By Olivia Trani  

Dry January is an opportunity to take a break from drinking and see how cutting back from alcohol impacts your health and well-being. It’s also a good time to examine the role alcohol plays in your life and reflect on whether your drinking habits are becoming a long-term health issue. 

“When we think about alcohol, we often focus on the short-term effects: feeling relaxed, maybe a hangover, or the immediate risks like accidents and injuries,” said Juan Pablo Arab, M.D., director of alcohol sciences at the VCU Stravitz-Sanyal Institute for Liver Disease and Metabolic Health. “The long-term effects are much quieter, but far more serious.” 

A recent study co-authored by Arab shows that alcohol use in the United States have shifted in several concerning ways, with heavy drinking and binge drinking becoming more common. These changes in drinking patterns are mirrored by what is seen in the clinic and in national health statistics: a substantial rise in alcohol-related liver disease and increases in liver cancer.  

Women are especially impacted by these trends. They are drinking at higher levels compared to previous years, tend to develop liver damage more quickly and are less likely to receive treatment for alcohol use disorder. In recent years, annual death rates from alcohol-related liver disease rose nearly three times faster for women than men. 

Pablo Arab, M.D., a liver specialist with VCU Health and director of alcohol sciences for the VCU Stravitz-Sanyal Institute for Liver Disease and Metabolic Health. (Enterprise Marketing and Communications)

The data shows that alcohol-related harm is not just about “extreme” drinking, Arab said. Having “just a bit too much” alcohol over many years can also be enough to cause permanent consequences for your health. 

“That’s why periods like Dry January are so valuable: they give people a chance to step back and ask, ‘How much am I really drinking? And what might this mean for my health 10 or 20 years from now?’” Arab said.  

VCU Health News spoke to Arab for tips on how reflect on your relationship with alcohol, recognize problematic drinking behavior and develop sustainable healthy habits for the new year. 

What are some of the unseen, long-term dangers of alcohol for our health? 

Alcohol can cause progressive damage to the liver, starting with fat accumulation, then inflammation and scarring, and eventually cirrhosis and liver cancer. Importantly, this damage can happen for years before a person has any symptoms. By the time people feel unwell, the liver may already be significantly scarred. 

But alcohol’s impact goes well beyond the liver. It raises the risk of several cancers (including breast, colon, and esophageal cancer), contributes to high blood pressure, heart disease, and stroke and worsens diabetes and obesity. It also affects mental health, increasing the risk of depression, anxiety and sleep disorders, and it’s strongly linked to injuries, intimate partner violence and self-harm. 

How can I tell if my drinking habits are problematic?  

A useful starting point is to look honestly at how much, how often and why you are drinking. 

Some warning signs that your drinking may be problematic include: 

• Needing alcohol to relax or cope with stress, anxiety or sleep most days of the week. 
• Regularly drinking more than you planned or finding it hard to stop once you start. 
• Increasing tolerance – needing more drinks to feel the same effect. 
• Drinking despite negative consequences, such as relationship conflicts, missing responsibilities or health problems. 
• Feeling irritable or defensive when someone brings up your drinking. 
• Hiding or minimizing your drinking or feeling shame about it. 

If you don’t know whether your drinking habits are normal, take a look at the low-risk drinking guidelines and see if your “normal” is actually above those thresholds. Many people are surprised when they add up their weekly consumption. 

Finally, pay attention to your gut instincts. If you find yourself wondering, “Is my drinking becoming a problem?” it’s often a sign that something doesn’t feel right. It’s good to take a moment to pause, track your alcohol intake and consider talking with your primary care provider or a mental health professional. 

How can I rethink my relationship with alcohol and develop sustainable healthy habits after Dry January? 

Dry January is a powerful experiment: It shows you what life feels like without alcohol — how you sleep, your mood, your energy and your relationships. The key is not just to “hold on” for a month and then go back to old habits, but to use what you learned to design a healthier long-term pattern. 

Here are a few practical ways to rethink your relationship with alcohol: 

• Reflect on what you noticed after you stopped drinking. Did your sleep, mood or productivity improve? Did you feel more present with family or less anxious? Those benefits are strong motivators to keep some of the changes going. 
• Set clear limits for the rest of the year. For example, decide on specific alcohol-free days each week, a maximum number of drinks on any occasion or situations where you prefer not to drink at all, like when you’re stressed or upset. 
• Find alternative ways to unwind. Build other stress-relief habits — exercise, walks, hobbies, time with friends, mindfulness or simply a non-alcoholic drink you enjoy in the evening. The goal is to replace the role alcohol was playing, not just remove it. 
• Redesign your routines and environments. If you usually drink while cooking, watching TV or socializing, plan in advance what you’ll do instead. Bring sparkling water or alcohol-free options to events and organize activities that don’t center around drinking. 
• Be open to support. If you find Dry January very difficult or if you quickly return to heavy drinking afterwards, that’s a sign you may benefit from talking with a health professional. There are effective medications and counseling approaches that can help people cut back or stop. 

Ultimately, “rethinking your relationship with alcohol” isn’t about perfection or never drinking again unless that’s what you choose. It’s about aligning your drinking with your long-term health and values, and recognizing that even modest, sustained reductions can make a real difference for your liver and overall well-being. 

Want learn more? Dive deeper into new research that shows alcohol’s growing impact on liver disease and cancer in Americans.

See how VCU’s Stravitz-Sanyal Institute for Liver Disease and Metabolic Health is making an impact.