An extensive body of data shows concordant J-shaped associations between alcohol intake and a variety of adverse health outcomes, including

• coronary heart disease,
• diabetes,
• hypertension,
• congestive heart failure,
• stroke,
• dementia,
• Raynaud’s phenomenon, and
• all-cause mortality.

Light to moderate alcohol consumption (up to 1 drink daily for women and 1 or 2 drinks daily for men) is associated with cardioprotective benefits, whereas increasingly excessive consumption results in proportional worsening of outcomes.

Alcohol consumption confers cardiovascular protection predominately through improvements in insulin sensitivity and high-density lipoprotein cholesterol.

The ethanol itself, rather than specific components of various alcoholic beverages, appears to be the major factor in conferring health benefits.

Low-dose daily alcohol is associated with better health than less frequent consumption.

Binge drinking, even among otherwise light drinkers, increases cardiovascular events and mortality.

Alcohol should not be universally prescribed for health enhancement to nondrinking individuals owing to the lack of randomized outcome data and the potential for problem/alcoholic drinking.

Research; Alcohol and Cardiovascular Health. James H. O’Keefe; Kevin A. Bybee; Carl J. Lavie. J Am Colledge of Cardiology.  2007;50(11) ©2007 Elsevier Science, Inc.

Under the Influence: A Guide to the Myths and Realities of Alcoholism by James Robert Milam, Katherine Ketcham Read more about this title…

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Yasir Abbasi and Ruta Rele suggest services for health professionals

In the United Kingdom about one third of the population is addicted to nicotine, while 6% are addicted to alcohol. The public is usually influenced by the media, which mainly concentrates on hard core illegal drugs such as heroin, cocaine, and sometimes cannabis. Other substances, which are also of growing concern, get overlooked. These can be volatile substances (such as glue or aerosols), stimulants, hallucinogens, benzodiazepines, prescribed opioid analgesics, and non-prescribed methadone.

Health professionals, like everyone else, are susceptible to addiction. Yet few of us are aware of facilities available to doctors with substance misuse problems. These services respect vital issues like confidentiality and patient care.

Full stort at; BMJ Career Focus 2007;335:163

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Alcoholics Anonymous and long term matching effects.

AIMS: (1) To examine the matching hypothesis that Twelve Step Facilitation Therapy (TSF) is more effective than Motivational Enhancement Therapy (MET) for alcohol-dependent clients with networks highly supportive of drinking 3 years following treatment; (2) to test a causal chain providing the rationale for this effect. DESIGN: Outpatients were re-interviewed 3 years following treatment. ANCOVAs tested the matching hypothesis. SETTING: Outpatients from five clinical research units distributed across the United States. Participants: Eight hundred and six alcohol-dependent clients. INTERVENTION: Clients were randomly assigned to one of three 12-week, manually-guided, individual treatments: TSF, MET or Cognitive Behavioral Coping Skills Therapy (CBT). MEASUREMENTS: Network support for drinking prior to treatment, Alcoholics Anonymous (AA) involvement during and following treatment, percentage of days abstinent and drinks per drinking day during months 37-39.

FINDINGS:

• The a priori matching hypothesis that TSF is more effective than MET for clients with networks supportive of drinking was supported at the 3 year follow-up;
• AA involvement was a partial mediator of this effect; clients with networks supportive of drinking assigned to TSF were more likely to be involved in AA;
• AA involvement was associated with better 3-year drinking outcomes for such clients.

CONCLUSIONS:

• in the long-term TSF may be the treatment of choice for alcohol-dependent clients with networks supportive of drinking;
• involvement in AA should be given special consideration for clients with networks supportive of drinking, irrespective of the therapy they will receive.

Research; Longabaugh R, Wirtz PW, Zweben A, Stout RL. Network support for drinking, Alcoholics Anonymous and long-term matching effects.Addiction. 1998 Sep;93(9):1313-33.

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