Problems with alcohol

Alcohol: Our Favourite DrugHospital trauma teams urged to help combat alcohol related injuries and deaths
Introduction
Alcohol is our favourite drug. Most of us use it for enjoyment, but for some of us, drinking can become a serious problem. In fact, alcohol causes much more harm than illegal drugs like heroin and cannabis. It is a tranquilliser, it is addictive, and is the cause of many hospital admissions for physical illnesses and accidents.
Problems with alcohol

Many of these problems are caused by having too much to drink at the wrong place or time. Alcohol affects your judgment, so you do things you wouldn't normally think of. It makes you less aware of risks and so more vulnerable. You are more likely to have fights, arguments, money troubles, family upsets, or spur-of-the-moment casual sex. Alcohol helps to cause accidents at home, on the roads, in the water and on playing fields.
Problems with alcohol - physical health

Being very drunk can lead to severe hangovers, stomach pains (gastritis), vomiting blood, unconsciousness and even death. Drinking too much over a long period of time can cause liver disease and increases the risk of some kinds of cancer. It can reduce the risk of heart disease for men over 40 and women of menopausal age - but only if their drinking is very moderate.
Problems with alcohol - mental health

Although we tend to think of alcohol as something we use to make us feel good, heavy drinking can bring on depression. Many people who kill themselves have had drinking problems. Alcohol can stop your memory from working properly and can cause brain damage. It can even make you hear noises and voices - a very unpleasant experience which can be hard to get rid of.
Warning signs

Alcohol is addictive. Some warning signs are:

you do not feel right without a drink, or need a drink to start the day
you get very shaky, sweaty, and anxious/tense a few hours after your last drink
you can drink a lot without becoming drunk
you need to drink more and more to get the same effect
you try to stop, but find you can't
you carry on drinking even though you can see it is interfering with your work, family and relationships
you get "memory blanks" where you can't remember what happened for a period of hours or days.

Dealing with alcohol problems

If you are worried about your drinking or a friend's drinking, tell them - they need to make changes as soon as possible. It is much easier to cut back before drinking problems damage your health than it is once they are out of hand.
First steps

Keep a diary of your drinking - you may be surprised by how much you really do drink, and this can give you the motivation to cut down. It helps if you can talk your plans over with a friend or relative. Do not be ashamed to tell someone. Most real friends will be pleased to help - you may find they have been worried about you for some time.
Getting help

If you find it hard to change your drinking habits then try talking to your GP or go for advice to a local alcohol organisation (see below for contact details). If you feel you cannot stop because you get too shaky or restless and jumpy when you try to cut down; your doctor can often help with some medication for a short time. If you still find it very difficult to change then you may need specialist help.
Changing habits

We all find it hard to change a habit, particularly one that plays such a large part in our lives. There are three steps to dealing with the problem:



Realising and accepting that there is a problem.
Getting help to break the habit.
Keeping going once you have begun to make changes.



You may find that you have been using alcohol as a way of handling stress and worries. A psychiatrist or a psychologist may be able to help you find ways of overcoming these worries that do not involve relying on drink.



Groups where you meet other people with similar problems can often be very helpful. There are self-help groups like Alcoholics Anonymous, or those run by professionals at an alcohol treatment unit.



Most people dealing with their drink problems do not need to go into hospital. Some people will need to get away from the places where they drink and the people they drink with. For them, a short time in an alcohol treatment unit may be necessary. Medications are mainly used for "drying out" if you get withdrawal symptoms. It is important to avoid relying on tranquillisers as an alternative.



Anyone who drinks can develop an alcohol problem - and some people lose everything - alcohol is a major cause of homelessness. Although some people may just need support and to talk, others may need longer-term help so that they can get somewhere to live, start to make relationships again and get back to work.



Tackling your alcohol problem can be hard work, but it pays off in the end by making a difference across all aspects of your life.
How much alcohol is too much?


Some drinks are stronger than others. The easiest way to work out how much we are drinking is to count "units" of alcohol. 1 unit is 1mls of alcohol - the amount in a standard pub measure of spirits, a half pint of normal strength beer or lager, or a small glass of wine.

If a man and woman of the same weight drink the same amount of alcohol, the woman will have a much higher amount in her bodily organs than the man. So, unfair as it may seem, the safe limit is lower for women (14 units per week) than for men (21 units per week).
Binge" drinking
How much you drink at one time is also important. These "safe limits" assume that our drinking is spread out through the week.

