Alcohol-Facts.pdf - NHS Borders

A guide to responsible drinking

ALCOFACTS( )

iHealth

Scotland

1157-HS Alcofacts 09new:115726 10/3/09 17:12 Page 1

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what is alcohol?Alcohol is part of our culture. Many of us drink alcohol on all sorts of

occasions and for all sorts of reasons. A small amount of alcohol does littleor no harm and can be enjoyable.

This booklet explains what you need to know about alcohol, and how, for

those who choose to drink/consume alcohol, to drink it responsibly.

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What is alcohol?Before you can make decisionsabout your use of alcohol, you needto know the facts. Alcohol maymake you feel lively and talkative,and small amounts may make youfeel relaxed, but:

• alcohol is a depressant drug

• alcohol can make you aggressiveand argumentative

• drinking large amounts on asingle occasion could lead to acoma and even death

• alcohol dehydrates the body andlowers blood sugar levels

• alcohol is associated with arange of physical and mentalhealth risks, as well as being afactor in a variety of social harmissues, for example, communityproblems, drink driving, fatalfires, violence and crimes.

Why do we drink alcohol?• ‘I like the taste.’

• ‘It helps me to relax.’

• ‘You need alcohol to make aparty go with a swing.’

• ‘I like alcohol to celebratesomething.’

• ‘It’s part of our culture;weddings, parties, and wherewould our communities bewithout pubs?’

• ‘I need a drink after a hardday’s work.’

• ‘Drinking helps me to feel lesslonely and bored.’

• ‘I like a drink after a game.’

• ‘It’s sociable; I like it.’

• 'It helps me block out/forget myfeelings.'

Alcohol is part of a way of life for most people. It can be enjoyable.It can help us to socialise and celebrate. But there is a downside.

Drinking too much can cause serious conditions which can be fatal.There were 2,365 alcohol-related deaths, and 1,399 deaths inwhich alcohol was the underlying cause, in Scotland in 2007.


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Facts and figures aboutalcohol in Scotland:

• 65% of people questioned see alcoholabuse as a big social problem

• 43% of people questioned report thatother people being drunk or rowdy ina public place has an effect on theirown quality of life

• 42,430 alcohol-related dischargesfrom general hospitals (involving28,586 patients) took place inScotland in the year 2007–2008

• 6,702 offences of drunkenness wererecorded in the year 2007–2008

• A recent audit found that alcohol wasa contributory factor in 11% of allA&E attendances; 70% of assaultsattending A&E are estimated to bealcohol-related

• 22% of the accused in homicidecases in 2007–2008 were drunk, anadditional 14% were drunk and ondrugs at the time of the allegedoffence, and only 13% were reportednot to have been under the influenceof either alcohol or drugs

• 49% of prisoners in Scottish prisonssaid that they were drunk at the timeof their offence

• 63% of men and women who hadexperienced partner abuse/forceinvolved the perpetrator having beendrinking on at least one occasion.


alcohol consumption( )Alcohol consumptionhas a cost to thetaxpayer and to theeconomy.• Every year alcohol misuse costsNHS Scotland over £405 millionin treatment.

• Every year, the total cost ofalcohol misuse in Scotland isestimated to be £2.25 billion,taking into account costs to NHSScotland, social work services,criminal justice and fire services,wider economic costs andhuman/social costs.

If you drink at all, you are affectedby alcohol. Generally, if you drinkmoderately and not too often, therisks are very small.

• So what does drinking ‘a little’mean?

• What is 'in moderation'?

• How much is responsible?

• What are the limits?

• How can you tell how much youare drinking?

The amount of pure alcohol in adrink is important. Different drinkscontain different amounts ofalcohol. They are measured inUNITS and one unit can varydepending on the size of themeasure or the percentage volume.Percentage volume of alcohol hasincreased in recent years, andspirits and wine in particular areoften sold in pubs in largermeasures than in the past. Theamount you may pour for yourselfwhen drinking at home may bedifferent from this amount – oftenmore.

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How many units in your drink?

