9 min|Dr. Maya Kuczma
The Effects of Alcohol on the Body (plus A How-To Guide to Getting Sober)Wellness, Mind Health, Health, Gut Health
Abstaining from alcohol traditionally has been thought to be reserved for addicts, full-fledged alcoholics who know they must refrain, lest they end up losing control. Religious motivations are also a known motivation for abstaining, albeit often poorly understood by secular drinkers. However, depending on where you live, you may gain little exposure to people who are motivated by these two reasons or other reasons entirely. Without seeing abstinence as an option, many of us begin to drink based on social pressure, and continue, without ever inquiring as to why we drink, or if we want to.
As we gear up for St. Patrick’s Day, a holiday generally defined by alcohol use, we’re presented with an opportune moment to assess our relationship with alcohol. Many of us engage in a glass or two, perceiving it to be harmless, blissfully unaware of the impact this casual alcohol use is having on our health. But for some, the awareness is real and present - our mental, physical, and emotional health are suffering. No matter which group you fall in, understanding why you drink, and what effects it may be having on your health, can enable more-informed decisions, regardless of whether you continue to imbibe.
The Truth About Alcohol
Alcohol is the most commonly abused substance in Canada(1). In 2016, 19% of Canadians over the age of 12 years old reported alcohol use that classified them as heavy drinkers (2). Heavy drinking is defined as at least 5 or more drinks, for males, or 4 or more drinks, for females, at least once a month during the past year (3). Drinking patterns and dosage matter, although we are unclear about how much. The International Agency for Research on Cancer’s World Cancer Report 2014 and the Canadian Cancer Society state that there is no “safe limit” of alcohol consumption when it comes to cancer prevention(4).
Studies suggest that even one drink per day increase the risk of breast cancer(3). Youth are more at risk of the harms of alcohol use since developing brains are more vulnerable to the effects. But there are still significant gaps in our understanding of the physiological and psychological effects of drinking, how familial and social patterning influences usage, and risk factors for abuse, and yet alcohol remains legal, and the most commonly used and abused drug in Canada.
Sober For The Health Of It?
Perhaps it is in contrast to the rise in binge drinking(5), the natural pendulum swing that must occur when we’ve gone too extreme. Maybe it is a reflection of our growing interest in fitness and wellbeing, and our recognition that alcohol may not be the healthiest choice for our mental and physical health. Regardless of the motivation, an interest in sobriety is increasing, as well as an effort to understand our relationship with alcohol - also known as ‘sober curiosity’. This new rise of conscious alcohol consumption is leading to a dipping of toes into the proverbial pool of sobriety, offering a low-risk way of exploring our relationship with alcohol before determining if we need to break-up.
The Effects Of Alcohol On The Body
Within alternative healthcare, we’re determining which foods help us prevent, and treat, disease. We’re researching how the toxins we eat, drink and breathe negatively alter our physiology. And we’re beginning to understand how the interplay between genetics and environment, what we were born with and what we choose, can trigger illness. It is a natural progression to look at alcohol consumption and try to understand the role it plays in our health.
- Alcohol has been shown to promote intestinal bacterial growth and increase intestinal permeability (‘leaky gut’), a physiological change that has been linked to a wide variety of health conditions (6,7)
- Alcohol acts as a diuretic, causing the kidneys to produce more urine, thereby decreasing water and electrolytes in the blood
- Acetylaldehyde, a metabolic by-product of alcohol, is 10-30 times more toxic than alcohol and is believed to be responsible for an increase in inflammatory cytokines that lead to the symptoms of a hangover (8)
- Genetic mutations lead a certain percentage of the population (disproportionally people of East Asian descent) to poorly metabolize alcohol, resulting in a build-up of acetylaldehyde, leading to a variety of symptoms such as flushing and worsened hangovers (9)
- Alcohol, as a nervous system depressant, can induce sleepiness, but reduces sleep quality by affecting deep sleep, REM sleep, and disrupting circadian rhythm (10,11)
- Alcohol use has been linked to a variety of risky sexual behaviour, particularly for women who have higher risks of sexually transmitted infections (STIs) and sexual assault when drinking alcohol (12)
- Alcohol use can provide a substantial amount of calories, and maybe a significant factor in both adult and youth obesity (13,14)
- Due to the nervous system depressant effect of alcohol, combining alcohol with other depressants can be lethal
Perhaps the largest concerns with alcohol use are the factors that are tough to research - the impact it has on our decision making, the financial strain, and the way drinking can have a trickle-down effect: we set goals for the week on a Monday, health-related or otherwise, only to quickly abandon them after a few drinks on Friday night. I’m sure you can relate - how often have you thrown caution to the wind, abandoning your diet, cancelling a morning workout, or calling the ex you swore you wouldn’t contact again, once the buzz sets in?
