Return to Transcripts main page

CNN Sunday Morning

Weekend House Call

Aired February 09, 2003 - 08:29   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


HEIDI COLLINS, CNN ANCHOR: Good morning and welcome once again to CNN's "Weekend House Call." Joining us today is Dr. Drew Pinsky, and we are talking about a topic that's right up his alley, alcohol. I know that you are a specialist at treating addictions.
DR. DREW PINSKY, CO-HOST, LOVELINE: That's true, yes.

COLLINS: ... so I'm sure that you have some ideas and possibly new treatments.

PINSKY: Well, we're going to talk about really the headlines, and if you've head the headlines, you'd think that they're saying that alcohol is good for you. From "The New England Journal of Medicine" we heard, quote, "consumption of alcohol at least three to four days a week was associated with a lower relative risk of miocardial (ph) infarction." And from this week's "American Medical Association Journal," quote, "drinking fewer than two alcoholic drinks a day may reduce the risk of askemic (ph) stroke," which is the most common kind of stroke.

Should we be drinking a couple of drinks a day to reduce our chances of heart attack or a stroke? Is that what these researchers are really trying to say and is that what they really found? And what is the reality of alcohol? We'll try to get at some of these answers.

Joining me from New Orleans, Kristi Reynolds. She is the lead investigator on a recent alcohol study, published in the journal of the American Medical Association. Thank you for joining me, Kristi.

KRISTI REYNOLDS, TULANE UNIVERSITY: Good morning.

PINSKY: Good morning. We're going to get right to an e-mail. This is -- as much as possible, we're going to try to interact with our viewers. So here we go. This is Mark from Chicago. "I clearly do not drink more than a beer or two a month. I've enjoyed a scotch a few times in the past, and after hearing the report on drinking being beneficial to health, I was considering treating myself to a scotch every night before bed. What do you think?"

Is that what your study was supposed to be telling people?

REYNOLDS: Well, no. We conducted a meta (ph) analysis here at Tulane University in New Orleans, and the meta (ph) analysis was 35 epidemiologic studies that looked at the association between alcohol consumption and the risk of stroke. PINSKY: Correct. I understand that. And I think our viewers understand. My questions, though, is given that association, are people who are out there hearing these headlines supposed to conclude that they should be drinking more? Is that what the research was intended to suggest?

REYNOLDS: No. The research was intended to -- we had some conflicting results over these 35 studies, and we attempted to get some answers and determine what was going on between that association. Now, what we found was that there is a reduced risk of stroke. There can be a reduced risk of stroke when drinking alcohol. We're not recommending that...

PINSKY: You're not recommending people drink.

REYNOLDS: No.

PINSKY: So this e-mail, Mark from Chicago should not conclude that he's supposed to go out and drink. But let me ask you this, if people don't understand how scientific studies are done, you went out to answered a question, right? I mean, that was -- you had a hypothesis, does alcohol reduce the risk of stroke. I imagine that was the original hypothesis, yes?

REYNOLDS: Well, we wanted to answer that question and to know, does it -- is there increased risk also? What is that association? And at various levels of alcohol consumption, so at light drinking, versus heavy drinking, what is actually going on.

PINSKY: And so you found out that the reduce for stroke is less. Does that mean that people should drink necessarily, or does that mean that the research on stroke is just going to march forward and we'll figure out what it is about alcohol that affects the (UNINTELLIGIBLE) function or the physiology in such a way? In other words, going from a very specific question of research, the press has extrapolated it to a clinical recommendation. Isn't that kind of irresponsible?

REYNOLDS: Well, I don't want to comment on what the press has done. What I do want to say, there are guidelines that are currently existing. The American Heart Association has guidelines. The (UNINTELLIGIBLE) report from the Joint National Committee on the Prevention, Detection and Evaluation, Treatment of High Blood Pressure have guidelines, and so does the National Stroke Association. All of those guidelines recommend that if you currently drink alcohol that it is OK to drink alcohol in moderation, and moderation being no more than two drinks per day for men and no more than one drink per day for women and men with light body weight.

Now, if you don't currently drink alcohol, you should not start drinking alcohol.

PINSKY: OK. I think people are hearing that loud and clear.

REYNOLDS: I think that is the message that needs to get out there.

PINSKY: And when we come back, we'll be joined by a substance abuse expert, Dr. Karen Drexler -- Heidi.

COLLINS: And lots of questions, too, about who exactly we're talking that should be drinking. Clearly if you are at risk for stroke or if it runs in your family...

PINSKY: How about if you're at risk for alcoholism or addiction. We've got to look at that, too.

COLLINS: Yes, the other side. All right, we will do that, and we're going to do that when we come back. Coming up, more of your e- mails and phone calls as we dive into the good, the bad and the ugly of alcohol. Just give us a call at 1-800-807-2620, or send us an e- mail. That address on your screen, housecall@cnn.com. We'll be right back.

