Why there’s no such thing as a safe amount of alcohol, according to research

Few substances are as deeply woven into everyday life as alcohol. It is a fixture at holiday celebrations, work-related social gatherings, sporting events, airports, and brunch or dinner tables. A raised glass for a toast, the ubiquitous wedding open bar or drinks shared during a Fourth of July celebration all demonstrate how deeply alcohol has become embedded in social customs and cultural traditions.

Yet alcohol contributes to millions of deaths globally each year and is linked to cancer, liver disease, unintentional accidents, violence and, importantly, dependence and addiction. Despite this, the disconnect between alcohol’s cultural role and its serious health burden is striking.

Although drinking patterns vary substantially across countries, an estimated 2.3 billion people worldwide consume alcohol. It is deeply integrated into social life across the globe, despite its well-documented health risks.

As a physician working in addiction medicine, I regularly care for patients whose alcohol use affects nearly every organ system. It is often not until these patients end up admitted to the hospital that they learn the impact of alcohol on various parts of their body besides their liver.

No such thing as a ‘safe’ amount

Newer evidence challenges assumptions about what was long considered “safe drinking.” Even moderate drinking carries risk and is not as harmless as people, including experts, once thought.

Many people associate alcohol risk primarily with addiction or legal complications such as driving while intoxicated. However, its effects extend far beyond this, into nearly every aspect of a person’s well-being.

While alcohol may transiently improve mood and ease social anxiety, long-term alcohol use can lead to a worsening of mood, cognition and sleep, which can further compound use.

A 2021 literature review found that consuming approximately two standard drinks roughly doubles the odds of sustaining both motor vehicle and non-motor vehicle injuries. The review also found that heavy episodic (binge) drinking can increase the risk of injury by 20- to 50-fold, depending on the amount of alcohol consumed and the type of injury. While alcohol’s effects on the liver are well known, it can also lead to gastrointestinal complications and heart disease

The World Health Organization estimates that 2.6 million deaths each year are attributable to alcohol, accounting for nearly 1 in every 20 deaths worldwide.

Mixed messaging around alcohol and cancer

While many people recognize the risks of alcohol addiction, people are generally much less aware of the links between alcohol use and cancer risk.

The World Health Organization classifies alcohol as a Group 1 carcinogen, – the same category as tobacco and asbestos. In other words, these are agents classified as having sufficient evidence that they cause cancer in humans.

In 2025, a U.S. Surgeon General advisory emphasized that alcohol increases the risk of at least seven cancers and called for updated warning labels. It concluded that alcohol increases an individual’s risk of developing seven types of cancer, including cancers of the breast, colorectal, liver, oral, esophagus and larynx.

Yet fewer 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 use.

The relationship between alcohol and cancer is nuanced. Throughout the 1990s and early 2000s, observational studies suggested that moderate alcohol consumption might offer cardiovascular benefits.

Over the past decade, however, higher-quality studies have challenged those findings, suggesting 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.

According to the Dietary Guidelines for Americans, current evidence increasingly suggests that even low levels of alcohol may increase cancer risk.

The guidelines acknowledge that adults should “consume less alcohol for better overall health.” However, the most recent version of the guidelines for 2025-2030, updated in January 2026, removed 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 the growing evidence of alcohol-related harms and provides less specific guidance to consumers.

Against this backdrop, Dr. Mehmet Oz, Administrator of the Centers for Medicare & Medicaid Services, characterized alcohol as a “social lubricant” that brings people together, rather than emphasizing its well-established health risks.

That may be true physiologically, at least temporarily, but it obscures the fact that relying on alcohol as a social lubricant can lead to chemical and psychological dependency. In my view, statements to that effect are shortsighted, prioritizing short-term social effects over more insidious and long-term issues, including addiction.

A seismic cultural shift

While many dangerous mind-altering substances are hidden from public perception, alcohol is often placed at the center of it – a trend that shows no sign of changing imminently.

Further, large companies often profit from ads that appeal to young people.

Looking back at the history of tobacco smoking provides some helpful insights. In 1965, 42.4% of the U.S. population smoked. By 2022, that figure had dropped to 11.6%.

This dramatic decline did not happen because of a single intervention, but through decades of accumulating scientific evidence, public education campaigns, warning labels, restrictions on advertising, smoke-free policies, higher tobacco taxes and shifts in social norms. Together, these efforts transformed smoking from a widely accepted social behavior into one broadly recognized as a major health risk and, correspondingly, less socially accepted.

Although alcohol consumption has modestly declined in recent years, it remains deeply embedded in social life in ways cigarette smoking no longer is.

People often assume that if a substance is legal, common and widely socially accepted, as well as encouraged, then it must also be safe. But public health history suggests those assumptions can and should change.