Talk:Long-term effects of alcohol

For talk page discussion prior to the MCOTW, please click here.

Agenda for MCOTW

Having a quick review of this article, I can identify the following points:

• This is not about a disease, but a public health/epidemiology topic. Some variances will therefore have to be made from WP:MCOTW.
• A glaring omission is the development of chronic liver disease, on which there is significant (and worrying) epidemiological data available. At least some of the content of alcoholic liver disease should be discussed here. (I'm trying to borrow a copy of ISBN 0415275822 from one of its editors...)

Note: Theres a limited copy available to preview online here. Regards, CycloneNimrod^Talk? 11:12, 13 May 2008 (UTC)

• There is no section on psychiatric illness caused by, aggravated by, and possibly relieved by chronic alcohol use.
• We must apply a high level of scrutiny to all claims of benefit or harm. This is not child's play. News articles or other non-peer reviewed reports are not acceptable. Small observational studies cannot simply be cited unless they are methodologically highly sound and the conclusions are generalisable to most populations. Much rather than relying on individual studies we must try to find very large cohort studies, meta-analyses and systematic reviews. If this leads to citing less references but higher quality, we should be happy.
• We need a short section on the effect of alcohol on tissues. In many cases, adverse or beneficial effect of alcohol on an organ is not at all understood.

There seem to be many sub-articles that are very long but poor on actual information. Some may be merged here. JFW | T@lk 09:50, 12 May 2008 (UTC)

I found this a very good paper: Room R, Babor T, Rehm J (2005). "Alcohol and public health". Lancet. 365 (9458): 519–30. doi:10.1016/S0140-6736(05)17870-2. PMID 15705462.{{cite journal}}: CS1 maint: multiple names: authors list (link) JFW | T@lk 09:52, 12 May 2008 (UTC)

Spiro Keats (talk · contribs) asked me if we could also cast an eye on alcohol and cancer, to which he has devoted a lot of time. That article looks in a very good shape, and could certainly inform this article's content on alcohol vs malignancy. JFW | T@lk 12:41, 12 May 2008 (UTC)

I'm surprised that there's no mention of folate deficiency or Korsakoff's syndrome in the article. I'll try to write something (see what's in my text books) after finals get over on Thursday if no one else has added a section yet. JPINFV (talk) 23:33, 12 May 2008 (UTC)

What are we doing about reliable but not peer reviewed articles? (e.g. things like eMedicine?) Shall we use them or stick entirely to the peered stuff? Regards, CycloneNimrod^Talk? 08:14, 13 May 2008 (UTC)

I have a personal strong preference for leaving out Emedicine. For one thing, it focuses quite strongly on the American situation and does not adequately describe practice in the United Kingdom or elsewhere. Secondly, while Emedicine is "peer-reviewed" in the sense that fellow physicians review the content, it is not a classical source like a textbook or a journal. I'm open to persuation. JFW | T@lk 08:59, 16 May 2008 (UTC)

I've added a very short psychological effects section to the article. I'll try and expand upon it but I could really use some decent sources to help? Regards, CycloneNimrod^Talk? 11:11, 13 May 2008 (UTC)

I'm finding the differentiation between effects of light/moderate consumption vs abusive consumtion hard. We need some sort of structure e.g. two sections one for low consumption, one for heavy. Could be as two main sections, two sections per effect, or dare I say it as two articles :( LeeVJ (talk) 22:03, 13 May 2008 (UTC)

So, for example, Long-term effects of excessive alcohol consumption and Long-term effects of light or moderate alcohol consumption? Personally, i'm not sure, i'll go with consensus, but I reckon we could keep it as one article and just make it clearer. Regards, CycloneNimrod^Talk? 18:32, 15 May 2008 (UTC)

I disagree with an article split. There is very little to say on low consumption - most conditions associated with alcohol occur only as a result of heavy drinking. Let's please keep it as it is.JFW | T@lk 08:56, 16 May 2008 (UTC)

I suppose it could be reworded to start have each section on effects begin with effects of abstinence, low consumption moderate, heavy as a sort of progressive symptoms of a disease type section ? LeeVJ (talk) 11:55, 16 May 2008 (UTC)

I'm somewhat dismayed by the complete absence of acute and chronic pancreatitis in this article. Something else for this aspiring gut doctor to do... JFW | T@lk 08:56, 16 May 2008 (UTC)

Doesn't alcoholism damage the prefrontal cortex?