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Remember

DRINK

1 standardglass wine

1 pint normalstrength

beer/lager/cider

1/2 pint strongbeer/lager/cider

Spirits(whisky, gin, vodka)

Spirits(whisky, gin, vodka)

Fortified wine (sherry,martini, port)

Wine

Wine

Wine

Beer, lager or cider(normal strength)



Beer, lager or cider(medium strength)



Beer, lager or cider (strong)



Alcopops/coolers

Usual/average size ofmeasure 25ml (singlepub measure)

35ml (usual Scottishsingle pub measure)

50ml (small glass)

125ml glass

175ml (usual current‘small’ or ‘standardglass’ pub measure)

250ml (current ‘largeglass’ pub measure)

Half pint (284ml)

Small can/bottle(330ml)

Large can/bottle(440ml)

Half pint (284ml)

Small can/bottle (330ml)

Large can/bottle (440ml)

Half pint (284ml)

Small can/bottle (330ml)

Large can/bottle (440ml)

Bottle (275ml)

40.0% abv

40.0% abv

17.0% abv

12.5% abv

12.5% abv

12.5% abv

4.0% abv

4.5% abv

4.5% abv

5.0% abv

5.0% abv

5.0% abv

6.5% abv

6.5% abv

6.5% abv

5.0% abv

1.0

1.4

0.9

1.6

2.2

3.1

1.1

1.5

2.0

1.4

1.7

2.2

1.8

2.1

2.9

1.4

USUAL/AVERAGE SIZEOF MEASURE

USUAL/AVERAGEPERCENTAGE VOLUME UNITS

= = =

Information based on the Office of National Statistics data

2 small pubmeasures ofspirits

= 2 units


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What are the responsible drinking limits?You can work out how much you drink, and stay within your limits, bycounting up the units. In general, drinking in moderation (withinresponsible drinking guidelines) is unlikely to be hazardous to health.Drinking more than this, however, carries a progressive health risk aswell as risks associated with occasional episodes of excessive drinking.The guidelines for responsible drinking, based on maximum units ofalcohol, are based on this and are as follows:

know your limit!( )

MenNo more than 3–4 units in a dayand no more than 21 units in aweek, with at least two alcohol-freedays each week.

WomenNo more than 2–3 units in a dayand no more than 14 units in aweek, with at least two alcohol-freedays each week.

The daily guidelines are veryimportant due to the health andother effects of excessive drinking.Remember – tolerance does notprotect from harm.

If you are pregnant or trying tobecome pregnant, you should notdrink any alcohol at all. There is noknown safe level of alcoholconsumption in pregnancy.

If you are breastfeeding, it isimportant to limit the amount ofalcohol you drink to no more than1–2 units once or twice a week.


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There are situationswhen you definitelyshould not drink:

• before you plan to drive orwhen you drive

• before or when you areoperating machinery,mechanical equipment orelectrical equipment

• when you are at work

• before or during swimming orother active sports

• if you are taking certainmedicines, because the effectsof alcohol can be verydangerous if mixed with otherdrugs – check with your doctor

• if your doctor advises you notto drink at all.

General adviceIf you drink within responsible drinkingguidelines, there is unlikely to be any significanthealth risk. However, the effects of alcohol buildup through drinking too much over time as wellas from drinking too much in one episode. It'simportant to know that most people who sufferfrom alcohol-related health problems are thosewho drink heavily – at or above responsibledrinking levels – over time, or have frequentepisodes of drinking at or above this level.Tolerance does not protect you from harm.

Problems which can result from prolonged use ofalcohol can include:• weight gain• skin problems• sexual difficulties and fertility problems• a range of physical and mental healthproblems outlined later in this booklet

• family and work problems.

There is some research which suggests that, inmiddle-aged people who drink already, theremay even be some benefits from drinking smallamounts, for example in the prevention ofcoronary heart disease. For middle-aged men,drinking one or two units of alcohol a day mayhelp prevent this disease and for women,drinking one or two units of alcohol a week mayalso be beneficial as coronary heart disease ismore common in post-menopausal women.However, a non-drinker should not start drinking,or an infrequent drinker increase their drinking,simply to benefit their heart. There are otherstrategies which have fewer harmful side effects,and drinking large quantities outweighs anybenefits.

See section Women and drinking for details ofdrinking alcohol when pregnant andbreastfeeding.


