Why Is Alcohol Research So Conflicting? People Will Drink Anyway?

Everyone knows alcohol is poison. That’s part of why it’s fun. Since the dawn of civilization—or even earlier, if we consider that our primate ancestors developed the ability to metabolize alcohol between 7 and 21 million years ago—people have been drinking with this balancing act in mind. They’ve been drinking in moderation and drinking in excess. They’ve been drinking alone and drinking in the company of friends, family, and strangers. We’ve done this while broadly knowing the consequences—be they bad behavior, hangovers, or the long-term ramifications of alcoholism. 

And yet even with thousands of years of boozing behind us, new research on the practice continues to emerge. Recent studies suggest that mild alcohol consumption will lower your life expectancy—or extend it. We’re so long into this game. Why does the scientific narrative around alcohol continue to change? To be blunt, it’s because, after all this time, we don’t know shit. But we’d all really like to. 

Amid the constant deluge of alcohol studies, one published in the June 2023 issue of the Journal of the American College of Cardiology managed to both confuse and confirm the myriad ideas we have about alcohol. The study found that alcohol not only reduces immediate stress in the brain (duh), but that light-to-moderate drinking is associated with long-term stress reduction that correlates with a lower risk for heart disease. A win for alcohol, right? Sadly, not entirely: the study also found that consuming any amount of alcohol was correlated with an increased risk for cancer, and that having more than 14 drinks per week increased your risk for heart disease, too. And so, once again we’re left with conflicting answers about what alcohol does.

“Just like studies around individual components of nutrition—for example, eggs and chocolate—alcohol studies can be incredibly confusing,” says Neha Pathak, Chief Physician Editor for WebMD and Medscape. As she explains, there’s long been plenty of evidence to support the fact that alcohol is correlated with various cancers, liver disease, and mental illness, substance abuse included. But throughout this history of evidence, there has remained a long-held cultural belief that some alcohol consumption could actually be good for you. For example, several commonly-touted studies over the last decade have suggested that people who have one drink a day have better health outcomes than those who don’t drink at all. 

It’s these beliefs, says Pathak, that have become flimsier. “Even for the one place where we used to have more confidence about potential benefits, heart health, the evidence is getting shakier, and we know alcohol can increase your risk for arrhythmias like atrial fibrillation,” she says. In other words, for every study that concludes that alcohol might be good for you in some ways, there’s another that concludes the exact opposite. The only way to really get to the bottom of things, then, is to just keep doing more research to narrow down precisely why it seems helpful in some cases and harmful in others. “So what researchers continue to look at is: 1) Is there any safe level, and 2) Are there situations where having a little is better than having none at all?” she explains. 

And while information about drinking benefitting stress management and the heart might support the idea that having a little is better than none, it still may not change Pathak’s general advice. “I think a good rule of thumb is, if you don’t drink, don’t start. If you do drink, drink less—and stay in control of how much and how often to live a longer, healthier life,” she says.

But there still remains the question of why so many of these new studies are conducted in the first place. For one thing, the overall beer market was $115.4 billion in 2022, according to the Brewer’s Association, and the addiction treatment industry had an estimated value of $42 billion in 2020, a figure that has likely only increased since—so a possible answer is that the alcohol and alcohol-recovery industries are massively profitable. Just as simply put, alcohol directly affects a ton of people. “According to the 2021 National Survey on Drug Use and Health (NSDUH), 219.2 million people ages 12 and older (78.3% in this age group) reported that they drank alcohol at some point in their lifetime,” says Randall Dwenger, Chief Medical Officer at Mountainside Treatment Center. 

Maybe with more information, the science around drinking could become so advanced that we can isolate all the good and do away with the bad, yielding a perfectly healthy product. But this desire only highlights exactly what it is that makes alcohol so appealing, both as a topic of study and a beverage. The reasons why it’s enjoyable to drink—why it helps have fun and foster human connection—remain broadly unquantifiable. You can’t quite measure that against, say, the odds of developing pancreatic cancer as a mild to moderate drinker, particularly when other lifestyle factors come into play. Whether one imbibes or not has long been about taking calculated risks. For the researchers who study it, those calculations are literal. For the rest of us, we’re just making the same trade humans have made for generations. And no matter what the data says, some of us will still think it’s worth it.