Liver disease and pancreatitis as the two major negative effects are missing sections. The article seems slanted towards the positive.72.211.139.189 (talk) 06:40, 12 June 2008 (UTC)

I would like to add a link to: www.talkingalcohol.com The damaging effects of alcohol are clearly displayed and are viewable to any person(s) 18 or over. Contributions/79.121.177.78 (talk) 09:45, 15 June 2009 (UTC)

Removed potsdam.edu website link

Please see a discussion here as to why this website does not meet WP:RS as an objective, third-party source: Wikipedia talk:WikiProject Spam/2008 Archive Aug 1#About 400 links to the two sites of one individual Flowanda | Talk 01:02, 24 July 2008 (UTC)

"Beneficial" claim: I'm taking it out of the lead.

Okay, I'm taking out the section which currently reads:

Having between one to two alcoholic drinks a day has been shown to have positive effects on health, unless contraindicated,

with the reference

Yuan, Jian-Min; Ross, Ronald K; Gao, Yu-Tang; Henderson, Brian E; Yu, Mimi C Follow up study of moderate alcohol intake and mortality among middle aged men in Shanghai, China British Medical Journal, 1997, 314, 18-23.

Please don't re-add it without careful consideration.

• The study makes no causative claim
• The study's attempt at excluding a common causative factor for lowered risk of heart attack and alcohol consumption is rudimentary: age, level of education, and cigarette smoking. In particular, non-alcohol diet is totally ignored.
• The study itself cites several prior studies which appear to contradict the causative claim made here.
• The 95%-confidence claim of the study is a 4% lower risk of death by ischaemic heart attack in middle-aged Singaporean men who fall into the "1-14 drinks a week" group over the "lifelong non-drinker" group.
• The phrase "Having between one to two alcoholic drinks a day" is virtually meaningless. It's virtually impossible for any person to have at least one but no more than two standardised alcoholic drinks every day of their life; how people are categorised into consumption groups is itself a complicated question, and there is some reasonable suspicion, at least, that average alcohol consumption over a timeframe of weeks or months is a much worse indicator than the highest intoxication level reached regularly.

If you want to make an overall statement, it should be that no public health authority (that I'm aware of) recommends non-drinkers start consuming alcohol for health purposes, or alternatively a comparison of those (few) that do and those (nearly all) that don't. Note that a medical recommendation is itself a much weaker claim still than actual causation, and I do not believe even the weak claim, that a significant number of health professionals recommend alcohol consumption for non-drinkers in any case based on evidence-based medicine, rather than misinterpreted studies, is true.

In short, find a professor at a well-established university who tells people to drink alcohol, that it's good for them, and why, without misinterpreting statistics in an obvious fashion, and the claim can go in; otherwise, it's just outside the realm of evidence-based medicine.

RandomP (talk) 15:43, 23 November 2008 (UTC)

Numerous epidemiological studies have found an association between moderate alcohol intake and reduced coronary heart disease risk and also mortality rates. However, heavy and binge intake is associated with increased mortality rate and coronary atherosclerosis. From what I can gather, potential cardioprotective effects of moderate alcohol are thought to be attributed to an increase in high-density lipoprotein cholesterol (which decreases LDL oxidation and removes cholesterol from arterial walls and transports it back to liver), a decrease in plasma fibrinogen concentrations --> decreased platelet aggregation, increased fibrinolysis, increased NO production, increased insulin sensitivity, and antioxidant activity by re-reducing vitamins with NADH. On the other hand, heavy intake is associated with decreased fibrinolysis and increase or rebound of platelet aggregation, hypertension, and arrhythmias.

