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Alcohol Misuse

Most people in this country drink alcohol. According to the most recent statistics, 29.2 million adults aged 16 years and older say they drank alcohol in the previous week (i). For many, having a drink with friends or family is an enjoyable way to socialise or wind down after a busy day. However, while moderate alcohol consumption is considered safe, drinking too much may be harmful, especially where health is concerned.

The charity Alcohol Change claims 24 per cent of adults in England and Scotland regularly drink more than the Chief Medical Officers’ low-risk guidelines (ii). Indeed, alcohol Yet many people may not realise the damage their drinking could be causing.

One of the problems with alcohol is that – like many other drugs – it is physically and psychologically addictive. According to Alcohol Change in England there are an estimated 586,780 dependent drinkers, of whom 82 per cent are not getting any treatment (ii). You may even be one of them if drinking is an important – possibly the most important – thing in your life, even if you don’t drink excessively every night.

In fact there are varying degrees of alcohol dependence. And even if you simply feel the need to have a drink every evening to unwind or you drink when you’re in social situations because you can’t relax or enjoy yourself without it, you may already be drinking enough for your health to be affected.
 

How to tell you have a problem with alcohol

If you’re not sure you’re drinking too much, ask yourself the following questions:

  • Do you regularly exceed the recommended weekly alcohol limit (see How much should you drink, below)?

  • Do you find it hard to stop drinking once you’ve started?

  • Do you feel guilty about how much you drink or ever feel you should cut down?

  • Have other people said you drink too much?

  • Do you only socialise if alcohol is involved?

  • Do you find you often can’t remember what happened while you were drinking?

  • Do you need a drink first thing in the morning to help with hangover symptoms or to steady your nerves?

  • Have you ever missed events or appointments because you were drunk or hung over?

  • re you always thinking about when you’ll have your next drink?

  • Do you experience symptoms such as feeling shaky, sweaty or nauseated that get better whenever you drink alcohol?

If you have any of these symptoms, talk to your GP or ask someone from an organisation such as Alcoholics Anonymous or the charity We are with you. Drinkline also runs a confidential helpline for people who are concerned about their – or someone else’s – drinking. Call free on 0300 123 1110. If you prefer to chat with an adviser online, try Drinkchat


How much should you drink?

Many people aren’t sure how much alcohol is considered a moderate – and therefore safe – amount to drink. This is a problem because you only have to regularly drink a bit more than you should over a period of time to harm your health. So how much is considered the right amount?

The guidelines have changed a few times over the years, and currently the official government recommendation is that everyone – whether male or female – should not regularly drink more than 14 units of alcohol a week, and that those units should be spread evenly throughout the week rather than having them all at the same time. And if you’re trying to reduce the amount of alcohol you drink, the NHS also advises having several alcohol-free days each week (iii).

Binge drinking – which the NHS classes as drinking lots of alcohol in a short space of time or drinking to get drunk (iv) – can be particularly harmful because it increases your risk of alcohol poisoning. It’s defined by the NHS as having more than eight units in a single session if you’re a man and more than six if you’re a woman (iv). According to the alcohol awareness campaign Drinkaware, this definition may not apply to everyone, as people drink at different speeds or over a different amount of time (v). But what they do say is that the risks of short-term harms, such as accidents or injuries, increase between two to five times after drinking five to seven units of alcohol (the equivalent of two to three pints of beer).
 

What is a unit?

A unit of alcohol contains 10ml or 8g of pure alcohol, which means the number of alcohol units in any drink depends on how much pure alcohol it contains and the size of the measure. The strength of an alcoholic drink is measured as the percentage of alcohol by volume (ABV), which means the greater the percentage, the stronger the drink.

As a general guide, you can think of a unit as the equivalent of slightly less than half a pint of standard beer or lager (4% ABV), a single shot (25ml) of spirits (40% ABV) or slightly less than half a 175ml glass of wine (13% ABV).

Here are some other examples of the number of units found in some popular drinks:

  • 1.4 units = one bottle of alcopops

  • 1.5 units = one 125ml (small) glass of wine

  • 1.8 units = one can of standard lager, beer or bitter

  •  2.2 units = one can of strong lager, beer or bitter

  • 2.3 units = a pint of standard lager, beer or bitter

  • 2.8 units = a pint of strong lager, beer or bitter

  • 3 units = one 250ml (large) glass of wine

  • 4 units = one litre bottle of standard cider

  • 9 units = one bottle of wine or one litre bottle of strong cider

  • 27-28 units = 700ml bottle of spirits

To find out more about alcohol units, visit the Drinkaware website.