(COMMERCIAL BREAK)

COLLINS: And we are back with CNN's "Weekend House Call" and Dr. Drew Pinsky. Our topic today, alcohol and the confusion over recent headlines. Now, remind us, what exactly are we hearing in the headlines. It's been kind of misconstrued.

PINSKY: Right. The headline -- the headlines were consumption of alcohol, this is "The New England Journal" article -- consumption of at least three to four days a week was associated with a lower risk of miocardial (ph) infarction. That was the headline. There was also a headline which Dr. Reynolds was talking about, drinking fewer than two alcoholic drinks a day may reduce the risk of askemic (ph) stroke.

COLLINS: Miocardial (ph) infarction?

PINSKY: Heart attack.

COLLINS: Heart attack.

PINSKY: But the problem I have is the headline became, you need to drink more, should we be drinking more, and that is simply not what these research studies were attempting to answer. That is something that clinicians need to decide with their patients, and with us today we have Dr. Reynolds, and Dr. Reynolds, we're going to go -- Dr. Drexler, I beg your pardon, and you are?

DR. KAREN DREXLER, SUBSTANCE ABUSE SPECIALIST: I direct the substance abuse treatment program at the Atlanta BA, I'm on the faculty of (UNINTELLIGIBLE), addiction psychiatry residency training program.

PINSKY: And do you have a take on these studs?

DREXLER: Yes. I agree with you. I don't think that these studies are telling us that we need to increase the amount of drinking that we do. In fact, Kristi Reynolds' study showed that drinking more than two drinks a day may actually increase your risk of stroke.

PINSKY: And it's hemorrhagic strokes, as I read that study, right? And I deal a lot with alcoholics myself, as every internist does. You see tons of that problem. Now, whether or not that's related to high blood pressure or (UNINTELLIGIBLE) problem, the lining of the vessel (ph) problem, study didn't answer that, did it?

DREXLER: No, and it did show that heavy drinking is associated with an increased risk of stroke.

PINSKY: Dr. Reynolds, are you still with us?

REYNOLDS: I'm still there. It's not Dr. Reynolds.

PINSKY: I beg your pardon.

REYNOLDS: Our study did show that drinking five or more drinks a day does increase your risk of total stroke overall and also askemic (ph) stroke and hemorrhagic stroke.

PINSKY: All right, let's go right to the phones. This is George from San Juan -- George.

CALLER: Yes. I have a couple of questions.

PINSKY: Yes.

CALLER: How can a person determine if he or she has a problem with alcohol, and also why can't a person never, ever drink again?

PINSKY: Dr. Drexler?

DREXLER: Let's see, your first question. How can a person determine if they have alcoholism or alcohol dependence. Alcohol dependence is a disease. It's chronic. It comes on gradually, it lasts a long time and it has to do with changes in the brain that are results of drinking.

PINSKY: My experience, the headlines is -- the headline again. The way you know if you have a problem is by virtue of continued drinking in the face of adverse consequence.

DREXLER: Absolutely.

PINSKY: The difference between people who can stop and can't stop is really the bottom line. You either stop or you can't, and a non-alcoholic will stop when there are consequences.

DREXLER: Exactly.

PINSKY: We have an e-mail here. This is Karen from Clearwater. She says: "I'm a borderline diabetic and my triglycerides are high, 389. I was wondering if it's wise for me to have the occasional beer." Very interesting. What do you think?

DREXLER: I think that she should work very closely with her internist, and there are consequences to drinking in addition to cardiovascular risk. And it can have a beneficial effect on blood sugars in a small amount, but also could have an adverse effect. PINSKY: Ms. Reynolds, what do you think about the triglyceride issue? That kind of flies in the face of some of the data, at least the mild drinking and the moderate drinking suggests.

REYNOLDS: Right. Well, there are other ways that she can lower her triglycerides, and they may be more appropriate than drinking alcohol. So she should consult with her physician.

PINSKY: But from my standpoint, it really shows how complicated this phenomenon is. For me, when I see someone with hypertriglyceridemia (ph), I think about alcohol consumption, I think about diabetes and thyroid disease. But it increases triglycerides when people are using a good deal of alcohol, does it not?

REYNOLDS: That I don't know.

PINSKY: Does it not, Dr. Drexler?

DREXLER: Yes, it does.

PINSKY: And how do we reconcile that? Again, I'm trying to help people understand what they see in the press. How do you reconcile that with the press headline that say I should be drinking moderately, I'm going to have less heart attacks. Maybe if I have coronary disease, I should have a glass of wine a day.

