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My Lovely Wife and I were out at our favorite neighborhood bistro the other night and, as we sometimes do, shared a bottle of wine with our meal. We bicycled back home without incident and settled in for the evening, each of us enjoying a nightcap before bed.

It did not occur to either of us that we may be contributing to a public health crisis.

That’s how Bridget Grant, PhD, and her team of researchers from the National Institute on Alcohol Abuse and Alcoholism last month characterized the rise of geezer alcohol consumption in a study published in JAMA Psychiatry. Comparing data on the drinking habits of some 40,000 adults in a 2001–2002 national survey with the results of a similar survey in 2012–2013, they found a 22 percent increase among those 65 and older. It was the largest increase in any of the age groups surveyed.

And the number of elderly Americans who practiced what Grant calls “high-risk drinking” — five drinks in a day at least weekly for a guy; four for a woman — jumped by 65 percent. Alcohol use disorders (or what we used to call alcoholism) more than doubled among this group.

“Substantial increases in alcohol use, high-risk drinking, and DSM-IV alcohol use disorder constitute a public health crisis and portend increases in chronic disease comorbidities in the United States,” Grant notes.

Psychiatrist Marc Schuckit, MD, an addiction specialist at the University of California, San Diego, who wrote an editorial accompanying Grant’s study, sounded similar alarms. “The trajectory over time is remarkable,” he told Paula Span in the New York Times. “You have to say there’s something going on.”

Grant points to the stress brought on by the Great Recession as a possible reason for the rise, but other experts suggest that it may have more to do with the fact that boomers came of age at a time when drug and alcohol use was not widely condemned, as it was during their parents’ youth. “It’s a lot more acceptable,” University of Pennsylvania psychiatrist David Oslin, MD, told Span. “We no longer have those folks who grew up with Prohibition, and abstinence as a value.”

Others have noted that the most recent members of the Medicare set tend to be less frail than their parents were at the same age. If 70 is the new 50, in other words, there’s no reason to curb the drinking habits of your youth.

Mixed Messaging

I would suggest that other factors are at play, however, not the least of which is a constant stream of muddled messages about alcohol’s health benefits. We’ve been told for many years that the resveratrol in red wine is a key to longevity, for instance. In May, researchers in Madrid released a study showing how “wine-derived gut metabolites” may protect your brain neurons. And just last month, the Journal of Alzheimer’s Disease published the results of a study by a UC San Diego research team (which did not include Schuckit) suggesting that “among men and women 85 and older, individuals who consumed ‘moderate to heavy’ amounts of alcohol five to seven days a week were twice as likely to be cognitively healthy than non-drinkers.”

More recently, the Journal of the American College of Cardiology featured a study showing that “moderate drinking was associated with a 13 percent and 25 percent decreased risk of all-cause mortality, and 21 and 34 percent decreased risk of cardiovascular disease mortality, respectively, in both men and women.”

Lead study author Bo Xi, MD, an associate professor at the Shandong University School of Public Health, acknowledges that too much booze can certainly lead to an early grave, but he admits that it can tricky to know how much is too much. “A delicate balance exists between the beneficial and detrimental effects of alcohol consumption,” he says.

The key, according to study coauthor Sreenivas Veeranki, MD, an assistant professor in preventive medicine and community health at University of Texas Medical Branch, is to “drink with consciousness.”

That’s the point Caren Osten Gerszberg makes in this EL piece from a few years ago (she also offers some helpful tips), and it’s something MLW and I discuss periodically when it feels like we’re drinking without thinking. Like anything else, it’s a practice.

Gerszberg, who watched her mother develop a drinking problem, does not drink alcohol on Mondays. As she puts it, “Sometimes I’d like to, but I’ve decided that for at least one day during the week, I need to rest from the dinnertime wine I drink on the other six days. I don’t think I have a drinking problem. But I’m trying to figure out when fun, take-the-edge-off drinking becomes serious drinking — like it did for my mother.”

My dad had a cold beer every day when he got home from work, a ritual I’ve been practicing for much of my adult life. I’m not sure it was mindfulness that limited his daily intake — my teetotaler mom probably had something to do with that — but he managed to control the demons that apparently vexed Gerszberg’s mother.

And I’m confident that MLW and I can maintain that delicate balance Bo Xi describes. Bicycling home from the bistro, after all, can be a bit daunting without it.

Thoughts to share?

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