Researchers reviewing decades of evidence conclude that alcohol plays a major role in disease and injury, affecting everything from the immune system to the brain and heart.
A major new review published in Addiction paints a sobering picture of alcohol’s impact on health, linking drinking to dozens of diseases, infections, and injuries that affect nearly every organ system in the body.
Researchers say some of alcohol’s harms may lessen after people reduce or stop drinking, but many effects of long-term heavy use can persist for years — and in some cases may never fully reverse.
Alcohol drives many diseases
The World Health Organization’s current International Classification of Diseases (ICD-11) identifies more than 60 diseases and injuries that are 100% attributable to alcohol use. Many are associated with chronic heavy drinking, including:
- Alcoholic cardiomyopathy (heart muscle disease)
- Alcohol-related liver disease, including cirrhosis
- Alcohol poisoning
- Fetal alcohol syndrome
- Alcohol-induced pancreatitis
- Alcohol-related neurological disorders
Alcohol also increases the risk of infectious diseases
Recent evidence shows alcohol weakens immune defenses and damages liver function, increasing vulnerability to infections such as:
- Tuberculosis
- Pneumonia
- HIV/AIDS
- Sexually transmitted infections
Researchers note that alcohol-related impairment can also contribute to behaviors that increase infection risk.
Alcohol Is Linked to Several Major Chronic Diseases
The review identifies five major categories of noncommunicable disease linked to alcohol use. Researchers found that drinking is associated with a higher risk of several cancers — including cancers of the mouth, throat, liver, breast, colon, and cervix — as well as cardiovascular diseases such as high blood pressure, atrial fibrillation, and stroke.
Other conditions linked to alcohol consumption include:
- Type 2 diabetes
- Dementia and epilepsy
- Liver cirrhosis
- Pancreatitis
Alcohol Raises the Risk of Injury
Even small amounts of alcohol can impair coordination, judgment, and reaction time. According to the review, injury risk depends not only on how much alcohol is consumed, but also on factors such as environment, activity, and use of other substances.
Alcohol use is linked to higher rates of:
- Traffic accidents
- Falls and other unintentional injuries
- Violence and assault
- Injuries affecting other people, not just the drinker
Some harms can reverse
Some alcohol related harms can improve or decline when drinking is reduced or stopped:
- Short-term risks, including injuries and sexually transmitted infections, mostly occur during intoxication, so the risk drops when drinking stops.
- Alcohol temporarily weakens immune function. The immune system may recover after a person stops drinking, although long-term heavy drinking can leave lasting damage.
- Many chronic diseases linked to alcohol, including cirrhosis and heart disease, cannot be fully reversed. However, drinking less can slow their progression even when some damage remains. Some cardiovascular effects may improve within days to weeks after abstinence begins.
- Brain damage caused by heavy drinking may partly improve with long-term abstinence, although risks such as dementia can remain.
Possible benefits remain disputed
Senior author Dr. Jürgen Rehm, Senior Scientist at the Canadian Centre for Addiction and Mental Health (CAMH), comments: “Even though we now know a lot about alcohol’s effects on health, it is still controversial whether a little drinking is good for your heart. When examining both cohort studies and Mendelian randomization studies, and all their potential strengths and biases, we conclude that there is not enough evidence to rule out a beneficial effect of drinking on ischemic heart disease and ischemic stroke.”
Sinclair Carr, first author of the review, adds: “Our review of the current evidence on alcohol’s effects on health leads to a cautious but clear conclusion: alcohol is a major cause of disease and injury, and its harms outweigh any potential benefits.” Sinclair Carr is a PhD candidate at the Department of Epidemiology, Harvard T.H. Chan School of Public Health.
Reference: “A review of the relationship between dimensions of alcohol consumption and the burden of disease: 2026 update including Mendelian randomisation studies” by Sinclair Carr, Ana Lucia Espinosa Dice, Gerhard E. Gmel, Ahmed S. Hassan, Kevin D. Shield and Jürgen Rehm, 13 May 2026, Addiction.
DOI: 10.1111/add.70435
Research reported in this publication was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIAAA), grant number 1R01AA028224.
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