More than eight out of ten people in the UK drink alcohol. It is part of our culture, and we feel comfortable with it.
Moderate drinking doesn’t cause many problems. However, over the last 30 years, society has become wealthier, and alcohol has become cheaper. We are starting to drink at a younger age, and we are drinking more.
More than one in four men, and about one in seven women are drinking more than is safe for them. According to the Department of Health, around one in eight men are physically addicted to alcohol.
This leaflet has been developed in partnership with the Alcohol and Substance Misuse Nurses at Salford Royal Hospital.
Our aim is to educate you about the effects of alcohol and enable you to make an informed decision about your alcohol use.
What are the problems of drinking too much alcohol?
Your body can usually cope with drinking a small amount of alcohol. Indeed, drinking a small amount of alcohol (one - two units per day) may help to prevent heart disease and stroke. However, drinking over the recommended limits can be harmful. If you drink heavily you have an increased risk of developing:
- Serious liver problems (alcoholic liver disease)
- Some stomach disorders
- Pancreatitis (severe inflammation of the pancreas)
- Mental health problems including depression, anxiety and memory problems
- Sexual difficulties such as impotence
- Muscle and heart muscle disease
- High blood pressure
- Damage to nervous tissue
- Some cancers (mouth, gullet, liver, colon and breast)
- Obesity (alcohol has many calories)
- Damage to an unborn baby in pregnant women
- Alcohol dependence (addiction)
In the UK deaths due to alcohol related diseases (particularly liver disease) have risen considerably over the last 20 years or so. This is because heavy drinking and binge drinking have become more common.
Alcohol and accidents
Alcohol is estimated to be a factor in 20-30% of all accidents. Drinking alcohol:
- Affects our judgement and reasoning
- Slows down our reactions
- Upsets our sense of balance and co-ordination
- Impairs our vision and hearing
- Makes us lose concentration
- Makes us drowsy
Alcohol delays recovery, interferes with the normal responses to shock and the cough reflex (increasing the chance of suffocation), and alters the heartbeat. Around half of adult pedestrians killed in road accidents have blood alcohol levels above the legal drink-drive limit.
Drinking and driving
Any amount of alcohol in your blood will impair your ability to drive. So it is much safer to not drink at all than to try to calculate the amount of alcohol you are drinking, you could find you are over the limit without intending to be. If you have had a heavy night drinking, you may still be over the limit or unfit to drive the next day. If you are convicted of drink driving you face:
- A minimum one year driving ban
- A fine of up to £5,000
- Up to six months in prison
- Endorsement of your driving licence for 11 years
- Life-time increase in insurance premiums
Drownings
Alcohol is present in around two-thirds of people who drown in swimming pools and boating accidents. Alcohol is a factor in around one in eight domestic drownings with falling into garden pond, slipping and falling asleep in the bath amongst the most common.
Fires
Around one in three fires are caused by people under the influence of alcohol. Two thirds of people who are admitted to hospital or die from burns have been drinking alcohol. Alcohol causes drowsiness, prompting some people to fall asleep while smoking. It can lessen the chance of seeing smoke or hearing fire alarms and can impede escape.
Alcohol and depression
Alcohol helps us to forget our problems for a while. It can make talking easier, helping us to relax and overcome shyness.
However, regular drinking can leave us feeling tired and depressed.
There is evidence that alcohol changes the chemistry of the brain and this increases the risk of depression. Regular drinking can make life depressing - family arguments, poor work, unreliable memory and sexual problems.
We know that there is a connection between alcohol, self-harm and suicide, which is much more common in people who drink excessively.
Four in ten men who try to kill themselves have had a long- standing alcohol problem, seven in ten of those who succeed in killing themselves have drunk alcohol before doing so.
Although many heavy drinkers feel depressed when they are drinking, most feel better within a few weeks of stopping. If the depression is still with you after four weeks of not drinking, talk to your GP.
If you drink alcohol to relieve anxiety or depression, you will become more depressed.
Alcohol: the calories
Calories from alcohol are ‘empty calories’ - they have no nutritional value.
In 2009 a Department of Health survey of 2,000 adults revealed that the average wine drinker consumes 2,000 extra calories each month. Over the course of a year that’s the equivalent of eating 184 bags of crisps or 38 roast dinners.
With a pint of bitter the same as a medium slice of pizza, and a standard size ‘alcopop’ the same as a chicken drumstick, the calories in alcohol soon add up...
