Long-term effects of alcohol
The
Long-term alcohol consumption is capable of damaging nearly every organ and system in the body.
Conversely, light intake of alcohol may have some beneficial effects. The association of alcohol intake with reduced cardiovascular risk has been noted since 1904
Overall effect
The level of ethanol consumption that minimizes the risk of disease, injury, and death is subject to some controversy.[16] Several studies have found a J-shaped relationship between alcohol consumption and health,[17][18][2][19] meaning that risk is minimized at a certain (non-zero) consumption level, and drinking below or above this level increases risk, with the risk level of drinking a large amount of alcohol greater than the risk level of abstinence. Other studies have found a dose-response relationship, with lifetime abstention from alcohol being the optimal strategy and more consumption incurring more risk.[20] The studies use different data sets and statistical techniques so cannot be directly compared. Some older studies included former and occasional drinkers in the "abstainers" category, which obscures the benefits of lifetime abstention as former drinkers often are in poor health.[21] However, the J-curve was reconfirmed by studies that took the mentioned confounders into account.[22][23][24][25] Nonetheless, some authors remain suspicious that the apparent health benefits of light alcohol use are in large part due to various selection biases and competing risks.[18][26] Mendelian randomization studies have been inconsistent regarding the risk curve, with 3 studies finding no non-linearity (dose-response) and 2 studies finding a J-shape for lipid profiles. The variance in alcohol consumption that is explained by genetics is small, requiring large sample sizes and potentially violating assumptions of the analysis.[27]
As one reviewer noted, "Despite the wealth of observational data, it is not absolutely clear that alcohol reduces risk, because no randomized controlled trials have been performed."
In light of the conflicting evidence, many have cautioned against recommendations for the use of alcohol for health benefits. At a symposium in 1997, Peter Anderson labeled such alcohol promotion as "ridiculous and dangerous".
The World
Globally, assuming the J-shaped curve is correct, the age-standardised, both-sexes consumption that minimizes risk is about 5 grams of ethanol per day, and an average individual would cause themselves harm by drinking more than 17 grams per day.[2] However, the average intake among current drinkers in 2016 was approximately 40 grams of ethanol per day.[a] Alcohol use accounted for 1.78 million deaths in 2020 and was the leading risk factor for mortality among males aged 15–49 years. 1.03 billion males (35.1% of the male population aged ≥15 years, ~2/3 of male drinkers) and 312 million females (10.5% of the female population aged ≥15 years, ~1/3 of female drinkers) consumed harmful amounts of alcohol.[2][b] The proportion of the population consuming harmful amounts of alcohol has stayed at approximately the same level over the past three decades. Risk is greatest in the population aged 15–39,[2] due to binge drinking which may result in violence or accidents.[21] 3 million deaths each year result from harmful use of alcohol worldwide. This represents 5.3% of all deaths across the globe. Besides this, 5.1% of the global burden of disease and injury is attributable to alcohol, as measured in disability-adjusted life years (DALYs) by the World Health Organization all as of May 2022.[40]
Extensive research of Western cultures has consistently shown increased survival associated with light to moderate alcohol consumption.[21][41] One study reported a "safe" drinking limit of up to 100 grams of pure alcohol per week.[42] In contrast to studies of Western cultures, research in other cultures has yielded some opposite findings.
India
A large study of 4465 subjects in India confirmed the possible harm of alcohol consumption on coronary risk in men. Compared to lifetime abstainers, alcohol users had higher blood sugar (2 mg/dl), blood pressure (2 mm Hg) levels, and the HDL-C levels (2 mg/dl) and significantly higher tobacco use (63% vs. 21%). Asian Indians who consume alcohol had a 60% higher risk of heart attack which was greater with local spirits (80%) than branded spirits (50%).[43] The harm was observed in alcohol users classified as occasional as well as regular light, moderate, and heavy consumers.[43]
Russia
One study claims that "excessive alcohol consumption in Russia, particularly by men, has in recent years caused more than half of all the deaths at ages 15–54 years."[44] However, there are some difficulties with this study. For instance, the same study also found a protective effect of heavy drinking on breast cancer mortality. This contradicts the well established scientific view that alcohol increases breast cancer risk.[45] On this account in further correspondence it was advised that "careful interpretation of mortality statistics in relation to alcohol use is needed, taking into account other relevant risk factors, incidence, and survival."[46]
South Asia
The landmark INTERHEART Study has revealed that alcohol consumption in South Asians was not protective against CAD in sharp contrast to other populations who benefit from it.[47]
United Kingdom
A governmental report from Britain has found that "There were 8,724 alcohol-related deaths in 2007, lower than 2006, but more than double the 4,144 recorded in 1991. The alcohol-related death rate was 13.3 per 100,000 population in 2007, compared with 6.9 per 100,000 population in 1991."[48] In Scotland, the NHS estimate that in 2003 one in every 20 deaths could be attributed to alcohol.[49] A 2009 report noted that the death rate from alcohol-related disease was 9,000, a number three times that of 25 years previously.[50]
A UK report came to the result that the effects of low-to-moderate alcohol consumption on mortality are age-dependent. Low-to-moderate alcohol use increases the risk of death for individuals aged 16–34 (due to increased risk of cancers, accidents, liver disease, and other factors), but decreases the risk of death for individuals ages 55+ (due to decreased risk of ischemic heart disease).[51]
A study in the United Kingdom found that alcohol causes about 4% of cancer cases in the UK (12,500 cases per year).[52]
United States
