Does alcohol cause cancer?
Yes. Alcohol is a carcinogen, meaning a substance that causes cancer. For many years, the usual advice was to limit drinking to 1 drink daily for women and 2 for men. The advice now is that it is best not to drink alcohol at all.
Drinking can increase the risk of cancers of the mouth, the throat, the voice box, the esophagus, the liver, the breast, and the colon and rectum. If you drink less alcohol, your risk of these cancers is lower. If you are a heavy drinker or a binge drinker, your risk is higher, and alcohol combined with other risk factors, including smoking, can significantly increase your cancer risk.
Fortunately, the risk appears to fall after a person stops, although it may take years to come back down.
What does alcohol do to the brain? Does drinking kill brain cells?
There are a lot of myths surrounding alcohol and the death of brain cells. When I was growing up, the common misconception was that getting drunk would kill something like 10 million or 100 million brain cells. When you divide the number of neurons in the human brain by those numbers, you might conclude that getting drunk regularly would leave you brainless after a few decades.
Of course, this cannot be correct. As it turns out, a night of drinking does not kill brain cells by the million. What regular drinking damages is the dendrites, the ends of brain cells that communicate with other brain cells.
Yet, the myth was not entirely wrong. Long-term, excessive drinking does damage brain cells and shrink brain tissue, most of all in the frontal lobes and the cerebellum. Memory loss, mood swings, and, eventually, dementia can follow. There is more detail in a longer article on the effects of alcohol on the brain and nervous system.
What are some long-term effects of alcohol on mental health?
Mental health conditions are made worse by regular drinking. Anxiety, depression, bipolar disorder, and antisocial personality disorder can all be made worse by alcohol. While people with trauma and post-traumatic stress disorder (PTSD) may drink to quiet their symptoms, they may be making the condition worse.
What does the brain of a lifelong heavy drinker look like?
You may have heard stories of the brains of lifelong heavy drinkers looking like Swiss cheese, full of holes, or of alcohol-caused “wet brain.” The stories are exaggerated, but the shrinkage is real. Alcohol toxicity is known to affect the cerebral cortex, the cerebellum, and the limbic system, and alcohol use can increase your risk of stroke.
Fortunately, in most cases, if you stop drinking, or drink far less, and start a program of healthy eating, you can recover significantly from the mental cloudiness and brain fog caused by excess drinking.
For example, in my interview on The Rehab Podcast with the author, Hoke Kimball, he describes a long and difficult bout with alcoholism, followed by many years of successful and fulfilling recovery. Mr. Kimball is a successful author and a highly talented artist. There are many examples of people who recovered from alcoholism and went on to achieve great things in life.
Can the long-term effects of alcohol lead to permanent brain damage?
Yes, and one cause of it is preventable. When you drink regularly, alcohol blocks the absorption of various nutrients in your intestines, and vitamin B1, also known as thiamine, is one of them.
A thiamine deficiency can lead to Wernicke encephalopathy, and from there to Wernicke-Korsakoff syndrome, the condition that people call wet brain. The main symptoms are confusion, vision changes, memory loss, and ataxia, or a lack of coordination, and the syndrome can lead to permanent brain damage and even death.
To prevent it, doctors give thiamine to heavy drinkers early, often along with folic acid and other vitamins. Sudden confusion, trouble walking, or a change in vision in a person who drinks heavily is an emergency, and a reason to call 911.
What does alcohol do to the liver?
Your liver is a vital organ that acts as a filter for the body, and when it is severely damaged, you will get very sick. How do you know if your liver is being strained by your alcohol use? You can get a blood test. Two tests that are often looked at first are the enzymes, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), which appear on a liver function panel.
While other causes can elevate these enzymes, if both are high, and the AST is higher than the ALT, it points toward alcohol as the cause. Of course, you should review all blood tests with your doctor.
What liver diseases does long-term drinking cause?
If you drink excessively, your liver is working overtime, trying to metabolize all of that alcohol. Over time, you may develop a fatty liver, or even alcohol-associated hepatitis, long known as alcoholic hepatitis, which can cause abdominal tenderness, nausea, vomiting, fever, and fatigue.
