July 04, 2025
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Mocktails can help people reduce their alcohol consumption, but they also may trigger relapses for some people with alcohol use disorder, addiction specialist Aviva Fohrer says.
The "sober-curious" movement has gained strength in recent years alongside research directly linking alcohol to seven cancers and increased risk of heart disease.
Earlier this year, former Surgeon General Vivek Murthy advocated for putting cancer warnings on alcohol labels. That followed the World Health Organization issuing a statement in 2024 stating no amount of alcohol use is safe.
These factors have contributed to the proliferation of mocktails and non-alcoholic beers, wines and spritzers on the market. But non-alcoholic drinks should not be confused with health drinks. Some have unregulated additives and supplements that can pose health risks. And for people with alcohol use disorder, non-alcoholic drinks may trigger relapse, Narberth psychiatrist and addiction specialist Aviva Fohrer said.
"I never say no to anything, but the big picture for me with these non-alcohol substitutions, for somebody that struggles with alcohol use disorder is, it's sort of sometimes like switching seats on the Titanic," Fohrer, of Thalia Medical Center, said.
Beverages must have less than 0.5% alcohol by volume to qualify as a non-alcoholic drink, so some of these products may have trace amounts of alcohol. The American College of Obstetricians and Gynecologists, along with other health advisory boards, say pregnant women should avoid alcohol altogether, so non-alcoholic drinks may not be safe. A 2010 report found that nearly 30% of low- and non-alcoholic drinks contained more alcohol than stated on the labels.
Non-alcoholic beverages may not necessarily be low in calories, and many contain "empty" calories with little to no nutritional value.
Some non-alcoholic drinks being marketed contain supplements not regulated by the U.S. Food and Drug Administration, such as ashwagandha, guarana and L-theanine. Research suggests ashwagandha may help reduce stress and anxiety and improve sleep for some people, but its long-term safety is unknown. Guarana comes from berries but has twice the caffeine of coffee beans. L-theanine is derived from tea leaves, but there is limited evidence that it enhances brain health and relaxation.
"There's no such thing as a free lunch," Fohrer said. "If something is advertising itself as somehow having psychoactive effects or mood altering, question 'Where is that coming from?'"
Fohrer said she is particularly concerned about products that contain kratom, an herbal extract that has stimulating effects at low doses and sedating effects at higher doses. Although kratom is unregulated in the United States, the FDA has warned people not to use it because of potential liver toxicity, seizures and other adverse health effects.
People who do use kratom on a regular basis may develop a physical dependence and experience opioid-like withdrawal symptoms coming off of it.
"I'm detoxing people off of kratom – like legitimately doing a full opiate detox," Fohrer said. "They get nausea, they get shakes, they get chills, they get diarrhea, they get teary, they get anxious. It is all of the symptoms of opiate withdrawal."
Fohrer also warned that consuming non-alcoholic drinks may be a slippery slope for people with substance use disorders.
A 2024 study showed that about half the people using non-alcoholic drinks cut back on their actual alcohol consumption.
But non-alcoholic drinks may socialize people who are underage to drinking because they have the look, taste and branding of beer, wine and liquor, researchers wrote in a 2024 opinion piece in JAMA Pediatrics. Also, craving and desire to drink increases among people with alcohol use disorder after consuming no- and low-alcohol beverages, research shows.
"You're cracking open a can that sounds like a beer," Fohrer said. "It tastes familiar, minus the alcohol. It's really difficult to change behaviors when you're engaging in the behaviors."