The Centers for Disease Control and Prevention (CDC) report, "From 2001–2005, there were approximately 79,000 deaths annually attributable to excessive alcohol use. In fact, excessive alcohol use is the 3rd leading lifestyle-related cause of death for people in the United States each year."[53] A 1993 study estimated US deaths through alcohol at 100,000.[54] Another CDC report from 2001 estimated that medium and high consumption of alcohol led to 75,754 deaths in the United States in 2001. Low consumption of alcohol had some beneficial effects, so a net 59,180 deaths were attributed to alcohol.[55]
Cardiovascular system
Alcohol has been found to have anticoagulant properties.[56] Thrombosis is lower among moderate drinkers than abstainers.[57] A meta-analysis of randomized trials found that alcohol consumption in moderation decreases serum levels of fibrinogen, a protein that promotes clot formation, while it increases levels of tissue type plasminogen activator, an enzyme that helps dissolve clots.[58] These changes were estimated to reduce coronary heart disease risk by about 24%. Another meta-analysis in 2011 found favorable changes in HDL cholesterol, adiponectin, and fibrinogen associated with moderate alcohol consumption.[59] A systematic review based on 16,351 participants showed J-shaped curve for the overall relationship between cardiovascular mortality and alcohol intake. Maximal protective effect was shown with 5–10 g of alcohol consumption per day and the effect was significant up to 26 g/day alcohol consumption.[60] Serum levels of C-reactive protein (CRP), a putative marker of inflammation and predictor of CHD (coronary heart disease) risk, are lower in moderate drinkers than in those who abstain from alcohol, suggesting that alcohol consumption in moderation might have anti-inflammatory effects.[61][62][63] Data from one prospective study suggest that, among men with initially low alcohol consumption (</=1 drink per week), a subsequent moderate increase in alcohol consumption may lower their CVD risk.[64]
Peripheral arterial disease
A prospective study published in 1997 found "moderate alcohol consumption appears to decrease the risk of PAD in apparently healthy men."[65] In a large population-based study, moderate alcohol consumption was inversely associated with peripheral arterial disease in women but not in men. But when confounding by smoking was considered, the benefit extended to men. The study concluded "an inverse association between alcohol consumption and peripheral arterial disease was found in nonsmoking men and women."[66][67]
Intermittent claudication
A study found that moderate consumption of alcohol had a protective effect against intermittent claudication. The lowest risk was seen in men who drank 1 to 2 drinks per day and in women who drank half to 1 drink per day.[68]
Heart attack and stroke
Drinking in moderation has been found to help those who have had a
Cardiomyopathy
Large amounts of alcohol over the long term can lead to alcoholic cardiomyopathy. Alcoholic cardiomyopathy presents in a manner clinically identical to idiopathic dilated cardiomyopathy, involving hypertrophy of the musculature of the heart that can lead to congestive heart failure.[76]
Hematologic diseases
Alcoholics may have
Atrial fibrillation
Alcohol consumption increases the risk of atrial fibrillation, a type of abnormal heart rhythm. This remains true even at moderate levels of consumption.[79]
Nervous system
Chronic heavy alcohol consumption impairs brain development, causes
Strokes
Epidemiological studies of middle-aged populations generally find the relationship between alcohol intake and the risk of stroke to be either U- or J-shaped.[88][89][90][91] There may be very different effects of alcohol based on the type of stroke studied. The predominant form of stroke in Western cultures is ischemic, whereas non-western cultures have more hemorrhagic stroke. In contrast to the beneficial effect of alcohol on ischemic stroke, consumption of more than two drinks per day increases the risk of hemorrhagic stroke. The National Stroke Association estimates this higher amount of alcohol increases stroke risk by 50%.[92] "For stroke, the observed relationship between alcohol consumption and risk in a given population depends on the proportion of strokes that are hemorrhagic. Light-to-moderate alcohol intake is associated with a lower risk of ischemic stroke which is likely to be, in part, causal. Hemorrhagic stroke, on the other hand, displays a log-linear relationship with alcohol intake."[93]
Brain
Alcohol misuse is associated with widespread and significant brain lesions. Alcohol related brain damage is not only due to the direct toxic effects of alcohol; alcohol withdrawal, nutritional deficiency, electrolyte disturbances, and liver damage are also believed to contribute to alcohol-related brain damage.[94]
Cognition and dementia
Excessive alcohol intake is associated with impaired prospective memory. This impaired cognitive ability leads to increased failure to carry out an intended task at a later date, for example, forgetting to lock the door or to post a letter on time. The higher the volume of alcohol consumed and the longer consumed, the more severe the impairments.[95] One of the organs most sensitive to the toxic effects of chronic alcohol consumption is the brain. In the United States approximately 20% of admissions to mental health facilities are related to alcohol-related cognitive impairment, most notably alcohol-related dementia. Chronic excessive alcohol intake is also associated with serious cognitive decline and a range of neuropsychiatric complications. The elderly are the most sensitive to the toxic effects of alcohol on the brain.[96] There is some inconclusive evidence that small amounts of alcohol taken in earlier adult life is protective in later life against cognitive decline and dementia.[97] However, a study concluded, "Our findings suggest that, despite previous suggestions, moderate alcohol consumption does not protect older people from cognitive decline."[98]
Essential tremor
Essential tremors—or, in the case of essential tremors on a background of family history of essential tremors, familial tremors—can be temporarily relieved in up to two-thirds of patients by drinking small amounts of alcohol.[103]
Ethanol is known to activate aminobutyric acid type A (GABAA) and inhibit N-methyl-D-aspartate (NMDA) glutamate receptors, which are both implicated in essential tremor pathology[104] and could underlie the ameliorative effects.[105][106] Additionally, the effects of ethanol have been studied in different animal essential tremor models. (For more details on this topic, see Essential tremor).
