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Alcohol and your health

Introduction

Alcohol misuse is a major public health problem, placing a heavy burden on society, and affecting a large number of individuals of all ages.

Contrary to what many people believe, alcohol is not a stimulant. It is a depressant. This is why drinking too much often leads to impaired judgement, slurring of the speech, a tendency to violent behaviour and loss of short-term memory.

As alcohol also irritates the stomach, heavy drinking can cause sickness and nausea, and sometimes diarrhoea. Alcohol also has a dehydrating effect, which is the main reason why excessive drinking can lead to a hangover. It can also lead to temporary impotence in men.

Facts and Figures

Either on its own or in conjunction with other factors, alcohol is estimated to be responsible for at least 33,000 deaths in the UK each year.(1)

In Great Britain, just under a third of men (31%) and one in five women (20%) drink more than the advised weekly limits of 21 and 14 units a week respectively. Some 8% of men and 2% of women drink more than the levels regarded as harmful, namely 50 and 35 units a week respectively. (2)

More than one in 25 adults are dependent on alcohol, and the UK has one of the highest rates of binge drinking in Europe (3)(4)

An estimated 17 million working days are lost each year due to people missing work due to the effects of alcohol. (5)

Around 6% of road casualties and 17% of all deaths on the road occur when someone has been drinking over the legal limit. (6)

In young adults, binge drinking is also associated with a range of risky behaviours, including a higher risk of contracting a sexually transmitted illness.(7)

The harmful effects of drinking are almost entirely related to the alcohol content of what you drink, not the type of drink. In other words, beers are no safer than spirits. What matters is how much you drink.

The alcohol content of drinks is measured in ‘units’. Each unit is equivalent to around 10mls or 8g of pure alcohol (ethanol). The number of units in any drink is related to the strength of the alcohol content (the concentration) and to the volume of the drink.

For example, a single (35ml) shot of spirits contains roughly the same amount of alcohol as a small (125ml) glass of wine. This is about the same amount of alcohol (1.4 units) as is contained in a half pint of normal strength beer.

You can find out how many units your favourite drinks contain by checking the below unit calculator.

Progression

The short term health risks of alcohol include:

Anxiety
Sexual difficulties such as impotence
Impaired judgement leading to accidents and injuries
Slowed breathing and heartbeat
Loss of consciousness
Suffocation through choking on your own vomit (aspiration)
Potentially fatal poisoning

Drinking heavily also increases your calorie intake, and it is frequently associated with obesity. This in turn leads to increased health risks. Adding 3 or 4 units per day to your usual diet would lead to an increase in weight of around 4lbs in four weeks.

The good news is that the short term effects of drinking are reversible. When you reduce your drinking, the symptoms improve.

In the long term, alcohol can contribute to a variety of problems, including damage to an unborn child, liver disease, osteoporosis (thinning of the bones), pancreatitis, stomach ulcers, infertility, heart disease, raised blood pressure, stroke, dementia and brain damage.

It can also lead to an increased risk of a variety of cancers, particularly breast cancer and cancer of the gullet. It is also frequently associated with mental health problems, such as depression and anxiety.

Advice and Getting Help

Reducing the risks

It is important to understand safe guidelines. The government advises that people should not regularly drink more than the daily unit guidelines of 3-4 units of alcohol for men (equivalent to a pint and a half of 4% beer) and 2-3 units of alcohol for women (equivalent to a 175 ml glass of wine). Regularly’ means drinking every day or most days of the week.

Even if you don’t drink all week, you cannot ‘save up’ your units and then drink them all in one night.

Drinking more than the daily unit guidelines is potentially dangerous. Drinking more than twice the daily unit guidelines (six units for women and 8 units for men) on any one drinking occasion qualifies as a ‘binge’.

If you are pregnant or trying to conceive, it is best to avoid drinking altogether. If you do choose to drink, restrict your intake to no more than one or two units once or twice per week.

If you think you may be drinking above the sensible limits, you should try to take some steps to reduce your consumption.

Drinking within these guidelines, and trying to give yourself a couple of days off alcohol every week, will help you avoid piling on the pounds.

Some suggestions include:

Make a deliberate decision about how to avoid drinking too much when you are in a potentially heavy drinking situation, either at home or when you are out with friends, at a restaurant, pub or wine bar.
Look online for more information- the tips and tools at www.drinkaware.co.uk
Call Drinkline, the national 24-hour helpline, on 0800 917 82 82
Make an appointment to see your GP or your practice nurse

Getting medical help

GPs and practice nurses are increasingly involved in helping people to stay fit and healthy. And since a healthy lifestyle is a key factor for preventing illness, your GP and/or practice nurse will be happy to spend time discussing concerns about alcohol with you.

If you think you are already experiencing some of the possible harmful effects of drinking, or that you have become dependent on alcohol, your doctor is almost certainly the best place to go.

Your GP can listen to your symptoms and concerns, and will be able to assess whether you have become dependent on alcohol. Your doctor may also examine you to see if there are any physical signs of disease, and will be able to arrange blood tests as appropriate and, if necessary, additional radiological examinations (like a liver ultrasound scan).

Depending on the findings, your GP may offer you advice and support in the practice, or decide to refer you to another professional, such as a hospital specialist consultant.

If you have become dependent on alcohol, your doctor may be able to offer you advice, support and appropriate prescriptions of medications to help you withdraw from alcohol (detoxification).

Alternatively, you and your GP may decide that it would be better for you to be referred to a specialist Alcohol Treatment Unit.

Author: Professor Paul Wallace

Paul Wallace is David Cohen Professor of Primary Health Care at UCL and a part time General Practitioner in the Hampstead Group Practice. In addition, he holds the post of Director, NIHR Primary Care Research Network

References

1 Academy of Medical Sciences (2004) Calling Time: The Nation's Drinking as a Major Health Issue. London: AMS,
2 Office of National Statistics (2008) General Household Survey : Smoking and drinking among adults 2006, London
3 Department of Health (2005) Alcohol Needs Assessment Research Project (ANARP): The 2004 national alcohol needs assessment for England,
4 TNS Opinion & Social. Attitudes towards alcohol. Special Eurobarometer. Brussel: European Commission, 2007
5 Strategy Unit Alcohol Harm Reduction project, Interim Analytical Report for the National Alcohol HarmReduction Strategy. 2003
6 Transport Statistics (2008) Road Casualties Great Britain: 2007 - Annual Report, Stationery Office
7 Harrison P, Kassler WJ. Alcohol Policy and Sexually Transmitted Disease Rates—United States, 1981-1995 JAMA. 2000;283:3063-4.

Page last updated by: Unknown, 10 May 2012.

Page checked on: 18 Sep 2008

Understanding unit guidelines

You should not regularly exceed…

Women: 2–3 units daily
Men: 3–4 units daily

The government advises that women should not regularly drink more than the daily unit guidelines of 2–3 units, or…

3 × 25ml shots of whiskey
1.3 × 175ml glasses of white wine
1.3 pints of 4% lager

The government advises that men should not regularly drink more than the daily unit guidelines of 3–4 units, or…

4 × 25ml shots of whiskey
1.7 × 175ml glasses of white wine
1.7 pints of 4% lager