DREXLER: My recommendation is, there are other ways to lower your risk of cardiovascular and stroke, including exercise, modifying your diet in other ways to decrease fats and salty foods, and drinking is a double-edged sword. So I would recommend that people be very cautious about it. The preponderance of the literature is showing that the amount of drinking that is helpful is certainly very low, and if you have a family risk of alcoholism, if you have a personal history of alcoholism, you need to be very cautious about that, and I would recommend that you lower your risk of heart disease in other ways.

PINSKY: Remember, George asked why can't you ever drink again if you're an alcoholic. That was his second question?

DREXLER: Yes, which is, because there have been changes in the brain that we are only now beginning to understand that make it so that you cannot go back to drinking moderate amounts safely.

PINSKY: It will continue to progress -- Heidi.

COLLINS: Right, I was just going to ask, you know, one of our first callers was asking about his take on these headlines and saying, well, I thought I might have scotch every night, but what I heard a while back was about red wine and the -- if used as an anticoagulant.

PINSKY: We have a question about that.

COLLINS: So are we talking about wine or alcohol?

PINSKY: Let's hear from one of our viewers. This is Rita from Michigan. Rita?

CALLER: Yes, hello?

PINSKY: You had a question about wine too, right?

CALLER: Yes, I do.

PINSKY: Go ahead.

CALLER: I need to know if red wine is good for you, and if it is, which kind of red wine is better for you?

PINSKY: French or Californian?

COLLINS: The good-tasting kind.

PINSKY: Heidi's question too -- Heidi's gearing up for tonight, you understand. So...

COLLINS: Well!

PINSKY: Dr. Drexler, what do you think?

DREXLER: Well, there have been some studies that show that actually it may not be the alcohol by itself, it may be other components in grapes that reduce your risk of heart disease. Again, I would urge people to be very cautious, to...

PINSKY: Ask their doctor.

DREXLER: Ask their doctor.

PINSKY: Kristi, you have a comment on this? I know there was a study -- I guess the miocardial (ph) study that came out in advance of you guys talked about different types of alcohol, and it seemed as though it didn't really make any difference, did it, what type of alcohol people were drinking.

REYNOLDS: No, that study did not make a difference. In our study that we conducted did not look at the type of beverage that was consumed, because not enough studies actually reported on at that level. So we were not able to determine whether it was a beer or wine or hard liquor.

PINSKY: If I read your study correctly, though, it was mostly hard liquor you guys were looking at, was it not, at least the people with hemorrhagic strokes.

REYNOLDS: No, not in the meta (ph) analysis that we conducted.

PINSKY: OK, very good. Well, this is very interesting.

We have more calls for you, and we will take more viewer calls when we return -- Heidi.

COLLINS: Sounds good. You know, I just want to mention, I had a blood clot a while back.

PINSKY: Where, like in your leg?

COLLINS: Yes. It's a big, long, long story.

PINSKY: Part of your pregnancy?

COLLINS: No. Before that.

PINSKY: Wow.

COLLINS: Yes, arterial occlusion.

(CROSSTALK)

COLLINS: No, none of those problems, but there was talk a little bit about natural anticoagulants, and that's where the red wine came up.

PINSKY: And you said, yahoo.

COLLINS: I said, that sounds good. Yes.

All right, we're going to be back in just a few minutes. Raising the bar before you head to the bar. The real news behind the headlines on alcohol when we come back.

(COMMERCIAL BREAK)

PINSKY: We're talking about alcohol and your health. Joining me is Karen Drexler and Kristi Reynolds. We're taking your phone calls. First, I want to stop for a second and talk to Heidi, because she's had a very harrowing study in regards with her own health, anticoagulants and hypercoagulation.

COLLINS: Right, yes.

PINSKY: What happened?

COLLINS: Well, I had (UNINTELLIGIBLE) thrombosis.

PINSKY: Which is a clot in the vein on your leg.

COLLINS: Blood clot, right.

PINSKY: And they tried to dissolve it.

COLLINS: They did, with absolutely everything, from, as you say, Cumidin (ph), which a lot of people are familiar with as an anticoagulant. Didn't work.

PINSKY: But they actually went ahead and tried to dissolve the clot (UNINTELLIGIBLE).

COLLINS: Another very...

PINSKY: Powerful.

COLLINS: ... more powerful drug, anticoagulant, wouldn't go away, and then it jumped into my artery, which landed me in the Mayo clinic in Minnesota.

PINSKY: So you almost lost your leg because of this?

COLLINS: Yes, (UNINTELLIGIBLE).

PINSKY: Now, what did your doctors recommend to you? Here's a great example of how confusing this all is. I mean, you have some sort of hypercoagulant state, although hypercoagulability (ph) is yet a whole other topic. It's really different than we've been talking about...

COLLINS: It is.

PINSKY: We don't know for sure that stroke and heart attack as it pertains to alcohol is necessarily the result of coagulability (ph).