Sleep
Chronic use of alcohol used to induce sleep can lead to
Mental health effects
High rates of major depressive disorder occur in heavy drinkers. Whether it is more true that major depressive disorder causes self-medicating alcohol use, or the increased incidence of the disorder in people with an alcohol use disorder is caused by the drinking, is not known though some evidence suggests drinking causes the disorder.[108] Alcohol misuse is associated with a number of mental health disorders and alcoholics have a very high suicide rate.[109] A study of people hospitalized for suicide attempts found that those who were alcoholics were 75 times more likely to go on to successfully commit suicide than non-alcoholic suicide attempts.[110] In the general alcoholic population the increased risk of suicide compared to the general public is 5-20 times greater. About 15 percent of alcoholics commit suicide, the most common methods being overdosing and cutting/scratching. There are high rates of suicide attempts, self-harm, suicidal ideation, and self-harm ideation in people with substance dependence who have been hospitalized.[111] Use of other illicit drugs is also associated with an increased risk of suicide. About 33 percent of suicides in the under 35s are correlated with alcohol or other substance misuse.[112]
Studies have shown that alcohol dependence relates directly to
While
Addiction to alcohol, as with any
The effect on depression and returning to drinking among individuals with alcohol dependence has always been controversial. Studies show that after doing a study on men and women hospitalized for alcohol dependence the likelihood of returning to drinking with depression is extremely high. A diagnosis of major depression at entry into an inpatient treatment for alcohol dependence showed shorter times to first drink and also relapse in both women and men.[126]
Digestive system and weight gain
The impact of alcohol on weight-gain is contentious: some studies find no effect,[127] others find decreased[128] or increased effect on weight gain.
Alcohol use increases the risk of chronic gastritis (stomach inflammation);[3][129] it is one cause of cirrhosis, hepatitis, and pancreatitis in both its chronic and acute forms.
Metabolic syndrome
A national survey (NHANES) conducted in the U.S. concluded, "Mild to moderate alcohol consumption is associated with a lower prevalence of the metabolic syndrome, with a favorable influence on lipids, waist circumference, and fasting insulin. This association was strongest among whites and among beer and wine drinkers."[130] Similarly, a national survey conducted in Korea reported a J-curve association between alcohol intake and metabolic syndrome: "The results of the present study suggest that the metabolic syndrome is negatively associated with light alcohol consumption (1–15 g alcohol/d) in Korean adults," but risk increased at higher alcohol consumption.[131]
Gallbladder effects
Research has found that drinking reduces the risk of developing
A large self-reported study published in 1998 found no correlation between gallbladder disease and multiple factors including smoking, alcohol consumption, hypertension, and coffee consumption.
