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Medical effects

  Medical effects of long term alcohol misuse and alcohol-related illnesses

Research shows that excessive drinking can damage most organs and body systems:

• Brain - heavy drinkers suffer brain shrinkage (loss of brain cells) and even moderate drinking may affect brain function
• Liver - heavy drinking can cause fatty deposits in the liver, eventually leading to cirrhosis. A liver damaged by alcohol cannot process the nutrients in food or eliminate toxins from the blood
• Stomach - alcohol is a common cause of gastritis and stomach bleeding
• Blood and heart - alcohol is an important cause of high blood pressure (hypertension), itself a cause of strokes
• Cancer - excessive drinking doubles the risk of cancer of the gullet, trebles the risk of cancer of the throat and quadruples the risk of cancer of the voice box. There is evidence that it can increase the risk of breast cancer
• Nervous system - drinking large amounts can cause nerve pains or tightening in the arms and legs

Other problems such as vitamin deficiency, obesity, sexual difficulties and infertility, muscle disease, skin problems and pancreatitis have all been linked to excess alcohol consumption.

Additional risks for women
Women are more susceptible to some of the long-term effects of alcohol and can develop liver disease at lower levels of drinking than men. Several studies have suggested a link between alcohol and breast cancer. A recent research review found that a woman’s relative risk of breast cancer increased by 6% for each additional unit regularly consumed per day.

In other words, the incidence of breast cancer by age 80 is estimated to increase from 8.8 per 100 non-drinking women to 9.4 and 10.8,11.6, 12.4 and 13.3 respectively per 100 women consuming an average of 1,2,3,4,5 and 6 units of alcohol a day.

Development of the foetus in pregnant women
During pregnancy alcohol from the mother’s bloodstream crosses the placenta and is taken up by the developing baby. The foetus is most sensitive to alcohol during the earliest stages of pregnancy, when the complex organs and nervous system are being formed. The Department of Health advises women who are pregnant or who are trying to get pregnant to drink no more than 1 - 2 units of alcohol per week. In the USA, the Surgeon General has been more cautious and has recommended that women do not drink at all during pregnancy or when they are intending to get pregnant.

Low birth weight
Research indicates that consumption of more than 10-15 units a week will result in a higher chance of giving birth to an underweight baby.

Miscarriage
Research in this area is as yet inconclusive. While it is certain that drinking while pregnant can cause miscarriage, the level at which drinking becomes a danger is disputed. Some studies conclude that the risk of miscarriage is increased in women drinking 1-2 units a day, while others report that the risks are only increased at higher levels of consumption.

Foetal alcohol syndrome / foetal alcohol spectrum disorder
Foetal alcohol syndrome (FAS) is the name given to a group of difficulties seen in the babies of very heavy drinking mothers, usually with identifiable drinking problems. Symptoms include: growth deficiencies, central nervous system defects, lowered IQ and facial malformations. There is greater uncertainty about the impact of smaller or less frequent alcohol exposure, although research suggests that no level of drinking is risk-free in pregnancy. The term foetal alcohol spectrum disorder (FASD) has recently been introduced as not all of the above symptoms are present in all cases and they can vary in their severity. Cases of FASD can range from relatively minor to very severe, with FAS at the severe end of the spectrum.

Mental health
Despite initially helping to relieve tension, alcohol can actually heighten anxiety. It is also a factor in many cases of depression, and it is estimated that alcohol has been involved in about 65% of suicide attempts.

What of stories in the press about alcohol being good for you?
There has been a lot of media coverage about research indicating that alcohol may be beneficial by reducing the likelihood of coronary heart disease. This has caused confusion for the public, GPs and health advisers as to what constitutes safe drinking. When the government published its report on Sensible Drinking in 1995 there was additional confusion, as it was widely reported that the recommended drinking limits had been relaxed. The Department of Health made it clear that the report was not relaxing existing sensible drinking advice. The major changes were that the new guidance focused on daily, rather than weekly, levels and highlighted that, for some groups of people, small quantities of alcohol can help protect against heart disease. The health benefit from drinking alcohol only applies to men over 40 and women who have been through the menopause. And even then only moderate amounts of alcohol (one or two units a day) can provide protection against coronary heart disease. Drinking more than that does not give any additional benefit.

So what is safe drinking?
There really is no such thing as totally safe drinking.

The sensible drinking guidance recommends that men should drink no more than three to four units a day and women no more than two to three units a day. If you do drink more than the recommended daily limit, you should then have at least two days of non-drinking to let your body recover.

Men consistently drinking four units a day and women consistently drinking three units a day incur a progressive health risk. The more consumed above the benchmarks, the greater the risk of damaging your health.

These limits are daily benchmarks and don’t apply to women who are pregnant or planning pregnancy or to young people who are not fully-grown.

Drinking between 21 and 50 units per week for men, 14 and 35 per week for women exposes you to increased risk of ill health and the problems arising from drinking.

Above these levels people may already be suffering from ill health and are at serious risk of alcohol dependency.

What is an alcohol unit?
One unit is equivalent to 8g or 10ml (1cl) of pure alcohol. The number of units in an alcoholic drink can be calculated by applying the formula Volume (ml) x ABV divided by 1000. As a rough guide:

How much is a unit of alcohol? A pint of ordinary strength lager or beer (eg Carling) = 2.3 units A pint of strong lager (eg Stella Artois) = 3 units A standard 175ml glass of 12% wine = 2 units A single pub measure of spirits = 1 unit A 440 ml can of strong lager = 2.2 units A 275ml bottled alcopop (eg Bacardi Breezer, WKD) = 1.5 units The alcohol content of beers and wine vary quite a lot. With pubs and wine bars now frequently offering ‘large’ (ie 250cl) glasses of wine, one glass at 13% could contain over 3 units of alcohol. Drinks poured at home are often much larger than those served in a pub.