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Summary: Yes, moderate drinking can cause health problems. New research shows drinking at levels defined as moderate by Centers for Disease Control (CDC) can increase risk of alcohol-related health problems, compared to not drinking at all.

Key Points:

  • Previous beliefs about moderate drinking have been called into question by the latest research on alcohol and health.
  • Moderate alcohol consumption increases risk of several types of cancer.
  • Moderate drinking can increase risk of premature mortality.
  • Detailed analysis shows moderate drinkers who occasionally binge-drink are at the highest risk of alcohol-related health problems.

Debunking Alcohol Myths: The Myth of Moderation

Over the past several decades, most adults around the U.S. and the world have heard from friends or read in an article somewhere that drinking one or two glasses of wine or maybe having a beer or two every evening with dinner is not so bad. In some cases – so the common theme goes – one or two alcoholic beverages with dinner actually improves health.

At face value, that old myth – because evidence shows it is a myth – makes a certain kind of sense. Alcohol can be relaxing – we all know that. And we all need a safe and heathy way to relax and reduce stress – we all know that, too. In addition, various studies show that red wine contains a chemical called resveratrol that may reduce coronary artery disease. The stress-reduction component and the heart health component, combined, gave millions of people the idea we introduce above: a glass or two of red wine with dinner is a good idea.

However, we now know that it’s not a good idea, although moderate alcohol consumption is within a range considered safe by all the expert authorities, including the Centers for Disease Control (CDC). It’s somewhat of a paradox. Consider this recent warning by the Surgeon General of the United States from the 2025 publication “Alcohol and Cancer Risk”:

“Emerging evidence suggests that even drinking within the recommended limits may increase the overall risk of death from various causes, such as from several types of cancer and some forms of cardiovascular disease. Alcohol has been found to increase risk for cancer, and for some types of cancer, the risk increases even at low levels of alcohol consumption (less than 1 drink in a day).”

That puts an entirely different spin on drinking a moderate amount of alcohol every day. And that’s not the only data point that signals the end of this familiar – and incorrect – cultural trope. Also, consider these further clarifications on the topic from Stanford University In the article “Is Moderate Drinking Actually Healthy? Scientists Say the Idea Is Outdated”:

“We don’t have strong evidence of any health benefit from moderate drinking, but we do have strong evidence of harm.”
“The only perfectly safe amount of alcohol is none.”

If we weren’t ready to put this notion to bed for good, a new, long-range study published in the American Journal of Preventive Medicine reveals evidence that will – or should – cause every person who’s a moderate drinker, as well as medical professionals who evaluate alcohol consumption, to reexamine and reconsider most of what they know about the relative risks and rewards of moderate drinking.

The MIDUS Study

The MIDUS study is the core work generated by a group of researchers funded by the John D. and Catherine T. MacArthur Foundation Research Network who launched the Successful Midlife Development Study (MIDMAC) in order to identify the “biomedical, psychological, and social factors” that allow some people to thrive during their adult years.

One important aspect of the study was an in-depth look at alcohol drinking patterns among adults. One outcome of the study was evidence directly related to the question of whether moderate drinking can cause health problems – and what they found was both surprising and informative.

Researchers were specifically interested in examining the relationship between moderate drinking and binge drinking. They hypothesized that binge drinking patterns among moderate drinkers might predict subsequent problem drinking and alcohol-related problems. They published the result of this sub-study in June 2022 a paper called “Binge Drinking and Alcohol Problems Among Moderate Average-Level Drinkers.”

The primary question the study sought to answer was whether moderate drinking and binge drinking interact to cause harm to moderate drinkers over time. That’s an important question, because most of us know people who have a drink or two every day (or most days) and have five or more drinks on one occasion around once a month. We also know this fairly typical pattern begins around early adulthood/college age and for some people, continues indefinitely – or at least into the middle years, defined here as over age 30 and under age 65.

Here’s how study participants responded to the first survey, which served as baseline to measure any changes observed in the second survey.

The Results: Big-Picture Numbers

Among 1,229 current drinkers, researchers identified:

  • 972 total moderate or heavy drinkers:
    • 925 reported moderate drinking at baseline
    • 47 reported heavy drinking at baseline

Among 1,229 current drinkers, researchers identified:

  • 257 total binge drinkers:
    • 182 reported moderate drinking at baseline
    • 75 reported heavy drinking at baseline

Of the 1,229 current drinkers, researchers identified:

  • 1,114 showed no presence of alcohol-related problems. Of those:
    • 1,030 reported moderate drinking at baseline
    • 84 reported heavy drinking at baseline
  • 101 showed clear presence of alcohol-related problems. Of those:
    • 77 reported moderate drinking at baseline
    • 38 reported heavy drinking at baseline

At 9-year follow up:

  • 666 participants showed no presence of alcohol-related problems
    • 606 were moderate drinkers at baseline
    • 60 were heavy drinkers at baseline
  • 101 showed clear presence of alcohol-related problems:
    • 80 were moderate drinkers at baseline
    • 71 were heavy drinkers at baseline

That’s essentially raw data, and we recognize that it’s not easy to tease the meaning out of these numbers.

