Drinking has always had a reputation for being cool. Legends who held their liquor like Hunter Thompson and Hank Williams were famous for their altered states and made the idea of total obliteration romantic. But booze’s status might be changing.

As people sharpen their palates and their home bars become libraries of spirits, society is simultaneously becoming more aware of the mental and physical damage drinking can cause. Consumption of alcoholic beverages can cause liver damage, memory problems, anxiety and heart disease, among other health issues.

Pop Sushi’s Tony Lemos has been a bartender in Durango for over a decade. His cocktails, such as the Coyote Tales – a tequila take on an old fashioned, are works of art in their own right. As pretty as the drinks may be, though, he understands the dangers of alcohol.

Lemos was already interested in serving high-quality drinks, but he saw close family members struggle with drinking, and his mother recently died from alcohol-related issues. It encouraged him to put extra care in what he was serving.

Pop Sushi’s menu has a list of alcohol-free mocktails, and he incorporates herbs, fresh juices, Demerara sugar, herbal liqueurs and other ingredients like CBD, or cannabidiol, into his cocktails.

Recent studies into the anti-inflammatory properties of cannabinoids have shown significant differences in liver health among drinkers who used marijuana and those who did not. Researchers are cautiously optimistic that cannabinoids may even slow or prevent the development of liver tumors. However, the same chemicals carry many unknowns, and researchers warn that they’re not cure-alls.

“There is a new level of health consciousness,” Lemos said. “It’s not that people are going to quit drinking; it’s they are going to drink better.”

Ariane Resnick is the author of “The Thinking Girl’s Guide to Drinking: Cocktails Without Regrets” recipe book of boozy drinks made with natural, whole ingredients. The idea of the book is to offer types of drinks with wholesome ingredients that negate alcohol’s harmful effects.

“It’s really important to remember that you’re still drinking,” Resnick said. “I very much shy away from the idea of ever saying a cocktail is ‘healthy’ or a ‘wellness cocktail.’ If you are consuming alcohol, you are consuming a poison.”

With that in mind, Resnick said there are certain ingredients that help. She said people should take into account how alcohol specifically affects them. For instance, alcohol can create a yeast imbalance in some people, so she suggests mixing a cocktail with a probiotic such as kombucha.

“Some people find that, more than anything, alcohol makes them nauseous.,” Resnick said. “For those people, fresh ginger versus a syrup is a great addition – or peppermint, peppermint extract or fresh mint leaves.”

There are specific alcohol brands that are marketing themselves as healthier options, too. FitVine Wine’s vino is fermented longer to create a lower sugar content and comes marked with nutrition labels. Low-calorie spiked seltzers were at most summer barbecues last summer. And non-alcoholic beers and wine and alcohol-free spirits such as Borrago and Kin, which are made from distilled botanicals, offer grown-up alternatives for non-drinkers. The sleek packaging and labels would fool anyone, drunk or sober.

Resnick warns against the marketing of alleged health products and encourages people to do their research. Some healthy drinks and their ingredients might not do what they claim – such as activated charcoal, which had a moment in the food and beverage world because it dyes edible items a hip leather-jacket black.

Drinking a cocktail that looks like it listens to Morrissey is not as cool as it looks. Resnick said that along with bad toxins, activated charcoal eliminates positive nutrients. She said drinking activated charcoal in a cocktail will keep drinkers from getting a buzz and encourage more drinking.

“It makes me happy to see these sorts of movements happening,” said Dr. Aaron White, senior scientific adviser at the National Institute on Alcohol Abuse and Alcoholism. He said the health benefits of quality ingredients, however, are minimal when mixed with alcohol.

He said ingredients like ginger would make little difference in ending nausea in an intoxicated person because, while the feeling of sickness occurs in the stomach, it’s mostly controlled by the brain.

“When you get really nauseous, that is from an area in the brain called the area postrema, where the blood-brain barrier is not as strong,” White said. “When (this area) detects levels of toxins that are too high, it causes you to vomit.”

But there are certain qualities to cocktails that can contribute to harsh hangovers. Burned out barrels that give whiskeys their flavor, for example, create congeners, chemicals that impart distinctive characters to wines or liquors, but also carry their own physiological effects. These can make people feel worse, White said.

“So far we don’t know of anything that will prevent the toxic effect of alcohol in the body,” he said. “And we don’t know anything that can prevent hangovers.”

White said other non-drinking movements like Dry January, where people take a break from drinking for a month, resulted in better sleep, more energy, weight loss and better drinking habits six months later.

Still, some Dry January practitioners find it to be boring. Americans drink to celebrate, we drink when we are sad, we drink to kill time. It’s how we socialize.

“When you talk about the social elements, drinking is good for being able to be social,” Resnick said.

College-aged and young adults are drinking far less. From 1991 to 2015, the percentage of college students who drank within a month dropped from 45% to 38%, a 15% drop. Drinking by middle and high school students has dropped by a third in the last decade. White said this could be a result of better policies, more awareness of risks and changing social norms.

“But it’s a little bit more nefarious than at first glance,” White said. They are not a result of better social or emotional well-being; Young people are socializing less and depression and anxiety are going up. Because drinking is a social activity, some of the decline could be a result of less socializing.

White said if you are going to drink, it’s important to eat and drink water. Four drinks result in the loss of a liter of water because alcohol causes more urination. Drinking on an empty stomach can hit the stomach and brain harder, and eating a meal can reduce a person’s blood alcohol level by a third and the body gets rid of alcohol quicker, he said.

“Alcohol has been a part of civilization for at least 9,000 years, probably longer. It’s going to play a role in modern cultures,” he said. “It’s so normative and woven into the fabric of the culture, but that can change over time.”