Liver disease
Pancreatitis
Alcohol misuse is a leading cause of both acute pancreatitis and chronic pancreatitis.[140][141] Alcoholic pancreatitis can result in severe abdominal pain and may progress to pancreatic cancer.[142] Chronic pancreatitis often results in intestinal malabsorption, and can result in diabetes.[143]
Body composition
Alcohol affects the nutritional state of chronic drinkers. It can decrease food consumption and lead to malabsorption. It can also create imbalances in skeletal muscle mass and cause muscle wasting. Chronic consumption of alcohol can also increase the breakdown of important proteins in the body which can affect gene expression.[144]
Oral and dental implications
In fetal alcohol syndrome
The frequency, time, and amount of alcohol consumption during pregnancy can cause various dental anomalies in children with fetal alcohol syndrome (FAS). Not only does it increase the chance of children developing cleft lip and palate, newborns will tend to show agenesis, maxillary overjet, crowded incisors, anterior open bite and diastemas. These dental and maxillofacial changes are thought to be caused by the teratogenic effects of alcohol on the fetus in which FAS causes an alteration in the MSX1 and MSX2 genes. Both genes play an important part in the maxillary process's fusion and odontogenic formation.[citation needed]
Oral clefts
Various maternal behavioral factors have been known to increase the risk of oral clefts such as folate deficiency, antiepileptic drugs, smoking, and alcohol consumption. Even though alcohol is known to be a folic acid antagonist, there is no significant correlation between mild to moderate consumption of alcohol during pregnancy and the risk of oral clefts. However, as a baby's palate and lip develop during the first trimester of the pregnancy (first 12 weeks), mothers should be aware to avoid drinking during this time. Research on the correlation between heavy drinking and orofacial cleft is still necessary for confirmation.[145]
Oral cancer
The consumption of alcohol alone is not associated with an increased risk of oral squamous cell carcinoma (OSCC); however, the synergistic consumption of alcohol and tobacco is positively associated with the occurrence of (OSCC), and significantly increases an individual's risk. Studies confirm that alcohol dissolves the lipid component of epithelium and increases the permeability, amplifying the toxicity of carcinogenic components of tobacco. Limiting the overall consumption of the two has shown to reduce the risk of OSCC by three-fourth. The knowledge provided is useful for better understanding the differences in the effect of the combined consumption of alcohol and tobacco, in the development of OSCC.[146]
Alcohol consumption has frequently been associated with an increased risk of oral cancer in current literature. Studies have found that people that consume alcohol were two times more likely to develop oral cancer in comparison to people who did not. The mechanisms in which alcohol acts as a carcinogen within the oral cavity are currently not fully understood. It is thought to be a multifactorial disease which then gives rise to a cancerous lesion. Many theories have become apparent in research, including alcohol being responsible for high estrogen and androgen levels, specifically in women, which may facilitate the alcohol-related immunodeficiency and/or immunosuppression that causes carcinogenesis. Therefore, immediate cessation of the habit of alcohol consumption can aid in decreasing the risk of oral cancer.[147]
Alcohol-based mouthwashes used to be very common and can still be purchased for use today. Correlation in the presence of alcohol in mouthwashes with development of oral and pharyngeal cancer is unknown due to lack of evidence. However, it has been suggested that acetaldehyde, the first metabolite of ethanol, plays a role in the carcinogenesis of alcohol in oral cancer. Acetaldehyde, has been found to increase when in the salivary medium after an alcoholic beverage has been consumed and could possibly occur with alcohol-based mouthwashes as well, posing as a possible risk factor for oral cancer. However, more research must be conducted regarding these theories.[148]
Periodontitis
Alcohol consumption is associated with a higher risk of periodontitis, an inflammatory disease of the gums around the teeth. There was also found to be a dose-response relationship in which the risk of periodontitis increased by 0.4% for each additional gram of daily alcohol consumption. Mechanisms explaining the relationship between the two are still unclear; however, several explanations have been suggested. One explanation is the weakening of neutrophil activity by alcohol consumption which potentially leads to bacterial overgrowth and increases bacterial penetration subsequently leading to periodontal inflammation and periodontal disease. Characteristics of the disease include shrinkage of gingival height and increased mobility of teeth which may exfoliate if the disease continues to progress. A patient's consumption of alcohol needs to be monitored to estimate the risk of periodontitis, but further well-designed cohort studies are needed to reaffirm theses results.[149]
Other systems
Respiratory system
Chronic alcohol ingestion can impair multiple critical cellular functions in the lungs.[150] These cellular impairments can lead to increased susceptibility to serious complications from lung disease. Recent research cites alcoholic lung disease as comparable to liver disease in alcohol-related mortality.[151] Alcoholics have a higher risk of developing acute respiratory distress syndrome (ARDS) and experience higher rates of mortality from ARDS when compared to non-alcoholics.[152] In contrast to these findings, a large prospective study has shown a protective effect of moderate alcohol consumption on respiratory mortality.[153]
Kidney stones
Research indicates that drinking beer or wine is associated with a lower risk of developing
Sexual function in men
Low to moderate alcohol consumption is shown to have protective effect for men's erectile function. Several reviews and
Men's sexual behaviors can be affected dramatically by high alcohol consumption. Both chronic and acute alcohol consumption have been shown in most studies
