long-term effects of alcohol long-term effects of alcohol the long-term heavy consumption of alcohol (alcohol use disorder) can cause severe detrimental effects. health effects associated with alcohol intake in large amounts include an increased risk of developing an alcohol use disorder, malnutrition, chronic pancreatitis, erectile dysfunction, heart failure, atrial fibrillation, gastritis, stomach ulcers, alcoholic liver disease, certain types of dementia, and several types of cancer. in addition, damage to the central nervous system and peripheral nervous system (e.g., painful peripheral neuropathy) can occur from chronic heavy alcohol consumption. there is also an increased risk for accidental injuries, for example, those sustained in traffic accidents and falls. studies show that individuals with heavy substance use have a much higher risk of having other disorders. a cross-sectional observational study found evidence that people who used substances had the highest risk for five of the disorders studied. however, even light and moderate alcohol consumption increase the risk for developing certain types of cancer. among women, light drinkers have a four percent increase risk of breast cancer, while moderate drinkers have a 23 percent increase in risk of the disease. the long-term use of alcohol is capable of damaging nearly every organ and system in the body. the developing adolescent brain is particularly vulnerable to the toxic effects of alcohol. in addition, the developing fetal brain is also vulnerable, and fetal alcohol spectrum disorders (fasds) may result if pregnant mothers consume alcohol. while alcohol consumption does not improve overall health, the inverse relation in western cultures between alcohol consumption and cardiovascular disease has been known for over 100 years. many physicians do not promote alcohol consumption; however, given the many health concerns associated with it, some suggest that alcohol should be regarded as a recreational drug, and promote exercise and good nutrition to combat cardiovascular disease. negative effects include increased risk of liver diseases, oropharyngeal cancer, esophageal cancer and pancreatitis. conversely, moderate intake of alcohol may have some beneficial effects on gastritis and cholelithiasis. chronic alcohol misuse has serious effects on physical and mental health. chronic excess alcohol intake, or alcohol dependence, can lead to a wide range of neuropsychiatric or neurological impairment, cardiovascular disease, liver disease, and malignant neoplasms. the psychiatric disorders associated with alcoholism include major depression, dysthymia, depersonalization, mania, hypomania, panic disorder, phobias, generalized anxiety disorder, personality disorders, schizophrenia, suicide, neurologic deficits (e.g. impairments of working memory, emotions, executive functions, visuospatial abilities and gait and balance) and brain damage. there is no evidence that alcohol consumption causes these disorders, but people with these conditions may turn to alcohol as a coping mechanism at a greater rate or frequency than the general population. alcohol dependence is associated with hypertension, coronary heart disease, and ischemic stroke, cancer of the respiratory system, and also cancers of the digestive system, liver, breast and ovaries. heavy drinking is associated with liver disease, such as cirrhosis. excessive alcohol consumption can have a negative impact on aging. some nations have introduced alcohol packaging warning messages that inform consumers about alcohol and cancer, and about risk of fetal alcohol syndrome for women who drink while pregnant. mortality effects a 2016 systematic review and meta-analysis found that moderate ethanol consumption does not prolong life compared with lifetime abstention from ethanol consumption. a systematic analysis of data from the global burden of disease study found that consumption of ethanol increases the risk of cancer and increases the risk of all-cause mortality, and that the level of ethanol consumption that minimizes disease is zero consumption. some studies have concluded that drinking small quantities of alcohol (less than one drink per day in women and two in men) is associated with a decreased risk of heart disease, stroke, diabetes mellitus, and early death. these studies, however, have been replaced by newer studies indicating that even light consumption of alcohol does not improve overall health. some of these studies lumped former ethanol drinkers and life-long abstainers into a single group of nondrinkers, hiding the health benefits of life-long abstention from ethanol. drinking more than this amount actually increases the risk of heart disease, high blood pressure, atrial fibrillation, and stroke. risk is greater in younger people due to binge drinking which may result in violence or accidents. about 3.3 million deaths (5.9% of all deaths) are believed to be due to alcohol each year. maximum quantity recommended further information: recommended maximum intake of alcoholic beverages total recorded alcohol per capita consumption (15+), in litres of pure alcohol different countries recommend different maximum quantities. in the uk, the chief medical officers' recommends men and women drink no more than 14 units per week. a single unit corresponds to 8 g of ethanol. for most countries, the maximum quantity for men is 140 g–210 g per week. for women, the range is 84 g–140 g per week. most countries recommend total abstinence during pregnancy and lactation. contradictory large-scale reviews were published in the lancet in 2018. one reported a "safe" drinking limit of up to seven "standard" drinks per week, equivalent to 100 grams of pure alcohol per week. the other concluded that there is no safe level of alcohol, that "the level of consumption that minimises health loss is zero" and emphasized the need to revise alcohol control policies worldwide in order to reduce overall alcohol consumption. alcohol-related death disability-adjusted life year for alcohol use disorders per 100,000 inhabitants in 2004: no data less than 50 50–150 150–250 250–350 350–450 450–550 550–650 650–750 750–850 850–950 950–1050 more than 1050 over-consumption of alcohol causes many deaths worldwide. the overall mortality from alcohol use was found to be similar to that of the effect of physical inactivity. a review in 2009 found that "the net effect of alcohol consumption on health is detrimental, with an estimated 3.8% of all global deaths and 4.6% of global disability-adjusted life-years attributable to alcohol." extensive research of western cultures has consistently shown increased survival associated with light to moderate alcohol consumption. a 23-year prospective study of 