However, there are important facts to glean – and we can help.

First, please notice that at baseline, 95 percent of current drinkers reported moderate drinking. Next, notice that 71 percent of binge drinkers reported moderate drinking, whereas only 29 percent of binge drinkers reported heavy drinking. Finally, note that at baseline, just over 67 percent of participants who reported moderate drinking reported the presence of alcohol-related problems, while in contrast, 33 percent of heavy drinkers reported alcohol-related problems at baseline.

The statistical analysis below expands and helps unravel this data, which is somewhat counterintuitive – but it’s information that’s crucial for everyone to know. We do mean everyone, from regular people on the street, to people in treatment, to professional addictionologists who see these numbers in real life every day.

The Results: In-Depth Explanation and Analysis

  • Moderate drinkers accounted for 85% of alcohol-related problems at 9-year follow-up.
    • Among men:
      • Moderate drinkers accounted for 85% of alcohol-related problems at 9-year follow-up.
    • Among women:
      • Moderate drinkers accounted for 64% of alcohol-related problems at 9-year follow-up.
    • Binge and heavy drinking at baseline predicted the presence of alcohol-related problems at 9-year follow-up.
      • Binge drinkers at baseline had a 40% increased likelihood of increased alcohol problems at 9-year follow-up.
      • Any binge drinking at baseline increased risk of multiple alcohol-related problems at 9-year follow-up by 160%
      • Any heavy drinking at baseline increased risk of multiple alcohol-related problems at 9-year follow-up by 97%
    • Participants who reported regular binge drinking at baseline were 385% more likely to report alcohol-related problems at baseline
    • Participants who reported regular heavy drinking at baseline were 111% more likely to report alcohol-related problems at 9-year follow-up.
    • Binge drinking episodes among moderate drinkers predicted alcohol-related problems at 9-year follow-up more robustly than binge drinking episodes among heavy drinkers.
    • Moderate drinking + binge drinking at baseline increased risk of multiple alcohol-related problems at 9-year follow-up by 439%

That last bullet point is the one we encourage everyone to understand. We’ll explain why in just a moment, and address the rest of the data first.

Drinking Patterns and Long-Term Harm

As we can see in the analysis, any binge drinking and any heavy drinking at baseline were associated with significant problems at 9-year follow-up. That makes sense. Everyone knows heavy drinking and binge drinking can cause serious physical, emotional, and psychological problems. Also, regular binge drinking at baseline increased problems at 9-year follow up and regular heavy drinking at baseline increased problems at 9-year follow up significantly more than any binge/heavy drinking. That also makes sense. More binge/heavy drinking, more problems.

Most of us could have predicted that.

What most of us probably could or would not have predicted was that moderate drinking at baseline – in the amount that for decades most everyone had heard might be good for us – combined with any amount of binge drinking causes more problems and increases risk at 9-year follow up more than any other combination of drinking patterns.

That means that a person who has a glass or two of wine every night and has five drinks on one night at least once a month is at higher risk than a person who drinks more than two drinks every night.

In other words, a person classified as a moderate drinker who binges once a month is at higher risk than a person classified as a heavy drinker who doesn’t binge, and also at higher risk than a heavy drinker who binges.

What This Means in Daily Life

Think about that.

A person who has a couple of glasses of wine with dinner probably doesn’t think they get drunk every night, and probably doesn’t consider themselves a heavy drinker. That person may go out once a month and get drunk – and that seems totally normal to them. And to be honest, it seems totally normal to most of us. That seems like typical behavior. On the other hand, someone who has more than two drinks a night might admit they get drunk most nights and probably also know they’re a heavy drinker. Whether or not they binge, they likely know heavy drinking isn’t the best health choice – and most of us would agree.

However, the data in this study says the former person is at highest risk of the most long-term harm from alcohol, and the latter person is at less risk of significant long-term harm from alcohol. At risk, certainly, but at less risk than the person most of us would think is not at much risk at all.

That’s what we want everyone to know. A pattern of drinking recently considered benign – with the addition of just one binge episode per month – leads to the greatest risk of harm from alcohol. This is something we can watch for in ourselves, in our friends, and in our families. This is also something mental health professionals and primary care physicians can include in their alcohol screening processes. If everyone works together to identify the highest risk individuals early and get them the help they need sooner rather than later, then we can mitigate the overall, long-term harm caused by alcohol.

That’s an achievable goal – and something to think about.