Mindful drinking – how much alcohol is too much?

March 16, 2023

Swedish Behavioral Health Team

[3 MIN READ]

Recent studies indicate even moderate alcohol consumption increases your health risks.
Alcohol consumption is associated with increased disease rates, including cancer, heart disease and other chronic illnesses.
A psychiatrist at Swedish Medical Center talks about mindful drinking and making informed choices about your health.

For years, wine aficionados and sommeliers have proclaimed the health benefits of drinking a daily glass of red wine. But recent research indicates those claims may not be entirely accurate.

A study published in November in the Journal of the American Medical Association showed that alcohol use resulted in about 140,000 deaths a year in the United States. Some of those deaths were caused by automobile accidents and homicide, but the rest were related to alcohol use.

In addition, the World Health Organization (WHO) recently published a statement saying the health risks of drinking start with the first sip of alcohol and the more you drink the more that risk increases.

Alcohol consumption contributes to the deaths of millions of people around the world every year. It is associated with increased rates of disease and injury, including cancer, liver cirrhosis, several mental health conditions and heart disease, according to WHO estimates.

We talked to Psychiatrist Susanne Weber, MD, about the recent study and the health risks of drinking – even in small amounts.

Know the health risks

“Alcohol is a toxin. And there's probably not any safe level of consumption of a toxin,” says Dr. Weber.

You may think the worst part of drinking too much is dealing with a hangover the next day. But overindulging can seriously affect your health – particularly when it's a regular occurrence.

Alcohol consumption:

Disrupts your brain’s communication pathways and affects its ability to process information.
Damages your heart, causing an increased threat of stroke, irregular heartbeat and high blood pressure.
Increases your risk of developing several liver conditions, including hepatitis, fibrosis and cirrhosis.
Prompts your pancreas to produce toxic substances, causing inflammation and pancreatitis.
Increases your risk of various cancers, including head and neck, esophageal, liver, breast and colorectal cancer.
Weakens your immune system, making it easier to contract serious diseases such as pneumonia and tuberculosis.

What about drinking in moderation?

We've all heard the term "drinking in moderation." But what exactly does that mean?

According to the Dietary Guidelines for Americans used by the Centers for Disease Control and Prevention, a standard alcoholic beverage is 0.6 ounces of pure alcohol. This is equal to:

12 ounces of beer
8 ounces of malt liquor
5 ounces of wine
1.5 ounces of liquor or distilled spirits such as gin, rum, vodka or whiskey

The long-standing guidelines state men should limit their drinking to two alcoholic beverages or less a day. Women should consume one or fewer alcoholic drinks a day. Anything above those recommendations is considered excessive drinking.

Although these guidelines have been the accepted standard for years, they may not reflect the most accurate information, according to Dr. Weber.

Better research yields better information

If earlier research said moderate alcohol use was good for your health, why does it now indicate something different? What’s changed?

“I think the guidelines that the CDC is working off are basically just old. They haven’t been revamped to reflect what we’ve learned from new, more accurate research studies,” says Dr. Weber.

Moderate drinking may not have been responsible for all the health benefits it’s been getting credit for, according to Dr. Weber.

“In retrospect, as we look back at those studies, we’re thinking, well, maybe the red wine was more of a correlative factor not the causative factor. Maybe people who were having a glass of red wine here and there were also people who were at a higher socioeconomic status. Maybe these were people who exercise more frequently or eat a healthier diet. And so, it wasn't the red wine, per se. It was the whole lifestyle that went along with being someone who has a nice glass of red wine a couple of times a week,” she explains.

How much is too much?

What if you’re not ready to cut out drinking altogether? Are there ways to self-monitor your alcohol consumption?

“That's where I still use the CDC recommendations,” says Dr. Weber. “If you’re drinking more than those CDC guidelines, Dr. Weber recommends you ask yourself some questions, including:

How is my drinking affecting me?
Do my friends or loved ones want me to cut back on how much I drink?
Have other people expressed concerns about my drinking?
Have my friends taken my car keys away at the end of the night?
Does drinking affect my work?
Do I wake up hungover?
Am I showing up late or not getting things done?

Carefully consider your answers and contact your health care provider if they reveal potential issues.

According to the National Institutes of Health, some people should avoid alcohol altogether, including those who are:

Unable to control the amount they drink.
Recovering from an alcohol use disorder.
Younger than 21.
Pregnant or trying to become pregnant.
Planning to drive or operate heavy machinery.
Taking medications that interact with alcohol.

Mindful drinking

Once you understand the potential health consequences, it’s up to you to decide whether alcohol is worth the added risk, says Dr. Weber.

“If the broader question is, ‘What is healthy for me and my alcohol use?’ Then we're kind of starting from scratch with this with these new studies,” says Dr. Weber. “Now the question will be based on how you think about health, your risk tolerance and what feels like a reasonable amount for you to drink. If you're someone who really enjoys a drink after work every day, and you have that one drink, you're not going overboard. You understand that alcohol is going to bump up your cancer risk for a various number of cancers.”

“That's where mindful drinking really comes in,” she explains. “Ask yourself if that drink is a symbolic thing. If it's like 'Work is done and now I have time to relax,' could you open a different beverage and still have that feeling? Or if you have two or three beers every night, you slow down and say, 'I'm going to be mindful about drinking this beer. I'm not just going to take it down quickly while watching a TV show. I'm going to really enjoy that one beer.' You may find that that's all you really want or need. Even if you're cutting down by just a little bit, you could really see some health benefits day to day," says Dr. Weber.

Reassess the role of alcohol in your life

"The new data throws things up in the air a little bit. I think we all got very comfortable with those CDC guidelines and believing on this side of the line it's fine and on the other side it's not fine," says Dr. Weber.

"Now you're going to have to stop and reassess the role of alcohol in your life and how much risk you're willing to take. I don't think you're going to run into a doctor or someone in health care who's adamant that you have to stop drinking altogether,” she adds. “To some degree, we all take risks with health every day. It’s just now that we've got to rethink it. We have to put a little bit more thought into it and decide where we want to end individually.”

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