Long term excessive intake of alcohol can lead to damage to the central nervous system and the peripheral nervous system resulting in loss of sexual desire and impotence in men.[168] This is caused by reduction of testosterone from ethanol-induced testicular atrophy, resulting in increased feminisation of males and is a clinical feature of alcohol abusing males who have cirrhosis of the liver.[169]
Hormonal imbalance
Excessive alcohol intake can result in
Diabetes mellitus
A meta-analysis determined the dose-response relationships by sex and end point using lifetime abstainers as the reference group. A U-shaped relationship was found for both sexes. Compared with lifetime abstainers, the relative risk (RR) for type 2 diabetes among men was most protective when consuming 22 g/day alcohol and became deleterious at just over 60 g/day alcohol. Among women, consumption of 24 g/day alcohol was most protective, and became deleterious at about 50 g/day alcohol.[citation needed] A systematic review on intervention studies in women also supported this finding. It reported that alcohol consumption in moderation improved insulin sensitivity among women.[13]
The way in which alcohol is consumed (i.e., with meals or binge drinking) affects various health outcomes. It may be the case that the risk of diabetes associated with heavy alcohol consumption is due to consumption mainly on the weekend as opposed to the same amount spread over a week.[174] In the United Kingdom "advice on weekly consumption is avoided".[citation needed] A twenty-year twin study from Finland reported that moderate alcohol consumption may reduce the risk of type 2 diabetes in men and women. However, binge drinking and high alcohol consumption was found to increase the risk of type 2 diabetes in women.[175]
Rheumatoid arthritis
Regular consumption of alcohol is associated with an increased risk of
The researchers noted that moderate alcohol consumption also reduces the risk of other inflammatory processes such as cardiovascular disease. Some of the biological mechanisms by which ethanol reduces the risk of destructive arthritis and prevents the loss of bone mineral density (BMD), which is part of the disease process.[184]
A study concluded, "Alcohol either protects from RA or, subjects with RA curtail their drinking after the manifestation of RA".[185] Another study found, "Postmenopausal women who averaged more than 14 alcoholic drinks per week had a reduced risk of rheumatoid arthritis..."[186]
Osteoporosis
Moderate alcohol consumption is associated with higher
Skin
Chronic excessive alcohol use is associated with a wide range of skin disorders including
A 2010 study concluded, "Nonlight beer intake is associated with an increased risk of developing psoriasis among women. Other alcoholic beverages did not increase the risk of psoriasis in this study."[193]
Immune system
Bacterial infection
Excessive alcohol consumption seen in people with an alcohol use disorder is a known risk factor for developing pneumonia.[citation needed]
Common cold
A study on the common cold found that "Greater numbers of alcoholic drinks (up to three or four per day) were associated with decreased risk for developing colds because drinking was associated with decreased illness following infection. However, the benefits of drinking occurred only among nonsmokers. ... Although alcohol consumption did not influence risk of clinical illness for smokers, moderate alcohol consumption was associated with decreased risk for nonsmokers."[194]
Another study concluded, "Findings suggest that wine intake, especially red wine, may have a protective effect against common cold. Beer, spirits, and total alcohol intakes do not seem to affect the incidence of common cold."[195]
Cancer
In 1988, the
It was estimated in 2006 that "3.6% of all cancer cases worldwide are related to alcohol drinking, resulting in 3.5% of all cancer deaths."
Even light and moderate alcohol consumption increases cancer risk in individuals, especially with respect to squamous cell carcinoma of the esophagus, oropharyngeal cancer, and breast cancer.[6][202]
Acetaldehyde, a metabolic product of alcohol, is suspected to promote cancer.[203] Typically the liver eliminates 99% of acetaldehyde produced. However, liver disease and certain genetic enzyme deficiencies result in high acetaldehyde levels. Heavy drinkers who are exposed to high acetaldehyde levels due to a genetic defect in alcohol dehydrogenase have been found to be at greater risk of developing cancers of the upper gastrointestinal tract and liver.[204] A review in 2007 found "convincing evidence that acetaldehyde... is responsible for the carcinogenic effect of ethanol... owing to its multiple mutagenic effects on DNA."[205] Acetaldehyde can react with DNA to create DNA adducts including the Cr-PdG adduct. This Cr-PdG adduct "is likely to play a central role in the mechanism of alcoholic beverage related carcinogenesis."[206]
Alcohol's effect on the fetus
Effects of alcoholism on family and children
Children raised in alcoholic families have the potential to suffer emotional distress as they move into their own committed relationships. These children are at a higher risk for divorce and separation, unstable marital conditions and fractured families.[210] Feelings of depression and antisocial behaviors experienced in early childhood frequently contribute to marital conflict and domestic violence. Women are more likely than men to be victims of alcohol-related domestic violence.[211][212][213][214]
Children of alcoholics are often unable to trust other adults due to
Sons of alcoholics are at risk for poor self-regulation that is often displayed in the preschool years. This leads to blaming others for behavioral problems and difficulties with impulse control. Poor decision-making correlates to early alcohol use, especially in sons of alcoholics.[211][212][214] Sons often demonstrate thrill-seeking behavior, harm avoidance, and exhibit a low level of frustration tolerance.[212][213][214]
Economic impact from long-term consumption of alcohol
There is currently no consistent approach to measuring the economic impact of alcohol consumption.[215] The economic burden such as direct, indirect, and intangible cost of diseases can be estimated through cost-of-illness studies.[216] Direct costs are estimated through prevalence and incidence studies, while indirect costs are estimated through the human capital method, the demographic method, and the friction cost method.[215] However, it is difficult to accurately measure the economic impact due to differences in methodologies, cost items related to alcohol consumption, and measurement techniques.
