Should Doctors ‘Prescribe’ a Drink a Day? No.

From the NYTimes:

The evidence regarding wine versus other beverages like grape juice is mixed.

For most people, low-risk drinking is not harmful to health — and may be helpful. However, I would discourage people from drinking in order to improve their health.

Compared with non-drinkers, men who consumed wine, beer, or spirits had a 36% lower risk of all-cause mortality and a 34% lower risk of cardiovascular mortality.

Before you recommend wine for cardiovascular risk reduction, consider this:

- One in five men at risk of drinking problem during their lifetimes

- Women have an 8 to 10 percent chance of becoming dependent on alcohol during their lifetimes

- Men have 15% lifetime risk for alcohol abuse, 10% risk for alcohol dependence. Each cuts your life short by 10-15 years.

- Heavy drinking increases risk of depression by 40%, and 80% of people dependent on alcohol are smokers

Alcohol literally kills: Gary Moore had 380mg/dL in his blood, Winehouse 416mg/dL when she died surrounded by 3 empty vodka bottles. Telegraph UK, 2012


Before you recommend wine for CV risk reduction, consider this: 1 in 5 men at risk of drinking problem
Rethinking Drinking - NIH interactive website
Image source: Wikipedia, public domain.

Comments from Twitter:

OMC ‏ @charlesayanleke: That's a recommendation most peeps can get behind

Tibor Banyai ‏ @tibor75: Do u tell your AF pts to be 100% abstinent? Curious RT @drjohnm: RT @DrVes: Should Doctors ‘Prescribe’ a Drink a Day? No.

John Mandrola, MD ‏ @drjohnm:  No I don't rec abstinence but I don't feel that alcohol adds to health. Mild intake prob neutral. Worry about cancer risk


  1. This article seems to be blurring the line between 1 drink a day and 5 drinks a day - the definition of binge drinking.

    The most important thing is knowing yourself. If you have an addictive personality, don't tempt yourself with 1 drink.

  2. good point. don't start if you can't stop.

  3. Umm, this makes little sense.

    If a drink a day lowers all cause mortality 36%, with a potential downside that 1/5 will be problem drinkers (and they figure that out without their docs telling them to have a drink a day, trust me), why would you not recommend it?

    It's got to be the cheapest, and most pleasurable, interventions a doc can recommend.

  4. The benefits of alcohol are far from certain. Most of the studies that showed benefit included people of affluent background. This hardly applies to the general population.

    I beg to disagree with the previous commenter - drinking is not cheap.

  5. Wine drinking is well known treatment but I'm not sure about beer.

  6. I agree with GruntDoc. Why not point patients to lifestyle behaviors that can help them? Of course, and add a comment about moderation.


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