If you’re living with COPD, you may have already made some lifestyle changes to stay healthy and make it less likely that your condition will get worse, which is great. And you might wonder if alcohol could prevent, improve, or make COPD worse. Here’s what the science says about drinking alcohol when you have COPD.
Could Drinking Alcohol Prevent COPD?
Some studies suggest that moderate alcohol use may be linked to a lower risk of COPD. The most recent was published in the American Journal of Epidemiology in 2019. Scientists surveyed over 40,000 Swedish men about how much alcohol, and what kind, they drank and then watched to see who developed COPD. They found that, compared to those who drank liquor, men who drank a moderate amount of beer or wine had lower rates of COPD.
But all of these studies are what scientists call “associational,” which means there was an overlap between people who did a certain thing (in this case, drinking alcohol) and then whether they developed a certain disease (in this case, COPD). Those kinds of studies aren’t the ones doctors use to make medical decisions. They don’t prove that alcohol was the reason someone didn’t get COPD.
It’s not like someone is telling people to drink or not drink, says MeiLan K. Han, MD, professor of internal medicine at the University of Michigan Health System. The kind of study she’s referring to, called a randomized, controlled trial, is much better at showing whether one particular thing -- in this case, alcohol -- can have a good or bad effect on your health. Those are the kind of studies experts use to approve medications and make treatment recommendations.
There are two other problems with the studies that suggest alcohol use could prevent COPD. One, most of them involve only men, and two, they use a research method called “self-reporting,” which means the people in the study had to remember how much they drank and then be truthful about it, which they sometimes aren’t.
“I have a hard time believing these kinds of studies,” Han says. “There can be significant differences in how much people drink, smoke or other risky behaviors.”
She doesn't recommend that patients go out and start drinking to decrease their risk of COPD, she adds.
Fair enough. But what if you already drink alcohol? Could it make your COPD worse?
Alcohol and Your Overall Health
There are, of course, many proven health risks that come from drinking too much alcohol, especially if you’ve been doing it for a long time. However, one 2015 study found that light to moderate drinking (between 1 and 60 drinks a month) did not seem to make COPD worse or cause more health problems related to COPD. But the researchers weren’t able to say what the effect of heavy drinking (more than 60 drinks per month) was on COPD, since there weren’t enough heavy drinkers in the study.
But there’s plenty of research showing that drinking too much can cause serious problems with your lungs.
“Chronic alcohol use can cause immune system changes that might be harmful,” Han says. And one of the places that can happen is in your lungs. It can make immune cells less able to fight off infection, break down the barriers that keep fluid and gasses in the right place inside your lungs, and make it harder for young lungs to clear our mucus.
In fact, people who have an alcohol use disorder are more than twice as likely to have something called acute respiratory distress syndrome. And studies show that high levels of alcohol use may increase your risk for pneumonia, one of the main concerns people with COPD have.
Can Alcohol Affect COPD Medications?
It’s a good question to ask since alcohol can cause problems with a number of medications. Han says alcohol doesn’t interact with many of the main COPD meds, which you inhale. But it might cause problems with antibiotics or oral steroids sometimes used to treat lung infections that can come with COPD.
And there are other medications you might be taking, like antihistamines or antianxiety medications, that make you sleepy. Alcohol will only add to that, making you even more drowsy, and that could make it harder for you to breathe. If your respiratory system is damaged and you’re taking medication that could affect your ability to breathe, Han says adding alcohol could raise your risk for other problems.
While Han isn’t overly concerned about moderate alcohol use and COPD medications, she says it’s always a good idea to ask your pharmacist if it’s OK to drink while you’re taking any new medication.
Making Choices About Alcohol When You Have COPD
My alcohol recommendations for someone with COPD are the same as they would be for anyone else, Han says. “As long as you don’t have liver disease, follow common sense. High alcohol intake isn’t good for anyone for many reasons, and acute intoxication, or getting drunk, is always risky.”