If your liver is severely damaged, your skin and eyes may turn yellow, which is known as jaundice. Over time, damage to your liver can leave scar tissue, or fibrosis. As your liver attempts to regenerate and repair itself, you may develop cirrhosis, a disorganized pattern of liver regeneration that leads to poor liver functioning.
A fatty liver can reverse if the drinking stops, while the scarring of cirrhosis generally cannot.
What are the long-term effects of alcohol on the heart?
Drinking too much can directly damage the heart. Alcohol use can raise your blood pressure, putting a strain on your cardiovascular system, and it can damage the blood vessels as well.
Drinking can also lead to cardiomyopathy, a weakening of the heart muscle, and to arrhythmias, or irregular heart rhythms, such as atrial fibrillation. Heavy, long-term alcohol use can result in permanent damage to the heart and serious heart disease.
What other organ damage can result from heavy drinking?
Excessive alcohol consumption can lead to pancreatitis, a painful and life-threatening inflammation of the pancreas, the organ that aids in digestion and metabolism. Long-term alcohol use can also lead to kidney disease, both through the high blood pressure that comes with heavy drinking and through the strain of a damaged liver.
Long-term drinking can cause chronic gastritis, stomach ulcers, and bleeding esophageal varices, a life-threatening condition in which swollen veins in the esophagus break open. Vomiting blood is always a reason to call 911. Indirectly, the lungs are affected as well, because heavy drinkers are more likely to develop lung infections, including pneumonia.
How does alcohol affect a man sexually?
In the short term, alcohol works against a man’s performance in bed. While a drink or two may lower inhibitions, more than that dulls arousal, makes an erection harder to get and to keep, and delays ejaculation.
In the long term, heavy drinking can lower testosterone, and it can cause impotence and problems with fertility. Is the damage permanent? Often, it is not. Sexual function often improves when the drinking comes down, although nerve damage that has built up over many years may not fully reverse.
How does alcohol affect the body as you get older?
It hits harder. With age, the body carries less muscle and less water, so an older adult may reach a higher blood alcohol concentration than a younger person after the same amount of alcohol.
Medications are the second problem. Mixing alcohol with any drug that causes sedation can be dangerous. Benzodiazepines, such as Xanax (alprazolam), Ativan (lorazepam), and Valium (diazepam), act on the same receptors in the brain that alcohol does, and the combination means more falls and, at worst, dangerously slowed breathing.
If you take one of these medications, do not stop it suddenly because of what you have read here. A benzodiazepine must never be stopped abruptly, because sudden discontinuation can trigger seizures and can be life-threatening. Any change should be gradual and supervised by your prescriber.
The third problem is that the signs are easy to miss. Falls, memory loss, and sleeping problems in an older person are often put down to aging, when alcohol may be part of the picture. And, an older or frail person who drinks every day should not stop abruptly without a doctor. There is a gradual way to bring the drinking down, which is explained further on.
If I get drunk and keep drinking, what will happen?
Acute alcohol intoxication can kill. Fraternity hazing has come under fire in recent decades, because there have been terrifying stories of college students locked in the trunk of a car, or in a closet, and not allowed to come out until they consumed a massive amount of alcohol. On multiple occasions, these incidents resulted in deaths from alcohol poisoning.
If someone who has been drinking cannot be woken, is breathing slowly or irregularly, or is vomiting while barely conscious, call 911 and stay with them.
What if I only get drunk on the weekends?
There is a pattern recognized in recent years, known as “gray area drinking.” A gray area drinker is a person who drinks excessively, but not every day, such as on the weekends.
How does a person know if they are a gray area drinker, as opposed to having alcohol use disorder? As the name implies, there is a gray area, where the distinction is not clear. A weekend binge is still a heavy dose of alcohol for the liver, the heart, and the brain.
If you are concerned about excess drinking, see your doctor for a full examination, even if you believe that you may only be a gray area drinker. There is a separate article on gray area drinking and The Sinclair Method.
Is it safe if I just quit drinking, cold turkey?
Not if you drink heavily every day. Alcohol withdrawal can be a life-threatening event in some cases.
Some of the symptoms of alcohol withdrawal include insomnia, anxiety, shakiness, restlessness, nausea, vomiting, and sweating. In more severe cases, there can be hallucinations, seizures, and a deadly condition known as delirium tremens, or DTs, which involves confusion, an irregular heartbeat, and sometimes a high body temperature.
