Moderate consumption of alcohol may have health benefits, including reducing the risk of developing some types of cardiovascular (heart and blood vessel) disease. However, some controversy exists over the quality of the evidence supporting this, and some doctors think the benefits of alcohol have been overstated. One thing seems certain — it’s not a case of ‘the more the better’ when it comes to drinking. Whether alcohol is good or bad for you seems to depend on the amount you drink and your individual characteristics and circumstances.
Drinking too much alcohol has several risks. In the short term, you risk accidents and injury, violence, reduced circulation, sexual dysfunction and raised stress levels. Your sleep can be disturbed after as few as one or 2 drinks. Over months and years, the risks of drinking too much include cancer, high blood pressure, stroke, heart muscle damage, inflammation of the liver and pancreas, brain damage and memory loss, and sexual problems.
If you drink alcohol, you can minimise your risk by aiming for low-risk drinking — a level of drinking at which there is likely to be little harm.
The National Health and Medical Research Council (NHMRC) currently recommends the following for low-risk drinking.
|NHMRC recommendation for alcohol consumption|
|Guideline 1:||For healthy men and women, drinking no more than 2 standard drinks on any day reduces the lifetime risk of harm from alcohol-related disease or injury.|
|Guideline 2:||For healthy men and women, drinking no more than 4 standard drinks on a single occasion reduces the risk of alcohol-related injury arising from that occasion.|
A standard drink is 100 mL of wine (an average restaurant wine glass contains 1.5 standard drinks) or one nip (30 mL) of spirits. One middy or pot (285 mL) of full-strength (4.9 per cent) beer is equal to 1.1 standard drinks.
A single occasion of drinking is a sequence of consuming drinks without the blood alcohol concentration reaching zero in between.
Drinking less frequently over a lifetime (e.g. drinking weekly rather than daily) and drinking less on each drinking occasion, reduces the lifetime risk of alcohol-related harm.
Binge drinking — drinking heavily over a short period or drinking continuously over a number of days or weeks — is thought to be especially harmful, even if you don’t do it very often.
How quickly you drink is also important — men are advised to drink no more than 2 standard drinks in the first hour, then no more than one drink per hour; women should have only one standard drink per hour.
Also, women who take the oral contraceptive pill may break down alcohol more slowly than women who are not on the pill.
Despite these differences, at low levels of alcohol consumption there is little difference between men and women in terms of alcohol-related harm, according to the NHMRC. However, at higher levels of alcohol consumption the risk of alcohol-related disease increases more quickly for women, while the risk of alcohol-related injury increases more quickly for men.
Also, if men and women drink the same amount on a single occasion, women tend to reach a higher blood alcohol level, but men are more likely to be injured because, in general, they are more likely to engage in risk-taking behaviour.
The NHMRC has recommended that certain groups of people should drink less than the amounts in the general guidelines. Have a look at the table below to see whether you fall into one of these groups.
|People who should drink less than the general guidelines|
|Group||NHMRC recommendation||Reason or comment|
People doing activities that involve risk or require skill, e.g.:
||Avoid alcohol before and during these activities.||Even small amounts of alcohol affect judgement and performance.|
People with a health or social problem linked to or made worse by alcohol, e.g.:
Temporary or permanent abstinence may be necessary.
You should discuss your alcohol intake with a health professional.
Continued drinking will cause further harm in people with significant alcohol dependence or major organ damage.
For some people with alcohol-related conditions, a planned programme of limited drinking under the supervision of a health professional may be appropriate.
|People with a relative who has had alcohol dependence or another alcohol-related problem||
Consider reducing the amount of alcohol to below the recommended amount for healthy adults.
A family history of alcohol-related problems increases the risk that a person will be unable to control their drinking.
|People taking medicines — this includes herbal remedies||
Carefully read the labels and leaflets to check for interactions with alcohol.
Discuss possible interactions with your doctor or pharmacist.
You may need to limit your alcohol intake or stop drinking altogether.
Even at low levels, alcohol can interact with medicines — this can alter the effect of the alcohol and/or the medicine.
The greater the number of medicines taken, the higher the risk of interactions with alcohol.
|People using illicit drugs, especially opioids such as heroin or methadone||Consuming alcohol with illicit drugs can have dangerous or lethal consequences.||
Alcohol, heroin and methadone all depress brain activity.
Combining alcohol with stimulant drugs such as cocaine, methamphetamines and ecstasy increases the risk of dehydration, heart rhythm abnormalites and fits.
|People with a mental health problem or disturbed sleep||
If you drink, be very careful to stay within the recommended limits.
Consider not drinking at all — especially if you find it hard to limit your drinking or if your symptoms persist.
Check with your doctor or pharmacist about interactions between medicines and alcohol.
Drinking above the guideline levels can aggravate mental health problems.
Even one or 2 drinks can disrupt your sleep.
Many medicines used to treat mental illnesses interact with alcohol.
Older people aged over 60 years
Older people are advised to consult their doctor about the most appropirate level of drinking for their health.
Older people tend to have a higher blood alcohol level than younger people for a given level of alcohol consumed.
Light to moderate alcohol consumption in older adults may lower the risk of several chronic conditions.
For some older adults, drinking alcohol increases the risk of falls and injuries, as well as some chronic conditions.
Many older people take medicines that can interact with alcohol.
|Young adults (aged 18-25 years)||
Be careful not to drink beyond the guideline limits, and take steps to avoid accidents and injuries.
Avoid alcohol for at least several hours before potentially risky activities like driving or swimming.
Don’t mix alcohol with other mood-altering drugs.
Statistically, young adults are most likely to be harmed by alcohol and to experience alcohol-related injury.
Alcohol affects brain development in young people, so drinking (especially heavy drinking) at any time before brain development is complete, which is not until about age 25, may adversely affect brain function.
Children and young people under 18 years of age
Not drinking alcohol is the safest option.
State and Territory Liquor Licensing Acts state that people younger than 18 cannot legally buy alcohol.
Alcohol can adversely affect brain development and lead to alcohol-related problems in later life.
People under the age of 15 are much more likely than older drinkers to undertake risky or antisocial behaviour connected with their drinking.
Risky behaviour is also more likely among those aged 15-17 – if drinking occurs in this age group it should be at a low risk level and in a safe environment, supervised by adults.
Women who are pregnant or who might soon conceive
[Includes women trying to conceive because the first weeks after conception are critical — women may not be aware they are pregnant at this stage]
|Not drinking is the safest option.||
Alcohol enters the developing fetus.
The risk of harm to the fetus is likely to be low if a woman has consumed only small amounts of alcohol before she knew she was pregnant or during pregnancy. The level of risk to the individual fetus is influenced by maternal and fetal characteristics and is hard to predict.
|Women who are breast feeding||
Not drinking is the safest option.
Specifically, consider not drinking for the first month after delivery until breast feeding is well established.
For women who choose to drink after this period, alcohol should be limited to no more than 2 standard drinks per day, and women should avoid drinking immediately before breast feeding.
Women could also consider expressing milk in advance if they are planning to drink alcohol.
|Alcohol passes into the breast milk. It may reduce milk supply and cause irritability, poor feeding and disturbed sleep in a breast-fed baby.|
|Source: Australian guidelines to reduce health risks from drinking alcohol. NHMRC, 2009|
If you’re concerned about the amount you are drinking and are having trouble cutting back, help is at hand. Talk to your GP or contact one of the support groups that help people with alcohol problems.
Last Reviewed: 20 April 2009