Alcohol: Slippery Slope

I am in New Orleans presenting at the Nurse Practitioner Associates of Continuing Education (NPACE) seminar. This morning at 0830, I walked down the stairs from my hotel room to the front lobby...looking for some oatmeal, nuts and fruit.  When I got to the lobby, there was a man sitting on the sofa drinking from an oversized bottle of Blue Moon and his buddy, holding a big jug of whiskey and taking sips. Both participating in a conversation that made no sense to the sober passerby and both leaning on their free hand to keep their heads propped up for the conversation.  The front desk employee saw me take a triple look smiled and said, "Welcome to New Orleans - what can I do for you?"  

So, as I sat down to eat my healthy breakfast I couldn't help but think about those 2 guys in the lobby.  Obviously, this isn't the time or place to inform them of the effects of alcohol; but, alcohol is the source of much individual and societal suffering and morbidity.  In fact, alcohol abuse is the 3rd largest preventable cause of Death.  There are health benefits to alcohol as well.  In fact, light to moderate drinking is associated with cardioprotective benefits.  This constitutes 1 drink daily for women and 1-2 drinks daily for men.   (For further clarification:  1 drink is equivalent to 12 ounces of beer or 5 ounces of wine or 1.5 ounces 80 proof spirits, or 1 ounce 100 proof spirits.  All of these contain 13 g- 15 g of ethanol.) 

Many people who are light drinkers believe that occasional "binge drinking" won't hurt their health.  But binge drinking even in light drinkers increases cardiovascular events and mortality(death).  Alcohol is a double edge sword and if you misuse it ... it can lead to much suffering (physical suffering too- heart disease, stroke, hypertension, liver disease, etc).  Because of that, the AHA guidelines caution people not to start drinking if you do not already drink alcohol; because it is not possible to predict who will develop alcohol abuse tendencies.  If you do drink without addiction tendencies 1 drink for ladies and 1-2 drinks daily for men will add some cardioprotection. 

After I finished my breakfast and headed back through the lobby to my room the employee said,  "Be glad you weren't here for Mardi Gras".

J Am Coll Cardiol. 2007 Sep 11;50(11):1009-14. Alcohol and cardiovascular health: the razor-sharp double-edged sword.  O'Keefe JH, Bybee KA, Lavie CJ.