Alcohol is a Group-1 carcinogen—but one that happens to be woven into our daily lives @PsychToday

Square profile picture

Psychology Today

@PsychToday

·

Alcohol is a Group-1 carcinogen—but one that happens to be woven into our daily lives and often viewed as a go-to way to cope with stress or disappointment. Here are 5 ways to change that mindset, writes

@shailiJainMd

The Hidden Cost of an Evening Glass of Wine

Key points

  • Alcohol is a Group 1 carcinogen—putting it in the same category as asbestos, radiation, and tobacco.
  • Alcohol is woven into our daily lives and often viewed as a go-to way to cope with stress and disappointment.
  • Less than half of Americans are aware that drinking alcohol increases their risk of cancer.
  • There are healthier, more sustainable ways to manage stress.

“I need a stiff drink!” “Let’s drown our sorrows.” “I just need to unwind with a glass of wine.”

Phrases like these are so common, we barely think twice about them. Alcohol has become deeply woven into our daily lives and culture. It’s often seen as a go-to way to cope with stress, disappointment, or just the pressures of everyday life. Got bad news? Feeling overwhelmed? Need to relax? Society has taught us that it’s totally normal—even expected—to pour a big glass of wine, toss back a couple of tequila shots, or order a double whiskey.

In fact, using alcohol to handle stress is often not only accepted but actively encouraged by friends, coworkers, and the media. Movies and TV shows constantly show characters doing the same, reinforcing the idea that this is just how we deal with life.

But here’s the truth: alcohol is the one of the most widely used drugs in the world. And the way we’ve normalized it’s use as a coping mechanism deserves a closer look.

The Hidden Cost of Your Evening Glass of Wine

Alcohol is a toxic, psychoactive substance that can lead to dependence. It’s also been officially classified as a Group 1 carcinogen by the International Agency for Research on Cancer—putting it in the same category as asbestos, radiation, and tobacco. Research shows that alcohol contributes to at least seven different types of cancer, including some of the most common, like colon cancer and breast cancer. In fact, earlier this year, former U.S. Surgeon General Vivek H. Murthy issued a public health advisory warning about the clear link between alcohol use and cancer risk.

What’s concerning is that less than half of Americans are aware that drinking alcohol increases their risk of cancer. As a psychiatrist who often discusses alcohol use with patients, this lines up with what I see in practice. Many people simply don’t know that alcohol is a carcinogen. Even more common is the belief that low levels of alcohol—like a glass of wine a day—are actually good for your health, especially for the heart and brain. But that idea is being seriously questioned. In January 2023, the World Health Organization published a statement in The Lancet Public Health making it clear: When it comes to alcohol, there is no safe amount that doesn’t affect your health.

5 Things to Think About Before Reaching for a Drink to Cope With Stress

  1. Alcohol is a known carcinogen—and a cancer diagnosis can deeply affect your mental health. Depression and anxiety are incredibly common among people with cancer. Research shows that up to 1 in 5 cancer patients experience depression, and 1 in 10 struggle with anxiety—regardless of where they are in their treatment or disease process. In fact, according to international diagnostic guidelines, about 35–40% of cancer patients meet the criteria for a psychiatric disorder. These mental health challenges don’t just impact emotional well-being—they can significantly reduce the overall quality of life for persons living with cancer. The global rate of depression among cancer patients is currently estimated at 27%. This is a noticeable increase compared to earlier data, and this trend appears to be on the rise.
  2. That “relaxing” drink may be increasing your anxiety. While alcohol can feel calming in the moment, it’s a short-lived effect. Once the pleasurable effects of alcohol wear off, anxiety can rebound—often worse than before. Over time, this can make stress and mood disorders more difficult to manage.
  3. Regular drinking can sneak up on you—building tolerance, dependence, and emotional numbness. What starts as the occasional glass of wine to unwind can quickly become a nightly ritual. Your body builds tolerance, meaning you need more to feel the same effects. Emotionally, alcohol can dull not just stress but joy, connection, and motivation—leaving you feeling more flat than relaxed.
  4. Alcohol disrupts sleep, even if it helps you fall asleep. Many people use alcohol to wind down at night, but it actually interferes with sleep architecture. It may help you fall asleep faster, but it reduces the quality of your rest—leading to more fatigue, irritability, and difficulty coping with stress the next day.
  5. There are healthier, more sustainable ways to manage stress. Whether it’s exercise, deep breathing, journaling, therapy, or connecting with others, there are countless tools for managing stress that don’t carry the risks alcohol does. Exploring these options might not provide the instant hit that a drink does—but they build resilience, not reliance.

