What you don’t know about alcohol
by Mary Wilson // April 29, 2025
Note: The following is based on a conversation between Kurt White and Dr. Geoff Kane.
Alcohol is deeply woven into our culture — poured to celebrate life’s milestones and used to relax after long days. But how often do we pause to consider its risks? While alcohol may seem harmless, especially in moderation, emerging research challenges this perception, revealing significant health risks even at low levels of consumption.
In a recent conversation for the Brattleboro Retreat’s bi-weekly podcast, “Unravelling,” Kurt White, vice president of Community Partnerships, sat down with Dr. Geoff Kane, Emeritus Chief of Addiction Services at the Retreat, to discuss the evolving understanding of alcohol’s impact on health. The discussion came on the heels of the U.S. Surgeon General’s call for cancer warning labels on alcohol and Canada’s updated guidelines on alcohol use, which recommend no more than two drinks per week — far lower than many might expect.
CHALLENGING OLD ASSUMPTIONS
“What was once thought of as ‘safe drinking’ is no longer supported by the science,” Dr. Kane explained. “The guidelines out of Canada, for instance, summarize a tremendous amount of medical and mental health research that highlights how alcohol’s effects, such as raising the risk of certain cancers, kicks in at relatively low levels of consumption.”
For women, this risk is particularly concerning. “One or two drinks might feel negligible,” Dr. Kane said, “but the research shows that even that level of alcohol consumption conveys an increased risk of breast cancer, among other health concerns.”
According to the U.S. Surgeon General, alcohol consumption is the third leading preventable cause of cancer in the United States, after tobacco and obesity, increasing risk for at least seven types of cancer. While scientific evidence for this connection has been growing over the past four decades, less than half of Americans recognize it as a risk factor for cancer.
CASUAL DRINKERS AT RISK
White and Kane’s conversation didn’t focus on extreme cases of alcohol dependence. Instead, the emphasis was on more casual drinkers — the majority of people who drink — who may not consider themselves at risk for health problems due to alcohol.
“It’s not just the people ‘in the deep end of the pool,’” White said. “We often overlook the risks faced by the broader community — those who might not drink every day but consume more than they realize during social occasions or weekend outings.”
Dr. Kane highlighted the importance of moving away from labels and instead focusing on behavior. “I favor descriptions over diagnoses,” he said. “If someone says, ‘I have an unhealthy relationship with alcohol. I don’t drink every day, but when I do, I consume an inappropriate amount,’ it’s more important to help them curtail their use of alcohol than to place them in a specific diagnostic category. They’re already concerned that their drinking can have significant health consequences.”
PERSONAL AUTONOMY AND RISK TOLERANCE
A key takeaway from the episode was the concept of personal autonomy and risk tolerance. Dr. Kane stressed that the goal isn’t to pass judgment or impose restrictions but to offer accurate information so individuals can make informed choices.
“Risk tolerance varies from person to person,” Dr. Kane explained. “Some might decide to embrace a ‘zero drinks a week’ approach, while others weigh the risks against their enjoyment of occasional drinking. What’s important is having the information to make those decisions thoughtfully.”
This aligns with Canada’s revised guidelines, which Dr. Kane praised for their respect for individual autonomy. “The guidelines don’t tell people what to do,” he said. “Instead, they offer what you might want to think about as you decide what’s right for you.”
UNDERSTANDING A STANDARD DRINK
Another common source of confusion is the concept of a standard drink. Dr. Kane provided clarity: “When researchers study alcohol’s health effects, they refer to a standard drink — one and a half ounces of spirits, a 12-ounce beer, or a 4- to 5-ounce glass of wine. Each contains the same amount of alcohol, but the concentration varies.”
Unfortunately, many people underestimate how much they’re drinking. “A large goblet of wine that’s half or two-thirds full often contains much more than a standard drink,” Dr. Kane pointed out. This misunderstanding can lead to unintended overconsumption.
MOVING TOWARD PREVENTION
Alcohol’s health risks aren’t limited to individuals with an official diagnosis of alcohol use disorder. Prevention plays a vital role in reducing harm. “The lines between treatment and prevention are breaking down,” Dr. Kane said. “Actions like reducing alcohol accessibility help prevent young people from starting and support adults in making healthier choices.”
