Day 26 – Where’s the harm?

Saturday night and I am treating myself to a non-alcoholic mojito. It’s not too bad actually. I think I’ll buy more non-alcoholic soft drinks in future so I’m not automatically reaching for the wine. I definitely want to have at least 2 or 3 alcohol-free days a week as this is the recommended guideline, and 48 hours after a binge to recover if necessary.

So what are the other guidelines we should all be aiming for, and how much alcohol do you have to drink for it to affect your health? These are the categories of drinking recognised by the NHS:

Lower Risk

Men No more than 3-4 units a day (21 a week) on a regular basis (i.e. most days of the week, or most weeks of the year) .

Women No more than 2-3 units a day (14 a week) on a regular basis (i.e. most days of the week, or most weeks of the year)

It’s called Lower Risk not “Safe”, because drinking is never completely safe in all circumstances – e.g. driving, operating machinery, after strenuous exercise or before swimming, and if on certain medication.

Pregnant women or those trying to conceive are advised to avoid alcohol, or failing that to drink no more than 1-2 units once or twice a week and avoid getting drunk.

While there is a reduced risk of heart disease for men over 40 and women post menopause, there is convincing evidence that alcohol increases the risk of developing a number of cancers- at lower risk levels it’s small but it increases the more you drink.

On the whole, for those of us who drink alcohol (and only about 10% of the UK population are abstinent), if you’re within these limits you don’t need to worry too much, just be aware of what you drink as it’s easy to start drinking more without really noticing. The majority (about 60%) of the UK population fall into the Lower Risk category.

Increasing Risk

Men More than 3-4 units a day on a regular basis

Women More than 2-3 units a day on a regular basis

A lot of us fall into this category, and may not realise that regularly drinking over the lower risk levels does increase the risk of damaging our health. The likelihood of cancers of the liver, mouth, larynx, oesophagus, breast, pancreatitis, hypertension, stroke, cardiac arrhythmias, coronary heart disease, mental health issues like depression, anxiety, and dementia increases the more we drink. Basically alcohol affects all the body’s systems and organs, and these are just a few examples.

Higher Risk

Men More than 8 units a day (or 50 a week) on a regular basis.

Women More than 6 units a day (or 35 a week) on a regular basis

Drinking at these levels carries a much higher risk to your health which progressively increases the more you drink. There’s likely to already be some damage, even though the drinker may not be aware of it. 

8% of men and 5% of women are estimated to drink at Higher Risk levels. This equates to 2.7 million people in England.

And 31% of men and 20% of women (about 10 million people) drink at Increasing Risk or Higher Risk levels.

Surprised by these facts? We often think that dependent drinking – when someone may have such a strong desire to drink that they experience difficulties controlling their drinking and persist despite harmful consequence – is the indicator of an alcohol problem (“alcoholism”), but the World Health Organisation also uses the definitions hazardous drinking (at Increasing Risk or Higher Risk levels) and harmful drinking (Higher Risk) as problematic.

What’s your drinking pattern?

People often underestimate how much they drink, and the number of units in alcohol, particularly as drinks’ strength, sizes and measures vary so much, and have got bigger in recent years. A glass of wine could be anything from 1 unit – if VERY small, to 2.1 units (175ml of 12 % abv), up to 3.5 units (250ml of 14% abv).

The NHS Choices www.nhs.uk/livewell/alcohol/pages/alcoholhome.aspx website has further information on units, as well as a Unit Calculator and downloadable Alcohol Tracker which will automatically work out your daily/weekly units. Keeping a Drink Diary can be a really useful exercise if you’re unsure how much you’re drinking, or want to cut down.

There’s also loads of other information and advice on the NHS site, including a Self Assessment tool, which can help you to work out the level of risk to your health and wellbeing linked to your alcohol use. It’s a routine screening tool also known as an AUDIT (Alcohol Use Disorders Identification Test) used by Alcohol Workers.

If you’re contemplating changing your drinking, there are some excellent online self help sites like www.downyourdrink.org.uk and www.drinkerscheckup.com which I would wholeheartedly recommend. They’re filled with e-tools, exercises, information and tips and based on well-evidenced treatment approaches, and you can work through them anonymously and get personalised feedback.

You can also call Drinkline on 0800 7314 314 if you’re worried about your alcohol use, or someone else’s, to get support and find out about local services in your area.

