Deeper Impact of Abstaining from Alcohol
- Article previously published in the Hudson Valley Pilot – see link below
As the social phenomenon of Dry January hits its tenth anniversary this year, many of us may know someone who has participated in this annual abstention from alcohol. While in years past I never criticized anyone’s attempts, I will admit that I never really gave it any serious thought. But as we continue to forge ahead with life in the time of Covid, thinking about our relationship with alcohol may be more important than ever.
Statistics indicate that Alcohol consumption in the United States has been steadily growing for years. Per capita, Americans now consume 2.45 gallons of alcohol a year, a growth of almost 12 percent compared with 20 years ago. In March 2020, during the COVID-19 pandemic and while many Americans were under stay-at-home orders, market research by Nielsen showed that alcohol sales increased by 55% relative to the same time the previous year (Bremner, 2020).
We can all relate to the increased stress that quarantine placed on individuals and families, but even more eye-opening is the data that women’s drinking habits have been slowly catching up to men’s, and the use of alcohol to cope with the stresses of the COVID-19 pandemic has been more significant for women’s drinking habits. A study published in the Journal of Addictive Behaviors in Nov 2020 states that every one-unit increase in COVID-19-related psychological distress was associated with a 13% increase in women’s number of drinks consumed during their heaviest drinking occasion and a 16% increase in women’s number of drinks on a typical occasion in the past month, whereas COVID-19 psychological distress was unrelated to drinking for men.
CDC statistics reveal that in 2020 9% of women overall and 17% of women aged 18 to 25 years had an alcohol use disorder. In the fall of 2022 approximately 13% of adult women report binge drinking, among whom 25% did so at least weekly, and almost 18% of women of child-bearing age (i.e., ages 18–44 years) binge drank.
All the Reasons Not to Drink
As a physician providing care to women for almost 25 years, I find this pattern of gender convergence between men and women’s alcohol consumption alarming. There are significant biological and chemical differences between women and men that make women more vulnerable to alcohol’s toxic effects, even at moderate use levels. Women appear to develop alcohol-related liver damage over a shorter period of time, and may be more vulnerable to alcohol-induced brain shrinkage and cognitive decline than males drinking similar amounts of alcohol. In addition, excess alcohol use can increase blood pressure, contributing to cardiovascular disease. It has also been linked to elevated risk for many cancers, specifically breast cancer, even at low levels of use.
As reported recently in the New York Times, Dr Marissa Esser, who heads the alcohol program at the Centers for Disease Control and Prevention, states that alcohol’s metabolites “damage your DNA”, and “once damaged, then a cell can grow out of control and create a cancer tumor”. It also causes increased oxidative stress, which is a major contributor to arterial damage, leading to coronary artery disease. Exactly what medical consequences arise for any individual however, are related to a host of other lifestyle factors and genetics. As Dr Esser explains “Every risk factor matters” and can be cumulative when accounting for increased risk for any condition.
How much drinking is problematic?
According to the CDC, a standard drink is defined as either a 12-ounce beer, 8-ounce malt liquor, 5-ounce wine, or 1.5-ounce 80-proof distilled spirits or liquor. Excessive or dangerous drinking is defined as binge drinking (for women more than four, and for men more than five drinks on a single occasion), heavy drinking (for women more than eight drinks, and for men more than 15 drinks in a week), or any drinking by pregnant women or those under age 21.
Alcohol use disorder is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational or health consequences. It can be mild, moderate or severe, and encompasses the condition that some refer to as alcoholism – which is the inability to control drinking due to both physical and emotional dependence on alcohol. If you are concerned, the AUDIT (Alcohol Use Disorders Identification Test) is a simple and effective method of screening for unhealthy alcohol use.
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Benefits of giving up alcohol
In 2011, Brit Emily Robinson decided to give up alcohol for the month of January to make training for a marathon in February a little bit easier. After pairing with Alcohol Change UK, the Dry January movement was born in 2013. Not only did Robinson sleep better, lose weight, and have more energy for her training, she sparked conversation and debate about the benefits of giving up drinking for a bit. This concept does have its critics, though, who less affectionately refer to it as “Dryuary” or “Janupause.” An article published in Grubstreet in 2019 argues that for most people, it is “more about optics, than any real behavior change” and is a “casual social phenomenon” that pretends that anyone can give up alcohol for 31 days and post about it incessantly to the annoyance of others around them. .
No matter how you feel about the politics, within days of avoiding alcohol, the health benefits become evident, and continue to improve the longer alcohol is avoided. Initially, sleep quality improves and levels of concentration increase. As hydration status improves, headaches will decrease and skin will appear more radiant. Eventually memory improves, and unpleasant gastrointestinal symptoms such as reflux and bloating will dissipate. With continued abstinence, blood pressure will go down, reducing the risk of heart disease, and liver function will return to normal after approximately one month. Additionally, caloric intake decreases by 3840 for the month if you are used to drinking six glasses of wine a week, or 4320 calories over the month if you are used to drinking six pints of beer a week.
Although the severity of social distancing and the stay-at-home orders are hopefully in the past, the lasting effects of living in a pandemic can not be overestimated. The intention here is not to cast aspersions on anyone for enjoying a delicious cocktail with friends or a lovely glass of wine with a meal, but rather to ask us to consider our own relationship with alcohol in light of any stressful circumstances we are encountering. The evidence is mounting that evaluating our own alcohol use is good at any time of year and that limiting our overall intake of alcohol, be it daily, or weekly, or taking a pause no matter what time of year, and no matter what you call it, can be beneficial to our overall health.
