Alcohol:
What you
Need to
Know
You and Your Care
2
CONTENTS
Contents
4
What are the Problems
of Drinking too much
Alcohol?
12
12 Ways to Reduce
your Drinking
7
Alcohol: The Calories
14
How Alcohol Affects
our Bodies
8
Understanding &
Measuring Alcohol
16
10 Ways to Cope
with Craving
9
Drinks Diary
17
Alcohol & Liver Disease
10
Measuring Alcohol Units
20
Local & National
Contacts
INTRODUCTION
Introduction
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.
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4
WHAT ARE THE PROBLEMS OF DRINKING TOO MUCH ALCOHOL?
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.
However, drinking over the recommended
limits can be harmful. If you drink heavily
you have an increased risk of developing:
It takes
one hour
for your
liver to
remove
one unit
of alcohol.
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•
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•
•
•
•
•
•
•
•
•
Seriousliverproblems(alcoholicliverdisease)
Somestomachdisorders
Pancreatitis(severeinflammationofthepancreas)
Mentalhealthproblemsincludingdepression,
anxiety and memory problems
Sexualdifficultiessuchasimpotence
Muscleandheartmuscledisease
Highbloodpressure
Damagetonervoustissue
Somecancers(mouth,gullet,liver,colonandbreast)
Obesity(alcoholhasmanycalories)
Damagetoanunbornbabyinpregnantwomen
Alcoholdependence(addiction)
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.
WHAT ARE THE PROBLEMS OF DRINKING TOO MUCH ALCOHOL?
Alcohol & Accidents
Alcohol is estimated to be a factor in
20-30% of all accidents. Drinking alcohol:
•
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Affectsourjudgementandreasoning
Slowsdownourreactions
Upsetsoursenseofbalanceandco-ordination
Impairsourvisionandhearing
Makesusloseconcentration
Makesusdrowsy
Alcohol delays recovery, interferes with the normal
responsestoshockandthecoughreflex(increasingthe
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
ofalcoholyouaredrinking,youcouldfindyou
are over the limit without intending to be. If you
have had a heavy night drinking, you may still
beoverthelimitorunfittodrivethenextday.
If you are convicted of drink driving you face:
•
•
•
•
Aminimumoneyeardrivingban
Afineofupto£5,000
Uptosixmonthsinprison
Endorsementofyourdriving
licence for 11 years
• Life-timeincreaseininsurancepremiums
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.
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6
WHAT ARE THE PROBLEMS OF DRINKING TOO MUCH ALCOHOL?
Fires
Aroundoneinthreefiresarecausedbypeopleunderthe
influenceofalcohol.Twothirdsofpeoplewhoareadmitted
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
smokeorhearingfirealarmsandcanimpedeescape.
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
Medications?
and sexual problems.
Taking
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.
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.
ALCOHOL: THE CALORIES
Alcohol:
The Calories
Calories from alcohol are ‘empty calories’
– they have no nutritional value.
In 2009 a Department of Health survey of 2,000 adults
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...
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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)=555calories
Bottle of Wine (Red)=510calories
5% Lager (Pint)=240-250calories
Cider (Pint)=180-250calories
Bitter / Ale (Pint) = 180 - 230 calories
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8
UNDERSTANDING & MEASURING ALCOHOL
Understanding &
Measuring Alcohol
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.
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
Morethan50
units per week
(or more than 8
units per day) on
a regular basis
Morethan35
units per week
(or more than 6
units per day) on
a regular basis
DRINKS DIARY
Drinks Diary
Target Units
for the Week:
Day /
Date
Time of
First Drink
What Did
you Drink
Where &
With Who
Quantity
& Amount
Cost
(£)
Weekly
Total:
Total Units
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10
MEASURING ALCOHOL UNITS
Pub Measures
%
Alcohol
by
Volume
Beer /
Cider
Beer /
Cider