Why is stopping so dangerous? After months or years of daily drinking, the body adapts to alcohol being there, which is known as physical dependence. Physical dependence is not addiction, and it is not a character flaw. It is a medical condition, and it is the reason that alcohol cannot simply be taken away all at once.
If you drink heavily every single day, see your doctor about medically supervised withdrawal before you stop. The doctor may prescribe a short course of a medication such as Librium (chlordiazepoxide), a benzodiazepine that is given for a few days under supervision, and then tapered off. Thiamine and folate are also essential.
Call 911 or go to the nearest emergency room if you, or someone you are with, has cut back or stopped drinking and:
- has a seizure.
- becomes confused, or sees or hears things that are not there.
- has a fever, a racing or irregular heartbeat, or severe shaking and sweating.
- cannot keep fluids down.
If you are having thoughts of suicide, call or text 988, the 988 Suicide and Crisis Lifeline, at any hour.
Is there a medical treatment for alcohol dependence after withdrawal?
Yes. Two of the medications approved by the Food and Drug Administration (FDA) for alcohol dependence are acamprosate and naltrexone.
Acamprosate, known by the brand name, Campral, is meant for people who have already stopped drinking, and it helps them to stay stopped. The way it works is not completely understood.
Naltrexone blocks the receptors through which alcohol is thought to deliver much of its reward, and with the reward turned down, the cravings for alcohol can ease over time. It is available as a daily tablet, and also as Vivitrol, a monthly injection.
Naltrexone is not for anyone who takes opioid pain medication, because it blocks those medications as well and can bring on sudden withdrawal, and your doctor may check your liver tests before and during treatment. There is a fuller comparison in acamprosate vs naltrexone.
Can the long-term side effects of alcohol be managed if a person continues to drink?
This is a good question. Doctors usually prescribe naltrexone to be taken daily, after a person has quit drinking. If they follow The Sinclair Method, or TSM, they prescribe naltrexone for the patient to take one hour before drinking.
TSM uses the principle of pharmacological extinction. Each time a person drinks with the reward blocked, the brain unlearns a little of the habit, and over time people reduce, and in some cases eliminate, their drinking.
While stopping all at once can be dangerous for a heavy daily drinker, TSM lets the drinking come down gradually, with your doctor watching for withdrawal along the way, much as a taper does with any other substance that the body has come to depend on.
Treating alcohol use disorder with medication increases the likelihood that you will drink less, or stop, and it will give your body a chance to recover.
Can Alcoholics Anonymous help with the effects of alcohol on my body?
If Alcoholics Anonymous (AA) can help you not to drink long term, it will help to promote physical recovery and healing. However, for some people, AA can be more harmful than helpful. If you find that you are triggered to relapse and drink again while working in the AA program, it may not be the right path for you.
Also, beware of groups where smoking and unhealthy eating are encouraged, because they can work against your progress in physical healing.
See your doctor and find out if alcohol has caused any health problems.
To get started, first see your doctor. Your family doctor or internist can examine you, order the appropriate blood tests, and, if needed, refer you to a specialist.
If your doctor is not familiar with the treatment of alcohol use disorder, you may decide to see a doctor with experience in treating alcohol dependence, including one who provides The Sinclair Method.
Alcohol is not beneficial for your health.
Alcohol use at any level can increase your risks for long-term health problems. While your body and mind can recover from most of the effects of alcohol after you quit, it is possible to have permanent and severe consequences from drinking.
Even if you are not ready to entirely quit drinking, you can begin a plan to reduce your alcohol intake. The best time to quit drinking was at the time when you first started. The next best time to stop is right now.
How do I treat alcohol use disorder?
In my practice, I treat alcohol use disorder and gray area drinking by telemedicine, for patients throughout Florida, with naltrexone and The Sinclair Method. The aim is to let the drinking come down gradually, at a pace the patient directs, so that the body has a chance to heal. Patients do not have to stop drinking before starting treatment, and no one is required to attend group meetings.
To ask about an appointment, use the contact form.
This article is educational. It is not medical advice, and reading it does not create a doctor-patient relationship. Decisions about starting, continuing, or tapering any medication should be made with your own physician.
