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Health Information

Sensible drinking

Published by Bupa's health information team, April 2009.

This factsheet is for people who are concerned about alcohol, or who would like information about it.

Drinking a small amount of alcohol every day can help prevent coronary heart disease, angina and stroke in middle-aged men and women. However, drinking too much alcohol can lead to serious health problems.

Animation - How alcohol affects the body long term
About sensible drinking
Problem drinking
Symptoms of problem drinking
Complications of problem drinking
Causes of problem drinking
Diagnosis of problem drinking
Treatment of problem drinking
Special considerations
Questions and answers
Related topics
Further information
Sources

How alcohol affects the body long term

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About sensible drinking

In the UK, the Department of Health has introduced the unit measurement of alcohol and guidelines about how many units men and women can safely drink. Nearly one in four adults in the UK risks their health by drinking more than the recommended daily amount of alcohol. On average, men drink nearly twice as much alcohol per week than women.

One unit is equal to 8g, or about 10ml, of pure alcohol. The number of units of alcohol in any particular drink depends on its strength and volume.

All alcoholic drinks sold in the UK must state on the label how much alcohol they contain. This is usually expressed as 'percentage alcohol by volume' (% ABV). By the end of 2008, the packaging of most drinks will also state the number of units of alcohol.

To calculate the total number of alcohol units in a particular drink, multiply the volume (in ml) by the % ABV and then divide your answer by 1,000. See our 'Alcohol units calculator'.

The alcohol content of some common drinks is as follows.

One pint of strong lager (5% ABV) contains around three units.
One pint of standard strength lager or bitter (3 to 3.5% ABV) contains around two units.
One 275ml bottle of an alcopop (5.5% ABV) contains around one and a half units.
One standard (175ml) glass of wine (12% ABV) contains around two units.
One measure (25ml) of a spirit strength (around 40% ABV) drink contains one unit.

Recommended weekly alcohol intake

Current UK guidelines recommend that:

men drink no more than three or four units a day
women drink no more than two or three units a day

If you drink more than the recommended amount in one session, don't drink alcohol for 48 hours afterwards.

The recommended limits are lower for women than for men because they have different amounts of fat, muscle and water in their bodies to men. This affects the way that women's bodies can cope with alcohol. Some experts think that women may develop liver disease at lower levels of drinking than men.

Problem drinking

Problem drinking can be divided into three categories based on the severity, duration, behaviour patterns and consequences of drinking alcohol.

Hazardous drinking

Drinking which could cause harm to either the drinker or others is known as hazardous drinking (for example binge drinking). Binge drinking is defined as drinking with the intention of getting drunk and/or drinking over twice the recommended daily amount of alcohol in one session. If you drink in this way very occasionally, you're probably not dependent on alcohol and are unlikely to have any long-term health effects, but it may cause you or others harm (for example hangovers, or antisocial or violent behaviour).

Harmful drinking

Frequent or regular binge drinking is an example of harmful drinking. If you drink in this way you may be dependent on alcohol and can develop long-term health problems.

Alcohol dependence

If you prioritise alcohol above anything else in your life, you're likely to be dependent on alcohol. You may feel the need to drink frequently throughout the day, drink large amounts at a time, or experience withdrawal effects between drinks. Alcohol dependence often leads to serious long-term health problems.

Symptoms of problem drinking

Short-term effects

A small amount of alcohol may relax you and make you feel less anxious. In increasing amounts, alcohol will suppress the part of your brain that controls judgement, resulting in inappropriate behaviour and a loss of inhibitions. Alcohol is a contributing factor to many assaults, incidents of domestic violence and fatal road accidents.

Alcohol negatively affects your physical coordination, vision, speech and balance.

Drinking a very large amount at one time can lead to unconsciousness and coma. If you vomit when you're unconscious you may choke, which can result in suffocation and death.

Complications of problem drinking

Long-term physical effects

Drinking too much alcohol can lead to a range of long-term health problems including:

liver/brain/heart damage
gastritis (inflammation of the stomach lining)
pancreatitis (inflammation of the pancreas)
high blood pressure
cancers
seizures
impotence/infertility

Psychological effects

Long-term heavy drinking can increase anxiety and cause depression, memory loss and dementia. It can also lead to sleeping problems, mood-swings, violence and suicide.

Causes of problem drinking

If you have a family or personal history of alcohol/drug-related problems you may be more likely to have problems with alcohol. Emotional, financial, legal, social and employment issues may also lead to alcohol misuse or result from it.

Drinking problems can develop when drinking in particular situations or at particular times becomes routine (for example, after work or at lunch or in stressful situations). Over time it can become more difficult not to manage on these occasions without having a drink.

Diagnosis of problem drinking

If your GP thinks that alcohol may be affecting you, he/she may ask you about how much, when, where and how often you drink. He/she may also ask you four specific questions.

Have you ever felt you should cut down on your drinking?
Have people annoyed you by criticising your drinking?
Have you ever felt bad or guilty about your drinking?
Have you ever had a drink in the morning to get rid of a hangover (known as an "eye opener")?

Your GP may also ask if you have:

physical withdrawal symptoms, such as sweating, shaking, agitation and feeling sick when you try to cut down
a need to drink increasing amounts of alcohol to get the same effect
'blackouts' (ie if you're unable to remember periods of time when you have been drinking)
continued drinking despite knowing that it may be harming you

Treatment of problem drinking

Your GP may ask you to keep a 'drinking diary'. It will reveal how much you're drinking and help identify the situations in which you drink too much, provided that you're honest and accurate.

If you're not dependent on alcohol but need to cut down the amount you're drinking, the following tips may help.

Replace your usual drink with one containing less alcohol.
Drink more slowly or have non-alcoholic drinks between alcoholic ones.
Skip the 'quick drink' at lunchtime or after work.
Make other people aware that you're trying to cut down, so that they will be able to support and help you.

If you're dependent on alcohol, you should only cut down under medical supervision because you may experience withdrawal symptoms such as headaches, feeling sick, sweating, and tremors. Sometimes you can get more serious symptoms like confusion, paranoia, fits or hallucinations. Your GP may refer you to a community alcohol team or specialist doctor who will help you cut down while treating withdrawal symptoms.

Medicines

If you're dependent on alcohol, your doctor may prescribe medicines such as diazepam or chlordiazepoxide to prevent and treat withdrawal symptoms. Before you stop drinking, you must talk to your doctor about how to do so and when to take these medicines.

You may be prescribed disulfiram to stop you drinking alcohol because it causes very unpleasant effects (such as headaches, feeling sick and vomiting) even if you only drink small amounts of alcohol while taking it.

Naltrexone and acamprosate help to reduce alcohol cravings. Your doctor may prescribe these after you have stopped drinking to help prevent you starting again.

You may be prescribed vitamin supplements because alcohol dependency can lead to thiamine (vitamin B1) deficiency. If severe or left untreated, this can result in brain damage.

Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

Special considerations

Alcohol and pregnancy

The current UK guidelines state that women shouldn't drink when trying to conceive or during the first three months of pregnancy. If you do choose to drink during pregnancy, you should limit yourself to only one or two units of alcohol, once or twice a week.

Drinking heavily during pregnancy can result in premature labour and underweight babies. It can also cause a condition called fetal alcohol syndrome, which can result in restricted growth, nervous system problems, lowered intelligence, behavioural problems and your child's face not developing properly.