Few substances are as deeply embedded in everyday life as alcohol. It is a common item at Christmas celebrations, work-related social gatherings, sporting events, airports, and lunch or dinner tables. They all demonstrate how profoundly alcohol has become. Embedded in social customs. and cultural traditions.
Still Alcohol contributes to millions of deaths worldwide each year. and is linked to cancer, liver diseaseunintentional accidents, violence and, most importantly, dependency and addiction. Despite this, the disconnect between the cultural role of alcohol and its serious health burden is striking. an estimate 2.3 billion people around the world consume alcohol.
like a doctor who works in addiction medicineI regularly see patients whose alcohol consumption affects almost all organ systems. Often, it is not until these patients end up admitted to the hospital that they learn the effects of alcohol on various parts of their body besides the liver.
The latest evidence challenges assumptions about what has long been considered “safe drinking.” Even Moderate drinking carries risks and it's not as harmless as people, including experts, once thought.
Many people associate alcohol risk primarily with addiction or dangerous behaviors such as drunk driving. However, its effects extend far beyond that, encompassing almost every aspect of a person's well-being.
While alcohol can temporarily improve mood and relieve social anxiety, prolonged alcohol consumption can cause a worsening mood, cognition and sleepwhich can further aggravate use.
A 2021 literature review found that consuming approximately two standard drinks approximately double the odds of sustaining injuries, with or without a vehicle involved. The review also found that excessive alcohol consumption (binge drinking) can increase the risk of injury by up to 50 times, depending on the amount of alcohol consumed and the type of injury. While the effects of alcohol on the liver are well known, it can also cause gastrointestinal complications and heart disease.
The World Health Organization estimates that 2.6 million deaths each year are attributable to alcoholaccounting for almost 1 in 20 deaths worldwide.
While many people recognize the risks of alcohol addiction, in general much less conscious of links between alcohol consumption and cancer risk.
The World Health Organization classifies alcohol as a group 1 carcinogen — the same category as tobacco and asbestos. In 2025, the US surgeon general emphasized that Alcohol increases the risk of at least seven types of cancer.including breast, colorectal, liver, oral, esophageal, and laryngeal cancers. One notice asked for updated warning labels.
However, less than half of Americans Recognize alcohol as a risk factor for cancer.particularly for cancers such as breast cancer that are not commonly associated with alcohol consumption.
Throughout the 1990s and early 2000s, observational studies suggested that moderate alcohol consumption could offer cardiovascular benefits. However, higher quality studies have been conducted over the last decade. questioned these findingssuggesting that much of the apparent benefit may have reflected differences in the health and lifestyles of moderate drinkers rather than a protective effect of alcohol itself.
Current evidence Increasingly suggests that even low levels of alcohol may increase cancer risk.
Federal guidelines recognize that adults should “consume less alcohol for better overall health.” However, the most recent version of the “Dietary Guidelines for Americans,” updated in January, eliminated the previous recommendation to limit intake to no more than one drink per day for women and two for men. It also omitted explicit discussion of alcohol's links to cancer.
These changes have drawn criticism from public health experts, who argue that the revised language downplays growing evidence of alcohol-related harms and provides less specific guidance to consumers. The current administrator of the Centers for Medicare and Medicaid Services. characterized alcohol as a “social lubricant””that brings people together, rather than emphasizing its well-established health risks.
This may be true physiologically, at least temporarily, but it obscures the fact that reliance on it as a social lubricant can lead to chemical and psychological dependence. In my opinion, statements to that effect are short-sighted and prioritize short-term social effects over more insidious, long-term issues, including addiction.
While many dangerous, mind-altering substances are hidden from public perception, alcohol often sits at the center of them, a trend that shows no signs of changing imminently.
Furthermore, large companies often benefit from ads that attract young people.
A look back at the history of smoking provides some useful insights. In 1965, 42.4% of the American population smoked. By 2022, that figure had fallen to 11.6%.
This steep decline did not occur due to a single intervention, but through decades of accumulating scientific evidence, public education campaigns, warning labels, advertising restrictions, smoke-free policies, higher tobacco taxes, and changes in social norms. Together, These efforts transformed smoking. from a widely accepted social behavior to one widely recognized as a significant health risk and, consequently, less socially accepted.
Although alcohol consumption has decreased modestly In recent years, it remains deeply embedded in social life in ways that cigarette smoking no longer is.
People often assume that if a substance is legal, common, and widely socially accepted (even encouraged), it must also be safe. But the history of public health suggests that those assumptions can and should change.
Emma Fenske is an addiction medicine fellow and internal medicine physician at Oregon Health and Science University. This article was prepared in collaboration with the conversation.
