Written by Josephine Fagan

Health

Alcoholism – why all the fuss?

According to Alcohol Concern, more than 10 million British adults are drinking more than the recommended guidelines, with an annual estimated cost to the NHS of £3.5 billion. Dr Josephine Fagan gives us the facts.

What is alcoholism?

The word alcoholism is usually used to mean alcohol-dependence or addiction. In the UK, two in every hundred women and six in every hundred men are alcohol-dependent.

How much can I safely drink?

• For women: 14 units per week, with no more than 3 units on any one day, and at least two alcohol-free days per week.
• For men: 21 units per week, with no more than 4 units on any one day, and at least two alcohol-free days per week

However, many experts believe there are no guaranteed ‘safe’ limits. One study has demonstrated an increased risk of developing certain cancers even with low daily alcohol intake. And even small quantities of alcohol can affect your driving skills.

What damage can alcohol cause?

Because alcohol is broken down by your liver, excessive drinking can cause scarring of the liver, or cirrhosis. This may take years to develop. Symptoms include nausea, itch, jaundice (yellowing of the skin), tarry stools, vomiting blood, and a buildup of fluid in the legs (called oedema) or the abdomen, (ascites). Every year, in the UK, cirrhosis kills approximately 4,000 people, and 700 will require life-saving liver transplants.

Any other associated health problems?

If you regularly drink more than the current guidelines, you are at increased risk of:

•Certain cancers of the throat, neck and mouth. Women are also 1.2 times more likely to develop breast cancer
•High blood pressure, an irregular heartbeat, or an enlarged heart.
•Injuries due to accidental harm, violence and road traffic accidents
•Brain damage, which can lead to Wernicke-Korsakoff Syndrome, (symptoms include memory and balance problems, confusion, hallucinations, and eye movement abnormalities).

Heavy drinking during pregnancy can result in babies with Foetal Alcohol Spectrum Disorder, which includes facial abnormalities, learning and behavioural difficulties.

What is problem (or harmful) drinking?

Problem drinkers continue to drink heavily, despite causing harm to themselves and others. They may be in debt because of their drinking. They may have lost a job, or their driving license, or had relationship problems.

Problem drinkers aren’t necessarily addicted to alcohol and could stop without developing withdrawal symptoms; studies indicate one in three can to return to sensible drinking without professional help.

What is alcohol-dependence?

For those dependent on alcohol, the craving for a drink may be hard to resist. Because their bodies are used to high levels of alcohol, they need more and more to feel its effects. They may get drunk regularly, or may never appear drunk because they drink small amounts often, to keep withdrawal symptoms at bay.

What are the withdrawal symptoms?

Nausea, trembling and even fits. These symptoms tend to pass off in five to seven days, although the craving for alcohol may persist.

• Delirium tremens is potentially more serious. The so-called DT’s usually begin two to three days after stopping alcohol and can affect one in twenty alcoholics. Symptoms include shakes (or tremors), agitation or confusion, during which they may see and hear things that aren’t real (delirium), and convulsions. In some cases, the condition can be fatal.

What treatments are available for alcoholics?

• GPs can help with some symptoms, and underlying conditions such as stress or depression. They may also recommend referral to a liver specialist, or another expert, depending on the state of health.

• Local specialist drug and alcohol teams may offer counselling, motivational therapy, cognitive behavioural therapy and / or detox, which involves taking progressively lower doses of prescription medication to help the body readjust to alcohol withdrawal.

How can an alcoholic stay sober?

• Detox can’t stop the drinking. Only willpower can do that.
• Talking therapies appear to help, especially with younger drinkers
• Self-help groups such as Alcoholics Anonymous can provide support
• NHS drug and alcohol teams can also provide ongoing support.

What’s the take home message?

• The more you drink, the more damage alcohol can do, so aim to drink less than the recommended so-called safe limits.
• If you or someone you care about has a drink problem, seek help.
But is it enough?
Families and friends of those with alcohol problems need support too.

According to Alcohol Concern:
• An estimated 2.6 million children in the UK are living with parents who are drinking dangerous amounts
• Approximately 700,000 people live with someone who is alcohol-dependent.

Here are some helpful websites:
www.alcoholics-anonymous.org.uk
www.al-anonuk.org.uk – includes link to Alateen for teenage relatives and friends of alcoholics, plus support for spouses and partners
www.nacoa.org.uk  – National Association for Children of Alcoholics
www.alcoholconcern.org.uk
www.nofas-uk.org National Association for Foetal Alcohol Syndrome UK

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Written by Josephine Fagan

Josephine works as a doctor in urgent and primary care. She’s also a bit of a globetrotter, is working on her first novel, and loves the colour purple.