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The Royal College of Psychiatrists Improving the lives of people with mental illness
 

Alcohol: Our Favourite Drug

 

alcohol and depression

 

Introduction

Alcohol is our favourite drug. Most of us use it for enjoyment, but for some of us, drinking can become a serious problem. In fact, alcohol causes much more harm than illegal drugs like heroin and cannabis. It is a tranquilliser, it is addictive, and is the cause of many hospital admissions for physical illnesses and accidents.
 

Problems with alcohol

Many of these problems are caused by having too much to drink at the wrong place or time. Alcohol affects your judgment, so you do things you wouldn't normally think of. It makes you less aware of risks and so more vulnerable. You are more likely to have fights, arguments, money troubles, family upsets, or spur-of-the-moment casual sex. Alcohol helps to cause accidents at home, on the roads, in the water and on playing fields.

Problems with alcohol - physical health

Being very drunk can lead to severe hangovers, stomach pains (gastritis), vomiting blood, unconsciousness and even death. Drinking too much over a long period of time can cause liver disease and increases the risk of some kinds of cancer. It can reduce the risk of heart disease for men over 40 and women of menopausal age - but only if their drinking is very moderate.

Problems with alcohol - mental health

Although we tend to think of alcohol as something we use to make us feel good, heavy drinking can bring on depression. Many people who kill themselves have had drinking problems. Alcohol can stop your memory from working properly and can cause brain damage. It can even make you hear noises and voices - a very unpleasant experience which can be hard to get rid of.

Warning signs

Alcohol is addictive. Some warning signs are:

  • you do not feel right without a drink, or need a drink to start the day
  • you get very shaky, sweaty, and anxious/tense a few hours after your last drink
  • you can drink a lot without becoming drunk
  • you need to drink more and more to get the same effect
  • you try to stop, but find you can't
  • you carry on drinking even though you can see it is interfering with your work, family and relationships
  • you get "memory blanks" where you can't remember what happened for a period of hours or days.

Dealing with alcohol problems

If you are worried about your drinking or a friend's drinking, tell them - they need to make changes as soon as possible. It is much easier to cut back before drinking problems damage your health than it is once they are out of hand.

First steps

Keep a diary of your drinking - you may be surprised by how much you really do drink, and this can give you the motivation to cut down. It helps if you can talk your plans over with a friend or relative. Do not be ashamed to tell someone. Most real friends will be pleased to help - you may find they have been worried about you for some time.

Getting help

If you find it hard to change your drinking habits then try talking to your GP or go for advice to a local alcohol organisation (see below for contact details). If you feel you cannot stop because you get too shaky or restless and jumpy when you try to cut down; your doctor can often help with some medication for a short time. If you still find it very difficult to change then you may need specialist help.

Changing habits

We all find it hard to change a habit, particularly one that plays such a large part in our lives. There are three steps to dealing with the problem:

  • Realising and accepting that there is a problem.
  • Getting help to break the habit.
  • Keeping going once you have begun to make changes.

You may find that you have been using alcohol as a way of handling stress and worries. A psychiatrist or a psychologist may be able to help you find ways of overcoming these worries that do not involve relying on drink.

Groups where you meet other people with similar problems can often be very helpful. There are self-help groups like Alcoholics Anonymous, or those run by professionals at an alcohol treatment unit.

Most people dealing with their drink problems do not need to go into hospital. Some people will need to get away from the places where they drink and the people they drink with. For them, a short time in an alcohol treatment unit may be necessary. Medications are mainly used for "drying out" if you get withdrawal symptoms. It is important to avoid relying on tranquillisers as an alternative.

Anyone who drinks can develop an alcohol problem - and some people lose everything - alcohol is a major cause of homelessness. Although some people may just need support and to talk, others may need longer-term help so that they can get somewhere to live, start to make relationships again and get back to work.

Tackling your alcohol problem can be hard work, but it pays off in the end by making a difference across all aspects of your life.

How much alcohol is too much?

Some drinks are stronger than others. The easiest way to work out how much we are drinking is to count "units" of alcohol. 1 unit is 10 mls of alcohol - the amount in a standard pub measure of spirits, a half pint of normal strength beer or lager, or a small glass of wine.

If a man and woman of the same weight drink the same amount of alcohol, the woman will have a much higher amount in her bodily organs than the man. So, unfair as it may seem, the safe limit is lower for women (14 units per week) than for men (21 units per week).
 
Drink Aware has further information on 'what is an alcohol unit?'

