Alcohol, in moderation, can seem like an essential part of adult life. After all, who could get through the work Christmas party without a little tipple? Or have a summer picnic in the back garden without a pitcher of Pimms? Some studies have even suggested that a glass of red wine a day can actually benefit your health. The problem for some people, unfortunately, is keeping to that moderate level.
As a depressant, which means that it slows down your body and mind's responses, alcohol can help the drinker relax in social situations. Addiction forms when the drinker becomes reliant on alcohol, whether this is feeling the need to have a bottle of wine before bed or a shot of whisky to get up in the morning. Excessive consumption of alcohol can impact the way an individual functions in society, damage their organs, and even result in death.
Prevalence of Alcoholism
As a product that is available for sale to adults over the age of 18, alcohol can easily be found in supermarkets, corner shops, and local pubs all over the country. There are restrictions in place to prevent alcohol being sold to those underage, with many stores asking for identification from anyone who could be too young under the “Challenge 25” policy. Additionally, The Licensing Act (2005) in Scotland limits the hours during which alcohol can be sold. Even with these regulations, however, alcohol is still easily accessible to adults who want to drink.
A report by the United Kingdom National Statistics found that 28.9 million people in the UK – almost 60% - admitted to drinking alcohol in the previous week. 2.5 million of these people reported drinking more than fourteen units of alcohol in twenty four hours, using up the maximum recommended units per week in a single day. In England alone, 1.1 million hospital admissions were related to alcohol and, in 2012, the consumption of alcohol was linked to 21, 485 deaths.
Men are more likely than women to be both admitted to hospital for alcohol-related reasons and to suffer an alcohol-related death. This trend is shared with alcohol dependency, as the NHS suggests that around 9% of UK men exhibit the symptoms of alcohol dependency compared to only 5% of women. Numbers are, however, hard to be sure of as only around 1% of these drinkers attempt to access treatment for their dependency and individuals with addictive behaviours can often be secretive about their problem.
Recent statistics do suggest that teenage drinking has actually decreased since surveys first began in 1988, as only 38% of respondents between 11 and 15 reported that they had ever tried alcohol and only around 9% drinking at least once a fortnight. The majority of child drinkers were aiming to get drunk and did so to seem cool in front of their friends. Results showed that drinking regularly became more common with age but, unlike their adult counterparts, there were no differences in frequency of drinking between the genders.
Some research does suggest that moderate alcohol consumption can be part of a healthy lifestyle. And, along with being a pretty good cleaning agent, it does have some use in the medical profession as it can be used to treate anti-freeze poisoning. Excessive consumption and alcohol dependency, however, can present very real risks to the health of the drinker.
Excessive alcohol consumption, even if not an alcoholic, can negatively impact the drinker in a number of ways. It is well known that drinking can give you “Dutch courage”, boosting confidence and perhaps encouraging the drinker to do things that they might not have considered otherwise. This increases the likelihood of risk-taking behaviours and lowers inhibitions, making unsafe sex, alcohol-fuelled fights, and other possibilities the drinker wouldn't normally be part of. Drunkenness also lowers the drinker's awareness, making them more vulnerable to the actions of others.
Alcohol dependency has strong links with anxiety and depression, with people who experience these illnesses being twice as likely to become reliant on alcohol. For some, this is because alcohol initially acts a crutch and they see it as something to self-medicate their moods. The continued use of alcohol then goes on to change the way their brain works, leading to more low feelings, which they continue to treat with alcohol. For others, the abusive drinking behaviours can actually be the initial cause of their anxious or depressive feelings, creating a negative and seemingly inescapable loop.
The depressant qualities of alcohol can make the drinker feel tired and lethargic but excessive consumption does not improve sleep health. Insomnia, where an individual struggles to fallg asleep or wakes up in the night, can be a common problem for long-term drinkers. The sleep quality of heavy drinkers also tends to be worse than that of non-drinkers. Long lasting sleep problems or deprivation can feed into the depressive alcohol cycle, exacerbating the problem and making recovery from the addiction more difficult.
We all know that alcohol can impact balance. The after-club stagger home is a familiar experience for many of us, even if it's only a once-in-a-while type thing. As more alcohol is consumed, the brain-altering effects spread to a part of the brain called the cerebellum (responsible for fine muscle movement) leading to clumsiness and balance issues. While this problem usually goes away for a person who only drinks occasionally once they sober up, new research has found that long-term alcoholism can mean long-term balance problems. The Neurobehavioral Research Inc. put three groups of participants – former alcoholics who had been sober for a number of weeks, former alcoholics who had been sober for seven years, and people with no prior history of alcoholism – through a series of exercises to compare their balancing abilities. The recently sober group, as expected, did worse in all tests, but it was also found that those who had been sober for several years still performed significantly worse than non-drinkers when completing tasks where their eyes were closed. This clearly indicates that, while there is a marked improvement for those who have been recovering from alcohol addiction longer, their drinking history still has an impact on the way their brain functions.