12,000 male british physicians aged 48–78, found that overall mortality was significantly lower in current drinkers compared to non-drinkers even after correction for ex-drinkers. this benefit was strongest for ischemic heart disease, but was also noted for other vascular disease and respiratory disease. death rate amongst current drinkers was higher for 'alcohol augmentable' disease such as liver disease and oral cancers, but these deaths were much less common than cardiovascular and respiratory deaths. the lowest mortality rate was found for consumption of 8 to 14 'units' per week. in the uk a unit is defined as 10ml or 8g of pure alcohol. higher consumption increased overall mortality rate, but not above that of non-drinkers. other studies have found age-dependent mortality risks of low-to-moderate alcohol use: an increased risk for individuals aged 16–34 (due to increased risk of cancers, accidents, liver disease, and other factors), but a decreased risk for individuals ages 55+ (due to lower incidence of ischemic heart disease). this is consistent with other research that found a j-curve dependency between alcohol consumption and total mortality among middle aged and older men. while the mortality rates of ex-drinkers and heavy drinkers are significantly elevated, the all-cause mortality rates may be 15–18% lower among moderate drinkers. although the definition of a drink varies between studies and countries, this meta-analysis found that low levels of alcohol intake, defined as 1–2 drinks per day for women and 2–4 drinks per day for men, was associated with lower mortality than abstainers. this claim was challenged by another study that found that in certain low quality studies occasional drinkers or ex-drinkers were included as abstainers, resulting in the increased mortality in that group. however, the j-curve for total and chd mortality was reconfirmed by studies that took the mentioned confounders into account. there seems to be little discussion of what proportion of individuals classified as abstainers are those already at greater risk of mortality due to chronic conditions and do not or cannot consume alcohol for reasons of health or harmful interactions with medication. the observed decrease in mortality of light-to-moderate drinkers compared to never drinkers might be partially explained by superior health and social status of the drinking group; however, the protective effect of alcohol in light to moderate drinkers remains significant even after adjusting for these confounders. additionally, confounders such as underreporting of alcohol intake might lead to the underestimation of how much mortality is reduced in light-to-moderate drinkers. a 2010 study confirmed the beneficial effect of moderate alcohol consumption on mortality. subjects were grouped into abstainers, light, moderate, and heavy drinkers. the order of mortality rates from lowest to highest were moderate, light, heavy, and abstainers. the increased risk for abstainers was twice the mortality rate as for moderate drinkers. this study specifically sought to control for confounding factors including the problem of ex-drinkers considered as non-drinkers. according to another study, drinkers with heavy drinking occasions (six or more drinks at a time) have a 57% higher all-cause mortality than drinkers without heavy drinking occasions. mortality is lowest among young abstainers and highest among young heavy drinkers. according to a 2018 study people who had more than seven and up to 14 standard drinks per week, were likely to have their life expectancy shortened by around 6 months. those who consumed over 14 drinks and up to 25 per week were likely to have 1–2 years taken off their lifespan, and a consumption of over 25 standard drinks per week correlated with 4–5 fewer years. in contrast to studies of western cultures, research in other cultures has yielded some opposite findings. the landmark interheart study has revealed that alcohol consumption in south asians was not protective against cad in sharp contrast to other populations who benefit from it. in fact asian indians who consume alcohol had a 60% higher risk of heart attack which was greater with local spirits (80%) than branded spirits (50%). the harm was observed in alcohol users classified as occasional as well as regular light, moderate, and heavy consumers. another large study of 4465 subjects in india also confirmed the possible harm of alcohol consumption on coronary risk in men. compared to lifetime abstainers, alcohol users had higher blood sugar (2 mg/dl), blood pressure (2 mm hg) levels, and the hdl-c levels (2 mg/dl) and significantly higher tobacco use (63% vs. 21%). russia one study claims that "excessive alcohol consumption in russia, particularly by men, has in recent years caused more than half of all the deaths at ages 15–54 years." however, there are some difficulties with this study. for instance, the same study also found a protective effect of heavy drinking on breast cancer mortality. this contradicts the well established scientific view that alcohol increases breast cancer risk. on this account in further correspondence it was advised that "careful interpretation of mortality statistics in relation to alcohol use is needed, taking into account other relevant risk factors, incidence, and survival." united kingdom a governmental report from britain has found that "there were 8,724 alcohol-related deaths in 2007, lower than 2006, but more than double the 4,144 recorded in 1991. the alcohol-related death rate was 13.3 per 100,000 population in 2007, compared with 6.9 per 100,000 population in 1991." in scotland, the nhs estimate that in 2003 one in every 20 deaths could be attributed to alcohol. a 2009 report noted that the death rate from alcohol-related disease was 9,000, a number three times that of 25 years previously. a uk report came to the result that the effects of low-to-moderate alcohol consumption on mortality are age-dependent. low-to-moderate alcohol use increases the risk of death for individuals aged 16–34 (due to increased risk of cancers, accidents, liver disease, and other factors), but decreases the risk of death for individuals ages 55+ (due to decreased risk of ischemic heart disease). a study in the united kingdom found that alcohol causes about 4% of cancer cases in the uk (12,500 cases per year). united states the centers for disease control and prevention (cdc) report, "from 2001–2005, there were approximately 79,000 deaths annually attributable to excessive alcohol use. in fact, excessive alcohol use is the 3rd leading lifestyle-related cause of death for people in the united states each year." a 1993 study estimated us deaths through alcohol at 100,000. another cdc report from