Recent statistics show that about 1,060 people are injured and 50 peopleare killed in Scotland every year as a result of drinking and driving. Onaverage, 740 accidents in Scotland each year involve the driver/rider havingan illegal alcohol level. (These figures are 2002–2006 averages).

Recent statistics show that there were 10,697 drink-driving offences inScotland in the year 2007–2008.

drinking and driving( )

What is the legal limit?UK law says that it is an offence todrive with more than 80 mg ofalcohol in every 100 ml of blood,but the level in most Europeancountries is 50 mg.

But how does drinkaffect you?There is no simple answer to thisquestion. How alcohol affects youdepends a lot on your age, gender,whether or not you have eatenanything and if you are taking otherdrugs. It’s best just not to drink at allif you are going to drive.

Can you tell if you aresafe to drive?You can’t. Alcohol affects yourmind. It makes you feel moreconfident, so you are less likely tomake a balanced decision aboutwhether or not to drive. It also

reduces your inhibitions so youmay be more likely to take risksand to react violently when youare driving.

How does alcoholaffect driving?Alcohol slows down the brain andso:

• your ability to concentrate isreduced

• your ability to judge speed anddistance, and to deal with theunexpected, is impaired

• your reaction time is slower

• your vision and awarenessbecome blurred, especially in thedark

• you can lose muscle control andcoordination.

All this means that you are farmore likely to have an accident.

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It’s important to remember

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Drinking and driving doesn’t just affectyou – you can cause untold damage toother people’s lives. Only time canclear the bloodstream of alcohol.

Attitudes towards drinking and drivinghave hardened over the years. Massmedia campaigns have been used toreinforce the anti-drink drivingmessage, and evidence suggests thatpublic tolerance of drink-driving hasbeen steadily declining. For example, 4out of 5 people believe that you shouldnot be allowed to drink any alcoholbefore driving. Drinking any alcoholcan, in fact, reduce or impair yourability to drive. This has been reflectedin harsher legal penalties beingawarded for drink-driving offences.

Remember that you might still be overthe limit the morning after a heavybout of drinking.


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Why are responsibledrinking limits differentfor women?Women are more readily affectedby alcohol than men.

The body can be divided intowatery and fatty areas.Proportionally women have lesswater and more fat than men andalcohol is absorbed into the wateryareas. Women will usually getdrunk faster than men do on thesame amount. Women will alsofeel the effects for longer and aremore likely to risk liver damagewith heavy drinking.

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If you are pregnant orbreastfeeding...As there is no known safe level ofalcohol consumption in pregnancy, ifyou are pregnant or trying to becomepregnant, you should not drink anyalcohol at all.

• Even small quantities of alcohol canharm your baby, because alcoholpasses from your bloodstream to thebaby, across the placenta.

• It's not just mothers with a seriousdrink problem who risk having a babywith fetal alcohol spectrum disorder(FASD). FASD can include physical,behavioural, emotional and learningabnormalities due to damage to thebrain and central nervous systemcaused by the mother drinking duringpregnancy. Even small quantities maycause harm to babies (as there is noknown safe level) and FASD iscompletely preventable by avoidingalcohol during pregnancy.

• When you drink, small amounts ofalcohol pass into your breast milk. Forthis reason, it is important to limit theamount of alcohol you drink to nomore than 1–2 units once or twice aweek. Drinking more than this canaffect the baby's development andcause feeding, sleeping and digestingproblems. Alcohol can also affect yourmilk supply. If it's a special occasionand you know you are going to have adrink, consider expressing your milk inadvance. To be on the safe side, youmay want to avoid alcohol altogetherwhile you are breastfeeding.


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”Why do young peopledrink?• ‘It looks grown up.’• ‘All my mates drink, so I wantto join them.’

• ‘It’s fun; you have to take risks,don’t you?’

• ‘There’s nothing else to doround here.’

• ‘It relaxes me for sex.’

What do we knowabout young peopleand drinking?Young people in Scotland reporthigher levels of drinking anddrunkenness than in other parts ofEurope.

Most young people drink alcoholwithout experiencing serious harm.However, there are risks for youngpeople under the influence ofalcohol.

