How much drinking is safe?

After Wednesday evening swim practice, I caught up with Sue leaving the locker room. She led our lane today. At a brutal pace.

“My grandson, one year old already,” Sue flashed a picture of a baby Buddha on her phone.

“Looks nothing like you,” I said honestly.

“Yeah,” Beaming still. “What you up to?”  

“Thinking about alcohol consumption,” I said, walking faster to keep up.

“Good idea.” In the parking lot, Sue waved her key fob like a wand. A white sedan blinked and blipped in response.

“The WHO reports alcohol causes one in 20 deaths worldwide,” I said, tailing her to the car.

“Who reported on what now?”

“Not who, Sue. W-H-O – the World Health Organization.”

“Oh, how’s that compared to the opioid crisis?”

“Good question … I don’t know,” I said, now eager to show what I did know. “Alcohol-related injury – like road accidents, suicides, violence – causes as many deaths as diseases.”

“Sounds complicated.”

“What’s more complicated,” I said, “how much drinking is considered safe.”

“Oh,” Sue backed against her car, studying her key fob, clearly contemplating the incontrovertible gravity of my statement.

“In the U.S., moderate drinking is up to one drink per day for women and two drinks for men. Countries like Japan and Italy, the cutoffs are higher.”

“Really.”

“You wonder what’s a standard drink? A 12-oz beer, 5-oz wine, or 1.5-oz of spirits. What also raises a red flag – binge drinking – that is, four or more drinks on a single occasion for women, five or more for men.”

“Done it once at 18,” Sue said.

“Eighteen is the average age when alcohol use disorder begins,” I added helpfully. “Only 10 percent of alcoholics receive treatment. Fewer receive drug treatment even though we’ve offered disulfiram or Antabuse since 1949. Remember Antabuse?”

“Yeah. Doesn’t Antabuse make you feel like crap when you drink.”

“Supposedly. Now we have other options like naltrexone, which works partly by curbing craving."

“I thought a little drinking is good for you,” Sue said, waving her key fob again. Her car blipped and blinked – I believe for the third time.

“Your doors are already opened, Sue,” I said, appraising her trigger fingers critically.

She sighed.

“But to properly answer your question about moderate drinking,” I said.

“You don’t have to. I’m sure you’re tired.”

Tired? I looked at Sue. She swam well today; half the lane wore paddles to keep up. I was last. Swimming, I’m no dolphin, but alcohol use disorder, I’m an owl. “I’m OK. Recently, an interesting study from The Lancet stacked the good against the bad on drinking. Even at low-level drinking, the potential benefits to heart and diabetes are offset by its harms, especially cancer. The authors conclude ‘the level of alcohol consumption that minimized harm across health outcomes was zero.’”

“No drinks at all?” Sue said.

“No drinks at all,” I said, “is what the number crunchers support. What’d you like to know about drinking?”             

“Does it taste good?” Sue laughed, opening the car door. “Have an umbrella?”