COLLINS: Exactly, and because we don't know the origin of where this came from, still to this day.

PINSKY: Did they recommend alcohol for you?

COLLINS: Well, not real strongly. But we did talk about that.

(CROSSTALK)

COLLINS: No, we did talk about that in, you know, way after I had recovered, which was a long process, so going back every year for checks in the Mayo clinic, then there was talk about some natural anticoagulants, and that's where it all came up.

PINSKY: Interesting. Let's go ahead and take a call. This is David from Illinois -- David.

CALLER: Yes, this is David.

PINSKY: Go ahead, David.

CALLER: Yes. I've been in studies regarding if you have one drink a day, I've been seeing it for a year now or a couple of years, it seems.

PINSKY: Right.

CALLER: And I've been wondering, is that OK? Like let's say I don't drink all week, is it OK if I have like seven beers at the end of the week? For example?

PINSKY: I'm sure a lot of people have this question. Kristi. Let's see if Kristi -- this is Heidi's question. Kristi, can people binge on the weekend? REYNOLDS: Well, our studies did not look at binge drinking, because binge drinking has a different effect on the brain and the body. I do not believe that it is the best thing to do. The study that we have done looks at usual consumption during the week.

PINSKY: Are there any studies out there about binge drinking? Oh, you guys excluded those -- you must have excluded those.

REYNOLDS: We did exclude those, but there are studies out there that have looked at binge drinking...

PINSKY: Right. Any conclusion from that?

REYNOLDS: I believe that it does increase your risk of stroke as well. I don't think that binge drinking is what the study that we looked at is doing.

PINSKY: If I understand, Dr. Drexler, binge drinking tends to raise your blood pressure almost more than any other form of drinking, especially heavy binge drinking, and so just from that standpoint alone, you would think you would raise the risk of stroke.

We have Fred on the line. He is from Pennsylvania. He has a really specific question. Fred, what is that question?

CALLER: Thank you. First and foremost, I enjoy your program. Secondly, it's like your analysis between a heavy drinker and an alcoholic. What constitutes a drink in liquid ounces of hard liquor, versus, for example, having a scotch on the rocks. Put the rocks in, pour the scotch in. What constitutes a drink?

PINSKY: I understand, Fred, and Kristi, do you guys have an answer for that?

REYNOLDS: Well, a drink constitutes 12 ounces of beer, five ounces of wine, a small glass of wine, or 1.5 ounces of 80 proof distilled liquor.

PINSKY: So we've got it on next to you there; people can see that. And in your study, was it two drinks was the one that's sort of the target that helped people? At least in terms of stroke?

REYNOLDS: Two drinks for askemic (ph) stroke. One drink for all strokes combined.

PINSKY: That's very interesting. We also have an e-mail. Let me -- this sort of summarizes a lot of confusion. Heidi's story highlights it as well, but this is from Sandy in Mississippi, I guess this is. "My husband had a heart attack two years ago, underwent angioplasty. He was fortunate to have only one blockage, made a full recovery while in the hospital. The doctor told him a small amount of red wine would be beneficial to him." Should people with heart disease, should they -- should doctors be recommending to them to have a glass of red wine? Dr. Drexler, what do you think?

DREXLER: I think if you can limit it to small amounts, so if you're -- if you don't have risk factors for developing alcoholism and you can...

PINSKY: Should people expect their doctors to be able to tell them whether they have that risk?

DREXLER: I think that would be a good source to go to. I would also say you should know that if you have a family history of alcoholism, your risk is increased. If you have a history of addiction to alcohol or any other drugs, your risk is increased.

PINSKY: And I would say people need to take personal responsibility. Not all physicians are as sophisticated about alcoholism as we'd like them to be, and they may miss it. So you really have to assess your risk on your own, and be careful with these recommendations.

And I want to thank our guests for joining us. Dr. Karen Drexler, Kristi Reynolds, thank you. You've been terrific. And we will be back for some final thoughts on alcohol and health. Please stay with us.

(COMMERCIAL BREAK)

PINSKY: Thank you. So a few final thoughts. Beware of medical headlines. Understand how research is developed and be careful to let it influence your health behavior and choices. You shouldn't be extrapolating from the headline from the research directly into the choices you make. And be sure, above all, check with your doctor. The doctor is more trained to be able to interpret the research and give you recommendations that are specific to your situation.

And make sure to catch "Weekend House Call" next time. Dr. Sanjay Gupta will be hosting the program from Kuwait. He spent time with the U.S. troops seeing how prepared they are for a biochemical event. He'll talk with the doctors on the front line, take your phone calls and e-mails.

