Ask the Pharmacist

Q) I find myself consuming more alcohol these days as a result of holiday celebrations and, paradoxically, the sheer boredom brought on by the continuing restriction of my activities. It’s almost always in moderate amounts. Should I be concerned or is it not really so bad for my health?

A) At the risk of putting a damper on one of the few joys we are still allowed to indulge on in the midst of another wave, we should talk at least a little about just how bad even small amounts are to our health. This will likely be unpopular news which speaks to how effectively the consumption of alcohol has been incorporated into our culture.

For many of us, there are very few celebrations that do not require the use of alcohol to be considered properly occasioned and for more than a few of us a glass of wine or a pint is the signal for the end of a hard day’s labour. Three quarters of Canadians aged 15 and older drink alcohol at least once a year and as a country we consume about 50% more alcohol than the global average with the average Canadian downing 98.6 litres every year. This is regrettable because there is growing evidence that even moderate amounts are quite injurious to our well-being and we would do well as a society to learn to enjoy life’s better moments in some other fashion.

We are discovering that alcohol is a poison. While the amount imbibed absolutely matters, it is a fact that there are no safe levels of alcohol consumption. Alcohol is known to kill 5,000 Canadians a year and results in 77,000 hospitalizations while costing society at large $14.6 billion. And these numbers may be grossly underestimated as we are now discovering some of the previously hidden costs of alcohol. A lot of this new information has come to light in just the last 12 months but has not received the attention it deserves due to the long-shadow cast by COVID and our general unwillingness to listen to even more news that tells us things we would rather not hear.

In early 2021, the U.S released the results of an epidemiological analysis that estimated that alcohol was a contributor in 4.4% of all cancer cases and 3.2% of deaths related to cancer.

Later this summer, the esteemed British publication the Lancet followed up with the results of a population-based study that tried to assess the impact of alcohol on the incidence of cancer world-wide. This research found that 4% of new cancer cases globally could be attributed to alcohol and that this wasn’t just from the well known negative consequences that arise from high levels of consumption.

Their data indicates that moderate levels of drinking accounted for 103,100 out of the 741,300 projected annual cases of cancer. The take home message here is quite evident; There is no safe level of alcohol consumption. Even people with low to moderate levels (1-2 alcoholic drinks per day) are at a significantly increased risk of cancer which is why alcohol has now been classified as a Class A carcinogen joining the likes of such well known toxins as asbestos.

While low levels of consumption are certainly safer than large ones, there was a further study conducted in South Korea that indicated that when it came to the risk of developing a gastrointestinal cancer, even binge drinking (the consumption of large amounts of alcohol but on a sporadic basis) may be preferable to continuous but moderate consumption.

There is also evidence that alcohol might be more harmful to the female population as the proportion of cases that could be attributed to alcohol was higher than that seen in men (although men still represented about 2/3rds of the total number of cancers due of course to their much higher incidence and levels of consumption). Cancers seemingly related to alcohol include those of the mouth, pharynx, larynx, esophagus, colon, rectum, liver and breast. But it’s not just the growth of tumors that makes alcohol a choice we need to rely on less.

There is also a growing body of evidence alcohol, even in moderate amounts is toxic to your brain.  A recent study that took brain MRI’s and conducted cognitive testing on 25,000 participants found that even low levels of alcohol use reduced the volume of our gray matter and the level of our functional connectivity. Changes such as these have been solidly linked to both decreased memory and dementia and the level at which alcohol seems to do this is greater than that seen in people who engage in other risky activities such as smoking.

We should also not forget the lesser harms that alcohol produces. Alcohol is expensive, particularly when bought in public spaces. For some of us, it prevents us from affording a healthier diet or treating ourselves and our loved ones to a better vacation each year.

Alcohol is also very calorie dense and contributes to our expanding waist lines which in turn increases our risk of numerous medical conditions (high blood pressure, diabetes…) and, for many of us, lessens our self-esteem. Drinking alcohol is also a great way to ruin a night’s sleep. While its initial effects can make one drowsy and shorten the onset of sleep, which is a good thing, it effects the rest of our sleep patterns throughout the night as it circulates throughout our system. It can suppress our REM sleep during our 1st two cycles (REM is where we dream and memory is consolidated) and as the night progresses it can create an imbalance between our slow-wave sleep and REM sleep which decreases our overall sleep quality as we tend to sleep for a shorter duration with more disruptions.

Lastly, even moderate amounts of alcohol can impact how we behave socially with others. For some, it may allow us to overcome our inherent shyness but for many of us it causes us to say things and behave in manners that if we were to listen or look back at a recording of it, we would be quite embarrassed.

Should we all abstain going forward?

Perhaps that is not necessary but we should at least rethink how often we turn to a glass of wine or a pint as a way of dealing with our everyday concerns. It’s an indulgence that should be a treat but one we don’t enjoy too much of too often. For more information about this or any other health related questions, contact your pharmacist.