Facebook image: Just Life/Shutterstock

5 Things Drinking Too Much Alcohol May Be Doing to Your Body

alcohol after 40

When you wake up with a hangover, it’s a no-brainer that last night’s drinks didn’t do you much good. But research shows that the effects of heavy alcohol consumption may be doing much more to your body than just leaving you with one day of misery. Over time, as the drinks add up, alcohol can affect your biology, changing it in detrimental ways.

Excess alcohol consumption can:

1. Change Your DNA — and Make You Crave More Alcohol

Binge drinking, which the National Institute on Alcohol Abuse and Alcoholism (NIAAA) characterizes as more than four or five drinks in a two-hour sitting, and heavy drinking, defined as binge drinking on five or more days a month, can actually change your genetic makeup. A recent study, published in December 2018 in the journal Alcoholism: Clinical & Experimental Research, identified two genes that are subject to change — one affecting the body’s biological clock and one regulating the stress response system. The study’s authors, from Rutgers University, also found that the genetic changes in binge and heavy drinkers were associated with a higher desire for alcohol.

2. Increase the Risk of Cancer — Especially of the Head, Neck, Liver, and Breast

The National Cancer Institute (NCI) cites several studies, such as one published in August 2012 in the journal Annals of Oncology, that have shown consuming alcohol ups the risk of an array of cancers. In 2012, over 5 percent of all new cancer occurrences and nearly 6 percent of all cancer deaths worldwide were estimated to be attributed to alcohol, according to a study published in October 2015 in the International Journal of Cancer. In heavy drinkers, the risk skyrockets. For example, heavy drinkers are 5 times more likely than nondrinkers to contract esophageal cancer, according to the NCI. But even moderate drinking increases the odds of getting cancer of the mouth, throat, and breast. Kathy Jung, PhD, director of the NIAAA’s division of metabolism and health effects, cautions about breast cancer specifically, saying as little as one drink a day can increase risk.

3. Change the Composition of Organisms in the Gut

There are tens of trillions of microorganisms — mostly “good” bacteria — in the digestive tract that help the body do things like digest food and produce vitamins. But alcohol interferes with their composition and function, according to a study published in 2015 in the journal Alcohol Research: Current Reviews, which found that chronic alcohol consumption can cause bacterial overgrowth and imbalances in the intestine. This can result in a slew of digestive issues, including stomach pain, bloating, constipation, diarrhea, and rosacea.

4. Affect Long-Term Memory and Brain Structure

One night of binge or heavy drinking can lead to blackouts, spans of time from which the intoxicated person can’t remember key events and details — if they can remember anything at all. But alcohol consumption can also cause long-term problems with brain function. People who drink heavily, over a long period of time, are at risk of changing the brain’s “hard wiring,” which can lead to cognitive problems even after sobriety is attained, reports American Addiction Centers. Heavy alcohol consumption can also erode brain tissue and raise the risk of stroke, according to previous research.

5. Cause Hormonal Disturbances

Chronic heavy drinking can also wreak havoc on the body’s endocrine system. The hormone producing glands tap into several important functions of the body, including growth and development, metabolism, and mood. Research published in September 2013 in the journal Endocrine and Metabolism Clinics of North America found that drinking heavily, and often, can disrupt communication between the nervous, endocrine, and immune systems. The consequences can be serious and wide ranging. Stress abnormalities, reproductive deficits, body growth defects, and immune dysfunction are just a few of the possible outcomes topping the list.

