How Does Alcohol Affect Cardiovascular Health?

Last Updated: February 11, 2024

Editorial Policy | Research Policy

Key Takeaways

  • Alcohol consumption patterns and types vary globally, with standard servings of spirits, wine, and beer containing similar amounts of alcohol.
  • Excessive alcohol use is linked to significant health risks, including cardiovascular diseases, liver cirrhosis, and certain cancers.
  • Alcohol metabolism, primarily in the liver, produces toxic byproducts affecting cardiovascular health, with heavy drinking increasing the risk of hypertension, stroke, and myocardial infarction.
  • Limited alcohol consumption may offer some cardiovascular benefits, but these are outweighed by the risks of heavy consumption.
  • Alcohol’s effects on heart rate and blood pressure are complex, with both immediate and long-term impacts on cardiovascular health.
  • Abstinence from alcohol can lead to significant improvements in cardiovascular health, including reduced risks of hypertension and atrial fibrillation.
  • Public health initiatives and policies are crucial in addressing the cardiovascular risks associated with alcohol consumption.
  • Preventive measures and raising awareness about alcohol’s cardiovascular risks can help mitigate the burden of alcohol-related cardiovascular disease.

Alcohol Types and Consumption Patterns

Alcohol, a substance consumed across the globe, is primarily sought for its psychological and physiological effects. Understanding its various forms and consumption patterns is crucial for recognizing its broader impacts on health and society. Alcoholic beverages range from spirits such as vodka, typically consumed in 1.5-ounce shots, to wine, often served in 5-ounce glasses, and beer, available in 12-ounce bottles or cans. These standard servings contain roughly the same amount of ethyl alcohol, making them equally intoxicating.

Patterns of alcohol consumption vary widely and are influenced by individual choices, cultural contexts, and legal frameworks, such as the minimum legal drinking age. Despite the debate on age restrictions, the World Health Organization (WHO) and other health authorities emphasize reducing harmful alcohol use through cost-effective interventions and policies. Notably, the WHO’s Global Information System on Alcohol and Health offers valuable data on consumption patterns and health outcomes associated with alcohol use.

The Centers for Disease Control and Prevention (CDC) outline moderate drinking guidelines, suggesting limits of up to two drinks per day for men and one for women. Nevertheless, excessive alcohol use, which includes binge drinking and heavy consumption, is linked to significant health risks, including cardiovascular diseases, liver cirrhosis, and certain cancers. The CDC underscores the health consequences of overconsumption, advocating for moderation or abstinence to mitigate risks.

While some research suggests potential health benefits from moderate alcohol consumption, such as a reduced risk for certain heart conditions, these must be weighed against known risks. Health experts recommend that individuals who do not currently consume alcohol should not start for health reasons and that healthier lifestyle choices, like diet and exercise, are more beneficial and less risky than moderate alcohol use.

Alcohol Metabolism and Its Impact on Cardiovascular Health

Alcohol metabolism is a complex biochemical process with significant implications for cardiovascular health. The body metabolizes alcohol primarily in the liver, producing acetaldehyde, a toxic byproduct that contributes to tissue damage and oxidative stress. This process influences the cardiovascular system in various ways, depending on the amount and pattern of consumption.

Research has demonstrated that alcohol consumption affects blood pressure and can lead to hypertension. A meta-analysis of cohort studies revealed that any level of alcohol intake in men and consumption beyond 24g per day in women is associated with an elevated risk of hypertension. Moreover, the relationship between alcohol use and blood pressure is causal and reversible, indicating that reducing alcohol intake can lower both systolic and diastolic blood pressure significantly.

Patterns of drinking, such as binge drinking, correlate with a higher risk of cardiovascular conditions such as hypertension, stroke, myocardial infarction, and increased mortality following a cardiac event. Chronic alcohol consumption also impacts the myocardium, leading to decreased protein synthesis and accelerated degradation.

Interestingly, the ‘J-shaped’ relationship between alcohol intake and ischemic heart disease (IHD) implies that low-level drinkers may have a lower risk compared to lifetime abstainers. However, the risk increases substantially with heavier consumption. This paradoxical effect underscores the importance of considering individual factors and drinking patterns when assessing alcohol’s impact on cardiovascular health.

