Some people see alcohol drinking as symbolic of manhood. As we approach the holidays, most men will drink more than usual. Experimentation with alcohol begins at an early age, especially for boys. They drink heavily to demonstrate their invincibility. Binge drinking on weekends is particularly worrying because of the association with road traffic accidents. We will discuss how alcohol can improve our health, while outlining the dangers of excessive intake.

Beneficial effects

There is good evidence that men who take moderate amounts of alcohol on a regular basis are protected from many diseases. One to two ounces of alcohol daily protects men from death due to a wide variety of causes, including heart disease, stroke, type two diabetes and cancer. This protective effect may be due to improved lipid profile. The studies show wine to be more protective than beer or whiskey. This might be due to the higher levels of antioxidants and flavinoids and lower levels of nitrosamines in wine. However, this apparent finding may be misleading, since wine drinkers tend to have healthier lifestyles. It is often proposed that red wine is better than white, but both have similar effects.

Deleterious effects

The danger of alcohol consumption is that many men are unaware of their total intake. They drink in social settings and imbibe more than the recommended amounts. Binge drinking has been defined as drinking more than half the recommended weekly intake on one occasion. Also, men often drink and smoke tobacco, and are exposed to the deleterious effects of active and passive inhalation.

Education about alcohol must not only highlight the beneficial effects but repeatedly counsel against exceeding the recommended amounts. When men exceed the recommended amounts, blood pressure drops initially but later rises to higher than normal levels. This effect occurs with 12oz of beer or 4oz of wine or 1.5oz of whiskey. Blood pressure rises with heavy binge drinking and conversely, blood pressure drops when heavy drinkers abstain. Alcohol abuse has certain ill effects resulting in liver disease, gastritis, reduced fertility, mental health disorders and addiction.

Identifying problem drinkers

Problem drinking encompasses a continuum of men who drink heavily at one end to those who have severe alcohol dependence at the other end. These men might present with absenteeism from work, domestic quarrels and fights as well as traffic accidents. Often these men are unaware of their drinking problems. The CAGE questionnaire is a simple screening tool to help identify people with a drinking problem. The questions are:

Have you ever felt you should cut down your drinking?

Have people annoyed you by criticising your drinking?

Have you ever felt bad or guilty about your drinking?

Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover? (EYEOPENER).

Anyone with a 'yes' answer to one or more questions should seek help from a physician, counsellor or alcohol support group.

Recommendations

While there seems to be benefits from drinking limited amounts of alcohol, it is debatable whether to recommend drinking for men who abstain. It is important for those who drink to assess how much alcohol they consume because of the insidious nature of this activity. Men should never surpass the two drinks per day limit. Men who tend to drink heavily on social occasions, especially during the Christmas season, should resolve to reduce drinking or not to drink at all.

Dr Pauline Williams-Green is a family physician and president of the Caribbean College of Family Physicians. Email: yourhealth@gleanerjm.com.