Here's a recent review article that elaborates on what's currently out there to suggest beneficial/detrimental effects of alcohol: http://www.ncbi.nlm.nih.gov/pubmed/19075312.

Unfortunately, I don't think there are any randomized intervention studies conducted on alcohol and mortality rates. Virtually all evidence of an association between cardiovascular effects and alcohol consumption comes from observational studies with a greater emphasis being seen with positive (beneficial) results with moderate alcohol (though this may be due to publication bias). But I still think it might be worth mentioning a potential beneficial effect of moderate alcohol consumption but that this conclusion is controversial due to numerous potential confounders in certain studies. —Preceding unsigned comment added by 219.90.163.139 (talk) 13:39, 7 December 2009 (UTC)

(Excessive) focus on moderate drinking breaches NPOV

As the article stands (27th Nov 2008), some sections focus solely on moderate consumption, with complete disregard to the effects of heavy consumption. For instance, the section "cardiovascular system" and the subsections "Cardiovascular disease"; "Coronary Heart Disease"; "Coronary Vascular Disease" ; "Peripheral Arterial Disease" ; "Intermittent claudication (IC)" ; "Heart attack and stroke", moderate consumption levels were discussed, but no mention was made of the effects of heavy consumption. Consequently, these sections are overwhelmingly positive, whereas discussion of heavy consumption would highlight deleterious effects.

This is not intended to be an article on the long-term effects of 'moderate' alcohol consumption - it is an article on long-term effects generally. The selective attention to moderate consumption biases the article.

NcLean 114.76.96.115 (talk) 23:27, 26 November 2008 (UTC)

This is possibly the worst Wikipedia article I've ever seen, and that's pretty bad. Who wrote it, the Alcoholic Beverage Association? Study after study, reference after reference, trying to state some f***ing positive aspect of alcohol consumption. Alcohol is a f***ing poison. It is habit forming and addictive to some people. To say that there are any positive effects is a f***ing lie by the peddlers of this shit. No single substance causes as much loss of productivity, crime, and destruction as alcohol. The people who write this sh*t need to have their bottles taken away for good, you self justifying pr**ks.— Preceding unsigned comment added by 75.18.183.226 (talk • contribs)

I completely agree, most NPOV article I've seen on wikipedia. Someone should really rewrite. 99.255.5.248 (talk) 21:33, 13 March 2009 (UTC)

I have done quite a bit of a rewrite and have removed a lot of biased and poorly sourced info, please make further suggestions of how the article can be further improved. Also please do consider registering an account and using reliable sources, eg pubmed for finding medical papers to quote to cover the impacts of heavy drinking. I was surprised at just how biased the article was when I read it in full. A lot of it was just copied and pasted, entire sections were copied and pasted quotes. Occasionally a short quote or two can be justified but a good third of this article was copied and pasted quotes, total copyright violation. I have reduced the amount of quoted text.--Literaturegeek | T@1k? 04:12, 14 March 2009 (UTC)

Ok I just did another major rewrite and got most of the bias out or added more up to date review articles. I think that it is clear that alcohol has some benefits at low levels for the general public but the way it was written by added by David J. Hanson who's funded by Distilled Spirits Council of the United States and who used sockpuppets, was basically a propaganda piece and highly biased. I think the remaining health benefits should stay but perhaps some research of the medical literature for the adverse effects of heavy use can be added.--Literaturegeek | T@1k? 07:14, 14 March 2009 (UTC)

Thanks for your work Literaturegeek. It certainly is an improvement. However, I would still say the article is quite NPOV. Not that any of the information is necessarily wrong (that I know of), but just the amount of space dedicated to benefits vs. risks is still very unbalanced.

As to a more specific comment, the cancer section should be clarified. One source claims alcohol is a carcinogen, one claims it is not. Also, perhaps this recent study should be included: http://professional.cancerconsultants.com/oncology_main_news.aspx?id=43299 99.255.5.248 (talk) 10:50, 14 March 2009 (UTC)

I've added in the view of the International Agency for Research on Cancer, which is unequivocal. The section does need further work, though. Nunquam Dormio (talk) 12:09, 14 March 2009 (UTC)

It seems that some people are very angry about any article that doesn't describe alcohol as evil. Given the fact that certain denominations of Christianity denounce the use of alcohol, it seems that there is a natural source for bias. This is just as ridiculous as the people who try to attack the evolution article as "NPOV" or biased.