To donate online please go to http://uk.virginmoneygiving.com/bethanfisher – running total £460 for Alcohol Concern.

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4 thoughts on “Day 26 – Where’s the harm?

  1. Me again! Firstly WELL DONE on such a huge total! That’s awesome! I’ll give it another tweet and see if I can find anyone to get you up to £500.

    Also, on the topic of harm… there is an extra warning that I wanted to add, if that’s ok. My understanding is that you can’t see liver damage happening gradually – tests either say you’re good, or you’re not – and once they show that your liver’s not well, it’s too late to rectify.

    I don’t think I explained that very well! I mean, I have regular blood tests (for another reason, but they include full liver profile). So far, my liver’s working well. But if I ever get results showing that it is damaged, then that is that. There isn’t any “warning level” where you can back off and things will be ok. Well, the liver is an amazing organ, and if you stop drinking then it might keep functioning, but damage has been done.

    I just thought I’d add that, because it’s easy to think “my tests show my liver is fine” and to carry on drinking, but in fact you can’t be sure that your liver will still be ok tomorrow, or the next day. I wouldn’t want any readers to be lulled into a sense of security.

    Not long to go now. You’re doing amazingly!

    • Thanks for sharing your experience and knowledge Flash.

      Damage can take place to the liver without there being any symptoms, and Liver Function Tests may not always show the extent of it, before it’s irreversible, or be 100% accurate. So it’s definitely worth keeping within the lower risk limits as a guide rather than seeing liver results being “fine” as permission to carry on drinking at increasing or higher risk levels.

      There are four stages of liver disease – fatty liver, hepatitis, fibrosis and cirrhosis, and stopping drinking at any stage of liver disease is beneficial and can improve the prognosis.

      Interesting page on this at
      http://www.drinksafely.info/AboutYourLiver/ comparing fatty liver to foie gras- unlike the poor geese it needn’t be a life sentence (if you stop drinking).

      I should add that I’m not a doctor (but I think you already know this!) and would always recommend discussing any concerns with your GP or specialist or contacting http://www.britishlivertrust.org.uk/ with any questions – looking at their website I see it is in fact Liver Awareness Month as well as Dry January – who knew?!

      Thanks also for the tweet – I’ve had another donation via your contacts today so now up to £470 🙂

  2. Not sure if this is the best place to leave this, so delete if you wish, I dont mean to hijack with my own agenda!

    But, Ive written ‘Toxic January’ about why I drink and what happens when I dont. Theres some soul searching in there and insightful comments have been left by sober friends. And of course a link to your blog in the hope that a reader or two may be able to sponsor you. Would love your views, if it inspires you to comment!
    http://flashsays.com/2013/01/27/toxic-january/

    • It’s definitely a good place to leave this Flash, it’s a shared agenda as I see it, to get people thinking, talking, and learning about alcohol issues.

      It shows you’ve been doing some serious self-reflection, and illustrates how complex our relationships with alcohol can be.

      There are always pros and cons of drinking, for you the main benefit is clearly that it reduces your pain in the short/medium term, and the cost is that it could increase the risk of harm to your health in the longer term, and interact with your medication.

      There are likely to be other pros and cons to your alcohol use as well (you might enjoy the taste, for example, but dislike the financial cost), and there will be pros and cons for change too. A cost benefit analysis can be helpful to analyse this (as on the Down Your Drink site) or you could talk it through with an alcohol worker if you want to contemplate the issues and decide whether to take any action.

      A lot of us use alcohol (or drugs) to self-medicate physical -or emotional- pain, so again I would have to refer you back to your doctor to discuss your pain management programme, i.e. your medication but I would suggest also consider a holistic approach to include relaxation techniques, mindfulness, counselling, complementary therapies etc.

      As you know, the danger with using alcohol as a coping strategy is that you end up needing more to get the effects, and risk developing dependence on top of your existing health condition, and what started as the solution becomes the problem…(Didn’t Homer Simpson say “Alcohol: the cause of – and the solution to – all of life’s problems”?)

      I do feel for you, as I know it can feel hard to see a way out when you’re living with chronic pain and it’s a matter of “whatever gets you through the night”. I’ll go over to your blog and comment there as well, and please let me know if you feel up to a chat some time, it you’re not sick of hearing my two cents yet!

      Finally, a respected blogger such as yourself referring to my site benefits me too as it’s increased the traffic to my blog, so cheers for that! X

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