Skip to main content
Medicine LibreTexts

14.3: Pros and Cons of Drinking Alcohol

  • Page ID
    2727
  • Skills to Develop

    • Explain the impacts of excessive alcohol intake (both acutely and chronically) on health.

    Pros and Cons

    Alcohol, when drunk in moderation, has beneficial effects. However, drinking any type of alcoholic beverage, beer, wine or hard liquor, can lead to dependency on the substance and the level of tolerance is different for everyone. Here we explore the beneficial and harmful effects of so that you will be better able to make wise decisions about drinking beverages that contain alcohol. It is important to remember when you consume alcohol, you are also consuming calories, seven calories per gram, that do not contain other beneficial nutrients. So alcohol is a source of "empty" or "naked" calories.

    Health Benefits of Moderate Alcohol Intake

    In contrast to excessive alcohol intake, moderate alcohol intake has been shown to provide health benefits. The data is most convincing for preventing heart disease in middle-aged and older people. A review of twenty-nine studies concluded that moderate alcohol intake reduces the risk of coronary heart disease by about 30 percent in comparison to those who do not consume alcohol.Ronksley, P. E. et al. “Association of Alcohol Consumption with Selected Cardiovascular Disease Outcomes: A Systematic Review and Meta-Analysis.” BMJ 342, no. d671 (2011). doi: 10.1136/bmj.d671. Several other studies demonstrate that moderate alcohol consumption reduces the incidences of stroke and heart attack, and also death caused by cardiovascular and heart disease. The drop in risk for these adverse events ranges between percent. Moreover, there is some scientific evidence that moderate alcohol intake reduces the risk for metabolic syndrome, Type 2 diabetes, and gallstones. In addition to providing some health benefits, moderate alcohol intake has long served as a digestive aid and a source of comfort and relaxation, and it induces social interaction, thereby benefiting all aspects of the health triangle. It has not been clearly demonstrated that moderate alcohol consumption benefits younger populations, and the risks of any alcohol consumption do not outweigh the benefits for pregnant women, those who are taking medications that interact with alcohol, and those who are unable to drink in moderation.

    Health Consequences of Alcohol Abuse

    Distilled spirits have exceptionally few nutrients, but beer and wine do provide some nutrients, vitamins, minerals, and beneficial plant chemicals along with calories. A typical beer is 150 kilocalories, a glass of wine contains approximately 80 kilocalories, and an ounce of hard liquor (without a mixer) is around 65 kilocalories. Alcoholic drinks in excess contribute to weight gain by substantially increasing caloric intake. However, alcohol displays its two-faced character again in its effects on body weight, making many scientific studies contradictory. Multiple studies show high intakes of hard liquor are linked to weight gain, although this may be the result of the regular consumption of hard liquor with sugary soft drinks, juices, and other mixers. On the other hand drinking beer and, even more so, red wine, is not consistently linked to weight gain and in some studies actually, decreases weight gain. The contradictory results of scientific studies that have examined the association of alcohol intake with body weight are partly due to the fact that alcohol contributes calories to the diet, but when drunk in excess reduces the secretion of pancreatic juice and damages the lining of the gastrointestinal system, impairing nutrient digestion and absorption. The impaired digestion and absorption of nutrients in alcoholics contributes to their characteristic “skinniness” and multiple associated micronutrient deficiencies. The most common macro nutrient deficiency among alcoholics is water, as it is excreted in excess. Commonly associated micronutrient deficiencies include thiamine, pyridoxine, folate, vitamin A, magnesium, calcium, and zinc. Furthermore, alcoholics typically replace calories from alcohol with those of nutritious foods, sometimes getting 50 percent or more of their daily caloric intake from alcoholic beverages. Alcohol can also interfere with the ability of organs to use nutrients.

    Effects of Alcohol Abuse on the Brain

    Alcohol can adversely affect nearly every area of the brain. When BAC rises, the central nervous system is depressed. Alcohol disrupts the way nerve cells communicate with each other by interfering with receptors on certain cells. The immediate impact of alcohol on the brain can be seen in the awkwardly displayed symptoms of confusion, blurred vision, slurred speech, and other signs of intoxication. These symptoms will go away once drinking stops, but abusive alcohol consumption over time can lead to long-lasting damage to the brain and nervous system. This is because alcohol and its metabolic byproducts kill brain cells. Excessive alcohol intake has the following effects on specific areas of the brain:

    1. Medulla. This area controls automatic functions, such as heart rate. When alcohol first limits its functioning, people feel sleepy. With greater BAC levels, unconsciousness, comas, and death can result.
    2. Cerebellum. This is where conscious movement is coordinated. With too much alcohol, balance and motor skills are impaired.
    3. Cerebral cortex. Senses and thoughts are processed here, and this is where action is initiated. When BAC levels increase, the ability to think, exercise good judgment and feel pain decrease.
    4. Hypothalamus and pituitary gland. Alcohol increases sexual desire but decreases sexual performance. It also prompts signals which increase urine production.
    5. Limbic system. When alcohol affects this area, individuals may become very emotional and lose memory function.