Overall, alcohol’s effects on the cardiovascular system are dose-dependent, with heavy and chronic drinking posing greater risks. Understanding these effects is crucial for developing public health policies and individualized care plans that address the cardiovascular risks associated with alcohol consumption.

The Influence of Alcohol on Blood Pressure

Alcohol consumption has been consistently linked to changes in blood pressure, with particular concern for its role in the development of hypertension. Studies have demonstrated that heavy alcohol use can substantially increase both systolic and diastolic blood pressure. Notably, reducing alcohol intake can lead to significant improvements in these readings. For instance, individuals who transition from heavy to moderate drinking may observe a decrease in systolic pressure by approximately 5.5 mm Hg and diastolic pressure by about 4 mm Hg.

The mechanism behind alcohol’s hypertensive effect appears to involve its impact on vasoconstrictors and various homeostatic responses aimed at restoring normal blood pressure levels. Additionally, research indicates that plasma renin activity, which plays a critical role in blood pressure regulation, increases as a late effect of alcohol consumption.

While some evidence suggests that limited alcohol consumption might benefit cardiovascular health, the relationship between alcohol and blood pressure is complex and not fully understood. It’s important for individuals with high blood pressure to either avoid alcohol or consume it in moderation. For those who find it challenging to cut back on alcohol, professional guidance and support are encouraged. The interplay between alcohol use and blood pressure underscores the need for personalized medical advice and potential lifestyle adjustments to manage cardiovascular risks effectively.

The Effects of Alcohol on Heart Rate

Alcohol consumption has immediate and varying effects on heart rate, which is a critical factor in cardiovascular health. According to The New York Times, even one standard drink can elevate the heart rate by about five beats per minute in the hours following consumption. While typically temporary, this elevation in heart rate can be concerning for individuals with conditions that cause irregular heart rhythms.

Heavy drinking, defined as eight or more drinks per week for women and 15 or more for men, is associated with a higher risk of heart disease and heart muscle damage, as reported by Northwell Health’s The Well. Notably, the relationship between alcohol and heart rate is complex, as limited consumption can increase levels of HDL (good) cholesterol, according to Harvard Health. HDL helps to prevent LDL (bad) cholesterol from clogging arteries.

Furthermore, alcohol is a depressant that can slow down the brain’s control over the body, potentially reducing heart rate to dangerously low levels with excessive intake, as highlighted by the British Heart Foundation. The Cleveland Clinic warns that alcohol may cause an irregular heartbeat and raise blood pressure, emphasizing that individual responses to alcohol can vary based on age and existing health conditions.

It’s crucial for individuals to understand their own limits and the potential risks associated with alcohol consumption. Moderation is key, and for those with pre-existing heart conditions or risk factors for cardiovascular disease, it’s advisable to consult with healthcare providers about safe levels of alcohol intake.

The Connection Between Alcohol Consumption and Cardiovascular Diseases

Extensive research has established that alcohol consumption can significantly impact cardiovascular health, both positively and negatively, depending on the quantity and patterns of consumption. Investigations utilizing Mendelian randomization (MR) have been employed to predict alcohol consumption’s effects on cardiovascular diseases (CVDs), though a definitive causal relationship remains elusive. Evidence suggests that binge drinking and higher frequencies of alcohol intake are correlated with an increased risk of cardiovascular conditions such as hypertension (HTN), stroke, myocardial infarction (MI), and an enhanced likelihood of mortality post-MI.

Alcohol’s dose-dependent effects on blood pressure were observed in studies, indicating that women who consume more than 20 grams of ethanol per day (approximately 1 to 2 drinks) and men who consume slightly higher amounts face an increased risk of developing HTN. Long-term alcohol use also affects the cardiovascular system by decreasing myocardial protein expression and synthesis, accelerating protein degradation in the myocardium, and affecting long-chain fatty acid (LCFA) uptake and triglyceride formation.

While some observational studies have reported potential cardioprotective effects of low alcohol consumption, the lack of randomized controlled trials (RCTs) leaves the question of whether these effects are truly causal or the result of observational study biases. Excessive alcohol consumption, characterized as more than 60 grams per day for men and more than 40 grams per day for women, is a known contributor to the mortality and burden of CVDs. Conditions such as alcoholic cardiomyopathy, systemic hypertension, arrhythmias, stroke, and atherothrombotic disease, particularly coronary artery disease (CAD), have all been associated with alcohol intake.

