Trending Clinical Topic: Reducing Alcohol Consumption

Ryan Syrek


February 03, 2023

Each week, we identify one top search term, speculate about what caused its popularity, and provide an infographic on a related condition. If you have thoughts about what's trending and why, share them with us on Twitter or Facebook

Each year, millions of people abstain from alcohol for the first month of the year in what is known as "Dry January." As February begins, new guidelines and other sobering findings related to the need for reduced alcohol consumption prompted the top trending clinical topic of the week. Perhaps most notably, the Canadian Centre on Substance Use and Addiction (CCSA) has issued a final report and related infographic. Replacing Canada's 2011 Low-Risk Drinking Guidelines, the new recommendations were created in consultation with an executive committee, national organizations, three scientific expert panels, and an internal evidence review working group (see Infographic).

Using different mortality risk thresholds, the CCSA developed the following continuum of risk:

  • Low (≤ 2 standard drinks per week)

  • Moderate (3-6 standard drinks per week)

  • Increasingly high (≥ 7 standard drinks per week)

The guidance also points out that having more than two standard drinks per occasion is associated with an increased risk for harms and that no amount of alcohol is safe for those who are pregnant or trying to become pregnant. The CCSA also noted differences between men and women: Above the moderate risk, health risks increase more steeply for women, whereas far more injuries, violence, and death result from men's alcohol use. The experts stress that any reduction in alcohol use is beneficial.

That statement is echoed by recent findings related to alcohol-related liver disease. A study of patients with alcohol-related liver disease found that those who abstain from alcohol have improved outcomes, including reduced all-cause and liver-related mortality, even if they have clinically significant portal hypertension. More than 300 patients with clinically significant portal hypertension were followed for a median of 3 years. Those who abstained from alcohol had a 61% reduced risk for hepatic decompensation, as well as a 57% reduced risk for liver-related mortality and a 55% reduction in the risk for all-cause mortality. The reduction in hepatic decompensation was seen even in patients with hepatic venous pressure gradients ≥ 20 mm Hg, signifying high-risk portal hypertension.

Reduction of alcohol may also reduce colorectal cancer (CRC) risk. Findings from a large European cohort suggest that lifestyle changes lowered CRC incidence. Specifically, decreases in alcohol consumption were significantly associated with a reduction in CRC risk among participants aged 55 years or younger at baseline. Overall, improving from an "unfavorable lifestyle" to a "favorable lifestyle" was associated with a 23% lower risk for CRC (compared with no change). Likewise, a decline from a "favorable lifestyle" to an "unfavorable lifestyle" was associated with a 34% higher risk.

Reducing alcohol consumption isn't just for patients to consider. A recent study found that problematic alcohol use by physicians appears to be increasing. In a systematic literature review, researchers found that self-reported use among doctors rose to more than 1 in 4. The investigators reviewed 31 studies from 2006 to 2020 involving 51,680 residents, fellows, or staff physicians in 17 countries. The data showed an increase in reported problematic alcohol use over time, from 16.3% between 2006 and 2010 to 26.8% between 2017 and 2020.

With millions set to potentially resume previous levels of alcohol consumption now that "Dry January" is over, the health concerns associated with drinking become increasingly important to recognize. The new CCSA guidance and studies on the frequency and effects of alcohol consumption were well timed to make an impact, and helped establish the week's top trending clinical topic.

Take a quiz about recent studies on alcohol use and abuse.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.