This information is to do with Alcohol misuse. It is important to note that alcohol misuse and alcoholism are not the same thing. You can have someone who drinks an alcoholic under the table, doesn’t make them an alcoholic; you can have someone who can’t “hold their liquor”, they can still be an alcoholic.
Alcohol misuse means drinking excessively – more than the lower-risk limits of alcohol consumption.
Alcohol consumption is measured in units. A unit of alcohol is 10ml of pure alcohol, which is about:
- half a pint of normal-strength lager
- a single measure (25ml) of spirits
A small glass (125ml) of wine contains about 1.5 units of alcohol.
To keep your risk of alcohol-related harm low, the NHS recommends:
- not regularly drinking more than 14 units of alcohol a week
- if you drink as much as 14 units a week, it’s best to spread this evenly over three or more days
- if you’re trying to reduce the amount of alcohol you drink, it’s a good idea to have several alcohol-free days each week
Regular or frequent drinking means drinking alcohol most weeks. The risk to your health is increased by drinking any amount of alcohol on a regular basis.
As well as causing serious health problems, long-term alcohol misuse can lead to social problems, such as unemployment, divorce, domestic abuse and homelessness.
If someone loses control over their drinking and has an excessive desire to drink, it’s known as dependent drinking (alcoholism).
Dependent drinking usually affects a person’s quality of life and relationships, but they may not always find it easy to see or accept this.
Severely dependent drinkers are often able to tolerate very high levels of alcohol in amounts that would dangerously affect or even kill some people.
A dependent drinker usually experiences physical and psychological withdrawal symptoms if they suddenly cut down or stop drinking, including:
- hand tremors – “the shakes”
- seeing things that aren’t real (visual hallucinations)
- difficulty sleeping (insomnia)
Treating alcohol misuse
How alcohol misuse is treated depends on how much alcohol a person is drinking. Treatment options include:
- counselling – including self-help groups and talking therapies, such as cognitive behavioural therapy (CBT)
- detoxification – this involves a nurse or doctor supporting you to safely stop drinking; this can be done by helping you slowly cut down over time or by giving you medicines to prevent withdrawal symptoms
There are two main types of medicines to help people stop drinking. The first is to help stop withdrawal symptoms, and is given in reducing doses over a short period of time. The most common of these medicines is chlordiazapoxide (Librium). The second is a medication to reduce any urge you may have to drink. The most common medications used for this are acamprosate and naltrexone. These are both given at a fixed dose, and you’ll usually be on them for 6 to 12 months.
Risks of alcohol misuse
The short-term risks of alcohol misuse include:
- accidents and injuries requiring hospital treatment, such as a head injury
- violent behaviour and being a victim of violence
- 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
- alcohol poisoning – this may lead to vomiting, seizures (fits) and falling unconscious
People who binge drink (drink heavily over a short period of time) are more likely to behave recklessly and are at greater risk of being in an accident.
Persistent alcohol misuse increases your risk of serious health conditions, including:
- heart disease
- liver disease
- liver cancer and bowel cancer
- mouth cancer