FEATURE STORY

Absolute Moderation

Note: This story was published originally in the summer 2003 issue of MIZZOU, the magazine of the MU Alumni Association.

By Dale Smith

When do alcohol’s heart-healthy effects turn risky? New research helps answer the question.

Alcohol is a double-edged high. Up to a point, drinking may well be healthful for the heart. But drinking can also boost the risk of a potentially serious injury. Is there some magic amount of alcohol that’s both healthful and safe?

Researchers including Dan Vinson, professor of family and community medicine, have worked on parts of this puzzle for years. In May, Vinson, MS ’90, published research in the Journal of Studies on Alcohol that supplies important information about how drinking boosts the risk of injury. Now he is ready to offer data-based drinking advice.

The short answer: Bottoms up, but not more than twice.

In middle-aged people, taking as little as half a drink three or four times a week
may decrease the risk of heart attack, Vinson says. On the other hand, imbibing two drinks per session doubles the risk of injury for everyone, including anything from cutting a finger while slicing carrots to suffering serious injuries in a car accident.
So Vinson advises drinkers to keep their maximum consumption between one-half
a drink and two drinks on three or four days of each week.

Vinson’s study looked at 2,517 injured people who came to one of Columbia’s three emergency rooms. He says that the risk of alcohol-related trauma starts out small. “When it doubles at two drinks, it’s still a small risk, but it’s there, and it’s measurable, and it rises exponentially. At five or six drinks, the injury risk is tenfold.”

The common-sense idea that habitual abusers cause most alcohol-related injuries is simply wrong, Vinson says. Instead, it’s the far larger group of more moderate drinkers who sustain most of these injuries. In 1999, for instance, ERs nationwide treated 27 million people aged 18 or older for trauma associated with various things, including alcohol.

“We found that if nobody drank, there would be 10.5 percent fewer injuries coming into emergency rooms,” he says. That would mean roughly 2.8 million fewer ER visits a year.

At the national level, Vinson’s results could ratchet down guidelines for safe alcohol use from the current three drinks per occasion for women and four for men to as few as just two per occasion. That’s two for men and women alike because the injury risk in Vinson’s study was about the same for both sexes.

In clinics where individual doctors and patients meet, the concrete and helpful nature of Vinson’s work becomes clear. For instance, “When patients say to me, ‘I’m concerned about my health; how much should I drink?’ we now know the threshold of harm.” Also, Vinson regularly plugs his research results into a clinical intervention that doctors use to help patients drink less. His encounters often go something like this:

After getting some details about a patient’s drinking habits, Vinson asks about problems that alcohol has caused at home and work. Then he dispenses advice.

Vinson: As your doctor, I think you could live healthier if you reduced your alcohol consumption. I suggest that you don’t drink more than two drinks on one occasion. What do you think about that?

Advice gives way to negotiation if the patient balks at the two-drinks level.

Patient: Well, I think three would be OK for me.

Vinson: That would be a lot safer than the six or eight drinks you take on one occasion now.

Patient: Sure would.

Vinson: Good. I think you can do it.

After two visits along these lines and two phone calls from the clinic, 40 percent of patients in a study of the clinical intervention not only used less alcohol, but they also spent fewer days in the hospital and made fewer visits to the ER. Those trends continued all four years of the study.

“They didn’t just drink less,” Vinson says. “They actually were healthier down the road. Now that’s useful.”

Leading Types of Alcohol-Related Injuries
According to Dan Vinson’s study of 2,517 people who visited
emergency rooms in Columbia, Mo.

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Last Update: November 15, 2007