How Much Alcohol Is Too Much?

Medical professionals advise moderation when it comes to alcohol consumption. More than one drink a day for women and two for men gets into heavy and binge drinking territory, according to dietary guidelines published by the federal government’s Office of Disease Prevention and Health Promotion.

“Having one drink every day of the week is not the same as having seven drinks on a Saturday,” Dr. Jung says. “Binge drinking is never safe.”

 

Everyday Health
@EverydayHealth

This is what drinking too much does to your body.

Alcohol has risks. We must all aim to minimise those risks. @DrPaddy_Barrett preventative cardiologist @HealthBlackrock

Let’s start with some simple facts.
Alcohol is a toxin.
Alcohol is a factor in1:
30% of suicides
40% of fatal burn injuries
50% of fatal drownings
50% of homicides
65% of fatal falls
29% of fatal road traffic accidents
Globally, alcohol is responsible for 3 million deaths per year; in the United States, it is the third leading cause of preventable death2 3.
It is hard to see the upside when you see these figures.
So let’s go a little deeper.
First off, I drink alcohol. Not a lot. But I do drink.
So any comments made here are not some puritanical position on alcohol but reflections on the data that exist in the literature.
Multiple studies have demonstrated that excess alcohol consumption, usually defined as consuming greater than 2 to 4 drinks per day, is associated with worse outcomes and a greater likelihood of dying when compared to someone who drinks less than 2 to 4 drinks per day4.

Alcohol Dosing and Total Mortality in Men and Women: An Updated Meta-analysis of 34 Prospective Studies. Arch Intern Med.2006

In the study shown above, females start to accrue an increased risk at greater than two drinks per day on average and males at greater than four drinks per day.

These findings shouldn’t come as a surprise to anyone.

Surprisingly, on average, individuals who consume less than two drinks per day appear to have better outcomes than those who do not drink at all. This is where things start to get a little counterintuitive, and the story of alcohol being beneficial for you starts to appear.

This relationship is known as a ‘U’ shaped curve where those in the middle have the best outcomes, and those on the edges have worse outcomes. A kind of ‘Goldilocks’ relationship; “Not too hot. Not too cold. Just right.”

How might we explain this?

Enter the darling of the 1990s, Resveratrol. This compound in red wine spawned the mantra that red wine was ‘good for your heart’. This was based on research that suggested that it might reduce cholesterol levels, among other things.

But to consume the levels of Resveratrol tested in some of the animal studies that demonstrated benefit, you would have to drink 40 litres of wine…… Per day.

Not exactly a feasible strategy. Even with the best will in the world.

Let’s look at a more plausible explanation.

Data on alcohol consumption and outcomes are almost always based on observational data, not randomised controlled trials. This means that other factors or ‘confounders’ may explain the difference between the groups, not the alcohol consumption alone.

When you look at the trials that suggest a benefit of modest alcohol consumption, you will often find that this group tend to exercise more, smoke less, be in a higher socioeconomic bracket etc. This is referred to as a ‘healthy user bias’ and is likely to explain the difference between the groups.

Most trials try to correct or adjust for these confounders, but in truth, it is very hard to do. A recent publication looked at this problem and attempted to (as much as possible) correct for these ‘healthy user’ bias factors and then compare outcomes between alcohol consumption groups. The results were a little more in line with what we might expect.

Those in the lowest alcohol consumption category had the best lifestyle factors overall. When these healthy factors were corrected for, any benefit seen with modest alcohol consumption disappeared. What remained was a linear relationship between alcohol consumption and coronary artery disease5. Much more what you might expect.

Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease. JAMA Netw Open. 2022

Research like this and other studies is where the more recent media reports of ‘any’ alcohol being bad for you have come.

So, alcohol is a toxin. But, as Paracelsus notes:

“The dose makes the poison.”

Even water consumed to excess can be lethal.