Young people of both sexes aremore likely to suffer the effects ofalcohol because most won’t beused to drinking. They are morelikely than others to haveunplanned and unprotected sex,thus risking pregnancy or sexuallytransmitted infections. Drinking is

also associated with sexual assaultand rape.

Accidents are the major cause ofdeath among young people andalcohol is estimated to be acontributory factor in 20–30% ofall accidents.

Young, inexperienced drivers areover-represented in deaths fromdrink-driving. Nearly one-third ofpedestrians aged 16–19 killed inaccidents had been drinking.

What about alcopops?There are many flavoured alcoholicdrinks available in the UK. Manyhave an alcohol content which isstronger than most beers – someof them are much stronger. As thesweetness of these drinks makes itdifficult to taste and judge thealcoholic content, they provide aneasy introduction to alcohol foryoung people.

The producers of alcopops arguethat they are aiming at 18- to 25-year-olds. Findings from somesurveys suggest that the increasein drinking by those 16 years andunder – particularly young women– is partly accounted for by theintroduction of alcopops on to themarket.

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Some new legislation onalcohol is coming into force in2009. Also, a consultation onalcohol, including thelegalities, has recently beencompleted by the ScottishGovernment which may resultin further changes inlegislation. Currently it isagainst the law:

• for a person under 18 todrink alcohol in a bar

• for a licensee to sell alcoholto a person under 18, withthe exception that youngpeople over 16 can buybeer, wine or cider with ameal in a room or an areaused for meals in a publichouse or hotel.

From 2009, all young peoplemust provide proof of age in alllicensed premises beforebeing served. It will beillegal for people under 18to buy or be sold alcohol inany circumstances otherthan when eating a meal inlicensed premises. Buyingalcohol for anyone under 18commits an offence punishableby a fine and/or prison sentence.

In some areas, by-laws existwhich ban anyone from drinkingin the street.

What is the law on youngpeople and drinking?


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effects of alcohol )Immediate effects:• nausea• vomiting• headaches• hangovers (including tiredness,inability to concentrate and moodcontrol problems)

• accidents and getting into fights• risk of death through accidents,through acute alcohol poisoning, orthrough inhaling vomit while youare unconscious.

Effects on mental health caninclude:• anxiety• insomnia• depression• attempted suicide• suicide.

Social and community leveleffects:• criminal damage• unwanted pregnancy• family arguments• child neglect• child abuse• domestic violence.

Long-term effects:Drinking can cause serious damage.Your liver can only burn one unit inone hour. If it has to cope with toomuch over a number of years, it willbe damaged, for example, throughliver disease, hepatitis and/orcirrhosis. Most people who sufferfrom alcohol-related health problemsare those who drink heavily over anumber of years rather thanalcoholics.

Too much drinking canalso cause:• stomach disorders like ulcers andgastritis

• cancer of the mouth, throat andgullet

• brain damage• sexual difficulties• high blood pressure• muscle disease• increased risks of other illnesses,for example, breast cancer,coronary heart disease and stroke

• problems with the nervous systemlike pain in the legs and arms.

Effects on mental health caninclude:• suicide• personality changes• fits• depression and other mental healthproblems.

Social effects can include:• family problems• work problems.

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What about hangovers?Hangovers are caused byalcohol – it irritates thestomach and dehydrates thebody. The main problem is thatthe alcohol in your drink tendsto make the water move out ofthe cells in your body and moveinto the blood. Most alcoholicdrinks contain additives whichgive them their flavour, colourand taste. These additives addto the hangover. Different drinkscontain different levels ofadditives; vodka has very fewadditives, for example, whilered wine, port and brandy havelots.

Alcohol and weight gainAlcohol is loaded with calorieswhich go straight to thebloodstream. Heavy drinkers canbe overweight and yet sufferfrom malnourishment becausethey have replaced food withalcohol and are not gettingessential nutrients and vitamins.Alcohol can add to the problemsof diabetics.

One pint of beer or 1 large glassof wine or 1 alcopop = 200calories


Some questions to askyourself if you drinkalcohol regularly• How does drinking affect you?

• How does your drinking affect yourfamily, friends and others?

• How much does it cost you eachweek?

• How many units do you drinkeach day?

• Do you know the health risks ifyou drink more than therecommended responsible limits?

