Alcohol: what you need to know Inspiring Change
Contents 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 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. Reuse me! To help us reduce waste, when you have finished with this booklet, please pass it on.
What are the problems of drinking too much alcohol? 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) It takes one hour for your liver to remove one unit of alcohol. 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. 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.
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. Alcohol: the calories 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... 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 (Pint) 180-250 calories Bitter / Ale (Pint) 180-230 calories
Understanding and measuring alcohol 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. Day/ Date Time of first drink What did you drink Target units for the week Where and with who Quantity and amount Cost Total units 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. Men Women 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 Weekly Total
Pub Measures Bottles and Cans % Alcohol by Volume Beer/ Beer/ Spirit Vermouth Wine Beer/ Beer/ Beer/ Wines/ Spirits Wines/ Spirits/ Wines/ Spirits/ Beers/ 1% ¼ ½ ¼ ⅓ ½ ⅔ ¾ 1 3% ¾ 1¾ ⅓ ¾ 1 1⅓ 2 2¼ 3 3.5% 1 2 ½ 1 1 ¼ 1½ 2½ 2⅔ 3½ 4% 1 2¼ ½ 1 1⅓ 1¼ 2¾ 3 4 4.5% 1¼ 2½ ½ 1¼ 1 ½ 2 3¼ 3⅓ 4½ 5% 1½ 2¾ ⅔ 1⅓ 1⅔ 2¼ 3½ 3¾ 5 5.5% 1½ 3 ⅔ 1½ 1¾ 2½ 3¾ 4 5½ 6% 1¾ 3½ ¾ 1⅔ 2 2⅔ 4¼ 4½ 6 8% 2¼ 4½ 1 2¼ 2⅔ 3½ 5½ 6 8 9% 2½ 5 1 2½ 3 4 6¼ 6¾ 9 10% 2¾ 5⅔ 1¼ 2¾ 3⅓ 4½ 7 7½ 10 11% 3 6¼ 1⅓ 3 3⅔ 4¾ 7¾ 8¼ 11 12% 1½ 8½ 9 12 13% 1⅔ 9 9¾ 13 13.5% 1⅔ 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 1⅓ 3½ 18½ 20 26½ 37.5% 1 4⅔ 26¼ 28 37½ 40% 1 5 28 30 40 43% 1 5⅓ 30 32¼ 43 Low Alcohol Wines and Beers Low Strength Beers Standard Strength Beers and s: Carling, Fosters, John Smiths, Boddingtons, Guinness, Strongbow Export Strength Beers and strong s: Stella/Grolsch/Becks/ Kronenberg, Alcopops 5% Table Wines Super Strength Beers: Tennants Super/ Special Brew Barley Wine Ginger Wine Vermouths/Sanatogen British Sherry Cream Liquours Sherry/Advocaat Port Cherry Brandy Pimms/Campari Liquers Sub-Norm Spirits Standard Spirits Import Strength Spirits Babycham Pormagne
12 ways to reduce your drinking Keep a record of your drinking Make a note of the amounts you drink daily. Consider using a drink diary. Make an excuse 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. Learn to drink slowly Avoid rushing your drinks. Timing your drinking against the clock often helps, make a pint last an hour or so. 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. 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. Keep occupied Playing pool, dominos or cards when drinking can often slow down your drinking and help you to drink less. Avoid drinking in rounds It may seem a bit antisocial, but buying your own drinks will give you more control over your drinking. It may prove useful to limit the amount of money you take with you when you go drinking. Learn drink refusal Avoid heavy drinkers If you drink with heavy drinkers it s likely that you ll drink more - and faster. 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. Limit your spending Have a dry period 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.
How alcohol affects our bodies 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. 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. 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. 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: Muscles Alcohol reduces the flow and nutrients carried by the blood so all muscles work less efficiently. Weight Alcohol contains sugar and carbohydrates and is a form of energy. Heavy drinking can cause weight problems due to the high carbohydrate content.
10 ways to cope with cravings 1 6 2 3 4 5 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. 7Spoil 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. 8Eat 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. 9Take 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. 10 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... 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 Alcohol and liver disease 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.
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. 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.
Contacts The Cambridge Centre Tel: 01723 367475 Web: www.cambridgecentre.org 23 Alma Square, Scarborough. YO11 1JR Womens Community Project Tel: 01723 354093 27 Northway, Scarborough, YO11 1JH Carers Resource 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: www.nhs.co. ukllivewell www.knowyourlimits.gov. uk www.alcohollearningcentre.org.uk www.cambridgecentre.org CC_Scarborough TheCambridgeCentre Companies House Registration No. 3530847 Charity Registration No. 1070914 Registered Office: 23 Alma Square, North Yorkshire, YO11 1JR Inspiring Change