When "Everything in Moderation" Doesn't Apply to Alcohol

You've probably heard the saying "everything in moderation," but this advice doesn't always hold true when it comes to alcohol. For some health conditions and lifestyles, even moderate drinking might be too much. We're not just talking about avoiding excess—sometimes the healthiest choice is to avoid alcohol completely. It's about making informed decisions, understanding alcohol's effects, and becoming your own best health advocate.

How Alcohol Affects Your Body

Alcohol enters your bloodstream and travels throughout your body. That warm, fuzzy feeling of intoxication occurs when alcohol reaches your brain and triggers the release of feel-good chemicals. The lack of coordination and slower reaction times happen because alcohol slows down your central nervous system.

Since blood circulates everywhere, alcohol's effects are systemic—impacting your entire body. When one system is compromised, others often suffer too. So what happens when you add alcohol to the mix?

Physical Health Considerations

Alcohol affects every aspect of your physical health. Even in small amounts, it can damage your stomach, kidneys, bones, teeth, gut, liver, skin, and more. When it comes to prioritizing health, there's no truly "safe" amount of alcohol.

While some people choose to include alcohol in their lives while drinking responsibly, certain health conditions make alcohol particularly dangerous. Let's examine some common conditions where alcohol should be avoided.

Liver Conditions

Your liver processes alcohol, typically handling about one drink per hour. However, this capacity decreases if liver function is compromised. Alcohol not only causes liver damage but also worsens existing conditions like hepatitis, cirrhosis, and liver cancer. If you have liver failure, you should avoid alcohol entirely.

When you drink with a liver condition, your liver can't properly filter alcohol from your blood. This causes alcohol to remain in your system longer, increasing damage to your organs.

Heart Conditions

Alcohol puts stress on your heart. For those with existing heart conditions, alcohol creates additional problems:

• Hypertension: Alcohol raises blood pressure, which is particularly dangerous if you have high blood pressure or are at risk for clotting
• Arrhythmias: Alcohol increases heart rate and can trigger or worsen conditions like atrial fibrillation (AFib)—in fact, alcohol is the most commonly reported trigger of AFib episodes
• Cardiomyopathy: The added stress from alcohol can worsen cardiomyopathy or accelerate its progression to heart failure

Diabetes

When you drink alcohol, your liver shifts its focus from regulating blood sugar to processing alcohol. This can be particularly dangerous for people with diabetes who need careful insulin management. Heavy drinking can lead to hypoglycemia, whose symptoms resemble alcohol intoxication but can be life-threatening if untreated.

Alcohol use can also contribute to developing type 2 diabetes. Heavy drinking may trigger acute pancreatitis or worsen chronic pancreatitis—both major diabetes risk factors. Additionally, alcoholic drinks are often high in calories, increasing the risk of weight gain and subsequent type 2 diabetes. Sugary drinks and beer contain significant carbohydrates, and high-carb diets are another diabetes risk factor.

Gastrointestinal Disorders

Since alcohol enters through your digestive system, it often causes problems there first. While nausea and vomiting are common with binge drinking, more serious conditions can be affected:

• Acid reflux: Alcohol stimulates stomach acid production and can irritate the esophageal lining, worsening reflux symptoms
• IBS and IBD: Alcohol can either slow down or speed up gut motility, causing constipation or diarrhea—particularly problematic for those with Irritable Bowel Syndrome or Inflammatory Bowel Disease
• Peptic ulcer disease: Alcohol increases the risk of gastrointestinal bleeding, especially in people with existing sensitivities like peptic ulcers

Kidney Disease

Your kidneys filter toxins from your bloodstream, including those left after your liver processes alcohol. This means alcohol puts extra strain on your kidneys, forcing them to work harder.

For people with kidney disease—including kidney stones, infections, or kidney failure—alcohol is particularly dangerous. When kidneys don't filter properly, alcohol-related toxins remain in your body longer, causing more damage. Additionally, alcohol acts as a diuretic, increasing urination and disrupting fluid balance, which is crucial for managing kidney disease.

Mental Health Considerations

Alcohol negatively impacts mental health by disrupting brain chemistry and damaging your gut microbiome. Approximately 95% of serotonin—the chemical responsible for feelings of well-being—is produced in your gut. A healthy microbiome is essential for proper serotonin production and helps protect against anxiety and depression.

• Anxiety: Alcohol interferes with brain chemicals, increasing anxiety—whether generalized anxiety, "hangxiety," or social anxiety. If you have an anxiety disorder, avoid alcohol
• Depression: Alcohol triggers dopamine release, creating temporary happiness but eventually requiring more alcohol to feel good—a cycle called the "hedonic treadmill" that worsens depression
• Psychosis: Alcohol can cause or worsen psychosis, characterized by delusional thinking and persistent hallucinations
• Schizophrenia: While the relationship isn't fully understood, 30-70% of people with schizophrenia also report alcohol use disorder

Generally, alcohol creates chemical chaos in your brain, affecting nearly every mental health condition. It also interacts with many mental health medications, including antidepressants and antipsychotics. When working to improve mental health, reducing or eliminating alcohol is an excellent starting point.

Special Populations and Situations

• Drinking and driving: This is both illegal and dangerous—alcohol impairs judgment and reflexes, making it difficult to respond to road hazards
• Pregnancy: Pregnant women should never drink alcohol—it affects fetal development and increases the risk of Fetal Alcohol Syndrome, developmental disabilities, low IQ, ADHD, and vision or hearing problems
• Drinking at work: Alcohol impairs judgment and performance, particularly dangerous in skilled professions like medicine or trades, with potential legal and employment consequences
• Underage drinking: Alcohol affects developing brains more severely than adult brains, associated with lower IQ, ADHD, and increased risk of alcohol use disorder
• Medications: Alcohol interacts with many medications—when your liver processes alcohol, it can't properly metabolize medications, reducing their effectiveness

Alternative Options

Choosing an alcohol-free lifestyle might seem challenging since alcohol features in many social situations. However, reducing or eliminating alcohol benefits everyone, not just those with specific health conditions. Here are some ways to prioritize your health:

• Explore non-alcoholic alternatives: Try mocktails and other alcohol-free beverages during social events
• Create new rituals: Replace alcohol-related activities with new traditions, like special teas or morning walks
• Develop a support network: Share your reasons for not drinking with supportive friends and family
• Engage in new hobbies: Pursue activities that don't center around alcohol, such as sports, art, or volunteering
• Be mindful: Regularly reflect on the benefits of living without alcohol and acknowledge your healthy choices
• Plan for triggers: Identify situations where you might be tempted to drink and prepare responses to social pressure

You're in Control

Choosing to live alcohol-free is an empowering act of self-care. Even if you don't currently have any of the conditions mentioned, these factors might affect you or someone you love in the future. Keep this information in mind when making drinking decisions, and consider sharing it with others—knowledge truly is power!