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What You Don't Know Can Harm You

Perspective of someone driving a car People in the library
Doctors at work Pills falling out of a bottle

If you are like many Americans, you may drink alcohol occasionally. Or, like others, you may drink moderate amounts of alcohol on a more regular basis. If you are a woman or someone over the age of 65, this means that you have no more than one drink per day; if you are a man, this means that you have no more than two drinks per day. Drinking at these levels usually is not associated with health risks and can help to prevent certain forms of heart disease.

But did you know that even moderate drinking, under certain circumstances, is not risk free? And that if you drink at more than moderate levels, you may be putting yourself at risk for serious problems with your health and problems with family, friends, and coworkers? This booklet explains some of the consequences of drinking that you may not have considered.

What Is a Drink?

A standard drink is:

  • One 12-ounce bottle of beer*
    or wine cooler
  • One 5-ounce glass of wine
  • 1.5 ounces of 80-proof
    distilled spirits.
*Beer ranges considerably in its alcohol content, with malt liquor being higher in its alcohol content than most other brewed beverages.

Drinking and Driving

It may surprise you to learn that you don't need to drink much alcohol before your ability to drive becomes impaired. For example, certain driving skills--such as steering a car while, at the same time, responding to changes in traffic--can be impaired by blood alcohol concentrations (BACs) as low as 0.02 percent. (The BAC refers to the amount of alcohol in the blood.) A 160-pound man will have a BAC of about 0.04 percent 1 hour after consuming two 12-ounce beers or two other standard drinks on an empty stomach (see the box, "What Is a Drink?"). And the more alcohol you consume, the more impaired your driving skills will be. Although most States set the BAC limit for adults who drive after drinking at 0.08 to 0.10 percent, impairment of driving skills begins at much lower levels.

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Interactions With Medications

Alcohol interacts negatively with more than 150 medications. For example, if you are taking antihistamines for a cold or allergy and drink alcohol, the alcohol will increase the drowsiness that the medication alone can cause, making driving or operating machinery even more hazardous. And if you are taking large doses of the painkiller acetaminophen and drinking alcohol, you are risking serious liver damage. Check with your doctor or pharmacist before drinking any amount of alcohol if you are taking any over-the-counter or prescription medications.

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Interpersonal Problems

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The more heavily you drink, the greater the potential for problems at home, at work, with friends, and even with strangers. These problems may include:

  • Arguments with or estrangement from your spouse and other family members;
  • Strained relationships with coworkers;
  • Absence from or lateness to work with increasing frequency;
  • Loss of employment due to decreased productivity; and
  • Committing or being the victim of violence.

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Alcohol-Related Birth Defects

If you are a pregnant woman or one who is trying to conceive, you can prevent alcohol-related birth defects by not drinking alcohol during your pregnancy. Alcohol can cause a range of birth defects, the most serious being fetal alcohol syndrome (FAS). Children born with alcohol-related birth defects can have lifelong learning and behavior problems. Those born with FAS have physical abnormalities, mental impairment, and behavior problems. Because scientists do not know exactly how much alcohol it takes to cause alcohol-related birth defects, it is best not to drink any alcohol during this time.

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Long-Term Health Problems

Some problems, like those mentioned above, can occur after drinking over a relatively short period of time. But other problems--such as liver disease, heart disease, certain forms of cancer, and pancreatitis--often develop more gradually and may become evident only after long-term heavy drinking. Women may develop alcohol-related health problems after consuming less alcohol than men do over a shorter period of time. Because alcohol affects many organs in the body, long-term heavy drinking puts you at risk for developing serious health problems, some of which are described below.

Alcohol-related liver disease. More than 2 million Americans suffer from alcohol-related liver disease. Some drinkers develop alcoholic Doctors at work hepatitis, or inflammation of the liver, as a result of long-term heavy drinking. Its symptoms include fever, jaundice (abnormal yellowing of the skin, eyeballs, and urine), and abdominal pain. Alcoholic hepatitis can cause death if drinking continues. If drinking stops, this condition often is reversible. About 10 to 20 percent of heavy drinkers develop alcoholic cirrhosis, or scarring of the liver. Alcoholic cirrhosis can cause death if drinking continues. Although cirrhosis is not reversible, if drinking stops, one's chances of survival improve considerably. Those with cirrhosis often feel better, and the functioning of their liver may improve, if they stop drinking. Although liver transplantation may be needed as a last resort, many people with cirrhosis who abstain from alcohol may never need liver transplantation. In addition, treatment for the complications of cirrhosis is available.