Binge" drinking

How much you drink at one time is also important. These "safe limits" assume that our drinking is spread out through the week.
 
In any one day, it is best for a man to drink no more than 4 units and for a woman to drink no more than 3 units. Drinking over 8 units in a day for men, or 6 units for women is known as 'binge drinking'.
 
You can drink above the safe limit on one night, but still remain within your "safe" limit for the week. There is some evidence that, even a couple of days of binge drinking, may start to kill off brain cells. This was previously thought only to happen with people who drank continuously for long periods of time. Binge drinking also seems to be connected with an increased risk of early death in middle aged men.

Guide to units of alcohol

These tables give a rough guide to the amount of alcohol found in different drinks.
 
These guidelines are approximate and may vary depending on the brand chosen and the size of measure. All alcohol sold in the UK above 1.2% ABV (Alcohol By Volume) should state how strong it is in percentages (%).
 
The higher the percentage, the more alcohol it has in it. Pub measures are generally rather smaller than the amount we pour ourselves at home.
 
  Beer, Cider & Alcopops Strength
ABV
Half
Pint
 
Pint
 
Bottle/
Can
330ml
 
Bottle/
Can
500ml
 
Bottle
1 Litre
 
Ordinary strength beer, lager or cider eg.
Draught beer, Woodpecker 
3-4%
 
1 2 1.5 1.9 -
“Export” strength beer, lager or cider eg.
Stella, Budweiser, Heinekin, Kronenbourg, Strongbow 
5%
 
1.25 2.5 2 2.5 -
Extra strong beer, lager or cider eg.
Special Brew, Diamond White, Tennents Extra
8-9% 2.5 4.5 3 4.5 9
Alcopops eg.
Bacardi Breezer, Smirnoff Ice, Reef, Archers, Hooch
5% - - 1.7 - -
 
 
  Wines & Spirits Strength
ABV
Small glass/
pub measure
Wine glass
 
Bottle
750 ml
Table Wine   12-14% -  1.5 - 2.5 10
 Fortified wine
(sherry, martini, port)
  15-20% 0.8 2-3 14
Spirits
(whisky, vodka, gin)
  40% 1 - 30
 
 

Helpful organisations

Helpline: 0800 024 1488 / 0203 131 6354 OR TEXT "HELP" to 66777.
Free help for anyone affected by addiction with advice on both NHS & private Drug & Alcohol Treatment Options
 
Alcoholics Anonymous (Great Britain)
Helpline: 0845 769 7555; email: help@alcoholics-anonymous.org.uk.
Contact details for all English AA meetings. There is a quiz to determine whether AA is the right type of organisation for an individual, and a frequently asked question section about AA and alcoholism.
 
Al-Anon Family Groups UK and Eire
Confidential Helpline 020 7403 0888 (Helpline available 10 am - 10 pm, 365 days a year). Email for all departments: enquiries@al-anonuk.org.uk.
Support group for friends and families of alcoholics. Includes a frequently asked questions section, pamphlets and other literature, and information on group meetings in the UK.
 
Alcohol Focus Scotland
Tel: 0141 572 6700; email: enquiries@alcohol-focus-scotland.org.uk. If you are concerned about your own or someone else's drinking and would like to speak to someone now, call Drinkline on
0800 7 314 314. The national volunteer organisation for alcohol issues in Scotland. Provides information about alcohol, including legal matters, frequently asked questions, and tips for safe drinking.
Based at University College London Medical School, and managed by the charity Alcohol Concern, this site is designed to help you work out whether you're drinking too much, and if so, what you can do about it.
 
Worried about your drinking? Call the national drink helpline - Drinkline: 0300 123 1110

Further reading

Allen Carr's easy way to control alcohol by Allen Carr (Arcturus Foulsham).

The effective way to stop drinking by Beauchamp Colclough (Penguin Health Care & Fitness).
This leaflet was produced by the Royal College of Psychiatrists' Public Education Editorial Board.
This leaflet reflects the best available evidence available at the time of writing.
Series editor: Dr Philip Timms.
 

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© August 2013. Due for review: August 2015. Royal College of Psychiatrists. This leaflet may be downloaded, printed out, photocopied and distributed free of charge as long as the Royal College of Psychiatrists is properly credited and no profit gained from its use. Permission to reproduce it in any other way must be obtained from permissions@rcpsych.ac.uk. The College does not allow reposting of its leaflets on other sites, but allows them to be linked directly.

 

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Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.

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