In any one day, it is best for a man to drink no more than 4 units and for a woman to drink no more than 3 units. Drinking over 8 units in a day for men, or 6 units for women is known as 'binge drinking'.

You can drink above the safe limit on one night, but still remain within your "safe" limit for the week. There is some evidence that, even a couple of days of binge drinking, may start to kill off brain cells. This was previously thought only to happen with people who drank continuously for long periods of time. Binge drinking also seems to be connected with an increased risk of early death in middle aged men.
Guide to units of alcohol
These tables give a rough guide to the amount of alcohol found in different drinks.

These guidelines are approximate and may vary depending on the brand chosen and the size of measure. All alcohol sold in the UK above 1.2% ABV (Alcohol By Volume) should state how strong it is in percentages (%).

The higher the percentage, the more alcohol it has in it. Pub measures are generally rather smaller than the amount we pour ourselves at home.

Beer, Cider & Alcopops Strength
ABV
Half
Pint

Pint

Bottle/
Can
330ml

Bottle/
Can
500ml

Bottle
1 Litre

Ordinary strength beer, lager or cider eg.
Draught beer, Woodpecker

3-4%
1 2 1.5 1.9 -
“Export” strength beer, lager or cider eg.
Stella, Budweiser, Heinekin, Kronenbourg, Strongbow

5%
1.25 2.5 2 2.5 -
Extra strong beer, lager or cider eg.
Special Brew, Diamond White, Tennents Extra
8-9% 2.5 4.5 3 4.5 9
Alcopops eg.
Bacardi Breezer, Smirnoff Ice, Reef, Archers, Hooch
5% - - 1.7 - -



Wines & Spirits Strength
ABV Small glass/
pub measure
Wine glass
Bottle
750 ml
Table Wine 12-14% - 1.5 - 2.5 10
Fortified wine
(sherry, martini, port) 15-20% 0.8 2-3 14
Spirits
(whisky, vodka, gin) 40% 1 - 30



Helpful organisations
Drinkline - The National Alcohol Helpline
0800 917 8282 - (England and Wales, Mon -Fri, 9am -11pm)
Drinkline offers free, confidential information and advice on alcohol.

Alcoholics Anonymous
Helpline: 0845 769 7555; email: helpline@alcoholics-anonymous.org.uk
Contact details for all English AA meetings. There is a quiz to determine whether AA is the right type of organisation for an individual, and a frequently asked question section about AA and alcoholism.

Al-Anon Family Groups UK and Eire
Helpline: 020 7403 0888 (10am -10pm, 365 days a year); email: enquiries@al-anonuk.org.uk
Support group for friends and families of alcoholics. Includes a frequently asked questions section, pamphlets and other literature, and information on group meetings in the UK.

Alcohol Concern
Tel: 020 7928 7377; email: contact@alcoholconcern.org.uk
This site provides information and articles on a range of topics surrounding alcoholism. Includes 18 excellent factsheets crammed with information that would be very useful for professionals such as Alcohol and the Law and Drink-drive accidents, a search engine, and a good list of alcohol related links.

Alcohol Focus Scotland
Tel: 0141 572 6700; email: enquiries@alcohol-focus-scotland.org.uk
The national volunteer organisation for alcohol issues in Scotland. Provides information about alcohol, including legal matters, frequently asked questions, and tips for safe drinking.

Depression AlIiance
Tel: 0845 123 23 20; email: information@depressionalliance.org
Information, support and understanding for people who suffer with depression and for relatives who want to help. Self help groups, information, and awareness raising for depression.

Giveupdrinking.co.uk
50 Ways To Leave Your Lager
If you believe you’re drinking too much, or you know alcohol is having a detrimental effect on your life, this website can help.
www.downyourdrink.org.uk
Based at University College London Medical School, and managed by the charity Alcohol Concern, this site is designed to help you work out whether you're drinking too much, and if so, what you can do about it.
Further reading

Allen Carr's easy way to control alcohol by Allen Carr (Arcturus Foulsham).

The effective way to stop drinking by Beauchamp Colclough (Penguin Health Care & Fitness).


Reading about Self-Help:

Alcohol - a 2004 review of self help books.

This leaflet was produced by the Royal College of Psychiatrists' Public Education Editorial Board.
Series editor: Dr Philip Timms.
Last updated: January 2008


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