And I've certainly enjoyed being here. I hope to be back on CNN "Weekend House Call" at soon as possible. Thank you for watching. "CNN SUNDAY MORNING" continues right now.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com







Aired February 9, 2003 - 08:29   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
HEIDI COLLINS, CNN ANCHOR: Good morning and welcome once again to CNN's "Weekend House Call." Joining us today is Dr. Drew Pinsky, and we are talking about a topic that's right up his alley, alcohol. I know that you are a specialist at treating addictions.
DR. DREW PINSKY, CO-HOST, LOVELINE: That's true, yes.

COLLINS: ... so I'm sure that you have some ideas and possibly new treatments.

PINSKY: Well, we're going to talk about really the headlines, and if you've head the headlines, you'd think that they're saying that alcohol is good for you. From "The New England Journal of Medicine" we heard, quote, "consumption of alcohol at least three to four days a week was associated with a lower relative risk of miocardial (ph) infarction." And from this week's "American Medical Association Journal," quote, "drinking fewer than two alcoholic drinks a day may reduce the risk of askemic (ph) stroke," which is the most common kind of stroke.

Should we be drinking a couple of drinks a day to reduce our chances of heart attack or a stroke? Is that what these researchers are really trying to say and is that what they really found? And what is the reality of alcohol? We'll try to get at some of these answers.

Joining me from New Orleans, Kristi Reynolds. She is the lead investigator on a recent alcohol study, published in the journal of the American Medical Association. Thank you for joining me, Kristi.

KRISTI REYNOLDS, TULANE UNIVERSITY: Good morning.

PINSKY: Good morning. We're going to get right to an e-mail. This is -- as much as possible, we're going to try to interact with our viewers. So here we go. This is Mark from Chicago. "I clearly do not drink more than a beer or two a month. I've enjoyed a scotch a few times in the past, and after hearing the report on drinking being beneficial to health, I was considering treating myself to a scotch every night before bed. What do you think?"

Is that what your study was supposed to be telling people?

REYNOLDS: Well, no. We conducted a meta (ph) analysis here at Tulane University in New Orleans, and the meta (ph) analysis was 35 epidemiologic studies that looked at the association between alcohol consumption and the risk of stroke. PINSKY: Correct. I understand that. And I think our viewers understand. My questions, though, is given that association, are people who are out there hearing these headlines supposed to conclude that they should be drinking more? Is that what the research was intended to suggest?

REYNOLDS: No. The research was intended to -- we had some conflicting results over these 35 studies, and we attempted to get some answers and determine what was going on between that association. Now, what we found was that there is a reduced risk of stroke. There can be a reduced risk of stroke when drinking alcohol. We're not recommending that...

PINSKY: You're not recommending people drink.

REYNOLDS: No.

PINSKY: So this e-mail, Mark from Chicago should not conclude that he's supposed to go out and drink. But let me ask you this, if people don't understand how scientific studies are done, you went out to answered a question, right? I mean, that was -- you had a hypothesis, does alcohol reduce the risk of stroke. I imagine that was the original hypothesis, yes?

REYNOLDS: Well, we wanted to answer that question and to know, does it -- is there increased risk also? What is that association? And at various levels of alcohol consumption, so at light drinking, versus heavy drinking, what is actually going on.

PINSKY: And so you found out that the reduce for stroke is less. Does that mean that people should drink necessarily, or does that mean that the research on stroke is just going to march forward and we'll figure out what it is about alcohol that affects the (UNINTELLIGIBLE) function or the physiology in such a way? In other words, going from a very specific question of research, the press has extrapolated it to a clinical recommendation. Isn't that kind of irresponsible?

REYNOLDS: Well, I don't want to comment on what the press has done. What I do want to say, there are guidelines that are currently existing. The American Heart Association has guidelines. The (UNINTELLIGIBLE) report from the Joint National Committee on the Prevention, Detection and Evaluation, Treatment of High Blood Pressure have guidelines, and so does the National Stroke Association. All of those guidelines recommend that if you currently drink alcohol that it is OK to drink alcohol in moderation, and moderation being no more than two drinks per day for men and no more than one drink per day for women and men with light body weight.

Now, if you don't currently drink alcohol, you should not start drinking alcohol.

PINSKY: OK. I think people are hearing that loud and clear.

REYNOLDS: I think that is the message that needs to get out there.

PINSKY: And when we come back, we'll be joined by a substance abuse expert, Dr. Karen Drexler -- Heidi.

COLLINS: And lots of questions, too, about who exactly we're talking that should be drinking. Clearly if you are at risk for stroke or if it runs in your family...

PINSKY: How about if you're at risk for alcoholism or addiction. We've got to look at that, too.

COLLINS: Yes, the other side. All right, we will do that, and we're going to do that when we come back. Coming up, more of your e- mails and phone calls as we dive into the good, the bad and the ugly of alcohol. Just give us a call at 1-800-807-2620, or send us an e- mail. That address on your screen, housecall@cnn.com. We'll be right back.