    Effects of Alcohol Abuse on the Liver

    According to the CDC, 19,388 Americans died from alcohol-related liver diseases in 2014. Although not every alcoholic or heavy drinker will die from liver problems, the liver is one of the body’s main filtering organs and is severely stressed by alcohol abuse. The term Alcoholic Liver Disease (ALD) is used to describe liver problems linked to excessive alcohol intake. ALD can be progressive, with individuals first suffering from a fatty liver and going on to develop cirrhosis. It is also possible to have different forms of ALD at the same time.

    Figure \(\PageIndex{1}\): Liver Cirrhosis. Excessive alcohol consumption causes the destruction of liver cells. In an attempt to repair itself, the liver initiates an inflammatory and reparation process causing scar tissue to form. In the liver’s attempt to replace the dead cells, surviving liver cells multiply. The result is clusters of newly formed liver cells, also called regenerative nodules, within the scar tissue. This state is called cirrhosis of the liver. See a full animation of this medical topic. Image used with permission from BruceBlaus (via Wikipedia).

    The three most common forms of ALD are:

    • Fatty liver. A rather benign disorder that develops after excessive alcohol consumption; however, it can progress to more fatal diseases. Fatty liver is reversible if alcohol use is brought under control. Large fat droplets occur in the liver due to increased triglyceride synthesis, decreased fatty acid breakdown, and decreased VLDL release from the liver to transport the triglyceride to extrahepatic tissues. Fatty liver is associated with chronic alcohol consumption, generally, not one night of binge-drinking. 
    • Alcoholic hepatitis. The symptoms of this alcohol-induced liver inflammation are a swollen liver, abdominal pain, nausea, fever, jaundice, and vomiting. Although linked to alcohol use, even people who drink moderately can sometimes develop this condition, and not all alcohol abusers do. If a person stops drinking alcohol, the liver damage can be reversed. But if they continue, cirrhosis may develop and death can result.
    • Cirrhosis. Long term excessive alcohol consumption can cause cirrhosis. This serious and sometimes fatal form of ALD develops when liver cells die and form scar tissue, which blocks blood flow and causes wastes and toxins, like ammonia, to build up in the system. Normal liver function is disrupted and causes damage to the brain. Strictly speaking, cirrhosis cannot be cured. It can, however, be stopped with medical treatment and complications can be managed if the individual stops drinking, and many do survive. Not all cases of cirrhosis are strictly due to alcoholism or chronic consumption of alcohol, and not all alcoholics develop the disease. Symptoms of cirrhosis include the buildup of abdominal fluid (ascites), abdominal pain, fever, thirst, confusion, and fatigue.

    Fetal Alcohol Spectrum Disorders

    Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy. These symptoms can include physical problems and problems with behavior and learning. Often, a person with FASD has a mix of these problems. Different terms are used to describe FASD depending on the symptoms. 

    Fetal alcohol syndrome (FAS) is growth, mental, and physical problems that may occur in a baby when a mother drinks alcohol during pregnancy.The Institute of Medicine estimated 1996 that fetal alcohol syndrome (FAS) was between 0.5 and 3.0 cases per 1,000 (Stratton, K.; Howe, C.; Battaglia, F.; Eds. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment). Washington, DC: Institute of Medicine, National Academy Press, 1996). More recent reports from other sites suggest the prevalence may be 2 to 7 cases per 1,000 or as high as 20 to 50 cases per 1,000 (May, P.A.; Gossage, J.P.; Kalberg, W.O.; et al. Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies. Developmental Disabilities Research Reviews 15(3):176–192, 2009. PMID: 19731384; May, P.A.; Keaster, C.; Bozeman, R.; et al. Prevalence and characteristics of fetal alcohol syndrome and partial fetal alcohol syndrome in a Rocky Mountain Region City. Drug and Alcohol Dependence 155:118–127, 2015. PMID: 26321671

    There is no safe level of alcohol during pregnancy. If you are planning on becoming pregnant, you should stop drinking 4 to 6 weeks before conception. Alcohol consumed during the first trimester causes physical damage to developing tissues and organs. During the second trimester, the risk of spontaneous abortion increases and during the third trimester, both body and brain growth problems develop. the impact on the fetus and subsequent baby can manifest in a variety of symptoms including poor growth while in the womb and after birth, decreased muscle tone and poor coordination, and delayed developmental milestones. Characteristic facial features can occur with chronic alcoholism and these include small head circumference; narrow, receding forehead; flattened (low) nasal bridge; short, upturned nose; underdeveloped jaw and receding chin; extra skin folds on eyelids, drooping eyelids, or downward slant of eyes; short-sightedness, and inability focus; uneven or poorly formed ears; and absence of a groove in the upper lip.

    Alcohol-related neurodevelopmental disorder (ARND) is another alcohol related disorder which is associated with behavioral, cognitive, or central nervous system abnormalities. It is associated with prenatal alcohol exposure. Often women do not know they are pregnant and continue to drink. People with ARND tend to do poorly at school.

    Also, prenatal alcohol exposure can result in skeletal and organ malformation termed alcohol-related birth defects (ARBD). 

    Key Takeaways

    • Alcohol in excess is detrimental to health; in moderation, however, it is promoted as a benefit to the body and mind. The US Dietary Guidelines define moderate alcohol intake as no more than one drink per day for women and no more than two drinks per day for men.
    • Moderate intake of alcohol has been shown in multiple scientific studies to provide health benefits, including reducing the risks of heart disease, cardiovascular disease, metabolic syndrome, Type 2 diabetes, and gallstones.