Alcohol:
what you
need to
know
Inspiring Change
the Cambridge Centre Alcohol: what you need to know
the Cambridge Centre Alcohol: what you need to know
Contents
Introduction
4
What are the problems of
drinking too much alcohol?
7
Alcohol: the calories
More than eight out of ten people in
the UK drink alcohol. It is part of
our culture and we feel comfortable
with it.
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
Reuse me!
To help us reduce waste,
when you have finished with this
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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.
the Cambridge Centre Alcohol: what you need to know
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.
the Cambridge Centre Alcohol: what you need to know
Alcohol & Accidents
Drownings
Alcohol is estimated to be a factor in
20-30% of all accidents. Drinking alcohol:
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.
• 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
the Cambridge Centre Alcohol: what you need to know
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.
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.
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
If you drink alcohol to relieve anxiety or
depression, you will become more
depressed.
the Cambridge Centre Alcohol: what you need to know
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
Taking Medications?
• Bottle of Wine (Red)
510 calories
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.
• 5% Lager (Pint)
240 - 250 calories
• Cider (Pint)
180 - 250 calories
• Bitter / Ale (Pint)
180 - 230 calories
the Cambridge Centre Alcohol: what you need to know
Understanding and
measuring alcohol
the Cambridge Centre Alcohol: what you need to know
Drinks diary
Target units
for the week
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
Where
Quantity Cost
and with and
£
who
amount
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
units a day on a
regular basis
No more than 2-3
units a day on a
regular basis
Increasing Risk
More than 3-4
units a day on a
regular basis
More than 2-3
units a day on a
regular basis
Higher Risk
More than 50 units per week
(or more than 8 units per day)
on a regular basis
More than 35 units per week
(or more than 6 units per day)
on a regular basis
Weekly
Total
Total
units
the Cambridge Centre Alcohol: what you need to know
the Cambridge Centre Alcohol: what you need to know
Pub Measures
Beer/
%
Alcohol Cider
by
Volume
Beer/
Cider
Spirit
Vermouth
Bottles and Cans
Wine
Beer/
Cider
Beer/
Cider
Beer/
Cider
Wines/
Spirits
¼
½
¾
⅓
1
1⅓
⅔
1%
¼
½
3%
¾
1¾
3.5%
1
2
⅓
½
1
1¼
4%
1
2¼
½
1
4.5%
1¼
2½
½
5%
1½
2¾
5.5%
1½
3
6%
1¾
8%
Wines/ Wines/
Spirits/ Spirits/
Cider
Beers/
Cider
¾
1
Low Alcohol Wines and Beers
2
2¼
3
Low Strength Beers
1½
2½
2⅔
3½
1⅓
1¼
2¾
3
4
⅔
1¼
1½
2
3¼
3⅓
4½
1⅔
2¼
3½
3¾
5
1½
1¾
2½
3¾
4
5½
3½
⅔
1⅓
¾
1⅔
2
2⅔
4¼
4½
6
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
Standard Strength Beers and Ciders:
Carling, Fosters, John Smiths,
Boddingtons, Guinness, Strongbow
Export Strength Beers
and strong Ciders:
Stella/Grolsch/Becks/
Kronenberg, Alcopops 5%
Table
Wines
12%
1½
8½
9
12
13%
1⅔
9
9¾
13
13.5%
1⅔
9½
10¼
13½
Ginger Wine
Super Strength
Beers:
Tennants Super/
Special Brew
Barley Wine
14.5%
¾
1¾
10¼
11
14½
Vermouths/Sanatogen
15%
¾
2
10½
11¼
15
British Sherry
17%
¾
2
12
12¾
17
Cream Liquours
17.5%
1
2¼
12¼
13
17½
Sherry/Advocaat
1
2½
14
15
20
Port
1¼
3
16¾
18
24
Cherry Brandy
1¼
3
17½
18¾
25
Pimms/Campari
1⅓
3½
18½
20
26½
Liquers
20%
⅔
26.5%
⅔
37.5%
⅔
1
4⅔
26¼
28
37½
Sub-Norm Spirits
40%
1
5
28
30
40
Standard Spirits
43%
1
5⅓
30
32¼
43
Import Strength Spirits
24%
25%
Babycham
Pormagne
the Cambridge Centre Alcohol: what you need to know
12 ways to reduce
your drinking
the Cambridge Centre Alcohol: what you need to know
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.
Set drinking limits
Keep occupied
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.
Playing pool,
dominos or cards
when drinking can
often slow down
your drinking and
help you to drink
less.
Keep a record of
your drinking
Make a note of the amounts
you drink daily. Consider
using a drink diary.
Learn to drink slowly
Avoid ‘rushing’ your drinks.
Timing your drinking against
the clock often helps, make a
pint last an hour or so.
Make an excuse
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.
Avoid drinking in
‘rounds’
Avoid heavy
drinkers
If you drink
with heavy
drinkers it’s
likely that
you’ll drink
more - and
faster.
It may seem a bit antisocial, but
buying your own drinks will give
you more control over your drinking.
Learn drink refusal
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
It may prove useful to
limit the amount of
money you take with you
when you go drinking.
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.
the Cambridge Centre Alcohol: what you need to know
How alcohol affects
our bodies
the Cambridge Centre Alcohol: what you need to know
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.
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
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.
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:
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.
Weight
Muscles
Alcohol reduces the flow and
nutrients carried by the blood so
all muscles work less efficiently.
Alcohol contains sugar and
carbohydrates and is a form of
energy. Heavy drinking can cause
weight problems due to the high
carbohydrate content.
the Cambridge Centre Alcohol: what you need to know
10 ways to cope with
cravings
the Cambridge Centre Alcohol: what you need to know
Alcohol and liver disease
What is alcoholic liver disease?
1
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.
6
7
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
8
9
10
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.
Spoil 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.
Eat 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.
Take 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.
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...
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
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.
the Cambridge Centre Alcohol: what you need to know
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.
the Cambridge Centre Alcohol: what you need to know
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
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Companies House Registration No. 3530847
Charity Registration No. 1070914
Registered Office: 23 Alma Square,
North Yorkshire, YO11 1JR
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