Most people drink alcohol to some extent and for most of us, this is not a problem. In fact, alcohol drunk in moderation is actually thought by doctors to be good for our general health. It can help us to relax, unwind, socialise with friends and it can be enjoyable.
However, along with these positive aspects of drinking, there are problems with drinking alcohol for a sizeable minority of people. These problems can be varied and can include the following:
- drinking too much alcohol in total
- drinking too much alcohol at any one time ("binge drinking")
- becoming dependant on alcohol
- drinking at the wrong times and in the wrong places
- not being able to cope with the side effects of alcohol e.g. aggressive or violent behaviour
- drinking for the sole purpose of getting as drunk as possible
- social, domestic, financial, occupational or legal problems which may arise from problem drinking
- drink driving leading to road traffic accidents and potentially fatalities.
Binge drinking is seen as an increasing problem especially in the UK; where the culture amongst younger adults, teenagers and the under aged to drink to excess on a Friday and Saturday night is a particularly worrying aspect of drinking alcohol. Binge drinking is defined for men as drinking 8 units or more and in women as drinking 6 units or more of alcohol at any one time or session. This type of drinking is known to be far worse than drinking the same amount of alcohol but spread over a number of days.
Binge drinking is known to be linked with anti-social behaviour, aggressive and threatening behaviour, violence towards others, an increased chance of being assaulted and related injuries and illnesses.
However, the type of drinking seen amongst alcoholics is different. People dependant on alcohol, (either physically, psychologically or both) drink too much alcohol all the time. Therefore, their total alcohol consumption will be far in excess of that recommended. Alcoholics tend to share the following characteristic;
- they display a strong desire or need to drink
- they find it difficult to control their consumption of alcohol
- they may be aware of the risks of alcohol abuse but drink anyway
- they eventually develop an increased tolerance to large quantities of alcohol
- they have signs and symptoms of withdrawal if they stop drinking too quickly or without medical help.
How much alcohol you drink can be measured in different ways and different methods are used in different countries. The laws governing alcohol use, age limits, drinking limits for driving legally and other parameters also vary widely from country to country and therefore cannot be summarised here.
What is a unit of alcohol?
In the UK, alcohol intake is usually quantified using the concept of units. One unit of alcohol (ethanol) is defined as 7.9grams (10 millilitres) of pure alcohol. How many units each drink you consume contains depends on the volume and strength of that drink. In other words, the greater the volume and the stronger the drink, the more alcohol you consume. The table below gives examples of drinks containing one and two units served in a pub, and is intended as a rough guide;
1 unit per drink |
2 units per drink |
½ pint normal strength beer, lager or cider |
1 pint normal strength beer, lager or cider |
a small glass (125ml) lower strength wine |
1 large can of normal strength beer, lager or cider |
a single measure (25ml) of spirit e.g. whisky, vodka or gin |
½ pint or can of higher strength beer or lager |
|
a large or double measure (50ml) of spirit |
|
a large glass (175ml) of higher strength wine |
|
a bottle (330ml) of higher strength beer, lager or “alco-pop” |
What does AbV mean?
The number of units in a drink can be assessed more accurately if its AbV or %AbV is displayed. %AbV equates to the number of units of alcohol per litre of liquid. For example, a single litre of 12% AbV wine will have 12 units of alcohol. An average bottle which contains 75cl (750ml) of this wine will therefore contain 9 units. If 6 glasses are poured, then each glass contains 125ml of wine and thus has 1.5units of alcohol.
Therefore, multiplying the %AbV figure by 10, gives the number of millilitres of alcohol in 1 litre of drink. For example, a 40% whisky will contain 400millitres of alcohol in a 1 litre bottle. A double whisky (50ml) will contain 20millilitres of alcohol.
How much alcohol can I safely drink?
The answer to this question is complex and depends on a number of things. Generally, men have a higher ability to tolerate alcohol than women as they tend to be heavier, contain more water and metabolise differently. Therefore, recommended limits for alcohol intake differ for the 2 sexes.