Alcohol dependence has a far reaching impact on health outcomes. A study conducted in Germany in 2016 found the economic burden for those dependent on alcohol was 50% higher than those who were not.[217] In the study, over half of the economic cost was due to lost productivity, and only 6% was due to alcohol treatment programs. The economic cost was mostly borne by individuals between 30 and 49 years old. In another study conducted with data from eight European countries,[218] 77% of alcohol dependent patients had psychiatric and somatic co-morbidity, which in turn increased systematic healthcare and economic cost. Alcohol consumption can also affect the immune system and produce complications in people with HIV, pneumonia, and tuberculosis.[219]
Indirect costs due to alcohol dependence are significant. The biggest indirect cost comes from lost productivity, followed by premature mortality.[220] Men with alcohol dependence in the U.S. have lower labor force participation by 2.5%, lower earnings by 5.0%, and higher absenteeism by 0.5–1.2 days. Female binge drinkers have higher absenteeism by 0.4–0.9 days. Premature mortality is another large contributor to indirect costs of alcohol dependence.[221] In 2004, 3.8% of global deaths were attributable to alcohol (6.3% for men and 1.1% for women). Those under 60 years old have much higher prevalence in global deaths attributable to alcohol at 5.3%.
In general, indirect costs such as premature mortality due to alcohol dependence, loss of productivity due to absenteeism and presenteeism, and cost of property damage and enforcement, far exceed the direct health care and law enforcement costs.[222] Aggregating the economic cost from all sources, the impact can range from 0.45 to 5.44% of a country's gross domestic product (GDP).[223] The wide range is due to inconsistency in measurement of economic burden, as researchers in some studies attributed possible positive effects from long term alcohol consumption.[224][225]
See also
- Short-term effects of alcohol consumption
- Alcohol and suicide
- Self-medication on CNS depressants (alcohol)
- Self-medicated effectiveness on alcohol
Notes
- ^ Calculated as (1.5*1.7/0.39+0.9*0.87/0.25)/(1.5+0.9), with figures from GBD 2016 Alcohol Collaboration (2018). See also WHO figures by country
- ^ The fraction of current drinkers is estimated using WorldBank 2016 population numbers and combining the GBD 2016 and GBD 2020 analyses based on the statement that "Since 1990, the global proportion of drinkers consuming alcohol in excess of the NDE has not changed significantly." For example, GBD 2016 states there were 1.5 billion male current drinkers in 2016, WorldBank states there were 3,770,341,364 males and 1,018,695,045 males under 15, and we can assume based on GBD 2020 that 35.1% of males 15+ were drinking harmful amounts, so we calculate .351*(3770341364-1018695045)/1.5e9≈2/3
References
- ^ a b "No level of alcohol consumption is safe for our health". www.who.int.
- ^ PMID 35843246.)
{{cite journal}}
: CS1 maint: numeric names: authors list (link - ^ PMID 11199274. Archived from the original (PDF) on 2020-11-11. Retrieved 2006-07-31.)
{{cite book}}
:|journal=
ignored (help - ISBN 978-0-415-27891-1.
- PMID 17322182.
- ^ a b Cheryl Platzman Weinstock (8 November 2017). "Alcohol Consumption Increases Risk of Breast and Other Cancers, Doctors Say". Scientific American. Retrieved 13 November 2018.
In fact, alcohol consumption is known to increase the risk of several cancers, including head and neck, esophageal, liver, colorectal and female breast cancers.
- PMID 2988001.
- PMID 18613369.
- S2CID 24586529.
- PMID 20113871.
- ^ "Cancer warning labels to be included on alcohol in Ireland, minister confirms". Belfasttelegraph.co.uk. Belfast Telegraph. 26 September 2018.
- .
- ^ S2CID 32005728.
- S2CID 30141003.
- ^ PMID 23297738.
- PMID 37400823.
- PMID 17159008.
- ^ PMID 26997174.
- PMID 37286970.
- PMID 30146330.
- ^ PMID 24582196.
- .
- PMID 19473456.
- S2CID 10125924.
- PMID 20735372.
- .
- PMID 34420153.
- PMID 12439349.
- .
- PMC 7077768.
- .
- .
- PMC 3735930.
- PMC 8950884.
- ^ PMID 9496287.
- PMID 15831343.
- PMID 23496067.
- PMID 19851424.
- PMID 19739580.
- ^ "Alcohol". www.who.int. Retrieved 2024-03-18.
- ^ Di Castelnuovo A, Costanzo S, Bagnardi V, Donati MB, Iacoviello L, de Gaetano G. Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies. Arch Intern Med. 2006 Dec 11–25;166(22) 2437-45.
- PMID 29676281.
- ^ PMID 20226461.
- ^ IARC Alcohol causes more than half of all the premature deaths in Russian adults
- S2CID 21762284.
- S2CID 46431359.
- PMID 17227980.
- ^ "Alcohol Deaths: Rates stabilise in the UK". Statistics.gov.uk. Retrieved 2014-04-22.
