Alcohol misuse

On their website, the NHS defines alcohol misuse as “…when a person drinks levels of alcohol that can cause them physical, psychological, and social problems – both in the short-term and the long-term.” They go on to say that “…the outlook for people who misuse is actually moderately good. An estimated 60 per cent of people with an alcohol dependency who seek treatment for their condition will either achieve a substantial reduction in their alcohol consumption or achieve total abstinence.”
There are three escalating levels of alcohol misuse: hazardous drinking, harmful drinking and dependent drinking.

What is hazardous drinking?

A person’s drinking pattern is regarded as hazardous when they exceed the recommended weekly limit of 21 units for men and 14 units for women. Another form of hazardous drinking is so-called ‘binge-drinking’, which is considered risky even if you stay within your weekly limit. ‘Binge-drinking’ is when you drink an excessive amount of alcohol within a short time: 8 units in a day for men, 6 units in a day for women.

Although you may not experience health problems directly related to alcohol, hazardous drinking increases your risk of developing health problems in the future. As well as the dangers to your health, you may expose yourself to additional risks, especially when ‘binge-drinking’, such as drink-driving, being involved in an accident, or getting into an argument or fight.

What is harmful drinking?

Harmful drinking is defined as when someone drinks more than the recommended weekly amount and experiences health problems directly related to alcohol misuse. Typical problems include depression, an alcohol-related accident, or even acute pancreatitis, which is a sudden inflammation of the pancreas. This can lead to severe complications and sometimes death, despite having treatment.

It’s easy to underestimate how much physical damage harmful drinking can cause, because many of the associated health problems are not apparent until they become serious. These include high blood pressure, cirrhosis (scarring of the liver), heart disease, and some types of cancer (such as mouth, liver, bowel and breast cancer).

As well as resulting in serious physical problems, harmful drinking can also cause social problems such as damage to your relationships with your partner, family and friends, and problems at work.

What is dependent drinking?

It’s possible to become dependent on alcohol, as it is both physically and psychologically addictive. Alcohol dependency means that someone feels they are unable to function without alcohol. Consuming alcohol becomes an important factor in their life: sometimes the most important. And if their supply of alcohol is suddenly stopped, withdrawal symptoms may be experienced. These can be both physical and psychological.

Physical withdrawal symptoms include:
• hand tremors (sometimes known as ‘the shakes’)
• sweating
• nausea
• hallucinations (seeing things that are not actually real)
• seizures (fits)

Psychological withdrawal symptoms include:
• depression
• anxiety
• irritability
• restlessness
• insomnia
When they stop drinking, people who are moderately dependent do not usually experience withdrawal symptoms, or if they do get symptoms, they will only be mild or moderate.
But severely dependent drinkers usually experience correspondingly severe withdrawal symptoms. These can lead to ‘relief drinking’, where the person drinks to counter or avoid withdrawal symptoms. Severely dependent drinkers usually have an extremely high tolerance to alcohol and are capable of consuming amounts of alcohol that would incapacitate or kill most ordinary people.

How hazardous is drinking when pregnant?

If you’re pregnant or trying to conceive, you should totally avoid drinking alcohol. But if you do choose to drink, you should not consume more than 1 or 2 units of alcohol, once or twice a week at most, and you should definitely avoid getting drunk.

Guide to measuring alcohol units

Any purchased drink has a measurement of alcohol by volume, known as ABV, which shows how much of the drink is pure alcohol. The easiest way to calculate how many units of alcohol are in a drink is:
1. Find out the drink’s ABV
2. Multiply the ABV by the number of millilitres of liquid in the drink
3. Divide that by 1,000

For example, a standard pint of strong lager has an ABV of 5% and contains 568ml of liquid: 5 x 568 = 2840 ÷ 1,000 = 2.8 units.

Here’s a list of the units found in some standard drinks:
Can of standard lager/beer/bitter – 1.8 units
Can of strong lager/beer/bitter – 2.2 units
Pint of standard lager/beer/bitter – 2 units
Pint of strong lager/beer/bitter – 2.8 units
Small glass of wine (125ml) – 1.5 units
Large glass of wine (250ml) – 3 units
Bottle of ‘alcopop’ – 1.5 units
Glass of spirit (25ml) – 1 unit
Bottle of wine – 9 units
One litre bottle of standard cider – 4.5 units
One litre bottle of strong cider – 8.4 units
700ml bottle of spirits – 26.3 units