The long-term health impacts of alcohol

Alcohol continues to be one of the leading risk factors for poor health globally.¹

In Australia, alcohol is the sixth-highest risk factor contributing to the burden of disease. In 2017, there were 1,366 deaths that were directly attributed to alcohol consumption.^{2, 3}

While the short-term harms of alcohol – such as road accidents, injuries, violence and alcohol poisoning – are well understood, some people may be unaware of the serious long-term impacts that alcohol consumption can have on health.

Consuming alcohol can increase health risks

There are many things that can influence a person’s risk of certain health conditions, for example genetics, lifestyle and socio-economic status.

Long-term alcohol consumption also increases the risk of many health conditions.

Alcohol can increase the risk of cancer

• Alcohol is a Group 1 carcinogen (known to cause cancer in humans), with low levels of drinking (one standard drink per day) and higher levels (up to five standard drinks per day) both being associated with an increased risk.⁴
• In Australia, it is estimated that 3,208 cancer diagnoses in 2010 were linked to alcohol consumption.⁵
• For women, moderate alcohol consumption (1 to 2 drinks daily) has been linked to an approximate 30-50% increased risk in breast cancer.⁶
• For men, it has been estimated that low volume drinkers have an increased risk of between 8-23% for developing prostate cancer.⁷

Alcohol can increase the risk of heart disease

• A 2010 study estimated that people who regularly have episodes of heavy drinking have a 45% increased risk factor of developing ischemic (coronary) heart disease.⁸
• For those who already consume more than 36g (3.6 standard drinks) of alcohol per day, each additional daily drink results in a 10% excess risk of atrial fibrillation (irregular heartbeat).⁹

Alcohol can increase the risk of stroke

• Evidence has shown that drinking more than two drinks per day is associated with an increased risk of ischemic stroke.4
• Drinking more than four drinks per day is associated with an increased risk of haemorrhagic stroke4 (when a blood vessel in the brain leaks or ruptures).

Alcohol can increase the risk of osteoporosis

• Individuals that consume 1 to 2 standard drinks daily have a 1.34 times higher risk of developing osteoporosis (weak and brittle bones) compared to non-drinkers.¹⁰

Chronic health conditions caused by alcohol

Certain health conditions can be caused directly by alcohol consumption, and long-term exposure to frequent alcohol use increases their likelihood.⁴

Alcohol significantly affects the liver

• In 2015 in Australia, alcohol contributed to 28% of the burden of disease due to chronic liver disease.³
• Most individuals consuming more than 40g of alcohol (4 standard drinks) per day develop alcoholic fatty liver, with some individuals going on to develop more advanced liver diseases including alcoholic steatohepatitis (inflammation/swelling) and cirrhosis (permanent scarring).¹¹
• Liver cirrhosis occurs in 10-15% of people who experience a dependence on alcohol.¹²

Alcohol can cause pancreatitis

• Studies from the USA have noted alcohol causes nearly 50% of all cases of chronic pancreatitis.¹³
• In Australia in 2011, alcohol contributed to 10% of all pancreatitis cases.¹⁴
• Drinking more than 40g of alcohol per day (4 standard drinks), significantly increases the risk of pancreatitis.¹⁵

Alcohol can cause gastrointestinal diseases

• In 2015 in Australia, alcohol contributed to 10.5% of gastrointestinal diseases.¹⁶

Alcohol can impact muscle function

• Alcoholic myopathy (muscle weakness) occurs in 40-60% of people who experience a long-term dependence on alcohol.¹²
• Chronic alcohol-related myopathy is 10 times more common than the most common inherited myopathy.¹²

Dispelling myths

It has been reported that lower levels of alcohol consumption can provide some protection against heart disease and type 2 diabetes, but there is significant uncertainty about the evidence that supports this ‘protective effect’, with many considering it to be ‘shaky at best’.^{17, 18}

The studies that supported this protective claim compared moderate drinkers to non-drinkers and found that the moderate drinkers had better health outcomes.

A 2016 study re-analysed this research and found that:

• The abstainer group often included people whose underlying poor health had resulted in them having to give up alcohol all together – meaning moderate drinkers were being compared to people who had pre-existing health issues.
• Of the 87 studies analysed, 74 were found to be based on a flawed study design and the remaining 13 also found that alcohol had no health benefits.¹⁸

Further analysis of research on the protective effects of alcohol has found that:

• Studies often ignore the irrefutable evidence of low-level alcohol consumption being a proven carcinogen.⁴
• A lot of the evidence was based on self-reporting of alcohol consumption, and this can often be inaccurate.⁴
• The benefits in general were overestimated.⁴
• A lot of the research was funded by the alcohol industry, which raised the question of suspected bias towards results that showed positive outcomes.^19-21

To reduce the risk and prevalence of chronic diseases relating to alcohol use, public health messaging should provide a clear risk vs benefit analysis for consumers, allowing people to make informed choices.

Lower-risk alcohol consumption can reduce health risks

The current NHMRC guidelines state that no amount of alcohol consumption is safe, and if you do decide to drink, each individual should drink no more than 10 standard drinks per week and no more than 4 standard drinks on any one day to reduce the risks to your health.⁴

This is not to say that drinking alcohol will necessarily result in the development of a serious health condition, but it does increase your risk. The more alcohol you consume, the higher the risk.

Individuals with underlying health conditions, or who have a family history of illness, should be particularly cautious.

More information on the relationship between alcohol consumption and chronic health conditions can be found in the NHMRC draft guidelines, located here.