Holiday reminder: careful with alcohol

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I grew up in a culture in which alcohol consumption was a part of many social interactions. Go to any EMS convention and look at the crowds in the bars. When I teach the NAEMT Safety Course, I ask participants what they do for relaxation. There are always folks who respond with “a drink”.  Naturally, we all adhere to the concept of responsible drinking.  Perhaps most of us assume if we don’t drink and drive, or show up for work hung-over, we are responsible drinkers.  Some new data might change your mind.

A recent headline announced CDC findings that between 2006 and 2010, alcohol use was responsible for 1 in 10 deaths of people between the ages of 20-64. It defined binge drinking as 5 or more drinks for men, and 4 or more for women consumed within 2-3 hours. For men, having 15 or more drinks a week, or 8 or more for women is defined as heavy drinking.

Alcohol was declared a carcinogen in 1988. There is a dose related effect. The more you drink the greater your risk for developing cancer. Alcohol consumption can development cancers of the mouth, pharynx, esophagus, colon-rectum, liver, female breast, and the pancreas. Remember the dose-related part.  Cancers of the colon-rectum, liver, and larynx were not associated with light drinking. Light drinking increased the risk of oropharyngeal cancer, esophageal squamous cell carcinoma and female breast cancer. A study consisting 92,000 light drinkers and 60,000 nondrinkers with cancer data was pooled and analyzed.

Alcoholic beverages contain at least 15 carcinogens.  A few popular ones areacetaldehyde, acrylamide, aflatoxins, arsenic, benzene, formaldehyde, and lead. I it found surprising that the most carcinogenic substance in alcoholic beverages is ethanol. Hard liquor contains high concentrations of ethanol which kills cilia in the esophagus. This means that hard liquor consumption confers a greater risk for esophageal cancer than other forms of liquor, but wine, beer, and hard liquor give us equal risk for other types of cancer. Smoking and drinking have synergistic effects for inducing cancers. 80% or oral cancers and 90% of laryngeal cancers could be prevented by avoiding the combination of cigarettes and alcohol.

An article in Mayo Clinic Proceedings addressed what is called the “French Paradox”. It was observed that the French, who as a population have the highest alcohol intake, have the lowest incidence of cardiovascular disease.  The pattern of drinking that “seemed” most healthy is to ingest low to moderate doses of alcohol, preferably in the form of red wine before or during the evening meal.  However, in our country, the evidence indicates that the harmful effects of alcohol outweigh the beneficial effects.  Experts now state that “no absolutely safe level of alcohol intake can be promoted”. In my academic years, I worked with a researcher who was doing rat studies to determine what level of alcohol intake would be safe during pregnancy.  She was using genetic alteration as the marker. Alcohol is a folate antagonist and impairs important processes in DNA chemistry. She could not find an amount of alcohol that did not cause gene damage in rats.

Consider your approach to alcohol consumption as a personal health behavior.

  • If you don’t drink, don’t start.
  • If you don’t smoke, don’t start. If you do smoke, quit.
  • Monitor your alcohol intake.
  • Limit consumption: 1.5 drinks per day for men, 1.0 for women.
  • Remember the dose related effects.
  • Take a day off from drinking.

References
  • Norstrom, T., Ramsted, M.,  “Mortality and Population Drinking: A Review of the Literature.” Dru Alcohol Review, 20015: 24:537-547.
  • Regan, C. Intoxicating Minds , New York, Columbia University Press, 2001
  • Erickson, CK The Science of Addiction,  New York, WW Norton Company, 2007
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