Inspiring Change
Alcohol:
what you
need to
know
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 booklet has been developed in partnership with; service users, the Alcohol Care Team (Bradford District Care Trust), Piccadilly Project (Lifeline Bradford), Bradford Teaching Hospitals and NHS Bradford & Airedale.
Our aim is to educate you about the affects of alcohol and enable you to make an informed decision about your alcohol use.
Introduction
4 What are the problems of drinking too much alcohol?
7 Alcohol: the calories
8 Understanding and measuring alcohol 9 Drinks diary
10 Measuring alcohol units
12 12 ways to reduce your drinking 14 How alcohol affects our bodies 16 10 ways to cope with craving 17 Alcohol and liver disease 20 Local and national contacts
Contents
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Alcohol & 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 & 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 a garden pond, slipping and falling asleep in the bath amongst the most common.
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. owever, 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.
What are the
problems of drinking too much alcohol?
It takes one hour for your
liver to remove one unit
of alcohol.
Calories from alcohol are ‘empty calories’ – they have no nutritional value.
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...
Alcohol: the calories
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 & 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.
Taking Medications?
Many drugs and medications do not combine well with alcohol. Some
combinations could even be fatal. You should read the label carefully and if you are unsure, ask your pharmacist or doctor.
• Gin or Vodka and Tonic 126 calories
• Medium Glass White Wine (175ml) 130 calories
• Medium Glass Red Wine (175ml) 120 calories
• Bottle of Wine (White) 555 calories
• Bottle of Wine (Red) 510 calories
• 5% Lager (Pint) 240 - 250 calories
• Cider (Pint) 180 - 250 calories
• Bitter / Ale (Pint)
180 - 230 calories
Drinks diary
In any one day, it is best for men to drink no more than four units and for women to drink no more than three units. Drinking over eight units in a day for men, or six units for women is known as ‘binge drinking’. It is advisable to have at least two alcohol free days each week.
What is a Unit?
Units are a way of measuring how much alcohol you are drinking. One unit is eight grams of pure alcohol. We take for granted that drinks come in different measures and are poured into glasses of various sizes.
You need to be aware of the size and strength of a drink to be able to calculate the unit content.
Lower Risk No more than 3-4 No more than 2-3 units a day on a units a day on a
regular basis regular basis
Increasing Risk More than 3-4 More than 2-3 units a day on a units a day on a
regular basis regular basis
Higher Risk More than 50 units per week More than 35 units per week (or more than 8 units per day) (or more than 6 units per day) on a regular basis on a regular basis
Understanding and measuring alcohol
Men Women
Day/
Date
Time of first drink
What did you drink
Where and with who
Quantity and amount
Cost
£
Total units
Target units for the week
Weekly
Total
Pub Measures
Beer/
Cider
Beer/
Cider
Spirit Vermouth Wine Beer/
Cider
Beer/
Cider
Beer/
Cider
Wines/
Spirits/
Beers/
Cider Wines/
Spirits/
Cider Wines/
Spirits
Bottles and Cans
% Alcohol
by Volume
1% ¼ ½ ¼ ⅓ ½ ⅔ ¾ 1
3% ¾ 1¾ ⅓ ¾ 1 1 ⅓ 2 2¼ 3
3.5% 1 2 ½ 1 1 ¼ 1½ 2½ 2 ⅔ 3½
4% 1 2¼ ½ 1 1 ⅓ 1¼ 2¾ 3 4
4.5% 1¼ 2½ ½ 1¼ 1 ½ 2 3¼ 3 ⅓ 4½
5% 1½ 2¾ ⅔ 1 ⅓ 1 ⅔ 2¼ 3½ 3¾ 5
5.5% 1½ 3 ⅔ 1½ 1¾ 2½ 3¾ 4 5½
6% 1¾ 3½ ¾ 1 ⅔ 2 2 ⅔ 4¼ 4½ 6
8% 2¼ 4½ 1 2¼ 2 ⅔ 3½ 5½ 6 8
9% 2½ 5 1 2½ 3 4 6¼ 6¾ 9
10% 2¾ 5 ⅔ 1¼ 2¾ 3 ⅓ 4½ 7 7½ 10
11% 3 6¼ 1 ⅓ 3 3 ⅔ 4¾ 7¾ 8¼ 11
12% 1½ 8½ 9 12
13% 1 ⅔ 9 9¾ 13
13.5% 1 ⅔ 9½ 10¼ 13½
14.5% ¾ 1¾ 10¼ 11 14½
15% ¾ 2 10½ 11¼ 15
17% ¾ 2 12 12¾ 17
17.5% 1 2¼ 12¼ 13 17½
20% 1 2½ 14 15 20
24% ⅔ 1¼ 3 16¾ 18 24
25% ⅔ 1¼ 3 17½ 18¾ 25
26.5% ⅔ 1 ⅓ 3½ 18½ 20 26½
37.5% 1 4 ⅔ 26¼ 28 37½
40% 1 5 28 30 40
43% 1 5 ⅓ 30 32¼ 43
Ginger Wine
Vermouths/Sanatogen British Sherry
Cream Liquours Sherry/Advocaat Port
Cherry Brandy Pimms/Campari Liquers
Sub-Norm Spirits Standard Spirits Import Strength Spirits Low Alcohol Wines and Beers Low Strength Beers
Standard Strength Beers and Ciders:
Carling, Fosters, John Smiths, Boddingtons, Guinness, Strongbow
Table Wines
Barley Wine
Pormagne Babycham
Export Strength Beers and strong Ciders:
Stella/Grolsch/Becks/
Kronenberg, Alcopops 5%
Super Strength Beers:
Tennants Super/
Special Brew
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.
