To the Editor.
—We agree with the recent Editorial by Dr Pearson and Mr Terry1 that certain patients, such as pregnant women, should abstain entirely from alcohol. However, we wish to comment on their suggestion that physicians might advise other population subgroups to initiate moderate alcohol consumption.Epidemiological findings indicate that although women are less likely to drink, drink less heavily, and develop fewer alcohol-related problems than men, they develop alcohol dependence more rapidly.2 Women metabolize alcohol less efficiently than men, probably because of reduced first-pass metabolism. Together with less ethanol dilution attributable to lower body water content, this metabolic difference increases bioavailability of alcohol and may enhance sensitivity to alcohol-induced physiological impairment. There also seems to be a greater risk for liver cirrhosis for women than men at comparable consumption levels; and women contract pancreatic disease after shorter periods of consumption and liver disease at lower consumption
Gordis E, Dufour MC, Warren KR, Jackson RJ, Floyd RL, Hungerford DW. Should Physicians Counsel Patients to Drink Alcohol?. JAMA. 1995;273(18):1415. doi:10.1001/jama.1995.03520420027014