Beyond Dry January: Addressing the health effects of alcohol consumption – VCU News

Written by Grace Macomber
Faculty of Medicine

Earlier this year, approximately 21% of U.S. adults of legal drinking age reported observing “Dry January” by abstaining from alcohol for 31 days.

But even after January, health experts continue to urge people to reduce and monitor their drinking habits. According to the National Institutes of Health, even mild to moderate alcohol consumption (1.2 to 2.2 drinks per day) is associated with an increased risk of health problems such as liver disease, certain cancers, and alcohol use disorders. I am. A 2023 World Health Organization release further warns that there is no such thing as a healthy amount of alcohol.

Two Virginia Commonwealth University School of Medicine faculty members who regularly see alcohol-related illnesses in their clinics discuss the latest research findings and how they advise patients to balance their alcohol intake with their overall health. I looked back at what was going on.

change in mindset

Alcohol is a central nervous system depressant that affects the cerebral cortex, impairing inhibitory control and information processing. Albert Arias, M.D., associate professor of psychiatry and researcher at the Drug and Alcohol Research Institute, says that frequently exceeding the recommended daily and weekly limits for alcohol consumption changes neural pathways over time, making it more likely that alcohol will develop. He explained that the risk could be increased. Use disorders and other adverse psychosocial consequences.

“You don’t have to be drunk all the time for drinking to be a problem,” Arias said. “Alcohol causes subtle changes in the brain over time, which can lead to an addictive state.”

Recent changes in government advice lowering the limits for ‘safe’ or harmless drinking are part of a series of links that link all levels of alcohol consumption to medical problems over time, including an increased risk of cancer, stroke and heart disease. Based on a growing body of research.

“Alcohol appears to have harmful effects on the body even in low doses, but we didn’t always think so,” Arias said.

A major challenge for people wanting to reduce alcohol consumption is its current wide availability and cultural relevance. Arias said people often drink to cope with stress or anxiety or in social situations, and finding activities and outlets to reduce the urge to drink can help reduce alcohol intake. he pointed out.

“There are several behaviors you can change to reduce your drinking,” Arias says. “Instead of going to the bar, you can work out or do other activities to fill that time.”

Arias said that while there is scientific evidence that no amount of alcohol is good for health, he doesn’t expect drinking culture and habits to change anytime soon. He speculates that it will take time for the recent findings to “really sink in” at a societal level, but he hopes that eventually there will be a cultural shift around alcohol consumption.

“If you think about smoking, it’s still a huge problem that kills more people a year than alcohol, but its prevalence has decreased and it’s become more accepted within society.” Arias said. “Maybe something similar will happen with alcohol over time. The biggest thing is to make sure people who don’t drink don’t start drinking.”

physical impact

One of the biggest challenges for researchers and clinicians alike is determining who is susceptible to alcohol-induced disease. Alcohol consumption affects patients in a variety of ways, but many of the genetic determinants remain mysterious.

“Suppose you have three different people who consume the same amount of alcohol per day for 15 years, from one person with no health problems to one who develops alcoholic cirrhosis and needs a liver transplant. Each can lead to different outcomes,” said Dr. Amon Asgarpour. , professor of internal medicine. “We’re seeing such variation, and we still don’t fully understand why.”

Asgarpour said he has seen alarming trends in the patients he treats as a transplant liver specialist at VCU’s Sanyal Strawitz Institute for Liver Disease and Metabolic Health. Alcoholic hepatitis, an inflammation of the liver that can cause serious organ damage, is more prevalent among patients in their 20s and 30s — two decades ago, experts said the disease He said he was only looking at it in 60-year increments. Old man.

Dr. Asgharpour’s observations are consistent with what the American College of Gastroenterology calls a “concerning increase” in alcohol-related liver disease among 25- to 34-year-olds over the past 20 years. Over time, alcohol damages and kills healthy liver cells as it passes through the organ, causing diseases such as alcoholic hepatitis, steatosis (also known as fatty liver disease), cirrhosis, and scarring of the liver. When the process becomes irreversible, transplantation becomes necessary.

The good news, Asgharpour said, is that the liver is a “very strong and regenerative organ.” According to the NIH, steatosis can develop after just two weeks of heavy drinking, but abstinence for two to three weeks may reverse steatosis in its early stages.

“You can use the liver to reverse scarring,” Asgarpour says. “It’s important to eliminate the root cause of scarring, whether it’s a virus or alcohol. The liver is a very forgiving organ.”

Although any amount of alcohol can damage the liver, being aware of and following NIH guidelines when choosing to drink is an important step people can take to protect their health, Asgharpour said. Stated. He emphasized that clinicians should approach treatment with compassion and non-judgment, especially for patients who may experience relapse to alcohol use.

“I don’t tell my patients, ‘Don’t drink,’ I tell them, ‘Avoid alcohol,'” Asgharpour said. “Maintaining trust is important, especially when meeting the person seeking help for the first time.”