(COMMERCIAL BREAK)

COLLINS: And we are back with CNN's "Weekend House Call" and Dr. Drew Pinsky. Our topic today, alcohol and the confusion over recent headlines. Now, remind us, what exactly are we hearing in the headlines. It's been kind of misconstrued.

PINSKY: Right. The headline -- the headlines were consumption of alcohol, this is "The New England Journal" article -- consumption of at least three to four days a week was associated with a lower risk of miocardial (ph) infarction. That was the headline. There was also a headline which Dr. Reynolds was talking about, drinking fewer than two alcoholic drinks a day may reduce the risk of askemic (ph) stroke.

COLLINS: Miocardial (ph) infarction?

PINSKY: Heart attack.

COLLINS: Heart attack.

PINSKY: But the problem I have is the headline became, you need to drink more, should we be drinking more, and that is simply not what these research studies were attempting to answer. That is something that clinicians need to decide with their patients, and with us today we have Dr. Reynolds, and Dr. Reynolds, we're going to go -- Dr. Drexler, I beg your pardon, and you are?

DR. KAREN DREXLER, SUBSTANCE ABUSE SPECIALIST: I direct the substance abuse treatment program at the Atlanta BA, I'm on the faculty of (UNINTELLIGIBLE), addiction psychiatry residency training program.

PINSKY: And do you have a take on these studs?

DREXLER: Yes. I agree with you. I don't think that these studies are telling us that we need to increase the amount of drinking that we do. In fact, Kristi Reynolds' study showed that drinking more than two drinks a day may actually increase your risk of stroke.

PINSKY: And it's hemorrhagic strokes, as I read that study, right? And I deal a lot with alcoholics myself, as every internist does. You see tons of that problem. Now, whether or not that's related to high blood pressure or (UNINTELLIGIBLE) problem, the lining of the vessel (ph) problem, study didn't answer that, did it?

DREXLER: No, and it did show that heavy drinking is associated with an increased risk of stroke.

PINSKY: Dr. Reynolds, are you still with us?

REYNOLDS: I'm still there. It's not Dr. Reynolds.

PINSKY: I beg your pardon.

REYNOLDS: Our study did show that drinking five or more drinks a day does increase your risk of total stroke overall and also askemic (ph) stroke and hemorrhagic stroke.

PINSKY: All right, let's go right to the phones. This is George from San Juan -- George.

CALLER: Yes. I have a couple of questions.

PINSKY: Yes.

CALLER: How can a person determine if he or she has a problem with alcohol, and also why can't a person never, ever drink again?

PINSKY: Dr. Drexler?

DREXLER: Let's see, your first question. How can a person determine if they have alcoholism or alcohol dependence. Alcohol dependence is a disease. It's chronic. It comes on gradually, it lasts a long time and it has to do with changes in the brain that are results of drinking.

PINSKY: My experience, the headlines is -- the headline again. The way you know if you have a problem is by virtue of continued drinking in the face of adverse consequence.

DREXLER: Absolutely.

PINSKY: The difference between people who can stop and can't stop is really the bottom line. You either stop or you can't, and a non-alcoholic will stop when there are consequences.

DREXLER: Exactly.

PINSKY: We have an e-mail here. This is Karen from Clearwater. She says: "I'm a borderline diabetic and my triglycerides are high, 389. I was wondering if it's wise for me to have the occasional beer." Very interesting. What do you think?

DREXLER: I think that she should work very closely with her internist, and there are consequences to drinking in addition to cardiovascular risk. And it can have a beneficial effect on blood sugars in a small amount, but also could have an adverse effect. PINSKY: Ms. Reynolds, what do you think about the triglyceride issue? That kind of flies in the face of some of the data, at least the mild drinking and the moderate drinking suggests.

REYNOLDS: Right. Well, there are other ways that she can lower her triglycerides, and they may be more appropriate than drinking alcohol. So she should consult with her physician.

PINSKY: But from my standpoint, it really shows how complicated this phenomenon is. For me, when I see someone with hypertriglyceridemia (ph), I think about alcohol consumption, I think about diabetes and thyroid disease. But it increases triglycerides when people are using a good deal of alcohol, does it not?

REYNOLDS: That I don't know.

PINSKY: Does it not, Dr. Drexler?

DREXLER: Yes, it does.

PINSKY: And how do we reconcile that? Again, I'm trying to help people understand what they see in the press. How do you reconcile that with the press headline that say I should be drinking moderately, I'm going to have less heart attacks. Maybe if I have coronary disease, I should have a glass of wine a day.