History and Emphasis of this Article

This page originated as a discussion of the controversy surrounding possible health benefits of moderate alcohol consumption. For the discussion page on earlier versions of the article, click here.

This may account in large part for the perceived imbalance of the article. It would benefit from being re-written by a subject matter expert. 147.114.226.180 (talk) 14:34, 13 March 2009 (UTC)

Thanks that explains it. I figured out who was behind the biased edits to this article, see section above.--Literaturegeek | T@1k? 07:16, 14 March 2009 (UTC)

Finished

I have done a number of edits over the past few weeks to the article to bring back balance to the articles. Previously there was a lot of people complaining over the years about the severe pro-bias of the article in favour of alcohol being a wonder drug. Whilst alcohol does appear to have some health benefits at low doses tese were greatly inflated and almost entirely to the exclusion of the serious health problems associated with excessive alcohol use. No doubt further improvements can be made to the article but as I don't believe that there are any serious overall issues remaining regarding neutrality I have removed the tags. If anyone disagrees feel free to point out remaining issues and if necessary readd the tags.--Literaturegeek | T@1k? 11:16, 3 April 2009 (UTC)

Questions about authenticity

No offence intended to the authors/editors of this article but i noticed a certain change in attitude about the positives and negatives of this article. In the start of this article i noticed that the authors/editors were very pesimestic towards the long term effects of eccesive consumption of alcohol but then you started to become more optimistic "Two recent studies report that the more alcohol consumed, the lower the risk of developing rheumatoid arthritis" having positive attitudes towards eccesive consumption of alcohol. Maybe there was some outside influence in this sudden change in attitude??? Ulyanov322 (talk) 01:00, 4 May 2009 (UTC)

Thank you for your comments. Previously this article was severely biased in favour of chronic daily alcohol consumption but largely omitted the harmful effects. I removed a lot of the bias and added in the harms of alcohol. I didn't remove some of the positive effects which were cited because I was unable to find refs which disputed those claims. It seems factual that alcohol reduces rheumatoid arthritis. Alcohol however, increases the risk of gouty arthritis so that section is relatively neutral anyway. What changes do you think should be done to the article?--Literaturegeek | T@1k? 05:59, 4 May 2009 (UTC)

There seems to be a lack of information

There seems to be a serious lack of information in regards to the negative effects of alcohol on the brain. I have a hard time believing that alcohol is harmless to the brain and if that is the case, it's very well worth noting in fine detail [test results, medical research, etc]. Things like "atrophy", just don't cut it. What's the quantity of atrophy? What's the cause [a.k.a. the mechanism of action]? IMO, this article leaves much to be desired in this regard.

 —Preceding unsigned comment added by 76.202.194.131 (talk) 08:38, 3 June 2009 (UTC) 

Talking Alcohol is an informative and useful website highlighting the damaging effects of alcohol. The negative effects are clearly displayed and are viewable to any person(s) 18 or over. Contributions/79.121.177.78 (talk) 09:53, 15 June 2009 (UTC)

Title and content: Long-term effects of alcohol abuse

The title should be a little more specific here. Most of the article deals with the effects of long-term alcohol abuse so that (or at very least "consumption") should be more clear from its name. I'd also remove ad hoc references to the benefits of moderate consumption for the same reason. --mikaul^talk 10:54, 30 July 2009 (UTC)

Yea but then where does the content go on the beneficial effects of low - moderate alcohol consumption go to? The article as it is currently is named and its content puts long-term alcohol use into context, covering both non-harmful possibly beneficial use and harmful effects; I think that it is a nice balance now and informative to the reader.--Literaturegeek | T@1k? 00:40, 8 December 2009 (UTC)