Alcohol and your health

Drinking heavily in the short term can make you more likely to have an accident or injury because of the way alcohol affects your physical co-ordination and blurs your vision. Drinking too much on a long-term basis, however, can increase your risk of having a serious health problem, not to mention what it can do to your relationships and your quality of life.

According to Alcohol Change, alcohol is a causal factor in more than 60 medical conditions (ii). Here are some of the most common:
 

Liver disease

Drinking alcohol increases your risk of developing liver disease. According to Drinkaware, around seven in 10 people with alcoholic liver disease have an alcohol dependency problem (vi). Alcohol-related liver disease also accounts for 37 percent of liver disease deaths, with drinking a major cause of the 25 percent increase in deaths from liver disease in England during the last decade (vii). Drinking more than eight units a day if you’re a man and five a day if you’re a woman for just two or three weeks also significantly increases your risk of developing a condition called fatty liver, which is the first stage of developing liver disease (viii).


Heart problems

Drinking fewer than 21 units of alcohol a week if you're a man and fewer than 14 if you're a woman may reduce your risk of developing cardiovascular disorders such as high blood pressure, says a study published in 2017 (ix). Meanwhile, binge drinking may cause abnormal heart rhythms and regular heavy drinking may lead to dilated cardiomyopathy (enlargement of the heart). As such, it’s important to understand the impact that cardiovascular disease upon the body.

Many people believe drinking some alcohol may be good for their heart health. But a review of evidence carried out on behalf of the UK’s Chief Medical Officers suggests women over 55 may be the only group to experience any possible protective effect from drinking some alcohol (about five units a week) (x).


Stroke

Drinking alcohol can make you more likely to have a stroke because of how it affects some of the risk factors for stroke. For instance, drinking raises your blood pressure – the biggest risk factor for stroke – and can make you put on weight, thanks to the calories it contains. According to the Stroke Association, drinking excessive amounts of alcohol can also trigger an irregular heartbeat, called atrial fibrillation, which is linked to an increased risk of stroke (xi).


Cancer

Alcohol can cause seven different types of cancer, says Cancer Research UK (xii). It increases your risk of mouth, upper throat (pharynx), voice box (larynx), breast, bowel, liver and food pipe (oesophagus) cancers. Other cancers linked with drinking alcohol include breast, liver and bowel cancer. Even small amounts of alcohol can increase the risk of cancer, the charity claims.


Pregnancy Problems

Drinking alcohol during pregnancy – especially during the first three months – may cause serious birth defects such as low birth weight, premature birth and increase the risk of miscarriage (xiii). Women who drink heavily during pregnancy can also have babies who develop a serious condition called foetal alcohol syndrome. The NHS says experts are still unsure exactly how much – if any – alcohol is completely safe to have while you’re pregnant, so the safest approach is not to drink at all (xiii).


Pancreatitis

Alcohol misuse can lead to a potentially fatal condition involving inflammation of the pancreas called pancreatitis. There are two types – acute and chronic pancreatitis – both of which can be very painful and can be caused by heavy drinking (around seven out of 10 cases of chronic pancreatitis are caused by long-term heavy drinking)(xiv). If you have chronic pancreatitis, your risk of other illnesses such as diabetes and cancer is also higher than normal.


Diabetes

Experts believe drinking alcohol can contribute to the conditions that cause diabetes(xv). This may happen because heavy drinking can reduce the body’s sensitivity to insulin, which can trigger type 2 diabetes. Alcohol also contains lots of calories, which can make you put on weight (being overweight increases your risk of developing type 2 diabetes).


Mental illness

Heavy drinking is associated with mental illness, despite the fact that – for many people – it can boost mood, albeit temporarily. Indeed, drinking too much alcohol is linked to a range of mental health problems, from depression and memory loss to suicide.

The NHS also claims alcohol misuse is associated with other long-term health risks including dementia, infertility and sexual problems such as impotence and premature ejaculation (xvi).


How to drink less

Even with the best of intentions, nobody’s perfect, and we all have the occasional slip-up when it comes to drinking too much. But if you find yourself drinking too much more often than you should, here are some tips to help you drink less and make sure your drinking doesn’t reach a harmful level.

