My 22-year alcohol addiction drove me to take the ultimate risk: Here's how a radical life-or-death game set me sober in an instant... I haven't drunk a drop since: DR KNOWLES
Under a tree on a sunny Florida afternoon, a doctor sat across the table from a half-empty bottle of Bacardi and a handgun, convinced that his wife and two children would be better off without him.
Dr Charles Knowles, a professor of surgery in London, had come to the Sunshine State for a week-long vacation in an attempt to save his marriage after 22 years of alcoholism.
But instead of finding solace, he found himself drunk, alone and involved in a twisted game with the mystical.
'I was convinced that I could test God in a solo game of Russian roulette,' he wrote in his new book, Why We Drink Too Much. 'I thought, "If I am good, I will survive and carry on drinking, and if I am bad, I shall die, and everyone will be better off for it."'
It was only at that moment, as he contemplated the gun, that a thought popped into his head: 'I don't ever need to drink alcohol again.'
He has doggedly stuck to the resolution and, now, hasn't touched a drop of alcohol in nearly 17 years, which he said would have been unthinkable before.
Knowles, 57, had leaned on alcohol for as long as he could remember. A shy boy who was bullied in school, he found that liquor helped him to become outgoing and the life of the party.
His drinking escapades, which often resulted in vomiting, were dismissed in his early years as just part of being young. But later, when friends got careers and slipped into adult lives, his close relationship with alcohol continued, and sometimes got out of control.
Dr Charles Knowles, author of Why We Drink, is a professor of surgery at universities in London
Knowles was never focused on how much he drank, although at college he said he could easily sink 15 pints a night. But he found it impossible to stop drinking once he started, and would wake up the next morning craving more.
There would, however, be periods of abstinence. He said he never drank at, or just before, work, taking his responsibility to patients very seriously. But for at least seven years before his vacation to Florida, he had been trying, and failing, to quit.
In the book, Knowles described how he was finally able to quit, and detailed the impact alcohol has on our bodies.
Surprisingly, he added that he is not against alcohol. Knowles said it had benefitted his life in many ways, including helping him socialize with band mates and meet his wife.
His book comes amid a shift in guidance on alcohol consumption in the US after federal officials said Americans should 'consume less alcohol for better overall health.' The previous guidelines said men should not consume more than two drinks per day, while women should not consume more than one drink.
Below are Knowles's findings on how the drug impacts the human body.
Heart and circulation
Knowles, similar to many drinkers, experienced a rapid heart rate while drinking alcohol, an effect triggered when the drug dilates blood vessels and forces the heart to work harder.
Nearly 17 years on from his last drink, however, he feels he is 'out of the woods' when it comes to suffering the heart health drawbacks.
Studies have linked drinking to a higher risk of stroke or heart failure. But some say it's not permanent. Research suggests that the heart health risks associated with drinking decline after abstinence.
Alcohol can also exacerbate high blood pressure, the most common health condition in the US, by boosting levels of a hormone that causes blood vessels to narrow.
And there's bad news for those who believe a glass or two of red wine is beneficial: Resveratrol, the compound in red wine once believed to be heart-healthy, is not actually shown to have any benefits, Knowles said.
Studies have linked drinking to a higher risk of stroke or heart failure
Liver and pancreas
After a few days of heavy drinking, fats can build up in the liver - the organ that works to filter alcohol out of the blood.
Over time, and if drinking continues, these can cause fatty liver disease, raising the risk of scarring to the liver, which reduces its ability to function.
In more serious cases, the condition has also been linked to liver cancer and failure.
Knowles underlined, however, that someone would need to consume three alcohol drinks a day to cause these problems.
Stomach and intestines
Alcohol consumption can also irritate the stomach lining, causing vomiting.
But while binge drinking - consuming more than five drinks on the same occasion for men or more than four for women - alcohol can also enter the bowels rapidly and irritate the lining, causing indigestion, constipation and, possibly, incontinence.
