Alcohol

Alcohol is a legal depressant, a liquid obtained by fermentation of carbohydrates by yeast or by distillation. There are many different types of alcohol, but Ethanol (ethyl alcohol) is the type of alcohol that is used to make alcoholic beverages.

Alcohol misuse means drinking excessively – more than the recommended limits of alcohol consumption.
This can lead to a number of harmful physical and psychological effects, such as alcohol poisoning, cirrhosis of the liver, inability to work and socialise and destructive behaviours, such as drink-driving.
Your risk of developing problems increases with the amount of alcohol you drink. The three main risk categories based on how much you drink, that can be used to help judge your own level of risk, are lower-risk, increasing-risk and higher-risk.

Lower-risk drinking

Lower-risk drinking is drinking at a level associated with a low risk of future harm to your health.
For men, lower-risk is drinking no more than 3-4 units of alcohol a day on a regular basis. For women, it’s lower risk if they drink no more than 2-3 units of alcohol a day on a regular basis.
Sensible’ or ‘responsible’ drinking are sometimes used to mean lower-risk drinking.

Increasing-risk drinking

Increasing-risk drinking is drinking associated with an increased risk of future harm to your health, with the risk increasing the more you drink.
For men, this riskier level of drinking is drinking more than 3-4 units of alcohol a day on a regular basis. For women, it’s drinking more than 2-3 units a day on a regular basis.

Higher-risk drinking

Higher-risk drinking is drinking at such a high level that you’re at particularly high risk of harming your health.
For men, higher-risk drinking is regularly drinking over over 50 units a week (eight units of alcohol a day). For women, it’s regularly drinking over 35 units a week (over six units of alcohol a day).

Other categories of alcohol misuse

Binge drinking

The term ‘binge drinking’ usually refers to an episode of heavy drinking over a short period of time, such as over the course of an evening or over an hour or two. It also refers to an episode of drinking to intoxication or to drunkenness.
Binge drinking can affect your health in a number of ways. For example, it can increase your immediate risk of being in an accident, becoming involved in an argument or fight, or taking part in illegal or risky behaviour, such as drink-driving or unsafe sex.
Different people are affected differently by how much they drink. Alcohol can also affect a person differently at different times. Some people will be at risk of the immediate harms to their health even if they don’t think they’re getting drunk.

Hazardous drinking

Hazardous drinking usually refers to drinking above the recommended lower-risk levels but without, yet, showing evidence of harm to health.

Harmful drinking

Harmful drinking refers to those already experiencing or showing evidence of health harms (but not if just showing evidence of alcohol dependence).

Dependent drinking

Dependent drinking refers to having developed alcohol dependence, which is a specific health harm where the person affected has started to have an excessive desire to drink, or is showing some loss of control over their drinking.

This has usually started to affect the person’s quality of life and relationships, but they may not always find it easy to see this or to accept it.
For someone with severe alcohol dependence who experiences physical alcohol withdrawals when they cut down or stop drinking, suddenly cutting down or stopping can be dangerous without seeking medical advice.

Physical withdrawal symptoms include:

• hand tremors (‘the shakes’)
• sweating
• nausea
• visual hallucinations (seeing things that aren’t real)
• seizures (fits) in the most serious cases

Psychological withdrawal symptoms include:

• depression
• anxiety
• irritability
• restlessness
• insomnia (difficulty sleeping)

Severely dependent drinkers usually experience severe withdrawal symptoms. They often fall into a pattern of ‘relief drinking’, where they drink to avoid withdrawal symptoms.

Severely dependent drinkers are often able to tolerate very high levels of alcohol, amounts that would incapacitate or even kill some people.

Risks of alcohol misuse

The short-term risks of alcohol misuse include:

• alcohol poisoning – this may lead to vomiting, seizures (fits) and falling unconscious
• accidents and injuries requiring hospital treatment, such as a head injury
• violent behaviour that might lead to being arrested by police
• unprotected sex that could potentially lead to unplanned pregnancy or sexually transmitted infections (STIs)
• loss of personal possessions, such as wallets, keys or mobile phones, leading to stress and anxiety

Long-term alcohol misuse is a major risk factor for serious conditions including:

• heart disease
• stroke
• liver disease
• liver cancer and bowel cancer

As well as causing serious health problems, long-term alcohol misuse can lead to social problems, such as unemployment, divorce, domestic abuse and homelessness.

Units of alcohol

Alcohol is measured in units. A unit of alcohol is 10ml of pure alcohol, which is about half a pint of normal strength lager or a single measure (25ml) of spirits. A small glass (125ml) of wine contains about one-and-a-half units of alcohol.

Men should not regularly drink more than 3-4 units of alcohol a day, and women should not regularly drink more than 2-3 units a day.

‘Regularly’ means drinking this amount every day or most days of the week.

It’s also recommended that both men and women should have at least two alcohol-free days each week. Your health is at risk if you regularly exceed recommended daily limits.

Am I drinking too much alcohol?

You could be misusing alcohol if:

• you feel you should cut down on your drinking
• other people have been criticising your drinking
• you feel guilty or bad about your drinking
• you need a drink first thing in the morning to steady your nerves or get rid of a hangover

Someone you know may be misusing alcohol if:

• they regularly exceed the recommended daily limit for alcohol (see above)
• they are sometimes unable to remember what happened the night before due to their drinking
• they fail to do what was expected of them as a result of their drinking – for example, missing an appointment or work due to being drunk or hungover