Brain health: How drinking less alcohol can help

  • A new study reports that heavier drinking corresponds with reduced volume in certain regions of the brain.
  • Researchers said that while abstaining from alcohol is healthiest, benefits were also seen in those who curbed their drinking.
  • Increased alcohol consumption is associated with a higher risk of a wide range of adverse medical conditions.

A new study reports that reducing drinking – whether that means abstaining completely or just cutting back – is good for the brain health of people who have alcohol use disorder.

Data published in the journal Alcohol: Clinical and Experimental Research analyzed the brains of 68 adult participants between the ages of 28 and 70, all of whom had been diagnosed with alcohol use disorder.

Researchers found that people with alcohol use disorder had less cortical volume throughout their brains than those who did not have alcohol use disorder. Those who were heavier drinkers saw the most significant reduction in cortical volume.

The sample size for the study was small and composed mostly of veterans from the U.S. Armed Services.

Still, experts say it offers intriguing insights into some of the lesser-known drawbacks of heavy drinking.

Harm reduction and alcohol use disorder

April May, PhD, a postdoctoral scholar at the Sierra Pacific VA Mental Illness Research, Education and Clinical Centers, along with Stanford University in California, was the first author of the study.

She told Medical News Today that researchers expected to see a correlation between alcohol consumption and reduced brain volume, but she added the data still had some surprises.

“What was surprising was how similar individuals who returned to low risk levels of alcohol use after treatment looked to individuals who achieved abstinence in terms of brain volume,” May explained. “Of the 34 brain regions we examined, these groups only differed in two regions. These results really speak to the viability of harm reduction approaches to treatment for alcohol use disorder.”

May added that while the biggest benefits will always be seen in people who abstain from alcohol completely, the results show that cutting back from high-risk to low-risk drinking may have a benefit.

Drinking less has health benefits

May said that any type of relapse is often seen as a “treatment failure,” which contributes to the message that recovery is an all-or-nothing proposition.

“Abstinence is ideal, but some individuals may not be at the place in their life where they can make that change yet,” she said. “These findings suggest this isn’t an all-or-nothing thing and that even making significant reductions in drinking levels can be advantageous and individuals who are finding it difficult to maintain total abstinence shouldn’t just throw in the towel completely.”

Because of the study’s caveats – a small sample size, along with a population of mostly veterans – there’s plenty of opportunity for more research in this area. May said that future studies could look at whether neurobiological traits that existed prior to treatment could be a factor in differing alcohol use patterns.

“If so, these may be clinical markers of who is the most likely to achieve abstinence and who is least likely, so that interventions can be better tailored to each individual to help improve treatment outcomes,” May said. “We’d also really like to explore how these neurobiological differences relate to everyday functioning and quality of life.”

How much is too much alcohol?

Guidelines for alcohol consumption appear to be shifting.

The 2020-2025 Dietary Guidelines for Americans, a collaboration between the United States Department of Health and Human Services and the U.S. Department of Agriculture, recommends that men drink no more than two drinks per day with women advised to limit their consumption to just one daily drink.

On the other hand, Canada recommends two drinks or fewer per week to avoid alcohol-related health problems while the Netherlands advises zero to one drink per day.

Dr. Michael Olla is the medical director at Valley Spring Recovery Center in New Jersey and specializes in psychiatry and addiction treatment.

He told Medical News Today that there are some standard definitions for drinking: light drinking is one to two drinks per day, moderate drinking is two to three per day, heavy drinking is three to five in a day, and abusive drinking is more than five drinks per day.

“Every person is different and an individual may go through different stages before their alcohol consumption becomes problematic,” Olla explained. “The first stage, occasional abuse and binge drinking, usually becomes a problem quickly. It usually starts with occasional consumption – four or more drinks within two hours.”

The second stage is increased drinking, where a person becomes more dependent on alcohol to have fun or combat stress, while the third stage – problem drinking – is when the effects of alcoholism start to manifest.

“The fourth stage is dependence,” said Olla. “This is when an attachment to alcohol is already formed and increased drinking continues because of tolerance. This is also the stage where withdrawals are apparent when the person sobers up. The final stage is addiction, where compulsive behaviors will start, such as physically and psychologically craving for the substance.”

While these definitions seem self-explanatory, there’s a fair amount of nuance – and even people who see themselves as light drinkers should be mindful. Olla said that, depending on the person, drinking could become problematic during the first stage while others might not start to see the drawbacks until stage two or three.

“It all depends on the frequency and amount of the substance,” explained Olla.

The health effects from excessive alcohol

The health drawbacks of heavy alcohol use are well known. Among other things, it can increases the risk of liver damage and other chronic diseases.

The National Institute on Alcohol Abuse and Alcoholism reports that 47% of liver disease deaths in the United States in 2021 involved alcohol, 1 in 3 liver transplants in the United States are caused by alcohol-related liver diseases, and the vast majority of cirrhosis deaths come from alcohol use. Heavy drinking also raises the risk of developing cardiovascular diseases, pancreatitis, gastritis, organ damage, and mental health issues.

“Long-term drinking usually results in strained relationships, such as severed friendships and broken families. It can also lead to job loss and financial difficulties,” said Olla. “In worse cases, long-term alcohol consumption can turn your life upside-down, especially when you start facing drinking-related legal issues.”

However, it is possible to stop or reduce alcohol consumption. As noted by the authors of the study, it isn’t necessary to abstain completely in order to see positive results.

A good place to start, says Olla, is by talking with your doctor about your history and struggles with alcohol.

“This will help the doctor understand and know if there are any underlying issues that led to this point,” he said. “Aside from specific alcohol consumption info, you also need to discuss your goals and motivations with your doctor. Doing so can help them determine strategies on how you can achieve these goals and identify the appropriate treatment option for you. It can also help them understand how you want them to work with you.”

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