The effects of alcohol addiction are not just limited to the brain. Long-term alcohol abuse can also have a detrimental impact on the body of the drinker, from the heart and lungs to the digestive system and kidneys. Heart attacks, strokes, and long lasting high blood pressure (known as hypertension) are all associated with excessive daily drinking, as are alcoholic lung disease and gout.
As you can see above, the list of possible illnesses excessive alcohol abuse contributes to is extensive, and liver problems are high among them. Cirrhosis is one such problem, caused by scarring and long-term damage to the liver that the body is left unable to repair. It can cause yellowing, itchy skin, a build up of fluid in the abdomen, and swollen legs as the liver stops being able to work properly. Alcoholic liver disease, alcoholic hepatitis, and liver cancer are also well-documented problems.
The International Agency for Research on Cancer classes alcohol as a “Group 1” carcinogen, meaning that there is clear evidence that it increases the likelihood of cancer developing. It has been linked with 3.6% of cancer cases around the world and 3.5% of deaths from cancer. As with the other negative health effects, alcohol-related cancers are hugely varied across the body. The likelihood of cancers in the head and neck increase with any alcohol consumption and moderate daily alcohol intake is linked with cancer in the lungs, breast, and stomach, among other organs.
Alongside the lethal potential of the illnesses associated with alcohol addiction, too much alcohol in one sitting can result in alcohol poisoning and even death. When an individual drinks their liver filters the alcohol out of the blood at a rate of about one unit per hour. Too much alcohol in a short space of time leaves the liver unable to keep up and the body begins to struggle. Initial signs of alcohol poisoning include slurred speech and vomiting but, as the body can take around 30 minutes to process the last drink, this can progress to unconsciousness even after they have stopped drinking. In severe cases, the body can shut down completely, leading to death. Risk of death is also present in the earlier stages of intoxication as the drinker could potentially choke on their own vomit, develop hypothermia, or become severely dehydrated.
While alcohol can initially seem like a social boost, lowering inhibitions and increasing confidence, the impact of addiction in the long term can break down family life and prevent the drinker from functioning in society. It can affect the user's mood and it has also been shown to hinder their ability to read social cues – such as facial expressions – meaning that the drinker is likely to struggle in social situations, leading to possible problems in their working life and relationships.
The addiction itself can cause further problems to the drinker and to those around them. Like other addictions, a dependence on alcohol requires the individual to keep consuming it to stave off the negative effects of withdrawal, meaning that it can quickly become a priority above other responsibilities. Choices between their tipple of choice and food for the family or a day at the pub and going to work can become harder as the addiction takes hold. This can result in job losses, strained relationships with family members, and increases the likelihood of domestic violence.
Children are among the biggest victims of the social impact of alcoholism. Marital relationships can breakdown when one or both partners are reliant on alcohol, leaving children in the centre of a divorce. As they are dependant on the adult in their life to provide food, clothing, and emotional support, a parent who prioritises alcohol may not be able to take care of their needs which will, in turn, affect the child's health and development. This can affect the child physically, through possible malnutrition or violence, and psychologically, as the child's mental health and confidence may be impacted. A parent's alcohol dependence may also lead to behavioural issues in the child and may impact their ability to succeed academically. If a parent is deemed unfit to look after their children, they may be taken into the care system rather than being raised within their family. Children who have grown up with alcohol addicted parents are also more likely to follow in their footsteps, descending into alcoholism themselves.
Alcohol, while not illegal in itself, is restricted to adults over the age of 18 and stores found to have sold to children under that age could face penalties, fines of up to £5000 for the first offence, and even the loss of their licence to sell alcohol. Licensing laws also state that it is illegal to knowingly sell alcohol to someone who is drunk, with possible prosecution and a fine of up to £1000 among the consequences for doing so.
As alcohol lowers inhibitions, it is also associated with a rise of violent or criminal behaviours. It's thought that over half of offenders in a violent incident were intoxicated. A significant portion of violent crimes also occur in or around a bar or a pub, implicating alcohol as a probable cause. In domestic situations research indicates that that between 25% and 50% of domestic abuse incidents involve alcohol, although some studies suggest that this number could be higher. Someone who is intoxicated is also far more likely to be the victim of violent actions against them, including sexual assault and rape. These are under-reported crimes but government figures suggest that the minimum number of alcohol related rapes is probably around 20, 000 every year.
While the number of fatalities related to drink driving have fallen since records began in the 1970s, there was still an average of 407 deaths due to drink driving in Great Britain every year between 2004 and 2014. In addition to drink driving fatalities, there were over 1000 serious and 6900 minor injuries in 2014 alone. There were 37, 853 convictions for drink driving in that year, with the majority (over 30, 000 of them) being perpetrated by men.
