Alcohol

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.

What is 'moderate' or 'sensible drinking'?

Official drinking guidelines are issued by governments and public health entities to advise on levels of alcohol consumption considered 'safe', 'responsible,' or 'low risk'. They do not apply to those under the legal drinking age or to pregnant women. Those on medication or with a history of illness should consult their general practitioner or specific advice.   It is difficult to lay down strict guidelines as to what constitutes 'moderate consumption' - it will depend on your age, size, sex and health, how and when you consume alcohol, as both the speed of consumption and whether you're eating will effect how alcohol is absorbed by the body.

Guidelines are daily rather than weekly, as you should not 'save up' units and drink heavily at the weekends. This has become known as binge drinking. Binge drinking over one or two nights a week can lead to health problems and anti-social behaviour.

Risks of alcohol

Drinking too much alcohol will not only leave you with a hangover the next day, but binge drinking and/or drinking more than the recommended intake on a regular basis can also cause long-term damage to the body's internal organs.

Chronic alcohol use is one of the major causes of liver cirrhosis (irreversible scarring of the liver). This happens because healthy liver cells die and the dead cells are replaced by fibrous tissue.

The liver plays a central role in many essential body functions including the metabolism of carbohydrates, proteins and fats, detoxification and excretion of waste products from the body. Scarred tissue cannot function like healthy tissue so this condition can be life threatening if not treated early enough.

Stomach ulcers and gastrointestinal complications, as well as fertility problems, weight gain and depletion of certain vitamins and minerals can all be caused by excessive alcohol consumption.

Binge drinking can also increase blood pressure, a risk factor for heart attacks. One study showed binge-drinking patterns in Northern Ireland at the weekends led to higher blood pressure levels and a higher incidence of heart attacks on Mondays and Tuesdays. Blood pressure levels in French drinkers were constant throughout the week, reflecting their moderate drinking patterns.

A 2007 World Cancer Research Fund report showed alcohol increases the risk of cancers of the mouth, pharynx, larynx, oesophagus, colon (especially in men) and breast.

If you're worried about the negative effects of alcohol, either on yourself or on behalf of someone else, Alcohol Concern offers an excellent service.

Recommended alcohol intake

Moderation is the key. In the UK, the recommendation is no more than two to three units of alcohol a day for women and three to four units for men, with at least two or three alcohol-free days each week.

What's a unit?

One unit is considered to be 8g of alcohol, or equivalent to:

• half a pint of standard strength (3.5% AVB) beer, cider or lager;

• a pub measure of spirit;

• half a standard glass (175ml) of wine;

• a pub measure of sherry, vermouth or liqueur.

It's important to remember units differ according to the:

• size of your drink - pubs often serve wine in different-sized glasses and home measures of spirits are often more generous than a pub measure;

• varying alcohol content of different beers, wines and spirits.

The size and strength of your drink determines how many units of alcohol you consume.

To calculate how many units you've consumed, establish the strength of the drink (% ABV) and amount of liquid in millilitres (one pint is 568ml; a standard glass of wine is 175ml).

Multiply the amount of drink in millilitres by the percentage ABV, then divide by 1,000.

• For example, 175ml wine at 13% ABV:

• 175 X 13/1000 = 2.3 units

To make matters easier, many manufacturers state how many units of alcohol each can or bottle contains.

Nutritional value of alcohol

Each gram of alcohol contains seven calories. If you're watching your waistline, cutting down on alcohol will help to reduce calorie intake. Alcohol can also weaken your willpower, tempting you to eat more than you planned.

The energy provided by an alcoholic drink depends on the percentage of alcohol it contains, but also on the type of drink it is. For example, a creamy liqueur will have more calories than a clear liqueur. As a rough guide:

• a pint of continental lager is about 215 calories;

• a measure of spirit contains around 55 calories, but this doesn't include calories from the mixer - try to choose low-calorie options;

• a standard glass of dry white wine or red wine is about 115 calories and sweet wine is about 165 calories;

• a creamy liqueur contains around 163 calories per 50ml serving, while the same amount of sherry or port contains around 60 calories a glass.

Make cutting down on alcohol as easy as possible

1. Take the right approachGradually cutting down on alcohol is more likely to be something you will stay committed to as opposed to cutting out all alcohol immediately AKA cold turkey.
2. Ask for support
   Tell friends and family that you’re trying to cut down on alcohol - they might be more supportive than you think. But beware, some people don’t like to have their drinking behaviour challenged, so be prepared to defend your decision by remembering the benefits that cutting down on alcohol brings.

How to cut down on alcohol.... at home

1. Home measuresIt’s worth buying an alcohol measure for when you next have a drink at home. There will be no more guess work involved and you will be able to keep track of how much you’re drinking. A really easy way of cutting down on alcohol if you’re a wine drinker, buy small (125ml) glasses for the house rather than large ones.
2. Keep track of the alcohol units you’re drinkingDrinkaware recommends that women should not regularly exceed 2-3 units daily (equivalent to a 175ml glass of 13% wine) and that men should not regularly exceed 3-4 units daily (equivalent to a pint and a half of 4% beer). Using our unit calculator will make the calculations easier or you can sign up to MyDrinkaware to track your drinking over time.

How to cut down on alcohol... when you’re out

1. Leave your cash card at home Cashback at the bar or midnight trips to the cashpoint for more booze money can quickly add up. Instead leave the plastic at home, that way you can’t drink more than your budget allows and cutting down on alcohol will become a breeze. Remember to have the money put aside for a cab, bus or train home though!
2. Beware of rounds
   Drinking in rounds may be a British tradition, but they can be expensive, dangerous if it means keeping pace with the fastest drinker in your group and a nightmare if you’re trying to cut down on alcohol. Stay in control (and save cash) by opting for smaller rounds with only a couple of friends within your group or giving rounds a miss.
3. Eat up After-the-pub grub is another drinking tradition, but why wait until the night’s nearly over to load up on fast food? A healthy meal before you go out and snacks between drinks can help to slow down the absorption of alcohol and so helps you stay in control. With less alcohol inside you that greasy pizza or kebab will look a lot less appetising at chucking out time too.  
4. Track your drinking on the go  If you’re out and about use our free and simple Mydrinkaware tool on your smartphone to track the alcohol you’re drinking. It will help you stay within the recommended daily guidelines and stay on top of your night out.  
5. Small is better Make these recommended units go further by having bottles of beer or halves instead of pints and choosing a smaller glass for your wine. Buying spritzers or shandies will also help keep that unit count down.
6. Make space Sipping a soft drink between alcoholic drinks slows down the rate of your drinking and means you will drink less over the course of the evening. If you’re out clubbing, take a bottle of water out with you on the dancefloor. Down the pub (or even at home)? Then go for a non-alcoholic mocktail, a premium soft drink, or just a glass of water.

Why cutting down on alcohol is good for your health

1. Remember the short and long term effects of cutting down on alcoholDrinking less reduces the longer term risk of serious diseases such as cancer, liver disease and stroke; improves the condition of your skin; can have a positive effect on sleep patterns and can even boost your sex life. Worth remembering next time you’re at the bar.
2. Stress less
Some people drink alcohol to relax, but in reality alcohol can make you feel even more anxious. Try not to make alcohol key to your after work wind down and try some alternative stress-busters like hitting the gym with your mates or running a bath for yourself at home and putting some relaxing music on.