- ^ BBC Alcohol 'kills one in 20 Scots' 30 June 2009
- ^ Sam Lister The price of alcohol: an extra 6,000 early deaths a year The Times, 19 October 2009
- ^ White IR, Altmann DR, Nanchahal K (2000). "'Optimal' levels of alcohol consumption for men and women at different ages, and the all-cause mortality attributable to drinking" (PDF). London School of Hygiene and Tropical Medicine. Technical report. Archived from the original (PDF) on 2014-04-26. Retrieved 2014-04-25.
- ^ "Alcohol and cancer". Cancer Research UK. 2013-08-22.
- ^ Centers for Disease Control and Prevention Alcohol and Public Health
- PMID 8411605.
- ^ "Alcohol-Attributable Deaths and Years of Potential Life Lost — United States, 2001". Centers for Disease Control and Prevention. 2004-09-24.
- PMID 10195914. Archived from the originalon 2013-01-12. Retrieved 2009-01-10.
- S2CID 11553439.
- PMID 10591709.
- PMID 21343206.
- PMID 20338495.
- S2CID 323583.
- PMID 12463288.
- S2CID 8046780.
- PMID 10999974.
- PMID 9024142. Archived from the originalon 2011-02-12. Retrieved 2006-07-25.
- PMID 11836197.
- ^ Mingardi R, Avogaro A, Noventa F, et al. (1997). "Alcohol intake is no longer associated with a lower prevalence of peripheral vascular disease in non-insulin dependent diabetic women". Nutrition Metabolism and Cardiovascular Disease. 7 (4): 301–308.
- S2CID 1586122.
- S2CID 54365788.
- PMID 11308432.
- ^ "Alcohol helps reduce damage after heart attacks". Newswise.com. 2004-08-30. Retrieved 2014-04-22.
- PMID 18417065.
- PMID 17846344.
- S2CID 7243756.
- PMID 29253389.
- PMID 20109599.
- S2CID 25790752.
- PMID 15706762. Archived from the original(PDF) on 2021-09-14. Retrieved 2020-10-22.
- S2CID 22236791.
- S2CID 3123226.
- PMID 19494429.
- S2CID 205924421.
- PMID 11373253.
- PMID 15770107.
- S2CID 20270541.
- S2CID 33032529.
- S2CID 11980558.
- PMID 19715411.
- S2CID 23782870.
- S2CID 22619761.
- S2CID 42462804.
- ^ "Stroke Risk Reduction – Alcohol Use – National Stroke Association". Stroke.org. Retrieved 2014-04-22.
- PMID 17326330.
- PMID 9799959.
- PMID 19630703.
- PMID 15683959.
- PMID 18487267.
- S2CID 9226226.
- PMID 15303623.
- PMID 6806017.
- ISBN 978-0-471-79462-2.
- ISBN 978-0-7817-3200-0.
- ^
Bain PG, Findley LJ, Thompson PD, et al. (August 1994). "A study of hereditary essential tremor". Brain. 117 (Pt 4): 805–24. PMID 7922467.
Lou JS, Jankovic J (February 1991). "Essential tremor: clinical correlates in 350 patients". Neurology. 41 (2 (Pt 1)): 234–8.S2CID 20531450.
Wasielewski PG, Burns JM, Koller WC (1998). "Pharmacologic treatment of tremor". Mov. Disord. 13 (Suppl 3): 90–100.S2CID 21004382.
Boecker H, Wills AJ, Ceballos-Baumann A, et al. (May 1996). "The effect of ethanol on alcohol-responsive essential tremor: a positron emission tomography study". Annals of Neurology. 39 (5): 650–8.S2CID 11083928.
"Setting a steady course for benign essential tremor". Johns Hopkins Med Lett Health After 50. 11 (10): 3. December 1999.PMID 10586714. - S2CID 39981956.
- S2CID 16296043.
- S2CID 24179439.
- ISBN 978-0-19-530659-0.
- PMID 19255375.
- PMID 9809240.
- ISBN 978-0-7817-2468-5.
- PMID 16966196.
- ISBN 978-1-84310-221-2.
- PMID 18412750.
- PMID 18049433. Retrieved 2008-05-13.
- PMID 19673745.
- S2CID 24094651.
- PMID 1346485.
- PMID 17592911.
- ^ a b Alcohol-Related Psychosis at eMedicine
- PMID 2380692.
- ^ "A wine a day ... keeps the psychiatrist away? Light drinking linked to lower risk of depression". ScienceDaily. Retrieved 2014-04-22.
- PMID 15361983.
- PMID 7769598.
- PMID 24442756.
- PMID 9510220.
- PMID 9100213. Archived from the originalon 23 February 2007.
- PMID 16329757.
- PMID 15706765. Archived from the original(PDF) on 2006-09-02.
- PMID 15562213.
- PMID 15213051.
- PMID 7986868.
- PMID 10371403.
- PMID 9554603.
- PMID 9495691.
- ^ PMID 18376362.
- PMID 19073452.
- PMID 15763234.
- PMID 15508108.