12 ways to reduce your drinking
- Set drinking limits. Decide how much you are going to drink and stick to it. Try to make the limits ‘reasonable’ - ideally within guidelines. Calculate your drinking in units.
- Keep a record of your drinking. Make a note of the amounts you drink daily. Consider using a drink diary.
- Learn to drink slowly. Avoid ‘rushing’ your drinks. Timing your drinking against the clock often helps, make a pint last an hour or so.
- Make an excuse. While it seems extreme to have to make excuses, sometimes if you’ve got really pushy friends and you’re determined to cut back, it’s what you’ve got to do. Why not try “I’m in training” or “My Mum’s visiting tomorrow”.
- Eat before drinking. A meal before drinking can produce a ‘full up’ feeling thereby reducing the desire to drink heavily. Drinking on an empty stomach can be harmful, especially if you have ulcers.
- Avoid heavy drinkers. If you drink with heavy drinkers it’s likely that you’ll drink more - and faster.
- Shift to lower strength drinks. Try cutting down your units by switching to a lower strength drink e.g. switching to a wine that is 8% instead of 13%. This can dramatically reduce units. If you drink spirits try using a mixer or iced water. Drinking low alcohol (LA) or alcohol free drinks can also help.
- Keep occupied. Playing pool, dominos or cards when drinking can often slow down your drinking and help you to drink less.
- Avoid drinking in ‘rounds’. It may seem a bit antisocial but buying your own drinks will give you more control over your drinking.
- Limit your spending power. It may prove useful to limit the amount of money you take with you when you go drinking.
- Learn drink refusal. People may try to put pressure on you to drink more than you’d planned. Being assertive and practicing responses such as “No thanks, I’m under doctors orders to cut down”, can prove useful in dealing with these situations.
- Have a dry period. A period without alcohol is helpful in gaining control over your drinking. If you want to try and return to moderate drinking, start with a very low limit, e.g. five units weekly.
How alcohol affects our bodies
The diagram below shows how alcohol affects different parts of the body. The effects of drinking small irregular amounts of alcohol are short term. In generally healthy people this will not permanently harm the body. There is evidence that drinking up to one or two units a day may reduce the risk of heart disease. Some of the serious long term effects of heavy drinking are described:
10 ways to cope with cravings
- Think about why you’re trying to stop drinking. Think about the bad things that would happen if you were to carry on drinking. What would the effects be on your health, family, financial state and job? If you think it might help, make a list and read it when you feel you’ve really got to have a drink.
- Talk to someone. Find someone who’s understanding and supportive and talk to them about how you feel.
- Keep occupied. The worst thing you can do is sit around doing nothing, getting bored, and feeling restless. Find something to do. Read a magazine, watch some television, play a computer game, do the washing up or weed the garden. If it takes your mind off drinking for 15 minutes then do it.
- Stay positive. Think about what will happen if you change your alcohol use. You will feel healthier and happier. Your family relationships will improve. You will have more money to spend. You will be able to work better. Remember that all these things can start to improve quite quickly when you make the changes.
- Avoid situations that make you feel like drinking. Pubs, off-licences and parties are often difficult situations. Sometimes drinks displayed in supermarkets can also be difficult.
- Avoid people whom you know are heavy drinkers. Not everyone appreciates it when you try to stop drinking and they may put you under pressure to drink. Even if no one says anything the social pressure to conform can still be quite intense.
- Spoil yourself. Buy a book, CD or a computer game. Have a soak in the bath, go to the cinema, watch a game of sport or rent a DVD.
- Eat something. If you’re feeling hungry, the cravings will get worse. Have a snack, have a piece of cake, order a pizza, get a take away or a bag of chips. Feeling full will reduce the cravings.
- Take some time out. If you do decide to have a drink, agree with yourself that you won’t do anything for at least 30 minutes. After half an hour you may find the craving has subsided and you no longer feel you need to have a drink.
- Save money. Keep a record of how much you’re saving by drinking less. £20 saved per week translates to more than £80 a month, or £1,040 per year... Just think what you could do with that...
Alcohol and liver disease
What is alcoholic liver disease?
Drinking too much alcohol can lead to three types of liver conditions - fatty liver, hepatitis, and cirrhosis. This can happen quickly or over a longer period. For all types of liver disease caused by alcohol, the main treatment is to stop drinking completely.
What does the liver do?
The liver is in the upper right part of the abdomen. It has many functions which include:
- Storing glycogen, a chemical made from sugars
- Helping to process fats and proteins from digested food
- Making proteins that are essential for blood to clot (clotting factors)
- Processing many medicines which you may take
- Helping to remove or process alcohol, poisons and toxins from the body
- Making bile which passes from the liver to the gut and helps to digest fats
What happens when you drink alcohol?