1/2 pint
Spirit
25ml
Vermouth
Wine
125ml
50ml
1 pint
1% 1/4
1/2
3% 3/4
1 3/4
1
3.5% 1
Beer /
Cider
Be
Cid
275ml
330
1/4
⁄3
3
1
⁄4
⁄3
1
2
1/2
1
1 1/4
4% 1
2 1/4
1/2
1
1 1 ⁄3
4.5% 1 1/4
2 1/2
1/2
1 1/4
1 1/2
5% 1 1/2
2 3/4
2
⁄3
1
1 ⁄3
1 2 ⁄3
3
2
⁄3
1 1/2
1 3 ⁄4
6% 1 3/4
3 1/2
3
⁄4
1 2 ⁄3
2
8% 2 1/4
4 1/2
1
2 1/4
2 2 ⁄3
9% 2 1/2
5
1
2 1/2
3
10% 2 3/4
5 2 ⁄3
1 1/4
2 3 ⁄4
3 1 ⁄3
11% 3
6 1/4
1 ⁄3
3
3 2 ⁄3
5.5% 1 1/2
1
12%
1 1/2
13%
1 2 ⁄3
13.5%
1 2 ⁄3
14.5%
3/4
1 3 ⁄4
15%
3/4
2
17%
3/4
2
17.5%
1
2 1/4
1
2 1/2
20%
24%
2
⁄3
1 1/4
3
25%
2
⁄3
1 1/4
3
26.5%
2
⁄3
1 ⁄3
3 1/2
37.5%
1
4 2 ⁄3
40%
1
5
43%
1
5 1 ⁄3
1
MEASURING ALCOHOL UNITS
11
Bottles & Cans
eer /
der
Beer /
Cider
0ml
440ml
Wines / Wines / Wines /
Spirits Spirits / Spirits /
Cider
Beers /
70cl
Cider
75cl
1 litre
1/2
2
⁄4
1
Low Alcohol Wines & Beers
1 ⁄3
2
2 1/4
3
Low Strength Beers
1 1/2
2 1/2
2 ⁄3
3 1/2
1 3 ⁄4
2 3 ⁄4
3
4
2
3 1/4
3 1 ⁄3
4 1/2
2 1/4
3 1/2
3 ⁄4
5
2 1/2
3 ⁄4
4
5 1/2
2 ⁄3
4 1/4
4 1/2
6
1
2
⁄3
3
3
2
3
Standard strength Beers & Ciders: Carling,
Fosters, John Smiths, Boddingtons,
Guinness, Strongbow, Blackthorn Dry
ExportstrengthBeers
and strong Ciders Stella / Grolsch / Becks /
Kronenberg,Alcopops5%
Super Strength
Beers Tennants
Super / Special
Brew
3 1/2
5 1/2
6
8
4
6 1/4
6 3 ⁄4
9
4 1/2
7
7 1/2
10
4 ⁄4
7 ⁄4
8 1/4
11
8 1/2
9
12
9
9 ⁄4
13
9 1/2
10 1/4
13 1/2
Ginger Wine
10 1/4
11
14 1/2
Vermouths / Sanatogen
10 1/2
11 1/4
15
British Sherry
12
12 ⁄4
17
Cream Liqueurs
12 1/4
13
17 1/2
Sherry / Advocaat
14
15
20
Port
3
3
3
3
Table Wines
Barley Wine
16 ⁄4
18
24
Cherry Brandy
17 1/2
18 3 ⁄4
25
Pimms / Campari
18 1/2
20
26 1/2
Liqueurs
26 1/4
28
37 1/2
Sub-Norm Spirits
28
30
40
Standard Spirits
30
32 1/4
43
Import Strength Spirits
3
Babycham
Pomagne
12
12 WAYS TO REDUCE YOUR DRINKING
12 ways to Reduce
Your Drinking
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.
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.
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.
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”. 12 WAYS TO REDUCE YOUR DRINKING
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.
Avoid heavy drinkers
If you drink with heavy
drinkers it’s likely that you’ll
drink more - and faster.
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.
13
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.
Limit your
spending
power
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
lowlimit,e.g.fiveunitsweekly.
14
HOW ALCOHOL AFFECTS OUR BODIES
How Alcohol
Affects our Bodies
The diagram overleaf 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:
HOW ALCOHOL AFFECTS OUR BODIES
Oesophagus (Food Pipe)
Complications of liver
disease can cause serious
and often fatal bleeding.
Muscles
Alcoholreducestheflow
and nutrients carried by
the blood so all muscles
worklessefficiently.
15
Brain
Steady drinking leads to
permanent changes in the
brain. Brain solid tissue is
reducedandthefluidfilled
spaces between ventricles
are increased. The vitamin
foods of the brain are
reduced. Lack of vitamins
causes brain damage.
Heart
Skin
Alcohol causes small
blood vessels in the skin
to widen, allowing more
bloodtoflowclosetothe
surface. The temperature
control mechanisms are
disturbed producing a
flushedcolouranda
feeling of warmth.
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 pumping action of the
heart is weakened. This can
result in heart failure.
Liver
Frequently drinking
alcohol causes the liver
to expand, and fatty
deposits to build up. It can
repair itself but works less
efficiently.Alcoholcan
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
Alcohol contains sugar
and carbohydrates and is
a form of energy. Heavy
drinking can cause weight
problems due to the high
carbohydrate content.
16
10 WAYS TO COPE WITH CRAvING
10 ways to Cope
with Cravings
1
Think About Why you’re
Trying to Stop Drinking
Think about the bad things that would happen
if you were to carry on drinking. What
would the effects be on your health, family,
financialstateandjob?Ifyouthinkitmight
help, make a list and read it when you
feel you’ve really got to have a drink.
