The inconvenient truth.

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Last evidence review: October 2026 · next: November 2026

What excess does, and what to do about it

An informational page, written for adults who drink and want to drink better. Nothing here replaces a doctor, and we repeat that on purpose.

What excess really does

No sugarcoating: there is no level of alcohol consumption considered safe for health. That has been the World Health Organization's position since 2023, and alcohol is classified as a Group 1 carcinogen by IARC (the group with the strongest evidence). In Brazil, INCA (the National Cancer Institute) holds the same position.

And the good part, also sourced: cutting down or quitting lowers the risk of mouth and esophageal cancer, and for those who quit, the longer without drinking, the lower the risk (IARC, 2023 evaluation, published 2024). For the other alcohol-related cancers, the science isn't settled yet.

In the liver, the path of excess is well known: it usually starts with hepatic steatosis (“fatty liver”, silent and still reversible once you stop drinking), can progress to alcoholic hepatitis and, if the excess continues over the years, to cirrhosis, which generally doesn't heal (and even then, stopping prevents further damage and improves survival). Brazil's Ministério da Saúde (Ministry of Health) keeps an entire care pathway dedicated to alcohol use disorders, from screening to treatment through SUS, the public health system.

Hangovers, no fuss

A hangover is, in short, your body settling the bill, and the bill has several lines: the liver turns alcohol into acetaldehyde, a toxic, short-lived byproduct that contributes to inflammation in the liver, brain and digestive tract; alcohol itself increases inflammation in the body and irritates the stomach; mild dehydration and broken sleep make up the rest.

What actually helps:

• Water, before, during and after. The classic “a glass of water for every glass of wine” is the cheapest tip in the wine world.
• Eat before and while drinking (not after, as a fix): food in the stomach slows the absorption of alcohol. “Soaking it up with greasy food the next day” is folklore — the liver doesn't take bribes.
• Sleep, and accept the inconvenient truth: the only real cure for a hangover is time.
• Painkillers? With caution and guidance: after a lot of alcohol, paracetamol (acetaminophen) calls for special care precisely because of the liver. When in doubt, ask a pharmacist or a doctor, not us.

What's myth: coffee fixes it (it doesn't, it just leaves you awake and hungover), hair of the dog, more alcohol (it postpones the bill and makes it bigger), sweating it out in the sauna or at the gym (it dehydrates someone who is already dehydrated).

Hydration, no fuss

Water is the cheapest way a wine lover can look after themselves, and it works in two modes:

If last night involved wine: alcohol curbs the release of vasopressin, the hormone that tells the kidneys to hold on to water. The result: more trips to the bathroom and mild dehydration, which helps explain the next day's thirst, fatigue and headache. Replenishing is simple: water in steady sips (not liters at once), and if the day was really long, fluids with electrolytes help: homemade oral rehydration solution, a sports drink or the classic coconut water. The grown-up trick is still the same as always: a glass of water for every glass of wine, while drinking. Tomorrow's hydration happens today.

Day to day: the European reference (EFSA) talks about 2 liters of fluids a day for women and 2.5 for men, including what comes from food, coffee and tea. But the fine-tuning is individual: thirst is a signal, and pale urine is the honest marker that all is well. Heat, exercise and altitude call for more.

Quick myths: coffee dehydrates you (in normal amounts it counts as fluid; the diuretic effect is mild) · 2 liters is a universal law (a reference average, not a sentence: your body, the climate and your routine call the shots).

Am I drinking too much?

Instead of guesswork, the AUDIT, the World Health Organization's screening test, in its short version, AUDIT-C: the first three questions of the official test, validated in 1998 by Bush and Bradley's team (USA). Answer honestly. It really is anonymous: nothing leaves your browser.

One “drink”, in this test, is a glass of wine (150 ml), a can of beer (350 ml) or a shot of spirits of about 45 ml: about 14 g of pure alcohol, the US standard drink; the cut-offs the result uses were validated in the US. Brazil's official standard drink, since December 2024, is smaller: 10 g, the same as in the WHO manual. By that measure, a regular glass of wine counts as 1.5 drinks.

The AUDIT-C is a validated screening tool, not a diagnosis. Usual cut-offs in the literature: 4+ for men and 3+ for women suggest risky drinking (measured in the US, with the roughly 14 g drink this test uses).

Want the full test, with guidance? In Brazil, since August 2026, the Ministry of Health has offered Modera Brasil inside the Meu SUS Digital app (in Portuguese): the WHO's AUDIT, 3 to 10 questions depending on your answers, with guidance for each result and, when needed, the way to care in SUS, Brazil's public health system. Just search for “Modera Brasil” in the apps area.

Real help, without judgment

If drinking is weighing heavy — on you or on someone you love — that isn't a weakness of character: it's a health issue, and in Brazil there are real, free ways forward:

• CVV — Centro de Valorização da Vida (call 188) — free, confidential emotional support: by phone on 188, 24 hours a day, and also by chat (every day, at the hours shown on the site) and by email. If the weight comes with deep sadness, start here.
• Alcoólicos Anônimos do Brasil (Alcoholics Anonymous in Brazil) — more than 4,500 groups across the country (AA's own count in 2022), in-person and online meetings, and dozens of phone and WhatsApp help lines, many open 24 hours (the list, state by state). The only requirement: wanting to stop. No fees, no religious affiliation.
• SUS — CAPS AD — the Centros de Atenção Psicossocial Álcool e Drogas (psychosocial care centers for alcohol and drugs) offer free care through Brazil's public health system; the official care pathway explains the way in. General information also through Disque Saúde, 136.