Is alcohol increasing your health risks?

April is Alcohol Awareness Month and a good time to examine the possible effects that alcohol may be having in our lives.

Most people are aware that alcohol can be detrimental to their health. Many also have encountered people in their lives who are dependent on alcohol which is a serious health condition. Yet 9 of 10 people who drink excessively are not alcohol-dependent.

In between low-risk drinkers and alcohol dependence there are many people whose drinking puts them at increased risk of harm from alcohol use.

As individual awareness of the harm of excess alcohol seems high, the numbers of what alcohol is still doing on a societal level are surprising.

In the U.S. the monetary cost of excessive alcohol use reached $249 billion in 2010.

These costs are due to things like loss of workplace productivity, healthcare costs, collisions and criminal justice costs.

But tracking money is a cold way to look at a situation that has a tragic human cost.

The Center for Disease Control states that from 2006-2010, excessive alcohol use accounted for nearly one in 10 deaths among U.S. adults aged 20-64.

And excessive drinking does not just take a few years off; it shortened the life of those who died by an average of 30 years.

So, what constitutes low-risk use of alcohol? Adult male limits are no more than four drinks a day and no more than 14 drinks a week. Neither amount can be exceeded in a week to constitute low risk. For women and adults over 65 the limits are no more than three drinks a day and no more than seven drinks in a week. Low risk intake can still be a problem if it is combined with certain medications, or if one suffers from certain health conditions. Any intake by those under 21 or pregnant women is considered excessive.

Let's also increase awareness of what constitutes a drink: One drink is 12 ounces of regular beer, 5 ounces of wine and 1.5 ounces of distilled spirits. Be aware that regular beer is about 5 percent alcohol. Some brews have over 11 percent, putting their alcohol content closer to that of wine. With wine, please note large wine glasses hold much more than 5 ounces. In fact, 5 ounces will look skimpy in a big glass, and your server will pour more to keep you happy.

One in three adults fall into a higher risk intake category. At this level of drinking we cannot say for each person that alcohol is an issue but we can ask, is it a problem?

One pattern of risk is to exceed the daily high amount on a sporadic basis, often called binge drinking. Dangerous health events like alcohol poisoning can happen in situations when a lot of alcohol is imbibed in a short amount of time. Risk of injuries, motor vehicle crashes, violence, and suicide are seriously increased under the influence of alcohol. Exceeding daily amounts means changes in judgment and coordination that are inherently risky.

Many of the risks with alcohol occur at lower doses taken over a longer period of time. Long-term health issues that can result include an increased risk of liver disease, heart disease, stroke, bleeding from the stomach, increased incidence of sexually transmitted infections and several types of cancer including breast, colon and liver cancer.

These risks are harder to determine and involve individual biochemical and genetic factors as well as lifestyle factors. Regularly seeing your physician and getting basic lab work done as well as being aware of how alcohol makes you feel and being open to input from those closest to you can give you clues as to whether drinking is creating issues for your health.

It is common to consciously or unconsciously self-medicate with alcohol. Depression, pain and sleep issues seem at least temporarily helped by a drink. In reality however, each of these issues can be worsened by alcohol.

Alcohol is a central nervous system depressant and can create or exacerbate depression. Alcohol combined with pain medication can increase sedation or risk of bleeding, and alcohol exacerbates the sleep issues common with chronic pain. Alcohol may help people fall asleep faster but the quality of sleep is worse. Alcohol interferes with REM sleep and can affect breathing, worsening or creating episodes of sleep apnea.

Know that alcohol is not the best coping strategy for these conditions and look for healthier pain, mood and stress management techniques.

A healthy relationship with alcohol will look different depending on the individual. Understanding the risks inherent in certain intake amounts as well as growing awareness of one's bodily response to alcohol gives information from which to make better choices for health.