2
Talk to
Someone
3
Keep
Occupied
Find someone who’s understanding and
supportive and talk to them about how you feel.
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
mindoffdrinkingfor15minutesthendoit.
4
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.
5
Avoid Situations That Make
you Feel Like Drinking
Pubs, off-licences and parties are often
difficultsituations.Sometimesdrinksdisplayed
insupermarketscanalsobedifficult.
6
Avoid People Whom you
Know are Heavy Drinkers
7
Spoil
Yourself
8
Eat
Something
9
Take Some
Time Out
Not everyone appreciates it when you try to stop
drinking and they may put you under pressure
todrink.Evenifnoonesaysanythingthesocial
pressure to conform can still be quite intense.
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.
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.
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
findthecravinghassubsidedandyouno
longer feel you need to have a drink.
10
Save
Money
Keep a record of how much you’re
savingbydrinkingless.£20savedper
weektranslatestomorethan£80
amonth,or£1,040peryear...Just
think what you could do with that...
ALCOHOL & LIvER DISEASE
17
Alcohol &
Liver Disease
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:
• Storingglycogen,achemicalmadefromsugars
• Helpingtoprocessfatsandproteinsfromdigestedfood
• Makingproteinsthatareessentialforbloodtoclot
(clotting factors)
• Processingmanymedicineswhichyoumaytake
• Helpingtoremoveorprocessalcohol,
poisons and toxins from the body
• Makingbilewhichpassesfromtheliver
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
andintestinesfirstgoesthroughtheliverbeforecirculating
around the whole body. So, the highest concentration
ofalcoholisinthebloodflowingthroughtheliver.
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.
18
ALCOHOL & LIvER DISEASE
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
Hepatitismeansinflammation
oftheliver.Theinflammation
can range from mild to severe.
Mild hepatitis may not cause any symptoms. The only indication
ofinflammationmaybeanabnormallevelofliverenzymesin
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
scartissue(fibrosis).Thescarringtendstobeagradualprocess.
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.
ALCOHOL & LIvER DISEASE
Thiamine
Thiamine(vitaminB1)isusefulasasupplementindeficiencies
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,porkandfish.Symptomsofthiaminedeficiencyare
fatigue, irritability, drowsiness and poor concentration.
Inmoreseverethiaminedeficiency(Beriberi)therecan
also be muscle weakness, tingling or burning sensations,
cramp and tenderness in the leg muscles, breathing
problems and heart failure. Wernicke-Korsakoffs syndrome
isalsocausedbyThiaminedeficiency(seebelow)
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)andKorsakoff’spsychosis(KP).WEusuallyoccursbefore
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.
IfWEisnottreatedintheearlystagesitcanresultinpermanent
braindamageorsevereshort-termmemoryloss.WEcanbe
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.
19
20
LOCAL & NATIONAL CONTACTS
Local &
National
Contacts
Bradford District Care
Trust Community Drug
& Alcohol Team (18+)
Tel: 01274 256600
Project 6
Tel: 01535 610180
11-19 Temple Street, Keighley, BD21 2AD
Offersfreeconfidentialadvice
and counselling service.
Housing & Social Support
Bradford Day Shelter: 01274 393234
Bevan House: 01274 322400
Homeless Team: 01274 227555
Horton Housing: 01274 547017
Salvation Army: 01274 731221
Units 1&3 Legrams Terrace, Fieldhead
Business Centre, Listerhills , Bradford
BD7 1LN
Carers Support Services
ReferralviaGP,A&Eorotheragency.
Dependant drinkers only.
Carers Resource: 01274 449 600
Piccadilly Project:01274735775
Bradford District Care Trust
Airedale Community
Drug & Alcohol Team (18+)
Tel: 01535 338555
The Ingrow Centre, 200 South Street,
Ingrow, Keighley, BD21 1BB
Self referral or via GP or other
agency or call in daily between 1pm
– 4pm. All alcohol problems.
Piccadilly Project (18+)
Lifeline Bradford
Tel: 01274 735775
1st Floor Auburn House, 8 Upper
Piccadilly, Bradford, BD1 3NU
North Bradford Drug Service:
01274 322193
British Liver Trust
Tel: 0800 652 7330 (helpline)
Web: www.britishlivertrust.org.uk
Drinkline – National
Alcohol Helpline
Tel: 0800 917 8282
Web: www.drinkaware.co.uk
Alcoholics Anonymous
Tel: 0113 245 4567 (local helpline)
Tel: 0845 769 755 (national helpline)
Web: www.alcoholics-anonymous.org.uk
Self referral, via GP or other agency.
Freeconfidentialadviceandone-to-one
counselling service, support for carers.
Supported by:
You and Your Care