• What reasons would you give ifsomeone asked you why youdrank alcohol?

• Do you need to cut down?

• When you serve or offer drinksat home, do you have soft drinksor low-alcohol alternatives?

The following areresponsible drinkingguidelines for everyone• Drink and think in units.

• Keep a drinking diary for each dayof the week — it will help you tounderstand your own drinkingpattern.

• Pace yourself — enjoy a drinkslowly. You don’t have to join inwith every round.

• Alternate alcoholic drinks withwater or alcohol-free drinks.

• Try drinking low-alcohol andalcohol-free drinks.

• Not everyone drinks alcohol:it’s OK to say no.

• Treat yourself — if you manage tokeep to your limits!

• Have at least two alcohol-free dayseach week.

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effects of alcohol( )How alcohol affects you depends on your body weight, your gender, howquickly you drink, the length of time since your last meal, and whether or notyou are taking other drugs.


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Remember• Nearly all the alcohol youdrink will be burnt up bythe liver; the rest isdisposed of by either sweator urine.

• On average it takes aboutone hour for your body tobreak down one unit ofalcohol.

• Only time will sober you up– not coffee.

Have something to eatbefore you drink, and ifpossible, while you aredrinking. Alcohol isabsorbed in the stomach. Ifthere is food there already,it will provide a lining forthe stomach to lessen theirritation of alcohol on thestomach. To minimise thelikelihood of a hangover:

• follow the responsibledrinking guidelines

• don't mix drinks• stick to one unit per hour• have a pint of water asyour last drink.

Keep a glass of water besideyour bed to sip during thenight if need be.

Get help if you think thatyour drinking is slipping outof control – don’t be afraidto ask your doctor or otherhealth professional.

one hour per unit


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useful contacts( )If you are concerned about your own drinking or that of a family member,you can seek advice from your doctor or other health professional, or fromyour local alcohol advice centre.

NHS Health ScotlandWoodburn HouseCanaan LaneEdinburghEH10 4SGT: 0131 536 5500www.healthscotland.com

Resources are also available in libraries of local health boards and health promotion departments, contact your local NHS Board for details.

Alcohol Focus Scotland2nd Floor166 Buchanan StreetGlasgowG1 2LWT: 0141 572 6700www.alcohol-focus-scotland.org.uk

National charitable body concerned with all aspects of alcohol use and misuse in Scotland. There is a local network of councils on alcohol throughout Scotland.

Alcoholics Anonymous50 Wellington Street, Glasgow G2 6HJCentral services T: 0141 226 2214Helpline (24 hours) T: 0845 769 7555

Al-Anon Information CentreMansfield Park Building Unit 622 Mansfield StreetPartickGlasgowG11 5QPT: 0141 339 8884 Helpline (10am to 10pm)

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?useful contacts

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To work out the number of units of alcohol in a can or bottle,when this is not given on the label, follow these steps:

1. Multiply the % alcohol content by the volume of liquid.

2. Divide by: 100 if volume is stated in centilitres (cls) or;

3. Divide by: 1000 if volume is stated in millilitres (mls).

The result is the number of units of alcohol in the can orbottle, for example:

A 75 cl bottle of wine with an alcohol content of 11.5%;11.5 multiplied by 75 and divided by 100=8.8 units.

A 75 cl bottle of wine with an alcohol content of 14.5%;14.5 multiplied by 75 and divided by 100=10.9 units.

A 70 cl bottle of vodka at 40%;40 multiplied by 70 and divided by 100=28 units.


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www.healthscotland.com

Published by NHS Health Scotland.Alcofacts was first published by Health Promotion Wales.

This Scottish edition, with amendments, is published by permissionwhich is gratefully acknowledged.

Edinburgh OfficeWoodburn House, Canaan Lane,Edinburgh EH10 4SG

Glasgow OfficeElphinstone House65 West Regent StreetGlasgow G2 2AF

© NHS Health Scotland 2009First Published 1993Reprinted 1998, 2000, 2004, 2006, 2008, 2009

ISBN: 978-1-84485-324-3

NHS Health Scotland is a WHO Collaborating Centre forHealth Promotion and Public Health Development.


Documents

Alcohol-Facts.pdf - NHS Borders