Much of the information above covers crimes conducted by anyone under the influence of alcohol, with no focus on alcohol addiction. It can be expected, however, that a number of individuals with an alcohol dependency will become part of these statistics while their reliance and intoxication continue. Alcoholism also increases the likelihood of crimes, such as theft, to finance their addiction.
A study by Macmillan Cancer Support found that the average Brit spend around £787 every year, with men spending more than women and with drinkers in the London area taking on larger bills. The biggest spenders are, as expected, those with an alcohol addiction that is negatively impacting their lives. Around 60% of alcohol sales – making an estimated £23.7 billion in England alone – is to those risking their health through their alcohol consumption or labelled as “harmful drinkers”.
The societal cost of alcoholism is also steep. According to Public Health England, the total annual cost of alcohol abuse on society is £21 billion. This includes £7 billion due to lack of productivity and job losses, along with £11 billion spent on dealing with alcohol-related crimes in England alone. Additionally, the health implications of long-term alcohol abuse mean that it causes a huge strain on our NHS, amounting to £3.5 billion annually. Health problems associated with alcohol, such as cirrhosis and liver disease, are thought to account for around 12% of all NHS spending every year.
Signs of Addiction
An addiction to alcohol generally builds up gradually over time. Like other drug addictions, the drinker can build up a tolerance to the effects and therefore more alcohol is needed to feel the effect. Their reliance on alcohol may not be noticeable to them until they start to feel withdrawal symptoms when they stop drinking. Alternatively, they may realise that they have developed a problem when they find themselves having to drink to face a particular problem or even to get up in the morning.
Someone who has developed an alcohol addiction may wish to conceal their behaviour, becoming secretive to evade the consequences of detection. They may disappear periodically or choose not to attend a social event so that they can continue their drinking habit. The financial costs of alcoholism can also mean that they have less money than they should or that money which should have been spent on something else is re-attributed to fuel their addiction. Their need to continue drinking can impact their career, resulting in disciplinary action at work or even loss of employment.
The physical signs of an alcohol addiction include many of the typical side-effects of excessive drinking that you might see at a work Christmas party but, instead of being once in a while, it may be an almost daily occurrence. The drinker's breath is likely to smell off and speech may be slurred or confused. Walking may be impacted by the balance problems associated with too much booze. As excess drinking can result in vomiting and nausea, an alcohol addict can become malnourished. Additionally, the drinker's moods may be changeable and they are likely to become more forgetful, potentially having blank spots in their memory or finding themselves waking up in an unknown location.
Withdrawal from alcohol can also cause significant and noticeable side effects. While a single heavy night can result in headaches and hang overs, when alcohol starts to leave the system of an individual with a long-term addiction it can cause intense withdrawal symptoms. This includes physical symptoms, such as shaking, sweating, and nausea, but there can also be severe mental symptoms. Along with mood swings, the drinker may begin to experience heightened anxiety or hallucinations. In extreme cases they can develop into Wernicke-Korsakoff Syndrome, where the lack of vitamin B that many chronic drinkers experience causes bleeding in the brain and psychosis.
As the effects of withdrawal can be so impactful, it is inadvisable for an alcohol addict to stop their drinking abruptly. A gradual decrease, with the support of medical professionals, to reduce their dependence is generally preferable. There are a wide range of support and treatment options available to anyone with an alcohol addiction to help them improve their relationship with drinking.
If the drinker is admitted to hospital because of their alcohol dependency, or if they are admitted for another reason but are expected to go through withdrawal during their stay, doctors are likely to first prescribe a high dose vitamin b and c injection in order to stave off some of the more dangerous side-effects. Patients who are expected to remain in hospital for a longer term may be provided with vitamin b supplements and medications like Disulfiram, which causes a negative reaction such as vomiting or chest pain when alcohol is consumed, as medicinal supports to help the drinker abstain. Medications to assist the path to sobriety may also be an option for alcohol addicts outside of hospital but these are likely to be well-controlled.
Counselling may be recommended to treat the addictive behaviours or mental health issues associated with the alcohol dependency. Cognitive Behavioural Therapy, a talking therapy which focuses on encouraging the individual to adjust thought patterns and identifying the triggers that lead them to drink, and family therapy sessions, to discuss the wider impact of the drinker's dependence, are both possible treatment pathways. The drinker may also be directed to alcohol support groups in their local area and they are likely to be given advice about how to change their lifestyle to better suit an alcohol-free experience. A drinking diary – noting the whens, wheres, and whats of their alcohol lives – can be used both alongside these options or as an individual to help identify just how much alcohol they are consuming and what may be causing them to drink.
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