Am I drinking too much alcohol?

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Do I drink too much alcohol?
Written by Dr Dan Rutherford, GP

It can be hard for someone to tell exactly how much they normally drink. Accustomed drinkers are less aware of feeling drunk, so it may be a good idea to keep a diary of alcohol consumed over a period of time and make a note every time you have a drink.

What counts as a unit of alcohol?
# Half a pint (250ml) of average strength beer.
# 125ml glass of wine 8% ABV.
# One standard pub measure of spirits (25ml).
# 25ml of fortified wine, such as sherry or port.

Safe drinking

Present advice on safe drinking is:

* no more than two units of alcohol per day for women

* no more than three units per day for men

* you should have at least two drink-free days a week.

When drinking at home, people are almost always more generous, so it’s a good idea to get into the habit of using a spirit measure.

Staying within the ‘safe’ limits does not mean that a person is capable of driving a motor vehicle. When driving, it is best not to drink at all.

Advice for pregnant women

Pregnant women are advised to drink no more than one to two units of alcohol once or twice a week.

Heavy drinking during pregnancy can cause the baby to be born with a condition known as foetal alcohol syndrome (FAS).

FAS causes growth deficiencies, central nervous system defects, lowered IQ and facial malformations.

If I don’t feel drunk, I don’t have a problem - do I?

Alcohol tolerance can lead someone with a dangerously high consumption to be falsely reassured that as long as they don’t feel drunk, they will be fine.

The reverse is true.

Needing a lot of alcohol to get drunk proves that you are already drinking too much, too often.

Alcohol tolerance can be compared to a lack of the ability to feel pain. If you didn’t feel pain, you wouldn’t immediately remove your hand from a hot stove and notice it was burnt until it was too late.

If you have developed a tolerance for alcohol, you can no longer trust your body’s signals to tell you when you’ve had too much. Instead, you will have to keep count of drinks to know when you’ve drunk too much.

How do I reduce how much I drink?

A person who drinks too much may feel it is impossible for them to reduce their alcohol consumption.

If a drinking habit is very heavy, it is often hard work to reduce it - simply because it is always difficult to change habits. You may not even be sure whether you want to cut down.

Fortunately, there are many different ways to reduce alcohol consumption and most people are able to find a way that suits them.

A step-by-step guide to reducing alcohol consumption

Keep a record of all alcohol consumption. Work on ways to make it easier to reduce the alcohol intake.

Talking to a partner or friend could flag up some self-help ideas.

* I can stop drinking alcohol on weekdays.

* I can stop drinking alcohol during the day at work.

* I can substitute every second drink with water, non-alcoholic beer, coffee or a soft drink.

* I can take a different route home, so I won’t be tempted to visit a pub.

* I can visit my family instead of my drinking friends.

What if I can’t reduce my drinking by myself?

It may be difficult for a person to reduce their alcohol consumption without outside assistance. There are several places where it is possible to get help and counselling.

A GP will be able to help by:

* giving advice and drug prescription

* referring a heavy drinker to a counsellor or an organisation that can provide help, such as Alcoholics Anonymous.

Dedicated alcohol detoxification facilities are rare in the NHS, but there are several private units. These are expensive and it is unusual for the NHS to fund placement, but it does occur.

What about withdrawal symptoms?

For a very heavy drinker, stopping alcohol abruptly can be dangerous.

In addition to the anxiety that abrupt withdrawal can cause, a small proportion of people develop a potentially serious condition called delirium tremens (DTs). This can cause confusion and even convulsions.

Patients at risk of DTs are best managed by planned withdrawal from alcohol in hospital, along with supportive counselling and drug therapy to counteract the physical effects.

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