We know that excess alcohol consumption is harmful. But I don’t think there was any great uncertainty around that point.

The key takeaway is that modest alcohol consumption is unlikely to be ‘beneficial’ to you. As much as you loved the idea that red wine was good for your heart, we can say with reasonable confidence that this is not the case.

The real question we need to answer is whether consuming modest amounts of alcohol is considerably worse for you when it comes to heart disease and death from any cause.

Based on the literature to date, it seems that the incremental risk for modest amounts of weekly alcohol consumption is likely to be small. But that doesn’t mean there are no downsides.

Sleep

One of the main reasons I significantly reduced my alcohol consumption was its effect on my sleep. If I drink more than one drink, I find that the quality of my sleep gets worse. I am much more likely to wake in the middle of the night and feel the effects the following day. But that’s just my personal experience.

Although alcohol is likely to make you fall asleep faster, it impacts your sleep quality6. Additionally, alcohol also reduces the percentage of REM sleep a person gets overnight7.

A workaround for me is to consume any alcohol during the daytime, so my sleep is unlikely to be affected, and if I am going to have a drink, I make sure it is worthwhile. I.e. I am with friends, or it is a high-quality drink. No more drinks on airplanes for me. Mainly because you lose about 30% of your sense of smell and taste in a pressurised cabin and therefore you are less likely to enjoy your drink8. Why do you think they serve you tomato juice and the fact that you think it’s tolerable?!

Humans have been consuming alcohol as far back as the ancient Egyptians, and some evidence suggests the Chinese were consuming alcohol as far back as 7000 B.C. So I don’t see alcohol disappearing any time soon.

The question we all need to ask is:

How much are we realistically drinking on a daily or weekly basis &

Is it likely to be doing us harm?

Only you can answer that question.

The only way to be certain you are doing no harm is to eliminate alcohol entirely. But life is full of risks, some of which we can control, some we cannot.

And some risks are worth taking.

Want to eliminate all road traffic accidents worldwide?

Simple.

Ban cars.

But at what cost?

The risks of driving are a risk most of us are willing to take.

Alcohol has risks.

We must all aim to minimise those risks.

Whatever that means for you, only you can decide.

1

https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Whats-the-harm/What-Are-The-Consequences.aspx

2

Mokdad, A.H.; Marks, J.S.; Stroup, D.F.; and Gerberding, J.L. Actual causes of death in the United States, 2000. JAMA 291(10):1238–1245, 2004. Erratum in JAMA 293(3):298, 2005.

3

Centers for Disease Control and Prevention (CDC). Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI). Annual Average for United States 2011–2015 Alcohol-Attributable Deaths Due to Excessive Alcohol Use, All Ages.

4

Alcohol Dosing and Total Mortality in Men and Women: An Updated Meta-analysis of 34 Prospective Studies. Arch Intern Med.2006;166(22):2437–2445. doi:10.1001/archinte.166.22.2437

5

Biddinger KJ, Emdin CA, Haas ME, et al. Association of Habitual Alcohol Intake With Risk of Cardiovascular Disease. JAMA Netw Open. 2022;5(3):e223849. doi:10.1001/jamanetworkopen.2022.3849

6

Britton, A., Fat, L.N. & Neligan, A. The association between alcohol consumption and sleep disorders among older people in the general population. Sci Rep 10, 5275 (2020). https://doi.org/10.1038/s41598-020-62227-0

7

Ebrahim IO, Shapiro CM, Williams AJ, Fenwick PB. Alcohol and sleep I: effects on normal sleep. Alcohol Clin Exp Res. 2013 Apr;37(4):539-49. doi: 10.1111/acer.12006.

8

Burdack-Freitag, Andrea & Bullinger, Dino & Mayer, Florian & Breuer, Klaus. (2010). Odor and taste perception at normal and low atmospheric pressure in a simulated aircraft cabin. Journal für Verbraucherschutz und Lebensmittelsicherheit. 6. 95-109. 10.1007/s00003-010-0630-y.