DREXLER: My recommendation is, there are other ways to lower your risk of cardiovascular and stroke, including exercise, modifying your diet in other ways to decrease fats and salty foods, and drinking is a double-edged sword. So I would recommend that people be very cautious about it. The preponderance of the literature is showing that the amount of drinking that is helpful is certainly very low, and if you have a family risk of alcoholism, if you have a personal history of alcoholism, you need to be very cautious about that, and I would recommend that you lower your risk of heart disease in other ways.

PINSKY: Remember, George asked why can't you ever drink again if you're an alcoholic. That was his second question?

DREXLER: Yes, which is, because there have been changes in the brain that we are only now beginning to understand that make it so that you cannot go back to drinking moderate amounts safely.

PINSKY: It will continue to progress -- Heidi.

COLLINS: Right, I was just going to ask, you know, one of our first callers was asking about his take on these headlines and saying, well, I thought I might have scotch every night, but what I heard a while back was about red wine and the -- if used as an anticoagulant.

PINSKY: We have a question about that.

COLLINS: So are we talking about wine or alcohol?

PINSKY: Let's hear from one of our viewers. This is Rita from Michigan. Rita?

CALLER: Yes, hello?

PINSKY: You had a question about wine too, right?

CALLER: Yes, I do.

PINSKY: Go ahead.

CALLER: I need to know if red wine is good for you, and if it is, which kind of red wine is better for you?

PINSKY: French or Californian?

COLLINS: The good-tasting kind.

PINSKY: Heidi's question too -- Heidi's gearing up for tonight, you understand. So...

COLLINS: Well!

PINSKY: Dr. Drexler, what do you think?

DREXLER: Well, there have been some studies that show that actually it may not be the alcohol by itself, it may be other components in grapes that reduce your risk of heart disease. Again, I would urge people to be very cautious, to...

PINSKY: Ask their doctor.

DREXLER: Ask their doctor.

PINSKY: Kristi, you have a comment on this? I know there was a study -- I guess the miocardial (ph) study that came out in advance of you guys talked about different types of alcohol, and it seemed as though it didn't really make any difference, did it, what type of alcohol people were drinking.

REYNOLDS: No, that study did not make a difference. In our study that we conducted did not look at the type of beverage that was consumed, because not enough studies actually reported on at that level. So we were not able to determine whether it was a beer or wine or hard liquor.

PINSKY: If I read your study correctly, though, it was mostly hard liquor you guys were looking at, was it not, at least the people with hemorrhagic strokes.

REYNOLDS: No, not in the meta (ph) analysis that we conducted.

PINSKY: OK, very good. Well, this is very interesting.

We have more calls for you, and we will take more viewer calls when we return -- Heidi.

COLLINS: Sounds good. You know, I just want to mention, I had a blood clot a while back.

PINSKY: Where, like in your leg?

COLLINS: Yes. It's a big, long, long story.

PINSKY: Part of your pregnancy?

COLLINS: No. Before that.

PINSKY: Wow.

COLLINS: Yes, arterial occlusion.

(CROSSTALK)

COLLINS: No, none of those problems, but there was talk a little bit about natural anticoagulants, and that's where the red wine came up.

PINSKY: And you said, yahoo.

COLLINS: I said, that sounds good. Yes.

All right, we're going to be back in just a few minutes. Raising the bar before you head to the bar. The real news behind the headlines on alcohol when we come back.

(COMMERCIAL BREAK)

PINSKY: We're talking about alcohol and your health. Joining me is Karen Drexler and Kristi Reynolds. We're taking your phone calls. First, I want to stop for a second and talk to Heidi, because she's had a very harrowing study in regards with her own health, anticoagulants and hypercoagulation.

COLLINS: Right, yes.

PINSKY: What happened?

COLLINS: Well, I had (UNINTELLIGIBLE) thrombosis.

PINSKY: Which is a clot in the vein on your leg.

COLLINS: Blood clot, right.

PINSKY: And they tried to dissolve it.

COLLINS: They did, with absolutely everything, from, as you say, Cumidin (ph), which a lot of people are familiar with as an anticoagulant. Didn't work.

PINSKY: But they actually went ahead and tried to dissolve the clot (UNINTELLIGIBLE).

COLLINS: Another very...

PINSKY: Powerful.

COLLINS: ... more powerful drug, anticoagulant, wouldn't go away, and then it jumped into my artery, which landed me in the Mayo clinic in Minnesota.

PINSKY: So you almost lost your leg because of this?

COLLINS: Yes, (UNINTELLIGIBLE).

PINSKY: Now, what did your doctors recommend to you? Here's a great example of how confusing this all is. I mean, you have some sort of hypercoagulant state, although hypercoagulability (ph) is yet a whole other topic. It's really different than we've been talking about...

COLLINS: It is.

PINSKY: We don't know for sure that stroke and heart attack as it pertains to alcohol is necessarily the result of coagulability (ph).

