In spite of existing evidence compiled over the last 15 years, the effects of COPD and alcohol remain confusing. Many people with COPD still wonder is it okay, or not okay, to drink when you have COPD? And, if it is safe, how much alcohol is considered too much and how much is considered an acceptable amount, health-wise?
What Does the Research Say?
Study results related to COPD and alcohol are conflicting, at best. Here is some of the good news:
- In healthy people, drinking wine (in moderation) is associated with better lung function in the short-term and over a lifetime.
- Heavy alcohol consumption is NOT associated with an increased risk of COPD exacerbation, independent of tobacco smoking.
- Chronic alcohol abuse alone does not lead to acute lung injury; rather, what leads to acute lung injury is chronic alcohol abuse combined with oxidative stress (which occurs due to exposure to tobacco smoke, air pollution, dangerous chemicals and other airway irritants).
- Abstaining from alcohol improves diffusing capacity of the lungs.
And, here is some of the not-so-good news:
- Heavy drinking causes a profound deficiency of the antioxidant glutathione in the lungs, which generates a marked susceptibility to serious lung diseases.
- There is an increased incidence of acute respiratory distress syndrome (ARDS) in chronic alcoholics.
- There is an association between chronic alcohol abuse and altered pulmonary function.
- Alcohol consumption is associated with an increased risk of progressive decline in total lung capacity, residual volume (the amount of air left in the lungs after maximum exhalation), forced vital capacity and diffusing capacity of the lungs.
- Heavy alcohol abuse impairs mucus-clearing ability and worsens outcomes in lung function and mortality in COPD.
- Although abstinence from alcohol may restore diffusing capacity of the lungs as mentioned above, it does not improve airway obstruction in COPD.
Additional Things to Consider
Remember, too, that alcohol may:
- Interfere with some of the medications you take, making them less effective -- this is particularly true for glucocorticoids and antibiotics, but there are many more.
- Potentiate the effect of some medications -- for example, drinking alcohol will increase the intoxicating effects of anxiety and/or pain medications, which may dramatically slow down your breathing to the point of being life-threatening.
How Much Alcohol Is Safe?
Studies suggest that the dangerous effects of alcohol are dependent upon the amount of alcohol consumed, and the duration of the exposure. Most studies agree that heavy alcohol consumption over a long period of time causes the most damage.
That said, it is impossible to know how much alcohol is safe for any one person to drink without knowing that person's individual health history. Every person is unique.
The best thing to do if you enjoy drinking alcoholic beverages is to discuss your options with your health care provider. After all, identifying a safe amount is going to depend upon many other factors, like which medications you take, what other illnesses you have, whether you still smoke, and so on.
The decision to drink alcohol is a personal choice and one that should be approached with the same intensity that you approach other important lifestyle decisions that relate to COPD. Talk to your health care provider about COPD and alcohol at your next appointment. Your health as it relates to COPD may be dependent upon it.
Marc Moss et. al. The Effects of Chronic Alcohol Abuse on Pulmonary Glutathione Homeostasis. Am J Respir Crit Care Med. 2000. 161: 414-419.
Courtney C. Greene, MD, et. al. The Association Between Alcohol Consumption and Risk of COPD Exacerbation in a Veteran Population. CHEST October 2008 vol. 134 no. 4 761-767.
Joseph H. Sisson, MD. Alcohol and Airways Function in Health and Disease University of Nebraska Medical Center, Pulmonary, Critical Care, Sleep and Allergy Section, Department of Internal Medicine, Omaha. Alcohol. 2007 August; 41(5): 293–307.
Emirgil C, Sobol BJ. Pulmonary function in former alcoholics. Chest. 1977 Jul;72(1):45-51.
University At Buffalo. Drinking Wine, Particularly White Wine, May Help Keep Lungs Healthy, University At Buffalo Study. 2002 May 21.