Alcohol Consumption and Coronary Heart Disease

Scientific research presents a complex picture of the relationship between alcohol consumption and coronary heart disease (CHD). While limited alcohol intake might be associated with a reduced risk of CHD, excessive alcohol use is linked to negative cardiovascular effects. Evidence suggests a correlation between genetically predicted alcohol consumption and an increased risk of coronary artery disease, as well as other heart conditions such as atrial fibrillation and abdominal aortic aneurysm.

Limited alcohol consumption could potentially offer some protective benefits for the heart by affecting lipids and hemostatic factors, according to a meta-analysis. However, this association is not observed universally across different populations, including US Veterans, indicating that various factors, including genetics and lifestyle, may influence the relationship between alcohol and CHD.

On the flip side, excessive alcohol intake can lead to high blood pressure and increased heart rate and can contribute to the development of cardiomyopathy. Long-term alcohol use has been found to decrease myocardial protein expression and accelerate protein degradation in the heart. It is essential to understand that while light drinking might be associated with a lower risk of CHD for some individuals, this does not equate to a blanket recommendation for alcohol consumption as a protective measure for cardiovascular health.

Ultimately, the key to alcohol consumption and heart health seems to be moderation and individual assessment. Those with a history of alcoholism, certain health conditions, or who are pregnant should avoid alcohol, and anyone considering alcohol as part of a heart-healthy lifestyle should consult with their healthcare provider.

Alcohol Consumption and Stroke Risk

The consumption of alcohol has a complex relationship with the risk of stroke, a leading cause of disability and death worldwide. Excessive alcohol intake is associated with an increased risk of several types of stroke, while some studies suggest a nuanced, U-shaped curve where limited consumption may offer protective benefits against certain types of stroke.

Alcohol can contribute to conditions that heighten the risk of stroke, such as hypertension and atrial fibrillation. Research indicates that heavy drinking can trigger atrial fibrillation, a heart rhythm disorder significantly linked to stroke. Moreover, alcohol’s acute effects can lead to increased blood pressure, heart rate, and impaired fibrinolysis, all of which are potential precursors to stroke events.

Interestingly, the relationship between alcohol and stroke type appears to differ; ischemic strokes, which are caused by an obstruction within a blood vessel supplying blood to the brain, have a U-shaped association with alcohol. Light drinking might reduce the risk, whereas both abstinence and heavy drinking could increase it. On the other hand, hemorrhagic strokes, resulting from a ruptured blood vessel in the brain, show a more linear relationship, with risk increasing alongside alcohol consumption. Studies suggest that even moderate alcohol intake is not associated with a reduced risk of hemorrhagic stroke.

Given these findings, the advice on alcohol consumption remains cautious, with guidelines recommending that individuals do not regularly exceed 14 units per week to maintain a low risk of stroke. Strategies for reducing alcohol intake include drinking slowly, with food, and alternating alcoholic drinks with water.

Alcohol and Cardiomyopathy

Alcohol-induced cardiomyopathy (ACM) is a significant form of dilated cardiomyopathy that can be brought on by chronic and heavy alcohol consumption. The condition is characterized by a weakened and dilated heart that cannot pump blood efficiently, leading to a spectrum of health problems, including heart failure. The American Heart Association (AHA) recognizes alcohol as one of the leading causes of cardiomyopathy and a significant risk factor for heart failure.

Excessive alcohol intake leads to a toxic environment for heart cells, causing damage that results in myocyte hypertrophy, cell necrosis, and fibrosis. These pathological changes contribute to the loss of contractile function and ventricular dilation observed in ACM. Diagnostic criteria for ACM include a history of heavy alcohol use in the absence of other common causes of cardiomyopathy, such as coronary artery disease. Over time, the chronic misuse of alcohol can lead to a range of negative cardiovascular effects, including hypertension, arrhythmias, and stroke.

According to StatPearls, alcohol use accounts for 10% of all dilated cardiomyopathy cases. The prognosis of ACM can be poor and closely linked to the amount and duration of alcohol consumption. Moreover, mortality rates are higher among certain demographics, with males and the black population being more affected. Factors like genetics, additional exposure to cardiotoxic substances, and nutritional deficiencies such as thiamine also play a role in the disease’s progression.

