Life Is Longer on the Wagon, Study Finds

Alcoholics who stay off the bottle--even after more than 10 years of hard drinking--live as long as their nonalcoholic counterparts, according to a new medical study.

Since discovering that alcoholics tend to die younger than nonalcoholics, doctors have wondered whether the damage wrought by alcohol has permanent effects. But according to San Diego researchers, alcoholics who give up drinking live as long as casual drinkers or even teetotalers.

Giving up drinking “will literally save their lives,” said Dr. Igor Grant, an author of the study, which will be published next week in the Journal of the American Medical Assn.

The study confirms that alcoholics can physically recover and lead normal, full lives--something many experts believed but did not have supporting evidence for.

“The findings are consistent with my experience and most medical professionals’ experiences: that if people do stop drinking, their chances of survival are quite good,” said Dr. John Sullivan, medical director of the Francis Key Scott Medical Center’s chemical dependence center in Baltimore. He is also an assistant professor of medicine at the Johns Hopkins University School of Medicine.

Doctors have known that alcoholic men who do not give up the bottle have a death rate that is five times higher than the average, Grant said. Indeed, the rates are even more dramatic among young men.

Drinking men under 45 have a mortality rate 10 times as high as their sober counterparts, Grant said.

“The question we wanted to address was if you are an alcoholic who manages to go on the wagon forever, do you still have premature mortality because you have been an alcoholic for so long and you’ve picked up risks?” said Grant, an assistant chief of psychiatry at the San Diego VA Medical Center.

Researchers had similarly wondered whether former cigarette smokers remained at risk of getting lung cancer. But doctors have learned that the body gradually recovers. The longer a smoker abstains from smoking, the less likely he is to contract lung cancer.

To explore his own question, Grant and his two colleagues followed 199 alcoholic men over an 11-year period, starting in 1976. All the men were healthy--except for their drinking--and had been admitted to the VA Medical Center. It’s also a group Grant describes as “still working or functioning.”

Of the men, 101 relapsed and began drinking, while 98 stayed dry. On average, the men had been drinking at alcoholic levels for 15 years, said Grant, who is also professor and vice chairman of the psychiatry department at the UC San Diego School of Medicine.

For the purpose of the study, Grant used a standard medical definition of alcoholic , which includes a person who is frequently intoxicated, exhibits a pattern of excessive drinking or has a persistent desire to drink despite efforts to cut back.

The researchers also monitored a control group of 92 men, who were selected to be consistent with their counterparts in terms of age, race and education.

“Among alcoholics who were able to abstain continuously, their mortality rate was no different than their nonalcoholic controls,” said Grant, who hopes to continue the study over a 20-year period. “And those who resumed drinking have a mortality rate five times higher than you’d expect for a person of that race, age and sex.”

The causes of death among all the alcoholics were varied and included cancer, heart disease, cirrhosis and bleeding in the gastrointestinal tract (which can result when alcohol enlarges veins in the esophagus and upper stomach).

Grant and his co-authors--medical student Kim Bullock and Robert J. Reed, a senior research associate in UCSD’s psychiatry department--also monitored the groups for their smoking histories.

They found that, even though the abstaining alcoholics smoked substantially more than the nonalcoholic control group, that had no significant impact on the differences in mortality rates. Both groups of alcoholics were heavy smokers, puffing an average of eight packs a week.

One possible limitation to the study, Grant says, is that the researchers have not tracked their subjects long enough, which is one reason he hopes to continue the study for another nine years.

“It is possible that the long-term abstainers still might experience excess mortality in extreme old age, compared with nonalcoholics,” he wrote.

Musing over his own findings, Grant said he now wonders about the rarely studied social drinkers--those who drink up to five cocktails a day.

“Do these heavy social drinkers also have excessive mortality rates?” Grant asked. “If they do, by cutting down, could they achieve longer life? It’s an unanswered question.”