Ask the Pharmacist

Q. This pandemic has altered my lifestyle significantly and I have a new ritual of enjoying a drink in the evenings each day. Is moderate drinking that harmful or might I be able to continue this going forward without jeopardizing my health?

A. Let’s take a Clint Eastwood approach and look at The Good, the Bad and the Ugly.

The Good:

There was a time when a glass of red wine daily was construed to be good for the heart. Though there is some truth to that, there is some thought that it is not what you drink but rather how you drink.  One drink a day has shown to reduce the risk of cardiovascular issues such as heart attack and/or stroke. However, the same cannot be said for the weekly binge drinkers that drink 7 drinks in one day and nothing the rest of the week. Though the weekly total may be the same, the effect on the body is not.

Another thing to consider is the age of the person. A 20-or-30 something has a much higher risk of alcohol related incidents and therefore the benefit does not outweigh the risk. However, a male in his 60’s without a history of alcoholism may have cardio benefits surpassing the risk. A woman in her 60’s also benefits from this reduced cardiovascular risk, however many women are also afraid of the increased risk of breast cancer that occurs with alcohol.

Other benefits found with moderate drinking habits include a lower risk of developing gallstones as well as a reduced risk of developing type 2 diabetes. Mind you, since alcohol use lends itself to empty calories, beyond the low level of moderate drinking, many people choose to eat more while consuming alcohol. Over time, this will wreak havoc with one’s healthy weight and therefore increase the risk of diabetes.

A drink before dinner can help aid digestion as well as reduce the stress of the day. Again, it is easy for one drink to find its way to two or three to relax so it is important to keep below the limit defined as moderate drinking to avoid hampering our desired positive effects.

With the world opening up, the importance of having a social drink among friends can improve our social and mental psyche. Since the pandemic began two years ago, life as we knew it changed. We have been unable to socialize with friends and family for most of that time and may be hesitant to get back into the world. Having that beverage may help make the transition back a little easier, being mindful that the risk will outweigh the benefits with over-consumption.

The Bad:

Now, of course, along with the good, there is also the bad. It is a well-known fact that alcohol can disrupt our sleep patterns. While some people may resort to it as a means of helping us get to sleep, alcohol is famous for middle of the night awakenings with the inability to return to a restful slumber. This may then spiral from moderate use to heavy use to try and rectify this. This leads us to the next scenario. Alcohol is also brutal on bladders. For many of us already struggling with urinary frequency & urgency, any amount of alcohol will be detrimental to these challenges.

What may start as a single beverage on a few occasions a week may turn itself into a daily routine or perhaps for some this habit may result in a heavier than moderate consumption of alcohol. It is not uncommon to find that one drink may no longer achieve your goal of feeling relaxed etc., and that the undesired outcome of drinking too much each day occurs. This in turn alters the risk to supersede any benefit one might have had.

Alcohol lowers our inhibitions which can be beneficial in certain situations, it can also lead to painful decisions or, worse yet, it can ultimately lead to many unfortunate demises such as automobile accidents and violent crime.

The Ugly:

The fact that alcohol gets metabolized in our liver, it should not come as a surprise to learn that some of our liver cells die with alcohol consumption. The good news here is that our liver is capable of regenerating new cells but as we age or with continued heavy drinking, our liver reduces that ability to regenerate. This can lead to liver problems such as a fatty liver, alcoholic hepatitis (inflammation of the liver) and cirrhosis (scarring of the liver) as well as liver cancer among other types.

In an earlier column, we discussed the increased risk of various cancers that are attributed to our consumption. This cancer risk further increases with people that are also smokers and/or do not have a well-balanced diet so not only is it important to keep alcoholic beverage to a minimum, it is also important to take a good look at those other lifestyle choices.

Breast cancer is one of the cancers that drinking is associated with in an increased prevalence. For women that drink 2-5 drinks daily, the risk increases to 17-18 per 100 compared to the average risk of 13 per 100 women. Moreover, heavy drinking is also associated with a lower level of folate in the body which also increases the risk of breast cancer for both sexes. For both men and women who choose to drink moderately or more, strongly consider supplementing with folic acid to reduce this risk.


An important thing to consider is the definition of “a” drink has evolved over the years. In the past, an example of a drink was either 12 ounces (341ml) of beer or cider at 5%, 5 ounces (142ml) of wine at 12% or 1.5 ounces (4ml) of spirits at 40% such as gin, run, rye etc. and each of these choices would provide you with 12 to 14 grams of alcohol.

Fast forward to today, with many microbreweries and wine that offer a much higher alcohol content, and “a” drink has truly become more than one. There are different examples floating around as to what constitutes moderate drinking or low-risk drinking;

· Women: 2 standard drinks per day, 10 standard drinks per week, 3 standard drinks on special occasions and have alcohol free days

Men: 2 standard drinks per day, 15 standard drinks per week, 4 standard drinks on special occasions and have alcohol free days OR

· Women: no more than 1 drink per day

. Men: no more than 1-2 drinks per day

Clearly you can see the wide disparity of this definition.

The bottom line: If you are currently a non-drinker, there is no need to start. These same benefits can be seen by starting an exercise routine or boosting your current regimen as well as adhering to a healthful diet full of fruits and vegetables along with other rich anti-oxidant foods.

If you are a thin individual who is also a non-smoker and is physically active and eats a well-balanced diet without a family history of heart disease, there isn’t much benefit to be gained with that daily beverage.

On the other hand, an older male with a moderate/high risk of heart disease may be beneficial. This is especially true if the HDL (the good cholesterol) levels are on the low side and diet and exercise are not able to bump that number up.

As for women, as discussed above, they need to assess their own risk of heart disease versus their risk of breast cancer and decide from there. For more information on this or any other topic, contact your pharmacist.