Are You Feeling Sober Curious?
Mindful drinking, or becoming sober curious, may sound like a real buzzkill. But fear not - the aim is simply to assess your relationship with alcohol. You might find out it’s time to leave the bar altogether. Or you might realize you benefit from limiting alcohol use to a few key events per year, or that you do well with alcohol if you have a set monetary or drink limit defined, prior to going out. Regardless, you won’t be alone - mindful drinking is a trend that is on the rise.
2017 saw the release of a variety of sober-curious books such as The Unexpected Joy Of Being Sober, and the Sober Diaries, as well as Daybreaker, who hosts early morning sober dance parties, and Club Soda NYC, an event series for the ‘sober curious’. And the numbers don’t lie - you don’t need to be an alcoholic to be sober curious. All that is required is a curiosity about why you use alcohol and a willingness to begin:
1. Define Why You Drink
The best question to ask might be - what if you couldn’t drink? What does alcohol provide, that you would need to look elsewhere to find? Is it a sense of confidence? Does it quell social-behaviour, lubricating social events to help them feel less grating? Perhaps it helps you to relax, or you like the taste; maybe, it’s simply habit, an automatic behaviour associated with certain times or events. Home from work? Pour a drink. Out with the girls? Have a glass of wine. Hot summer day? Drink a cold one. No judgement allowed - just discover your patterns.
2. Decide If You Want to Change Your Relationship With Alcohol
Awareness can lead to change - perhaps this honest look at why you drink has helped you realize when you enjoy it, and given you the confidence to safely and consciously consume. Or maybe it has given you pause. Maybe it has even made you feel a bit shameful. Regardless, if you have discovered that you don’t like how you use alcohol, decide that you want to change. Just like that. Step two completed.
3. Define Why You Want to Change Your Relationship with Alcohol
If you’ve decided you want to change, you have to come to know why. Perhaps it’s a specific aspect of health that you’ve hit a stumbling block with, and you’re suspicious that alcohol is playing a role. Maybe you realize that you consume alcohol habitually, and want to bring more mindfulness to how, when, and why you’re drinking. Or you’d like to save money. Or you feel incongruence between the healthy habits you partake in and drinking alcohol. Regardless of your motivation, get clear about what you hope to gain from changing your relationship with drinking. Clarity equals commitment.
Alcohol can occupy a large space in our life. It can be the crutch we lean on when we’re anxious, or stressed, or shy. It can be the basis of how we plan our weekend or vacations. If we remove it, or even if we simply change how we use it, we feel its absence. Anticipate this emptiness, and replace it with an alternative. The alternative will differ, depending on how we’ve used alcohol. If it was a big part of how we connected with friends, suggest a new activity with them that doesn’t involve alcohol. If it helped us deal with social anxiety, begin to practice mindfulness or meditation.
If it’s habitual, create a new habit - pour a glass of kombucha after work, or go straight to a workout class from the office. If it relieved stress? Notice what is coming up for you when you feel stress - do you actually need a break? Or a chat with a friend? Or a nap?If you’re having trouble finding a replacement, seek the help of a trustworthy friend who supports your decision to change, or a medical professional.
5. Positive Reinforcement
Even with all the steps listed above, your commitment may waver. Perhaps you’re attempting a dry month, trying to decrease the number of drinks you have in a night, or interested in quitting altogether. Regardless, there will be times when you question your decision. The best defence is a good offence.
Create consistent positive reinforcement - share your goal with friends and family, consider attending a sober curious event, explore resources such as mindful drinking books and podcasts, build-in a reward for when you achieve your commitment, and whenever possible, ask for help. We are all trying to be better - rather than better, aim for curious.And the rest... will begin to sort itself out.
- Roehrs, T. and Roth, T., (2001) Sleep, sleepiness, and alcohol use. Alcohol research and Health, 25(2), pp.101-109.