What is "low risk" drinking?

If you haven't already, figure out your Drinking Pattern by completing the questionnaire from the National Institute of Alcohol Abuse and Alcoholism's (NIAAA's) website, Rethinking Drinking. Now compare it to the recommended guidelines above.

According to a nationwide study of 43,000 U.S. adults conducted by the National Institutes of Health (Hasin, 2005), only about 2% of people who drink within low-risk drinking limits (both the single-day and weekly limits) have an alcohol use disorder. How does that compare to your own drinking pattern?

Remember, when we are talking about drinks here, we are referring to the Standard Drink, as defined in the earlier article. If you haven’t looked at that yet, you might want to go back there and read it, as an understanding of what makes up one drink will be helpful in your assessment of your own drinking status. 

Please note that “low risk” does not mean “no risk.” Even within these limits, it is possible for people who drink alcohol to have health-related problems. But, given that most people who drink within these limits experience little to no negative impact as a result of drinking, it might be worth paying attention to.  

When is "low risk" drinking still too much? 
There are still some people who really should not drink at all, even in moderate amounts.

•  Children and adolescents. Even moderate consumption provides little, if any, health benefit to children or teens. More importantly, early drinkers are four times more likely to develop alcohol-related problems than those who begin drinking at or after the age of 21 (U.S. Department of Health & Human Services, 2006). 
  
• Pregnant women, or women trying to become pregnant. Major birth defects, including fetal alcohol syndrome, can be caused by heavy drinking by the mother during pregnancy. But, other fetal alcohol effects may occur even if the mother is drinking at “low risk” levels. 
  
• People who plan to drive, or operate heavy machinery.  
  
• People who are taking medications that interact with alcohol. 
  

What about the whole "alcohol helps lower the risk of heart disease" thing?
It is true that many researchers believe that drinking in moderation may lower the risk for coronary heart disease, mainly among men over 45 and women over 55. However, there are many other factors that reduce the risk of heart disease, including maintaining a healthy diet, physical activity, and avoidance of smoking. 

In addition, long term drinking and heavy alcohol consumption has been linked with cardiac dysfunction and heart failure. In fact, cardiac dysfunction associated with chronic and heavy use of alcohol is a specific cardiac disease known as alcoholic cardiomyopathy (ACM) (Guzzo-Merello, Cobo-Marcos, Gallego-Delgado, & Garcia-Pavia, 2014).

ACM is a disease of the left ventricle that develops when the heart becomes enlarged and weakened due to chronic alcohol use. An enlarged and weakened heart is unable to pump blood as fast or as easily. This can cause the heart muscle to thin out (dilated cardiomyopathy), which can lead to damaged internal organs due to lack of blood flow. ACM may even lead to heart failure if left untreated (George & Figueredo, 2011). In 2015 there were more than 27,000 deaths from ACM, which amounts to nearly 8% of all global deaths from cardiomyopathy being caused by alcohol (Rohde & Beck-da-Silva, 2018).

As such, it isn’t all that clear whether the potential cardiac benefit of “moderate drinking” outweighs the health risks associated with possible high-risk drinking. 

^References 

^{George, A. & Figueredo, V. (2011). Alcoholic Cardiomyopathy: A Review. Journal of Cardiac Failure, 17(10), 844-849.}

^{Guzzo-Merello, G., Cobo-Marcos, M., Gallego-Delgado, M., & Garcia-Pavia, P. (2014). Alcoholic Cardiomyopathy. World Journal of Cardiology, 6(8), 771-81.}

^{Hasin DS, Goodwin RD, Stinson FS, et al. (2005). Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch Gen Psychiatry. 62(10), 1097-1106.}

^{Rohde LE, Beck-da-Silva L. (2018). Alcohol and the heart: the good, the bad and the worse in heart failure. Heart 104, 1641-1642.}

^{U.S. Department of Health & Human Services. National Institute of Health. National Institute on Alcohol Abuse and Alcoholism. (2006). Alcohol Alert (67) January 2006. Retrieved from https://pubs.niaaa.nih.gov/publications/AA67/AA67.pdf}