It’s in the news, today, articles and reader comments about the F.D.A.’s proposed graphic warning labels on cigarette packs, like this one, “F.D.A. Proposed Graphic Warning Labels for Cigarette Packs,” by Gardiner Harris appearing on the New York Times website. If the F.D.A. is willing to go to this extent to warn smokers, which in turn will give pause to non-smokers within the smoker’s close proximity; pause to at least question and consider the secondhand smoking impacts to their own health – perhaps now is the time to consider standard drink labeling.As a society, we have long warned of the effects of secondhand smoke. In fact, the U.S. Surgeon General’s 2006 report reached some important conclusions about the impacts of secondhand smoke, which can be found here on the American Cancer Society’s website. But we don’t talk about the secondhand impacts (secondhand drinking) of a person’s excessive drinking — the kind of drinking that causes behaviors that in turn are harmful to others, such as: driving while impaired, unwanted sex, fights with loved ones or alcohol-related accidents.

So what’s the big deal – why a standard drink label?

Adding simple standard drink labels is not about prohibition. Rather it is about informed drinking. And, it is about informing moderate- and/or non-drinkers in a drinker’s company of how much that person has had to drink. Why would this matter? Because alcohol is not digested like other foods and beverages. Alcohol enters the bloodstream through the walls of the small intestine. Because alcohol dissolves in water, the bloodstream carries it throughout the body (which is 60-70% water) where it is absorbed into body tissue in proportion to the body tissue’s water content.

Contrary to popular belief, we cannot rid our bodies of the alcohol we drink by peeing or sweating or vomiting it out. It’s our liver that rids our bodies of the alcohol we consume.

Alcohol is metabolized by the liver, thanks in large part to enzymes produced only in the liver (ADH and ALDH). The liver can only metabolize a certain amount of alcohol per hour, which means alcohol leaves the bloodstream more slowly than it enters. This is why a person’s BAC (blood alcohol content) can continue to rise long after they have stopped drinking or passed out. As a very general rule of thumb, it takes the liver about one hour to process one standard drink. [And, a standard drink is either 5 ounces of wine, 12 ounces of beer or 1.5 ounces of 80-proof spirits (vodka, bourbon) or 3.3 ounces of champagne.]

The brain is mostly water and highly vascularized (lots of blood vessels). When a person drinks more alcohol than their liver can metabolize, the excess alcohol stays in his/her bloodstream and suppresses certain brain functions – especially those related to judgment, decision making, learning, memory and pleasure. In other words, the very areas of the brain a person needs in order to think straight and act responsibly. For this reason, a person who drinks too much can find him/herself engaging in what are known as drinking behaviors. These include:

• Fighting with friends or family about the drinking or the dumb, stupid, mean, nasty things you’ve said while under the influence.
• Doing things you don’t remember or regret.
• Binge drinking (defined as drinking 4 or more standard drinks on an occasion for women; 5 or more for men).
• Experiencing blackouts – fragmentary or complete; vomiting; passing out.
• Driving while under the influence; getting a DUI; thinking it’s safe to ride in a car driven by someone who has been drinking.
• Having unplanned, unwanted or unprotected sex; committing date rape.
• Being admitted to the emergency room with a high BAC, in addition to the “real” reason (e.g., a broken arm, broken nose or auto accident).
• Doing poorly at work or school because of the drinking or recovering from the effects of drinking.

So, what might the standard drink label on a 23.5 ounce can of Four Loko look like?

Standard Drinks (or SD) = 5
It takes the liver an average of about one hour to process one standard drink; four hours to process four drinks and so on. Unprocessed alcohol can affect normal brain function.