How Alcohol Impacts Your Body and Life

Sarah Wakeman, MD, Mass General Brigham senior medical director for substance use disorder, recently spoke with bestselling author and podcaster Mel Robbins about the spectrum of alcohol use.

In an episode of the Mel Robbins Podcast, Dr. Wakeman discusses alcohol use in depth, including the full spectrum of alcohol use from low-risk use to unhealthy use and alcohol use disorder. She notes that talking about unhealthy alcohol use is more important than ever because the pandemic led to an increase in alcohol-related harms. “After the onset of the pandemic, there was a 25% increase in alcohol-related deaths,” she says.

What alcohol does to your body

Most people know that alcohol negatively affects your liver and can lead to liver disease. But unhealthy alcohol use causes many other problems in your body, too, including:

• Acid reflux

• Brain shrinkage and damage after years of heavy drinking

• Changes to your gut microbiome

• Dehydration

• Depression and anxiety

• Increased risk of certain cancers

• Sleep problems

• Alcohol use disorder

You may have heard that drinking wine daily is healthy. However, Dr. Wakeman advises there are problems with the research this advice is based on. “Newer studies are better designed, and their results don’t necessarily support daily drinking as improving health. Large, recent studies (in BMC Medicine and in JAMA Network Open) have revealed that any level of daily alcohol consumption likely increases cancer risk,” she says.

Are there any benefits to drinking alcohol?

Is alcohol healthy at all?

Dr. Wakeman says it’s inaccurate to frame alcohol use as a health-promoting behavior. “We shouldn’t be thinking of it as a health benefit,” she says. “I would never say to a patient, I think you should start drinking a glass of wine a day for your health.”

However, there are many things people do regularly that may have some amount of health risk — driving, eating bacon, skiing. It is important to have the facts about alcohol and to explore the impact it may be having on an individual’s health and life. It also helps to understand lower-risk drinking limits, which are no more than 7 drinks per week and no more than 3 drinks per day for women and anyone over 65, and no more than 14 drinks per week and no more than 4 drinks per day for men under 65.

What role does alcohol play in your life?

To examine the role alcohol plays in your life, Dr. Wakeman offers these questions to ask yourself:

• How much are you drinking, and how frequently?

• Are you drinking more than you want to?

• Have you tried to cut back to stop but been unable to?

• Are you drinking despite negative consequences, such as concerns from family members or impacts on your health or work?

• Do you have cravings for alcohol?

• Do you need to drink more than previously to feel the effects of alcohol?

• Do you have withdrawal symptoms when you stop drinking?

She says people may feel shame about their alcohol use, and may not feel comfortable honestly sharing with their health care providers about how much they drink. “Doctors really need to get more comfortable talking to patients about this in a nonjudgmental way,” she says.

In the podcast, Dr. Wakeman offers tips for quitting or cutting back on alcohol. She also provides guidance for talking to a loved one about their drinking.

Dr. Wakeman wants everyone to know that treatment for alcohol use disorder works. “This is not a hopeless condition. It will not be with you forever,” she says. “Finding a trusted health care provider that you can partner with is a part of this journey. This isn’t an issue of willpower. There are treatments out there for you, just like there are for conditions like depression or diabetes or high blood pressure (hypertension).”