely to initially present with several cardiovascular diseases than non-drinkers it would be unwise to encourage individuals to take up drinking as a means of lowering their risk. That's because there are arguably safer and more effective ways of reducing cardiovascular risk, such as increasing physical activity and stopping smoking, which do not incur the increased risks of alcohol related harm such as alcohol dependence, liver disease and cancer.

Diabetes Type 2: A review found moderate alcohol consumption (less than 63g/day) was associated with a reduction in the risk of Type 2 Diabetes among women and non-Asian populations, compared to abstainers.

Non-Hodgkins Lymphoma (a less common type of cancer): A review of 29 studies involving nearly 19,000 patents showed that in light to moderate drinkers there was a small reduction in the relative risk of NHL. 

Dementia and cognitive decline: Moderate drinking, 1-14 units per week, was associated with a lower risk of dementia compared to those who completely abstained from alcohol, although consuming more than 14 units per week increased the risk.

It should be noted that research into people abstaining from alcohol can sometimes be skewed if the people abstaining were previously heavy drinkers who have since become abstainers or had been advised to abstain due to health concerns.

Conclusions:

• The recommended safe levels of alcohol consumption in the UK seem to be broadly supported by scientific studies – with relatively low levels of health risk.  

• To limit the harmful effects drink your alcohol with meals and avoid consuming all your alcohol in one or two days, while also aiming to have at least 2 alcohol free days per week. 

• Higher levels of alcohol consumption materially increase the risk of accident, liver disease and cancer – and other health risks. 

• Though there is evidence suggesting moderate alcohol consumption can protect against some conditions, the potential benefits are outweighed by increased risks of other harmful health effects.

• Factors such as a healthy diet, regular exercise and not smoking also contribute to the reduction of health risks. 

Reviewed and updated by Nicole Musuwo, April 2019. Next review date March 2023.