• A new analysis challenges the idea that low drinking levels may be better for your health than not drinking at all
  • The research has experts thinking through the lens of harm reduction
  • Women who drank even relatively moderate amounts were also at increased risk for dying prematurely.

A new analysis, published by the Journal of the American Medical Association (JAMA), has found that drinking low amounts of alcohol does not have health benefits. Their work, which included data from 107 studies and over 4.8 million participants, looked at all-cause mortality, a general metric, rather than deaths caused by a particular type of condition.

Dr. Paul Linde (MD), Medical Director of Psychiatry and Collaborative Care of RIA Health says that research like this helps those working in the field of addictions to have valuable conversations about alcohol consumption and to dispel the idea that low-level drinking is better than not drinking at all.

Linde was not part of the study.

“I feel like this kind of research does put a clinician into an ideal position to advise patients about their drinking,” Linde said. “Then maybe, perhaps, have a conversation about what are ways to reduce drinking, iff that is something that a patient is interested in.”

In the past, many studies have made headlines after they found people who drank a moderate amount of alcohol often had healthier outcomes than people who completely abstained from alcohol.

Moderate drinking is often defined as up to one drink a day for women or two or fewer drinks for a man.

These past research includes a study that found people who were moderate drinkers had slower cognitive decline. Another study found that moderate drinkers had lower risk of cardiac events such as a heart attack or stroke compared to people who never drank or drank heavily.

As a result of this research, occasional alcohol consumption was often considered to be compatible with a healthy lifestyle.

Now this new meta-analysis has now challenged the public’s perception of low alcohol consumption as being a healthy choice.

The study found that drinking relatively small amounts did not equate to a lower mortality risk than people who abstained from alcohol.

Dr. Eric Collins (MD), chief medical officer at the substance abuse-focused Recovery Education, said earlier research on drinking that found it might have general health benefits came from a flawed data analysis.

In his view, the idea of alcohol as being a healthy choice came about because in previous studies the definition of total abstainers used in studies likely included people who had already felt the effects of high alcohol consumption.

“The biggest question was whether the so-called lifetime abstainers were actually people who were prior drinkers, and, perhaps prior heavy drinkers, who had already incurred significant health risks as a result of their prior drinking.”

The research team pointed out that future studies should look at how much alcohol people have consumed over their lifetime to get a better sense of the risks and benefits.

This article was an update to two previous versions of this style of analysis produced by the same Canadian research team

The researchers also confirmed that women are at a higher risk of mortality related to alcohol consumption than men

One of the limitations of the analysis, according to its authors, is that self-reported data—where a participant self-declares the amount of alcohol they’ve consumed at any given time—tends to be lower than the reality and that most studies only capture that data at limited intervals. Linde says that’s something he often sees in his practice.

Among clinicians for decades, there’s [been] sort of a truism that whenever a patient reports the number of drinks that they have per day or per week to you, just go ahead internally and multiplied by two.”

Linde says that giving those in recovery tools to accurately share their data is a way to improve the baseline assumptions we make and the treatments we provide. He’s also hopeful that studies like this can help from a harm reduction perspective, giving him what he calls “ammunition” to give his clients a fuller perspective on the possible impacts alcohol consumption can have on their health, whether they want to stop completely or reduce their intake.

“Obviously, we really want to meet people where they’re at. We don’t want to be draconian. We want the clinical partnership to be collaborative with shared decision making,” said Linde.

For Collins, the main value of the study is that it helps with their own accountability.

“ I think societally it helps by not allowing people to fool themselves [into thinking] that they’re doing a good thing for their health [by drinking].”

The study researchers hope their work is a jumping off point for future projects to look into groups of people who may have elevated risk—they suggest those with HIV—alongside the data they’ve decoded that shows age and sex are two risk factors when looking at all-cause mortality and alcohol consumption.

Collins, whose work revolves around youth, hopes that this study can help build toward future research into risk factors in younger populations.

“I would love to see this kind of data look at mortality risk in people ages 12 to 25, specifically, because it’s there and I think it could be illuminating for parents, as they think about, what are the risks for their children?”

Meanwhile, Linde would like to see researchers dive further into specific mortality risks as they relate to alcohol, especially for those who already consuming more than is recommended by organizations like the National Institute on Alcohol Abuse and Alcoholism

“I would love to have studies that gave us a finer sampling to really elucidate, for cancer for example, how does your cancer risk change? Does your cancer risk change from six drinks a day to two drinks a day?”