Obesity
Poor diet, little exercise and poor sleep can cause obesity, but Knowles warned that drinking alcohol can, too.
Alcohol has a high calorie content. A pint of beer contains around 200 calories - the same as a KitKat or two chocolate chip cookies - while a bottle of wine has 700.
Alcohol can disrupt sleep too, causing hunger hormones to go haywire and prompting someone to eat more food the next day.
A 2020 study found people who drank a bottle of beer or a small glass of wine every day are up to 25 percent more likely to be obese.
People who drink a bottle of beer or small glass of wine each day are up to 25 percent more likely to be obese, a study of 26 million people found (stock image)
Cancer
In 1988, the International Agency for Research on Cancer declared alcohol a group 1 carcinogen, putting it on a par with asbestos, radiation and tobacco.
Alcohol has now been linked to at least seven cancers. This includes cancer in organs that come into direct contact with alcohol, such as the mouth, tongue, pharynx, esophagus and colon, and those impacted by its effects, including the pancreas, liver and breasts.
In 2025, the US Surgeon General warned that women who drank two alcoholic beverages per day had a 15 percent higher risk of developing breast cancer than those who did not.
For colon cancer, which is currently surging among young adults, a 2023 study warned women who were moderate drinkers - equivalent to one drink per day - had a 47 percent higher risk of colon cancer than those who do not drink. Among men, moderate drinkers had a 26 percent higher risk.
Fertility
Drinking has also been linked to problems with male fertility.
Immediately after drinking, men may struggle to get an erection. The alcohol can disrupt testosterone and cortisol levels in men, which can cause the low libido or erection issues.
Additionally, alcohol can damage sperm production, leading to fewer and lower quality sperm.
'I knew university students who, back in the day, had tried to donate sperm to make some additional money and had failed because of their lifestyle involving alcohol and smoking,' Knowles told the Daily Mail.
Alcohol has been associated with several cancers
Pictured: Why We Drink Too Much: The Impact of Alcohol on Our Bodies and Culture by Dr Charles Knowles
Brain and spinal cord
Knowles warned that alcohol is toxic to nerves and could even shrink the size of your brain.
A 2022 study on 36,600 people found that even those drinking relatively modestly, about one or two drinks per day, had reductions in grey matter, used for processing information, and fewer connections in white matter, which allows for communication between different areas of the brain.
Still, it wasn't clear whether this has a serious effect on function. Knowles doesn't believe so, citing his own study that suggests people are still able to function normally even with these changes.
But he did note that there is a risk that drinking large amounts of alcohol could lead to a condition called alcoholic dementia.
He emphasized that this required a lot (three or more drinks per day) of alcohol consumption over the course of at least 40 years. It is not clear exactly how much based on reports, but alcoholic dementia has been detected in homeless communities among those who rely heavily on alcohol.
Mental health
While drinking, alcohol causes spikes in the feel-good hormones in the brain. But afterward, it causes them to crash, leaving people feeling anxious or depressed.
Knowles struggles with depression himself and takes antidepressants, but said he did not believe his was linked to alcohol.
He said depression runs in his family and that his mood normally was negative (noting that this may have been something that drove him to drink in the first place).
Knowles said that there is a risk that drinking large amounts of alcohol could lead to a condition called alcoholic dementia
Are there any benefits?
Despite his personal experience with drinking, Knowles insisted that he is not anti-alcohol.
'If you look back on my life, would I change the first 10 years of drinking? No,' he said.
'I mean, a friend of mine wrote to me, and he said, "think of all the experiences we had." And then listed a number of crazy things that had happened. None of this would have happened without alcohol.
'I mean, I also met my wife drinking, and we have two children.
'When I look back, it is difficult because, for many people, alcohol is fun and, provided it is kept in check, it can lead to beneficial outcomes in their lives.
'That's why we've been manufacturing alcohol for 15,000 years and continue to consume it.'
Why We Drink Too Much: The Impact of Alcohol on Our Bodies and Culture by Dr Charles Knowles is published by Celadon Books.