Crucially, these limits do not apply to pregnant women, women planning to conceive, breast feeding women or those (men and women) who are not fully grown. For these groups of individuals, the limits are much lower and many doctors would argue that no alcohol should be drunk if a woman is pregnant or is breast feeding.
Currently, the recommended upper limits for alcohol in the UK for normal healthy adults are;
- men: 3-4 units daily (21-28 units weekly)
- women: 2-3 units daily (14-21 units weekly)
The pattern of how you drink is very important when thinking about sensible drinking. More important than the weekly intake is how much you consume in one sitting or session. Although the above limits for daily alcohol consumption should be used, it is strongly recommended that men drink no more than 8 units and women drink no more than 6 units at any one time. Also, drinking with a meal is far safer and better than drinking without food as food slows down the absorption of alcohol from the stomach and therefore slows down the time taken to get drunk and the severity of subsequent symptoms of being drunk.
What are the risks of alcohol abuse?
There are many reasons why alcohol intake should be controlled and sensible. Excessive drinking often leads to problems with personal relationships, social problems, employment problems, legal problems, and of course medical problems with both physical and psychological/psychiatric problems. Excessive alcohol can affect your judgement and ability to avoid risks or risky situations which then can lead to aggressive & violent behaviour, becoming a victim of violence and criminal convictions. Some of the well known medical and psychological & psychiatric consequences of alcohol abuse are tabled below;
Physical Problems |
Psychiatric Problems |
liver: hepatitis and cirrhosis |
depression |
anaemia |
suicide or attempted suicide |
pancreatitis |
personality changes |
heart: muscle damage – cardiomyopathy |
sexual problems |
nutritional problems e.g. vitamin deficiency |
hallucinations |
dementia |
memory problems and forgetfulness |
high blood pressure |
delirium tremens (the DT’s) |
strokes |
|
sleep disturbance |
|
lethargy and reduced concentration |
|
How will I know if my alcohol intake is a problem?
The simplest answer to this question is to count the number of units you drink on each day of the week. You can do this by looking at the questions and answers above and if you feel you’re drinking too much, then reduce your intake and change your pattern of drinking.
However, if you feel your problems are more serious, another simple guide to finding out whether you need some help is by answering the following 4 questions;
- Have you ever thought you should cut down on your drinking?
- Have other people annoyed you by being critical of your drinking?
- Have you ever felt guilty about your drinking?
- Have you ever needed to drink first thing in the morning to relieve symptoms of alcohol (“hair of the dog” or “eye opener”).
If you’ve answered “yes” to 2 or more of these questions, you may have a problem and you should now see your doctor to discuss this in more detail.
The symptoms of alcohol withdrawal can be serious and include; nausea, vomiting, shaking or tremor, sweating and abdominal pains. More serious effects include fever and hallucinations.
How can I cut down?
As with all addictions, controlling or giving up alcohol can be a difficult process. But with the right motivation and help, it can be done. Here are a few steps you can try;
- Be clear about your goal and why. Write this down as you will be able to refer to this anytime you’re going through a rough patch. Do you want to give up alcohol completely or do you want to cut your consumption down to recommended limits?
- Decide when you are going to start. Pick a day that you feel is suitable and stick to it.
- Prepare for this day. Plan how you are going to approach the day. Get rid of the alcohol you have at home and buy in non-alcoholic options instead. Tell your family and friends about your intentions so that they are not surprised by your actions when the day arrives.
- Don’t give up. Continue to work towards your goal even though on some days, you want to drink more. Remember that list you produced at the beginning about why you’re cutting down. Refer to it. Keep a drinks diary and write down what and how much you drink. Watch what you drink at home as each individual measure poured at home is usually much larger compared to that in the pub. Try to avoid rounds or at least skip your drink during some rounds to reduce your intake.
- If you are struggling, talk to someone. This could be a trusted friend or family member or professional counsellor. There are also various groups and organisations you could go to for further help and guidance such as Alcoholics Anonymous.
If you wish to contact us, please use our contact form to find out how we can help you.