Why the threshold has come down everywhere
Drinking guidelines have been revised downwards in most countries in recent years. The reason is not moral tightening: it is that no threshold below which alcohol would be risk-free has ever been established. For cancer in particular the curve starts at zero — risk rises from the first drinks, slightly, with no protective plateau.
The idea that a daily glass of wine protects the heart came from studies comparing moderate drinkers with abstainers who included former patients who had stopped. Correcting that bias, the benefit largely disappears. Current guidance is around ten drinks a week at most, not every day, with drink-free days.
A little history
Alcohol is humanity's oldest drug: residues of a fermented drink made from rice, honey and fruit have been identified on 9,000-year-old Chinese pottery from Jiahu, and grape wine is attested in Georgia 8,000 years ago. Beer was at the heart of daily life in Sumer and in Egypt, where it served as wages. Distillation, known to Arab alchemists, was applied to wine in Salerno in the twelfth century: "aqua vitae" was first a medicine.
Cheap spirits changed the scale of the problem. In London the "gin craze" of 1720 to 1751 made drunkenness an urban scourge and brought the first restrictive laws. The nineteenth century coined the word "alcoholism" (Magnus Huss, 1849) and the temperance movements, up to American Prohibition from 1920 to 1933; France banned absinthe in 1915. Alcoholics Anonymous was born in 1935 in Akron, Ohio.
The second half of the twentieth century made alcohol a matter of public health and law: breathalysers and driving limits in the 1960s and 1970s, advertising restrictions such as France's Évin law in 1991, then, as studies accumulated, downward revisions of the drinking guidelines. In 2023 the WHO finally wrote that there is no level of consumption that is safe for health.
What alcohol actually does
- Sleep: alcohol brings sleep on and wrecks the second half of the night. You fall asleep faster and recover less — the opposite of what someone drinking "to sleep" is after.
- Sex: lifts inhibition, impairs erection, delays orgasm. Repeated, the effect becomes lasting.
- Cancer: mouth, pharynx, oesophagus, liver, colon, breast. Breast cancer risk rises from low intakes, which few women know.
- Pregnancy: no safe threshold is known, at any stage. The guidance is therefore zero, and it applies while trying to conceive too.
Alcohol in the couple
It is among the commonest reasons for couples counselling, and rarely under that name: people come about arguments, withdrawal, infidelity, violence. The drinking surfaces afterwards. Two signals matter more than quantity: drinking alone or in secret, and stopping causing irritability or tremor.
Abrupt withdrawal can be dangerous
In a dependent person, stopping all at once risks a severe withdrawal syndrome, with confusion and seizures. That withdrawal is prepared medically, sometimes in hospital. If stopping causes sweating, tremor or intense anxiety, speak to a doctor before going further, not after.
Cutting down without imposing abstinence
For most problem drinking, reduction is achievable and already beneficial. What works: counting properly (mental estimates understate by about a third), setting drink-free days rather than a daily ceiling, changing the glassware — a glass of wine at home is often double a standard drink — and handling risky situations separately rather than the overall quantity. An addiction clinic is not only for extreme cases: it mostly serves people who want to cut down and cannot do it alone.
