To answer my own question, I found an excellent report from Canada. In it, it shows that there is really no such thing as "No risk drinking". just lower risk versus high risk drinking for long term health problems.

http://www.ccsa.ca/Resource%20Library/2011-Summary-of-Evidence-and-Guidelines-for-Low-Risk%20Drinking-en.pdf

Dear John! The problem of addiction to alcohol, smoking, drugs ... The problem catastrophically ruthless. Dying talented, beautiful people. In fact, we all know about the diversity of individual sensitivity to alcohol (the presence of enzymes, health, hormonal features ...). There are habits of Winston Churchill and is also known for a large enough length of his life. The critical value is the quality of alcohol. Of course it is important to raise a child a sense of moderation, liability in humans for their lives and the lives of others. It is advisable to take into account the individual characteristics of each person, which is important during therapy.

Vladimir

Very good points Vladimir. Even if we identify levels of risk for the general population, as the Canadian reports does so well, each individual is different.

I agree that prevention is so important. 

Dear John,

You are right; there is no agreed definition about low risk and high risk. The term is mostly used to define a "starting" point. No/low risk drinking (consumption) is mostly defined by the harm resulting from the addiction (for the consumer and other). It can be defined as: " a consumption pattern/ that does not confer elevated risk from use. Low-risk use may develop by transition from risky or harmful behaviour. (Gell et al. 2016)

Because of the missing definitions (also within the diagnostic systems) and consensus, new concepts starts to define consumption more like "use over time".  (Rehm et al. 2013). But this is a very pragmatic approach.

Best wishes

Sarah

hi John,

A recent report performed by the ScHARR group at Sheffield emphasises the variability of risk according to individual resilience. this evidence has now been used by the  Chief Medical Officer in the UK and  is based on an analysis of risk data for a range of alcohol-related mortality and morbidity. Published in 2016 it reports the most recent meta-analyses of lifetime risk from alcohol consumption. It acknowledges that there is variation in risk on an individual level, epidemiological data indicates that even drinking at low levels contributes to health harms and so there is no level of drinking that is safe over the long term. there is only one section of the population which shows small significant benefits from reduced heart disease in later life: women aged 55 and older. this evidence needs qualifying as it is based on relative risk and could be outweighed by risk increases in other conditions. the analysis is available from the Sheffield Alcohol Research Group at Sheffield University, UK:

Holmes J et al. (2016) 'Mortality and morbidity risks from alcohol consumption in the UK: Analyses using the Sheffield Alcohol Policy Model (v.2.7) to inform the UK Chief Medical Officers' review of the UK lower risk drinking guidelines', ScHARR, University of Sheffield.

hope this is helpful!

Lucy

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Many scientific articles devoted to the subject of alcoholism. What was the cause of Shakespeare's death 400 years ago? How many relatives and close friends is suffering from addictions? How many relatives and close friends have died from alcoholism?

There is a problem of alcoholism and alcoholism undying will for a long time to encourage scientists to address this problem.

 Thank you Micah for expanding the idea to risk of developing an alcohol use disorder and for giving a simplified guideline!

Which leads to Sarah's comment that there needs to be definition of what is considered "low risk" Thanks!

Lucy, Thank you for the citation of the study on the ScHARR study. I look forward to reading this. I agree, research seems to indicate that when it comes to physical health, there is no such thing as "no risk" drinking.

George, thanks for making that point clear in your comments!

It depends on the individual's ability to metabolize alcohol. However there is no such thing as lower risk vs high risk limit. In my opinion any amount of alcohol has a lower threshold for risk. Abstinence is the only safe level.

To complicate it even more; there is variation in the  definition of what constitute a "standard drink" or a "standard unit". It range from 10 - 13g alcohol / liter in different regions. 

http://www.ncbi.nlm.nih.gov/pubmed/2224197

Article Assessing alcohol use and smoking among patients admitted to...

See also WHO's "INTERNATIONAL GUIDE FOR MONITORING  ALCOHOL CONSUMPTION AND RELATED HARM"

http://apps.who.int/iris/handle/10665/66529

Thanks John-Kare, some excellent reference.

Thanks for this historic document, Humberto! Nice to finally read it, I've heard a lot about it. In this case, the concern is not so much on alcohol dependence, it is on high risk vs. low risk drinking. Many people have high risk drinking without reaching the diagnostic criteria of dependence, and it is more a matter of health education or brief interventions to make them aware of the risk and hopefully they will reduce their drinking. Of course, the diagnostic criteria of dependence should also be assessed when high risk drinking is observed. See our article mentioned above where we assessed the drinking patterns of patients admitted to general hospital wards. 

In addition to the amount alchohol used per week, risky drinking is also a matter of drinking pattern; i.e., if a person have a "binge" drinking pattern. At the moment, there is an ongoing discussion in Addiction about how to correctly define "binge drinking", see enclosed link. A higher all-cause mortality in both sexes, and higher cardiovascular disease mortality in men, have been observed with increasing frequency of binge drinking. 

http://onlinelibrary.wiley.com/doi/10.1111/add.13210/abstract?campaign=wolearlyview

http://www.ncbi.nlm.nih.gov/pubmed/23235547?dopt=Abstract

 Thank you John-Kare and Humberto to adding new perspectives to this discussion. I think the Binge-drinking pattern is an important consideration when assessing medical and social risks.

Obviously there are measurements, most of them oversimplified. But there are two approaches I think are worth considering. The first is allied high risk behaviors, such as in the adolescent S-BIRT questioning of drinking and driving involvement. I think there is some value in identifying the behaviors that are involved and considering those high-risk and a direct result from lowered inhibitions.

The second approach has to deal with the reasons for drinking. SUDs is a broad defining characterization which can include all forms of dysfunctional (but not necessarily addictive) drinking/use. People who use to keep symptoms of mental health issues at bay for example, due to lack of access to medication, are fundamentally different from people who have life long chronic alcoholism. It may be helpful to consider addiction as a subset of SUDs determination, operand on the subjective "cause" for the person's drinking.

Good point about assessment Austin, with the DSM V classification, the distinction between dependence and abuse is removed. I suppose this may help do away with the stigma of being labled "addicted" or "dependent", but it does leave it up to the clinician to determine the level of severity and subsequent level of care needed.