Those looking for a reset in the new year may be trying out “dry January,” the practice of abstaining from alcohol for the first month of the year. Other than avoiding a hangover, can a dry January impact health?
“I think people tend to overestimate the benefits,” said Sofia Jakab, MD, associate professor of medicine (digestive diseases) at Yale School of Medicine. “I don’t deny there is a benefit of dry January, but I would see it as a stepping stone for longer term solutions.”
In the short term, people who abstain from alcohol are getting the benefit of fewer calories, which is especially helpful if they are working on other weight loss goals. They may also experience better sleep, have improved experiences with reflux and relief from other gastrointestinal symptoms.
For patients who need to make long-term changes, Dr. Jakab says dry January can be a good exercise in willpower. Choosing to make changes for one month may be the motivation needed to reduce alcohol consumption long after January is over.
How much alcohol is safe?
The National Institute on Alcohol Abuse and Alcoholism states more than one drink a day for women and more than two drinks a day for men is considered at risk alcohol use. That doesn’t apply to people with underlying health conditions, where lower amounts of alcohol would be considered harmful.
“Each person needs to take into account their individual risk factors for alcohol related harm,” said Lamia Haque, MD, director of the Yale Clinic for Alcohol and Addiction Treatment in Hepatology. “Although emerging evidence is indicating that there may be harms associated with any amount of alcohol intake, those who have risk factors – whether it’s interactions with medications, issues related to weight, mental health conditions, alcohol addiction, or other chronic diseases that could potentially get worse with alcohol exposure – stand to benefit most from reducing or abstaining from alcohol.”
What is the impact of alcohol?
“Many people don’t realize that fat in the liver is caused by carbohydrates. Alcohol is sugar so it gets metabolized and stored in the liver as fat,” said Dr. Jakab. “In some patients, the presence of fat in the liver leads to inflammation and fibrosis or accumulation of scar tissue and some of these patients can go on to progress to have cirrhosis.”
Cirrhosis can have a significant impact on a person’s mortality and is one of the top reasons why people need a liver transplant.
The U.S. Surgeon General also recently issued an advisory warning of the link between alcohol consumption and increased cancer risk.
“I think it’s a very important step because it’s been known for some time that evidence is mounting that alcohol has some carcinogenic properties and is associated with a number of cancers,” said Dr. Haque.
How to safely stop drinking
For those who do not have underlying health conditions and who do not exceed alcohol consumption guidelines, Dr. Haque says it’s usually ok to go ‘cold turkey,’ although it is always prudent to monitor for any new symptoms that may signify the presence of alcohol withdrawal. Those who drink regularly or excessively need to be more aware of withdrawal symptoms when cutting down or stopping drinking, which would warrant immediate medical care. Symptoms that can occur several hours to a few days after someone reduces or stops drinking and can include:
- Shakiness
- Sweating
- Fatigue
- Malaise
- Trouble sleeping
- Increased heart rate
- Nausea
- Hallucinations
- Seizures
“The way I counsel patients is if they’ve had withdrawal in the past, and certainly if they’ve had complicated withdrawal that’s required hospitalization or intensive care, that’s somebody who would be advised not to stop cold turkey without some medical support,” she said.
Those patients may require the use of certain medications prescribed by a medical provider in an office setting, at a “detox” center, or in a hospital setting. If anyone is concerned about their drinking, or just wants to cut back, they should speak with their primary care or other medical provider, who can provide valuable health assessments that may lead to referrals for specialists or additional resources.