COLLINS: Exactly, and because we don't know the origin of where this came from, still to this day.

PINSKY: Did they recommend alcohol for you?

COLLINS: Well, not real strongly. But we did talk about that.

(CROSSTALK)

COLLINS: No, we did talk about that in, you know, way after I had recovered, which was a long process, so going back every year for checks in the Mayo clinic, then there was talk about some natural anticoagulants, and that's where it all came up.

PINSKY: Interesting. Let's go ahead and take a call. This is David from Illinois -- David.

CALLER: Yes, this is David.

PINSKY: Go ahead, David.

CALLER: Yes. I've been in studies regarding if you have one drink a day, I've been seeing it for a year now or a couple of years, it seems.

PINSKY: Right.

CALLER: And I've been wondering, is that OK? Like let's say I don't drink all week, is it OK if I have like seven beers at the end of the week? For example?

PINSKY: I'm sure a lot of people have this question. Kristi. Let's see if Kristi -- this is Heidi's question. Kristi, can people binge on the weekend? REYNOLDS: Well, our studies did not look at binge drinking, because binge drinking has a different effect on the brain and the body. I do not believe that it is the best thing to do. The study that we have done looks at usual consumption during the week.

PINSKY: Are there any studies out there about binge drinking? Oh, you guys excluded those -- you must have excluded those.

REYNOLDS: We did exclude those, but there are studies out there that have looked at binge drinking...

PINSKY: Right. Any conclusion from that?

REYNOLDS: I believe that it does increase your risk of stroke as well. I don't think that binge drinking is what the study that we looked at is doing.

PINSKY: If I understand, Dr. Drexler, binge drinking tends to raise your blood pressure almost more than any other form of drinking, especially heavy binge drinking, and so just from that standpoint alone, you would think you would raise the risk of stroke.

We have Fred on the line. He is from Pennsylvania. He has a really specific question. Fred, what is that question?

CALLER: Thank you. First and foremost, I enjoy your program. Secondly, it's like your analysis between a heavy drinker and an alcoholic. What constitutes a drink in liquid ounces of hard liquor, versus, for example, having a scotch on the rocks. Put the rocks in, pour the scotch in. What constitutes a drink?

PINSKY: I understand, Fred, and Kristi, do you guys have an answer for that?

REYNOLDS: Well, a drink constitutes 12 ounces of beer, five ounces of wine, a small glass of wine, or 1.5 ounces of 80 proof distilled liquor.

PINSKY: So we've got it on next to you there; people can see that. And in your study, was it two drinks was the one that's sort of the target that helped people? At least in terms of stroke?

REYNOLDS: Two drinks for askemic (ph) stroke. One drink for all strokes combined.

PINSKY: That's very interesting. We also have an e-mail. Let me -- this sort of summarizes a lot of confusion. Heidi's story highlights it as well, but this is from Sandy in Mississippi, I guess this is. "My husband had a heart attack two years ago, underwent angioplasty. He was fortunate to have only one blockage, made a full recovery while in the hospital. The doctor told him a small amount of red wine would be beneficial to him." Should people with heart disease, should they -- should doctors be recommending to them to have a glass of red wine? Dr. Drexler, what do you think?

DREXLER: I think if you can limit it to small amounts, so if you're -- if you don't have risk factors for developing alcoholism and you can...

PINSKY: Should people expect their doctors to be able to tell them whether they have that risk?

DREXLER: I think that would be a good source to go to. I would also say you should know that if you have a family history of alcoholism, your risk is increased. If you have a history of addiction to alcohol or any other drugs, your risk is increased.

PINSKY: And I would say people need to take personal responsibility. Not all physicians are as sophisticated about alcoholism as we'd like them to be, and they may miss it. So you really have to assess your risk on your own, and be careful with these recommendations.

And I want to thank our guests for joining us. Dr. Karen Drexler, Kristi Reynolds, thank you. You've been terrific. And we will be back for some final thoughts on alcohol and health. Please stay with us.

(COMMERCIAL BREAK)

PINSKY: Thank you. So a few final thoughts. Beware of medical headlines. Understand how research is developed and be careful to let it influence your health behavior and choices. You shouldn't be extrapolating from the headline from the research directly into the choices you make. And be sure, above all, check with your doctor. The doctor is more trained to be able to interpret the research and give you recommendations that are specific to your situation.

And make sure to catch "Weekend House Call" next time. Dr. Sanjay Gupta will be hosting the program from Kuwait. He spent time with the U.S. troops seeing how prepared they are for a biochemical event. He'll talk with the doctors on the front line, take your phone calls and e-mails.

And I've certainly enjoyed being here. I hope to be back on CNN "Weekend House Call" at soon as possible. Thank you for watching. "CNN SUNDAY MORNING" continues right now.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com