It’s important to note that while low to moderate alcohol consumption has been historically debated for potential cardiovascular benefits, chronic and heavy use is unequivocally harmful, leading to conditions like ACM. Public awareness and medical interventions focus on mitigating the risks associated with alcohol misuse to prevent the development of alcohol-induced cardiomyopathy and other related diseases.

The Impact of Moderate Alcohol Consumption on Heart Health

The relationship between moderate alcohol consumption and cardiovascular health is a subject of ongoing debate within the medical community. Recent studies have indicated nuanced findings, suggesting that the effects of alcohol on heart health are far from straightforward. For instance, the Prospective Urban and Rural Epidemiological (PURE) study revealed that low alcohol consumers experienced a 17% decrease in the incidence of cardiovascular disease (CVD) compared to teetotalers. In contrast, heavy drinkers faced an increased risk of CVD and death from any cause.

In light of this, it is crucial to understand that alcohol has a hormetic physiological behavior, meaning that its impact can either increase or decrease cardiovascular risk depending on several factors, such as the amount consumed, drinking frequency, and the type of alcoholic beverage. This complexity is compounded by factors like measurement inaccuracies and misreporting of alcohol consumption in studies.

Furthermore, recent research suggests that the type of alcohol consumed may play a role, with findings indicating stronger associations of all-cause mortality with beer or spirits compared to wine. However, these observations come with a caution about potential confounding effects.

While experts continue to examine these relationships, the commonly agreed-upon definition of moderate drinking by organizations such as the American Heart Association — up to one drink per day for women and two for men — remains a benchmark for public health recommendations. It is important to recognize that alcohol consumption, even at moderate levels, can contribute to excess calorie intake and weight gain, which are detrimental to long-term heart health.

Ultimately, while light alcohol consumption might not be harmful to the heart for most people, it is essential to consider individual health profiles and risks before making any decisions regarding alcohol intake.

The ‘French Paradox’ and Its Impact on Cardiovascular Health

The ‘French Paradox’ refers to the observation that the French population has a relatively low incidence of cardiovascular disease (CVD) despite a high intake of saturated fats. This phenomenon, first coined in 1992, has been widely discussed and researched, with many experts attributing the protective effect against CVD to light red wine consumption. Studies suggest that the compounds in red wine, such as resveratrol and flavonoids, may have cardioprotective properties, potentially explaining the paradox.

Research indicates that light alcohol intake, particularly of red wine, may be inversely related to ischemic heart disease. A pattern emerges where light drinkers, defined typically as those who consume the equivalent of two drinks per day, exhibit a decreased incidence of coronary disease compared to non-drinkers. However, this relationship forms a U-shaped curve, as higher doses of alcohol intake are associated with an increased risk of infarction and stroke. Clinical observations support the cardiovascular benefits of limited red wine consumption, suggesting it could be a therapeutic supplement to prevent or even treat coronary artery disease.

While the ‘French Paradox’ highlights the potential benefits of limited drinking, it’s essential to balance this with the known risks of heavy or binge drinking, which can lead to adverse health effects. Overall, the association between alcohol and health remains complex, with the need for further research to fully understand the implications of moderate alcohol consumption on cardiovascular health.

The Positive Cardiovascular Impact of Alcohol Abstinence

The cessation of alcohol intake has marked effects on cardiovascular health, with numerous studies emphasizing the benefits of abstinence after periods of excessive drinking. Research indicates that abstaining from alcohol can significantly reduce the risk of developing hypertension (HTN), which is a key factor in cardiovascular disease (CVD). A meta-analysis by Briasoulis et al. demonstrated that the risk of HTN increases with the consumption of more than 20 grams of ethanol per day, an amount roughly equivalent to 1 to 2 standard drinks.

Furthermore, alcohol abstinence has been associated with a lower incidence of atrial fibrillation (AFib), a common and potentially serious heart rhythm disturbance. A study published in The New England Journal of Medicine found that moderate and heavy drinkers with AFib could reduce their episodes by cutting out most alcohol. Beyond the immediate effects, long-term alcohol use has been shown to decrease myocardial protein expression and synthesis while accelerating protein degradation in the myocardium, underscoring the importance of abstinence in maintaining cardiac function.