  • Set yourself a limit for how much you’re going to drink. If you’re going out, setting yourself a fixed budget for drinks may be helpful.

  • Always have something to eat before you drink. Having food in your stomach can slow down the rate at which alcohol is absorbed into your bloodstream. Try eating foods that contain protein before going out, as protein is digested more slowly than carbohydrate, which means it stays in your stomach for longer (protein-rich foods include meat, fish, eggs, beans, tofu, nuts and seeds).

  • Have at least one soft drink or glass of water with each alcoholic drink to help you to spread your drinks out throughout the night. Drinking more water will also help keep you hydrated. And remember: it takes an hour on average for the body to process a unit of alcohol.

  • Instead of drinking pints or large glasses of wine, opt for halves or bottles of beer, and ask for wine in a small glass.

  • Don't try to keep up with other people or drink in rounds, as it can make you drink much faster than when you're buying drinks just for yourself. Some experts believe there’s a genetic reason for why some people can drink more than others without getting tipsy. Also bear in mind your body size and weight – your weight affects how alcohol is absorbed, with those weighing more having lower blood alcohol concentrations than those weighing less who drink the same amount.

  • Dilute your drinks – try having a spritzer or a shandy (but bear in mind that the bubbles in fizzy drinks help alcohol get into your bloodstream faster).

  • Sit when you drink rather than standing (some experts believe sitting helps you drink more slowly).

  • If you’re at a party, find something else to do besides drinking while you're enjoying yourself, such as dancing or playing party games.


What help is available?

If you're worried about how much you're drinking and its potential effect on your health, there is help available to make cutting down or stopping drinking altogether easier.

Your GP may be your first port of call if you have a drink problem. As well as being able to examine you for any alcohol-related health problems, your doctor can put you in touch with other organisations that can help near where you live or refer you for counselling.

If you don't want to see your GP, you can get help from a local alcohol service – there are many different types of services available, from drop-in centres to residential rehab clinics. To find what's available where you live, search for NHS alcohol addiction services.


Hangover cures and remedies

If anything could tempt a person to drink less, it’s a hangover. That pounding headache, the upset stomach and feelings of nausea and dizziness are enough to put anyone off. But somehow, cries of ‘never again’ are rarely acted upon or taken seriously.

There's no magic pill that can make you feel better when you’ve had one too many the night before. So if you can’t avoid alcohol altogether, here are some tips to help you feel more human the next morning:


Drink water

Alcohol is a diuretic, which means it makes you dehydrated. And according to the NHS, dehydration is what causes many of the symptoms of a hangover (xvii). So try to drink about a pint of water before going to bed after you’ve been out drinking, and keep a glass of water next to the bed to sip if you wake up during the night. Some natural health practitioners also recommend drinking fresh fruit juice, as fruit sugars are thought to help speed up the removal of alcohol from the body.


Treat the pain

A throbbing head is arguably one of the worst parts of having a hangover. If you need a painkiller, go for paracetamol rather than other types such as aspirin or ibuprofen, both of which can irritate a sensitive stomach.


Drink ginger tea

Ginger is often used as a remedy for nausea and an upset stomach – it’s frequently used to treat motion sickness, for instance (xviii). Try peeling and chopping up a small piece and add boiling water to make ginger tea.


Take milk thistle

Commonly taken for the relief of occasional overindulgence of drink. The active ingredient in milk thistle – a flavonoid called silymarin – is also thought to support liver function by acting as an antioxidant.


Stay cool

Try putting an ice pack on your forehead or back of your neck to help relieve a pounding headache. The ice helps the blood vessels in your head shrink back down to their normal size (alcohol makes them open too wide, which triggers pain).


Boost your Bs

When you drink one or two too many, your body loses nutrients through increased urination. This is because alcohol blocks the body’s production of an anti-diuretic hormone called vasopressin, which prevents dehydration by reducing the volume of urine. The nutrients you lose include B vitamins, which some experts believe are important when you drink, as they may help the body eliminate alcohol. Try taking a vitamin B complex supplement that includes good levels of all the B vitamins to reduce your hangover symptoms. Alternatively, a dry piece of toast with a spoonful of yeast extract spread may help settle your symptoms if you can’t face solid food.