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.
Keep occupied
Playing pool, dominos or cards when drinking can often slow down your drinking and help you to drink less.
Avoid heavy drinkers
If you drink with heavy drinkers it’s likely that you’ll drink more - and faster.
Avoid drinking in
‘rounds’
It may seem a bit antisocial, but buying your own drinks will give you more control over your 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.
It may prove useful to limit the amount of money you take with you when you go drinking.
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 w limit, e.g. five units weekly.
Have a dry period Limit
your
spending
The diagram on the next page 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:
How alcohol affects our bodies
Muscles
Alcohol reduces the flow and nutrients carried by the blood so all muscles work less efficiently.
Skin
Alcohol causes small blood vessels in the skin to widen, allowing more blood to flow close to the surface. The temperature control mechanisms are disturbed producing a flushed colour and a feeling of warmth.
Brain
Steady drinking leads to permanent changes in the brain. Brain solid tissue is reduced and the fluid filled spaces between ventricles are increased. The vitamin foods of the brain
are reduced. Lack of vitamins causes brain damage.
Liver
Frequently drinking alcohol causes the liver expand, and fatty to deposits to build up.
It can repair itself but works less efficiently.
Alcohol can also cause cirrhosis of the liver which is often fatal.
Stomach
Alcohol irritates the stomach lining causing sickness and pain and a range of disorders.
Weight
Alcohol contains sugar and carbohydrates and is a form of energy. Heavy drinking can cause weight problems due to the high carbohydrate content.
Heart
The pumping action of the heart is weakened. This can result in heart failure.
Reproductive Organs
Nerve impulses are depressed by alcohol causing men to lose erections and reduced vaginal discharges in women. Heavy drinking in pregnancy can reduce the size of the foetus and the brain and cause facial deformities - known as Foetal Alcohol Syndrome.
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.
Alcohol and liver disease
Think about why you’re trying to stop drinking
Think about the bad things that would happen 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...
10 ways to cope with cravings
1 6
7 8 9 10 2
3
4
5
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 (see below)
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 Wernicke-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 and be left with no memory problems, although this is not guaranteed. Overall Wernicke-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 Wernicke-Korsakoff’s syndrome occurs in one in eight of dependant drinkers.
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.
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Tel: 01723 850155
Web: www.carersresource.net FRANK
Tel: 0800 77 66 00 Web www.talktofrank.com Crisis Call
Tel: 0800 501254
Web: www. crisiscal/online. org. ouk Drink Aware
Tel: 020 7766 9900
Web: www.drinkaware.co.uk Alcohol Concern
Tel: 020 7264 0510
Web: www.alcoholconcern.org. uk
British Liver Trust Tel: 0800 652 7330
Web: www.britishlivertrust.org Alcoholics Anonymous Tel: 0845 769 755
Web: www.alcoholics-anonymous.org. uk North Yorkshire Horizons Drug and Alchohol Treatment Tel: 01723 30730
Sexual Health Councellor Tel: 01423 557367
Mind Scarborough, Whitby and Ryedale
Tel: 01723 588008 A & E Alcohol Worker Tel: 07738 321368 Other Useful Websites:
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