Short-term alcohol abstinence also leads to improvements in liver function, which is closely related to cardiovascular health. Cessation can reverse fatty changes in the liver, allowing it to return to normal function. This is significant because the liver plays a crucial role in regulating substances that affect blood pressure and heart health.

In sum, the body of evidence points to a clear cardiovascular advantage in reducing or eliminating alcohol consumption. The direct benefits of alcohol abstinence on cardiovascular health include lowered risk of hypertension, atrial fibrillation, and improved liver function, which in turn supports overall cardiovascular system health.

Cardiovascular Rehabilitation Post-Alcohol Abstinence

Abstaining from alcohol leads to notable improvements in cardiovascular health, with evidence suggesting a causal and reversible relationship between alcohol consumption and blood pressure. Meta-analyses reveal that reducing alcohol intake can significantly decrease both systolic and diastolic blood pressure in a dose-response manner, emphasizing the importance of moderation or abstinence for individuals at risk of hypertension. Additionally, a period of abstinence is associated with positive changes in the heart, such as reduced risks of ischemic stroke (IS) and coronary heart disease (IHD) morbidity and mortality.

Moreover, recovery from alcohol use disorder (AUD) shows encouraging signs of brain regeneration, which also impacts cardiovascular health. Studies indicate that cortical thickness in the brain shows improvement after months of abstinence, suggesting that the body has a natural propensity for repair once alcohol is no longer a contributing factor to organ damage. This recovery is not limited to the brain; the liver and other organs also exhibit signs of healing following a sustained period without alcohol. In animal models, abstinence has been shown to reverse alcohol-induced changes in the gut, which is closely linked to overall cardiovascular function.

It is important to recognize that the degree of recovery varies among individuals and depends on the duration and severity of previous alcohol consumption. The cardiovascular system’s ability to recover post-abstinence underscores the potential for reversing alcohol-related damage and improving overall heart health. However, the recovery process is complex and may require medical guidance, especially for individuals with a history of heavy alcohol use.

Addressing alcohol use disorders through treatment focused on abstinence or significant reduction in consumption is essential for mitigating the long-term cardiovascular effects of alcohol, such as hypertension, cardiac arrhythmia, cardiomyopathy, and heart failure. Ultimately, the choice to abstain from alcohol can lead to substantial health benefits and should be considered as part of a comprehensive strategy for cardiovascular disease prevention and recovery.

Public Health Implications of Alcohol Consumption on Cardiovascular Health

Alcohol consumption presents significant public health challenges, particularly concerning cardiovascular health. Research published in BMC Medicine indicates that the metabolomic profiles altered by alcohol consumption can have both beneficial and harmful outcomes for cardiovascular disease (CVD). Specifically, certain circulating metabolites have been linked to both increased and decreased risk of CVD, suggesting a complex relationship between alcohol intake and heart health.

The World Heart Federation (WHF) has released a policy brief calling for decisive action to combat alcohol-related death and disability globally. Contrary to popular belief, the WHF contends that even moderate alcohol consumption does not protect against heart disease and, in fact, may increase the risk of CVD, including hypertension, stroke, and myocardial infarction. This is supported by findings from studies mentioned in the policy brief and further elaborated on in research papers available on PubMed Central.

Moreover, the WHF and other experts stress the need for national cardiology foundations and societies to publish guidelines and advocate for domestic policies aimed at addressing the impact of alcohol on cardiovascular health. The lack of investment in alcohol control strategies and the persistence of misinformation, often perpetuated by industry interference, have been significant barriers to reducing alcohol-related harms. The emphasis on prevention and control of non-communicable diseases by the World Health Organization highlights the urgency of reducing harmful alcohol use as a key factor in managing CVD risk.

Understanding the public health implications of alcohol consumption on cardiovascular health is essential for developing effective policies and health guidelines. It also underscores the importance of robust public health initiatives and research to inform the public and guide policy-making decisions.