- PMID 18191686.
- PMID 18971885.
- PMID 18092710.
- S2CID 205502466.
- PMID 24789985.
- S2CID 201716448.
- S2CID 159040972.
- PMID 32584303.
- PMID 31655832.
- PMID 27029013.
- PMID 26492278.
- PMID 23584753 – via U.S. Government Printing Office.)
{{cite journal}}
: CS1 maint: multiple names: authors list (link - ^ Gregg, Valerie (2008). "The Hidden Truth about Alcohol". Emory University School of Medicine. Archived from the original on October 31, 2008. Retrieved October 22, 2020.
- PMID 15647313.
- S2CID 10690400.
- PMID 8610664.
- PMID 8561157.
- S2CID 43163872.
- PMID 29523476.
- PMID 17538641.
- S2CID 52300588.
- .
- PMID 11912073.
- ^
Mendelson, JH; Ellingboe, J; Mello, NK; Kuehnle, John (1978). "Effects of Alcohol on Plasma Testosterone and Luteinizing Hormone Levels". PMID 356646.
- ^
Mendelson, JH; Mello, NK; Ellingboe, J (1977). "Effects of acute alcohol intake on pituitary-gonadal hormones in normal human males". PMID 894528.
- ^
Sarkola, T; Eriksson, CJP (2003). "Testosterone Increases in Men After a Low Dose of Alcohol". PMID 12711931.
- ^
Emanuele, MA; Halloran, MM; Uddin, S; Tentler, JJ; Emanuele, NV; Lawrence, AM; Kelly, MR (1993). "The effects of alcohol on the neuroendocrine control of reproduction". In Zakhari, S (ed.). Alcohol and the Endocrine System. National Institute of Health Publications. pp. 89–116. NIH Pub 93-3533.
- ^
Ellingboe, J; Varanelli, CC (1979). "Ethanol inhibits testosterone biosynthesis by direct action on Leydig cells". PMID 219455.
- PMID 9396310.
- PMID 9396303.
- S2CID 21618414.
- PMID 15706799.
- ^ S2CID 9667914.
- PMID 16455479.
- PMID 19875607.
- PMID 14514580.
- S2CID 36034581.
- PMID 17910294.
- ^ "Rheumatoid Arthritis". Archived from the original on 2008-06-13. Retrieved 2008-06-18.
- PMID 10627433.
- S2CID 24940881.
- PMID 8311545.
- PMID 9797548.
- PMID 18535114.
- PMID 17185416.
- PMID 10627433.
- PMID 7986867.
- PMID 11735756.
- PMID 11063451. Archived from the originalon 27 May 2012.
- PMID 8518677.
- ^ PMID 17559547.
- S2CID 23377405.
- PMID 15369644.
- PMID 20713772.
- PMID 8363004.
- PMID 11978590.
- ^ IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Volume 44 Alcohol Drinking: Summary of Data Reported and Evaluation Archived 2012-06-17 at the Wayback Machine
- ^ National Toxicology Program Alcoholic Beverage Consumption: Known to be a human carcinogen Archived 2010-06-05 at the Wayback Machine First listed in the Ninth Report on Carcinogens (2000)(PDF)
- S2CID 14938863.
- ^ BBC News Drinking over recommended limit 'raises cancer risk' 8 April 2011
- PMID 21474525.
- ^ WCRF World Cancer Research Fund / American Institute for Cancer Research. Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC: AICR, 2007 Archived 2013-05-23 at the Wayback Machine
- S2CID 25271140.
Clearly, the greatest cancer risks are concentrated in the heavy and moderate drinker categories. Nevertheless, some cancer risk persists even at low levels of consumption. A meta-analysis that focused solely on cancer risks associated with drinking one drink or fewer per day observed that this level of alcohol consumption was still associated with some elevated risk for squamous cell carcinoma of the esophagus (sRR, 1.30; 95% CI, 1.09 to 1.56), oropharyngeal cancer (sRR, 1.17; 95% CI, 1.06 to 1.29), and breast cancer (sRR, 1.05; 95% CI, 1.02 to 1.08), but no discernable associations were seen for cancers of the colorectum, larynx, and liver.
- PMID 29323295.
- S2CID 11716548.
- S2CID 3231314. Archived from the original(PDF) on 2017-08-10. Retrieved 2013-01-19.
- ISBN 978-3-8055-8107-3.
- PMID 15804034.
- S2CID 84514766.
- PMID 3545731.
- ^ PMID 18925353.
- ^ PMID 20153586.
- ^ PMID 1757657.
- ^ PMID 27992890.
- ^ PMID 23948526.
- ^ PMID 28149834.
- PMID 11003181.
- PMID 27576562.
- PMID 26246514.
- PMID 22330211.
- PMID 22011424.
- S2CID 27947246.
- PMID 20534112.
- PMID 19939238.
- S2CID 20912577.
- ^ "The Social Costs of Drug Abuse in Australia in 1988 and 1992 (PDF Download Available)". ResearchGate. Retrieved 2017-09-17.