Take fish oils

Some experts believe reducing the body’s production of hormone-like compounds called prostaglandins may help reduce the symptoms of a hangover. These prostaglandins are thought to produce inflammation in the body, which may partly explain why your head hurts so much when you’re hung over. There is indeed some evidence that the omega-3 fatty acids found in fish oils may block the production of inflammatory prostaglandins by inhibiting an enzyme called cyclo-oxygenase (COX) (xix).


Try some zinc

This mineral is believed to be important for alcohol metabolism because of the way it’s needed by one of the enzymes the liver uses to detoxify alcohol, called alcohol dehydrogenase. It’s thought that drinking too much alcohol can deplete your zinc levels, which in turn may reduce your body’s ability to process alcohol effectively. Try eating zinc-rich foods after a heavy night on the town – such as pumpkin seeds, chickpeas, cashew nuts, almonds, oatmeal, crab, lobster and chicken. Or if you can’t handle much in the way of food, try having a bowl of fortified breakfast cereal or take a good quality zinc supplement.
 

For even more advice on how to improve your overall health, take a look at our dedicated hub.

 

References:

  1. Adult drinking habits in Great Britain: 2017. Office for National Statistics. Available online: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/drugusealcoholandsmoking/bulletins/opinionsandlifestylesurveyadultdrinkinghabitsingreatbritain/2017

  2. Available online: https://alcoholchange.org.uk/alcohol-facts/fact-sheets/alcohol-statistics

  3. Available online: https://www.nhs.uk/conditions/alcohol-misuse/

  4. Available online: https://www.nhs.uk/live-well/alcohol-support/binge-drinking-effects/

  5. Available online: https://www.drinkaware.co.uk/facts/drinking-habits-and-behaviours/binge-drinking

  6. Available online: https://www.drinkaware.co.uk/facts/health-effects-of-alcohol/mental-health/alcohol-dependence

  7. Available online: https://www.drinkaware.co.uk/facts/health-effects-of-alcohol/mental-health/alcohol-dependence

  8. Available online: https://www.drinkaware.co.uk/facts/health-effects-of-alcohol/alcohol-related-diseases/alcohol-related-liver-disease#fattyliverdisease

  9. , Association between clinically recorded alcohol consumption and initial presentation of 12 cardiovascular diseases: population based cohort study using linked health records. BMJ. ;356:j909. Available online: https://www.bmj.com/content/356/bmj.j909

  10. , et al. Mortality and morbidity risks from alcohol consumption in the UK: Analyses using the Sheffield Alcohol Policy Model (v.2.7) to inform the UK Chief Medical Officers’ review of the UK lower risk drinking guidelines. University of Sheffield. .

  11. Available online: https://www.stroke.org.uk/sites/default/files/publications/f13_alcohol_and_stroke_web_0.pdf

  12. Available online: https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/alcohol-and-cancer

  13. Available online: https://www.nhs.uk/conditions/pregnancy-and-baby/alcohol-medicines-drugs-pregnant/

  14. Available online: https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/chronic-pancreatitis

  15. Available online: https://www.drinkaware.co.uk/facts/health-effects-of-alcohol/alcohol-related-diseases/alcohol-and-diabetes

  16. Available online: https://www.nhs.uk/conditions/alcohol-misuse/risks/

  17. Available online: https://www.nhs.uk/live-well/alcohol-support/hangover-cures/

  18. , , , et al. Ginger root against seasickness. A controlled trial on the open sea. Acta Otolaryngol. ;105:45-49. Available online: https://www.tandfonline.com/doi/abs/10.3109/00016488809119444
    , , . Motion sickness, ginger, and psychophysics. Lancet. ;1:655-657. Available online: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(82)92205-X/fulltext

  19. , Omega-3 fatty acids cause dramatic changes in TLR4 and purinergic eicosanoid signaling. Proc Natl Acad Sci U S A. ;109(22):8517-22. doi: 10.1073/pnas.1200189109. Available online: https://www.pnas.org/content/109/22/8517





 

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Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.

 
 
Our Author - Christine Morgan

Christine

Christine Morgan has been a freelance health and wellbeing journalist for almost 20 years, having written for numerous publications including the Daily Mirror, S Magazine, Top Sante, Healthy, Woman & Home, Zest, Allergy, Healthy Times and Pregnancy & Birth; she has also edited several titles such as Women’ Health, Shine’s Real Health & Beauty and All About Health.

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