Influence of Alcohol Policies on Cardiovascular Health

Alcohol consumption has significant impacts on cardiovascular health, influencing the incidence of conditions such as hypertension (HTN), stroke, myocardial infarction (MI), and other cardiovascular diseases (CVDs). Alcohol policies play a crucial role in shaping drinking behaviors and consequently affect cardiovascular health outcomes. Research indicates that drinking patterns, particularly binge drinking and frequent heavy drinking, are associated with heightened risks of cardiovascular conditions. Moreover, consuming more than 20 grams of ethanol per day (approximately 1 to 2 drinks) is linked to an increased risk of developing hypertension, especially among women, with greater amounts further elevating risks in men.

Public health strategies to manage alcohol consumption and mitigate its cardiovascular effects are vital, especially in light of findings from the World Heart Federation, which highlight the urgent need for decisive action to tackle the rise in alcohol-related death and disability. A survey of members from the World Heart Federation revealed a strong consensus on the need for national cardiology foundations to publish guidelines and advocate for domestic policies addressing alcohol’s impact on cardiovascular health. Despite clear evidence of alcohol’s detrimental effects on cardiovascular health, efforts by public health professionals are often hindered by a lack of investment in proven alcohol control strategies, misinformation, and industry interference.

Overall, effective alcohol policies, including measures to reduce consumption, early identification of at-risk individuals, and accessible treatments for alcohol use disorder, are essential for reducing the burden of cardiovascular diseases. The establishment of such policies can lead to a decrease in alcohol intake and related harms, potentially improving public health outcomes on a global scale.

Promoting Preventive Measures and Raising Awareness on Alcohol’s Cardiovascular Risks

The relationship between alcohol consumption and cardiovascular health is complex and multifaceted. As such, preventive measures and public awareness campaigns are crucial in mitigating the risks associated with alcohol use. According to the World Heart Federation, an estimated 80% of cardiovascular diseases (CVD) are preventable, with alcohol use being a significant factor in many of these cases. The widespread belief that moderate alcohol consumption may be cardioprotective has been challenged by recent evidence, highlighting the need for more robust public health strategies.

Preventive measures include promoting healthy lifestyle choices, such as engaging in regular physical activity, maintaining a balanced diet, and avoiding excessive alcohol use. The Centers for Disease Control and Prevention (CDC) emphasizes that excessive alcohol use can lead to health problems such as liver diseases, cancer, and of course, cardiovascular issues. Moreover, raising awareness about the risks of excessive alcohol consumption can play a vital role in heart disease prevention. Public education campaigns, policy initiatives, and targeted interventions are essential in disseminating this knowledge.

Evidence suggests that community-based strategies, such as those recommended by The Community Preventive Services Task Force, can effectively reduce harmful alcohol use. Further, the implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT) in healthcare settings can help identify and address risky alcohol use before it leads to more severe health consequences. Public health messaging and transparent reporting of alcohol-related harms can also contribute to a more informed public and more effective policy actions.

Overall, a multi-pronged approach that combines preventive measures, public awareness, and supportive policies is necessary to address the impact of alcohol on cardiovascular health. By fostering a better understanding of this relationship, individuals and policymakers can take decisive steps to reduce the burden of alcohol-related cardiovascular disease.

Protect Cardiovascular Health by Quitting Alcohol

Heavy drinking can lead to many cardiovascular complications. If you struggle with alcohol use disorder and are worried about your heart health, it might be time to seek help. 

Alcohol addiction can be difficult and potentially dangerous to recover from on your own. Severe alcohol withdrawal can be deadly, so heavy alcohol users should not attempt to wean off alcohol without the help of a professional medical detox facility. Alcohol addiction treatment will begin with a detox period that focuses on managing any uncomfortable or severe withdrawal symptoms that arise. After detox ends, patients begin a rehab program that teaches them how to cope without alcohol and maintain sobriety.

Detox and rehab can take place in inpatient or outpatient settings. Outpatient treatment is best for mild alcohol addictions, and it allows patients to attend doctor and therapy visits while still living at home. Inpatient treatment is best for moderate to severe alcohol addictions or people who have relapsed. Inpatient treatment involves living on-site at the detox or rehab facility, an approach that keeps patients in a healing environment and allows for better monitoring and treatment.

The Recovery Village Cherry Hill at Cooper provides a full continuum of care, from medical detox and inpatient rehab to aftercare. We are here to help you and those you love recover from addiction and begin a healthier, alcohol-free future. Contact us to learn more about alcohol addiction treatment programs that can work well for your needs in recovery.

 

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