Heart disease. Moderate drinking can have beneficial effects on the heart, especially among those at greatest risk for heart attacks, such as men over the age of 45 and women after menopause. But long-term heavy drinking increases the risk for high blood pressure, heart disease, and some kinds of stroke.

Cancer. Long-term heavy drinking increases the risk of developing certain forms of cancer, especially cancer of the esophagus, mouth, throat, and voice box. Women are at slightly increased risk of developing breast cancer if they drink two or more drinks per day. Drinking may also increase the risk for developing cancer of the colon and rectum.

Pancreatitis. The pancreas helps to regulate the body's blood sugar levels by producing insulin. The pancreas also has a role in digesting the food we eat. Long-term heavy drinking can lead to pancreatitis, or inflammation of the pancreas. This condition is associated with severe abdominal pain and weight loss and can be fatal.


If you or someone you know has been drinking heavily, there is a risk of developing serious health problems. Because some of these health problems are both reversible and treatable, it is important to see your doctor for help. Your doctor will be able to advise you about both your health and your drinking.

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Research Directions

The National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health, supports about 90 percent of the Nation's research on alcohol use and related consequences. Through this research, NIAAA and the researchers it supports make an implicit promise--that alcohol research will yield practical applications that will help those who suffer as a result of alcohol abuse and alcoholism. Today, alcohol researchers are working on the cutting edge of medical science to answer questions such as:

  • Who is at risk for alcohol-related problems?
  • How does alcohol affect the body, including the brain?
  • How is the risk for alcoholism inherited?
  • What are the health benefits and risks of moderate drinking?
  • What therapies, including medications, show promise for treating alcohol dependence more effectively?

Each new discovery made by alcohol researchers provides a piece of the answer to the ages old question of how to prevent and treat the alcohol-related troubles that plague individuals, families, and society. We see the future of alcohol research both as a challenge and as a reward: A challenge, because with more answers come more questions, and we still have far to go. A reward, because the answers we find ultimately will help diminish a public health threat that has existed for far too long.

If you or someone you know needs help or more information, contact:

  • Al-Anon Family Group Headquarters
    1600 Corporate Landing Parkway
    Virginia Beach, VA 23454-5617
    Internet address:
    Makes referrals to local Al-Anon groups, which are support groups for spouses and other significant adults in an alcoholic person's life. Also makes referrals to Alateen groups, which offer support to children of alcoholics.
    • Locations of Al-Anon or Alateen meetings worldwide can be obtained by calling 1-888-4AL-ANON Monday through Friday, 8 a.m.-6 p.m. (e.s.t.).
    • Free informational materials can be obtained by calling the toll-free numbers (operating 7 days per week, 24 hours per day):
    • U.S.: (800) 356-9996
    • Canada: (800) 714-7498

  • Alcoholics Anonymous (AA) World Services
    475 Riverside Drive, 11th Floor
    New York, NY 10115
    (212) 870-3400
    Internet address:
    Makes referrals to local AA groups and provides informational materials on the AA program. Many cities and towns also have a local AA office listed in the telephone book.
  • National Council on Alcoholism and Drug Dependence (NCADD)
    12 West 21st Street
    New York, NY 10010
    (800) NCA-CALL
    Internet address:
    Provides telephone numbers of local NCADD affiliates (who can provide information on local treatment resources) and educational materials on alcoholism via the above toll-free number.
  • National Institute on Alcohol Abuse and Alcoholism
    Scientific Communications Branch
    6000 Executive Boulevard, Suite 409
    Bethesda, MD 20892-7003
    (301) 443-3860
    Internet address:
    Makes available free publications on all aspects of alcohol abuse and alcoholism. Many are available in Spanish.  Call, write, or search the World Wide Web site for a list of publications and ordering information.

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National Institute on Alcohol Abuse and Alcoholism
National Institutes of HealthNIH Publication No. 99-4323
Printed 1999


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