When you drink alcohol, it is absorbed into the bloodstream from the stomach and intestines. All blood from the stomach and intestines first goes through the liver before circulating around the whole body. So, the highest concentration of alcohol is in the blood flowing through the liver.
The liver cells can metabolise only a certain amount of alcohol per hour. So, if you drink alcohol faster than your liver can deal with it, the level of alcohol in your bloodstream rises.
Fatty liver
A build-up of fat occurs within liver cells in most people who regularly drink heavily. In itself, fatty liver is not usually serious and does not cause symptoms. Fatty liver will usually reverse if you stop drinking heavily, this can happen quite quickly after stopping. However, in some people the fatty liver progresses and develops into cirrhosis.
Alcoholic hepatitis
Hepatitis means inflammation of the liver. The inflammation can range from mild to severe. Mild hepatitis may not cause any symptoms. The only indication of inflammation may be an abnormal level of liver enzymes in the blood which can be detected by a blood test. However, in some cases the hepatitis becomes persistent (chronic), which can gradually damage the liver and eventually cause cirrhosis.
A very severe bout of alcoholic hepatitis can quickly lead to liver failure. This can cause deep jaundice, blood clotting problems, confusion, coma, bleeding into the guts, and is often fatal. One third of people in hospital with alcoholic hepatitis die within one month.
Alcoholic cirrhosis
Cirrhosis is a condition where normal liver tissue is replaced by scar tissue (fibrosis). The scarring tends to be a gradual process. The scar tissue affects the normal structure and regrowth of liver cells. Liver cells become damaged and die as scar tissue gradually develops. So, the liver gradually loses its ability to function well. About one in ten heavy drinkers will eventually develop cirrhosis. It tends to occur after ten or more years of heavy drinking.
There are many causes of cirrhosis other than alcohol. For example, persistent viral hepatitis and some hereditary and metabolic diseases. If you have another persistent liver disease, and drink heavily, you are likely to increase your risk of developing cirrhosis.
Thiamine
Thiamine (vitamin B1) is useful as a supplement in deficiencies of B vitamins which can occur in dependant alcohol use, poor diet or starvation. Natural sources are in plant and animal foods with good sources being in cereals, nuts, peas, beans, yeast, pork and fish. Symptoms of thiamine deficiency are fatigue, irritability, drowsiness and poor concentration.
In more severe thiamine deficiency (Beriberi) there can also be muscle weakness, tingling or burning sensations, cramp and tenderness in the leg muscles, breathing problems and heart failure. Wernicke-Korsakoffs syndrome is also caused by thiamine deficiency.
Wernicke-Korsakoff syndrome (WE)
Wernicke-Korsakoff syndrome is a common condition amongst heavy drinkers. The syndrome is made up of two separate, but related disorders. Wernicke’s encephalopathy (WE) and Korsakoff’s psychosis (KP). WE usually occurs before KP develops.
The main symptoms of Wenicke-Korsakoff’s syndrome are:
- Loss of memory
- Confusion about time and place
- Drowsiness
- Loss of spontaneity and
- Poor balance
If WE is not treated in the early stages it can result in permanent brain damage or severe short-term memory loss. WE can be treated by high-dose injections of thiamine.
The patient who receives thiamine in this way can recover fully an be left with no memory problems, although this is not guaranteed. Overall Wenicke-Korsakoff’s syndrome should be viewed as a treatable condition. It is vital that you take Thiamine as prescribed.
The question of how successful treatment of someone with Korsakoff’s psychosis depends on the degree of damage done to the brain. Post-mortem studies suggest that Wenicke-Korsakoff’s syndrome occurs in one in eight of dependent drinkers.
Local and national contacts
Alcohol & Substance Misuse Nurse - Telephone: 0161 206 0528
ACHIEVE - Telephone: 0161 358 1530
AA (Local) - Telephone: 0161 839 2881
Drinkline - Telephone: 0800 917 8282
Samaritans - Telephone: 08457 90 90 90
British Liver Trust - Telephone: 0800 652 7330
Job Centre Plus - Telephone: 0845 604 3719
Citizens Advice Bureau - Telephone: 0845 345 4345
Salvation Army (James St, Salford) - Telephone: 0161 831 7020
Date of Review: July 2023
Date of Next Review: July 2025
Ref No: PI_SU_1563 (NCA)