Q. My boyfriend and mom drink too much, but they say they don't, that beer and wine reduce heart disease, and blood tests are fine. Help!

A. Alcohol may not be as heart healthy as people say — go online and Google "Landis Lum wine" to see why. And drinking even small amounts is more harmful than folks realize. Alcohol kills brain and liver cells. Heart cells are damaged, leading to cardiomyopathy, particularly in women. Several studies found that women who drink three to five drinks a day had 40 percent more breast cancers.

Three or more drinks a day increases hemorrhagic strokes in men and women — worse than regular strokes, there's dangerous brain bleeding.

One drink is 12 ounces of beer, 5 ounces of 12 percent wine or 1 1/2 ounces of 80-proof liquor. Drinking three or more drinks a day increases death rates in both men and women not only from more strokes, accidents and liver disease, but also from higher blood pressure and fatal heart rhythms.

Blood tests are normal in many overdrinkers. Men younger than 65 years should drink no more than four drinks per day and no more than 14 drinks per week, and women of any age and men 65 years and older should drink no more than three drinks a day and no more than seven drinks a week. If you go above these amounts more than once a month, it's harmful drinking.

It's alcohol abuse if any of the following occur regularly: Risk of bodily harm (drinking and driving or operating machinery, etc.); trouble with family or friends (like arguments); trouble with home, work, or school obligations; or run-ins with the law (arrests or other legal problems).

It's dependence when several of the following indicators are present: Can't stick to drinking limits, can't cut down or stop, lots of time anticipating or recovering from drinking, less time spent on other important or fun activities, needing to drink more to get buzzed, or withdrawal (tremors, sweating or insomnia) when trying to stop.

Those with abuse or dependence usually relapse, so stopping completely is best. It's best to see an addiction specialist or enter a treatment program. In folks who won't, Revia in doses of 100 mg a day was found in the May 3, 2006, issue of the Journal of the American Medical Association to be just as good at reducing drinking, if patients were seen briefly by family or nonspecialist physicians or nurses to ask about alcohol and Revia intake and how they were doing one and two weeks later, then every two weeks for three months, then regularly thereafter. They were also encouraged to join Alcoholics Anonymous. I keep my patients on Revia six to 12 months.

Dr. Landis Lum is a family practice physician for Kaiser Permanente and an associate clinical professor at the University of Hawai'i's John A. Burns School of Medicine. Write: Prescriptions, Island Life, The Honolulu Advertiser, P.O. Box 3110, Honolulu, HI 96802; e-mail islandlife@honoluluadvertiser.com.