Problem drinking
 
Research has shown that drinking alcohol in moderate amounts has some health benefits for some people. For example, for men aged 40 and over, and for women after the menopause, there is evidence that drinking 1 to 2 units of alcohol per day - but no more - can protect against the risk of coronary heart disease.
 
Recommended daily limits
 
Recommendations suggested that men should drink no more than 3 to 4 units per day and women no more than 2 to 3 units per day. These are guides, not targets, so drinking 'up to the limit' every day is not recommended. Nor should the units not be 'saved up' over the week and used to binge on the weekend.
 
Strength and units
 
The strength of an alcoholic drink is indicated by the percentage of 'alcohol by volume' (ABV). Whisky, for example, is generally 40% ABV, so, in a given volume of whisky, 40% is pure alcohol. Ordinary strength lager is around 3.5% ABV, wine is typically 12%.

A 'unit' is 8 grams of pure alcohol, regardless of the amount of liquid it's contained in. The number of units in one litre of any drink is equal to the ABV. So, a 500ml (half-litre) can of 9% ABV lager contains 4.5 units.

One unit is equal to:
  • About half a pint (284ml) of ordinary strength lager, beer or cider
  • A 25ml pub measure of spirit or a small glass of fortified wine such as sherry or port (40% ABV)
  • A small glass (125 ml) of 9% ABV wine

The following table illustrates the unit content and the link to daily limits in more detail:
Type of Drink Units per drink Daily Limit for Men Daily Limit for Women
Super-strength lager 9% 1 can (440ml) = 4 units 1 can Half a can
Standard beer/lager 3.5% 1 pint = 2 units 2 pints 1.5 pints
Low alcohol lager 1% 1 can (275ml) = 0.3 units 13 cans 10 cans
Gin 37.5% 1 drink (25ml) = 1 unit 4 drinks 3 drinks
Wine 12% 1 glass (125ml) = 1.5 units 2.5 glasses 2 glasses
 
Problem drinking and alcohol dependence
 
When consumed frequently or in large quantities, alcohol is addictive. The World Health Organisation recognises alcohol dependence (alcoholism ) as a disease.

A person is considered to be dependent on alcohol when three or more of the following symptoms have been present during the previous year:
  • a strong urge to drink
  • difficulty controlling drinking
  • physical withdrawal symptoms (eg: sweating, shaking, agitation and nausea) when alcohol intake is stopped or reduced
  • growing tolerance to alcohol (needing larger quantities to create the same effect)
  • gradual neglect of other activities
  • persistent drinking even though it is obviously causing harm

Problem drinking (also called 'harmful drinking') applies when a person is not dependent on alcohol, but drinks enough to cause actual physical or psychological harm - ie: more than the recommended daily limits mentioned above.
 
What are the physical effects of drinking too much?
 
The short-term effects
Alcohol suppresses the part of the brain that controls judgement, resulting in a loss of inhibitions. It also affects physical co-ordination, causing blurred vision, slurred speech and loss of balance. Drinking a very large amount at one time ('binge drinking') can lead to unconsciousness, coma, or even death. Vomiting while unconscious can lead to death by asphyxiation.

The long-term effects
Alcohol is a poison. Even if a person rarely gets 'drunk' to the point of intoxication, drinking too much alcohol, too often, will damage the organs of the body, increase the risk of getting some diseases, and make others worse. Excessive drinking over time is associated with:
  • loss of brain cells
  • liver damage
  • gastritis and stomach bleeding
  • high blood pressure (which can lead to stroke)
  • certain cancers
  • nerve damage
  • heart failure
  • epilepsy

Excessive drinking has also been linked to vitamin deficiency, obesity, sexual problems, infertility, muscle disease, skin problems, and inflammation of the pancreas.
 
Alcohol and women
 
Women have less fluid in their bodies than men, so a woman who drinks the same amount as a man of the same size will get intoxicated faster, because the alcohol in her body will be more concentrated. Women can develop liver disease at lower levels of drinking than men.

Women who drink heavily during pregnancy are at risk of having babies with a condition called Foetal Alcohol Syndrome (FAS), which includes growth deficiencies, nervous system problems, lowered IQ and facial abnormalities. There is some evidence that pregnant women who drink more than 10 units a week are more likely to have underweight babies. It is not known if there is an absolutely safe limit for drinking during pregnancy, but one unit per day is generally agreed to incur a very low risk.
 
What are the psychological effects of drinking too much?
 
Although alcohol initially makes people feel relaxed, it can ultimately increase anxiety. It is also related to problems with sleeping, mood swings, self-harming behaviour, violence and depression (many suicide attempts are thought to involve alcohol).
 
Cutting down
 
Keeping a 'drinking diary' that notes how much alcohol is consumed within a week - and where - will reveal whether drinking is within safe guidelines and highlight the situations that need to be avoided in order to cut down. Tips that may help with cutting down are to:
  • go out later; have the first drink later
  • replace some drinks with non-alcoholic or low alcohol drinks
  • replace the 'usual' drink with one containing less alcohol
  • miss out the 'quick drink' at lunchtime or after work
  • have a minimum of two alcohol-free days per week
  • do something other than going to the pub
  • choose longer drinks, such as beer, and drink more slowly
  • buy beers and wines with lower alcohol content
  • set a limit of, for example, 5 units for any one occasion
  • use a standard drinks measure or smaller glasses at home
  • keep a supply of non-alcoholic drinks at home
  • find alternative ways to relax
  • avoid drinking on an empty stomach
 
What help is available for those who need to stop drinking?
 
Counselling and support groups
Confidential advice and support is available through GPs, and may involve a community alcohol team or specialist consultant care.

Medication
To reduce withdrawal symptoms, medication such as Valium may be prescribed for a few days at a time.

There are two drug treatments that may be used to prevent relapse:
  • Disulfiram, which causes very unpleasant effects if even a small amount of alcohol is consumed (and severe, occasionally life-threatening effects if a large amount of alcohol is consumed)
  • Acamprosate, which influences transmitters in the brain and reduces the craving for alcohol. It may have side-effects such as headache diarrhoea and rash

People with chronic alcohol dependence are often malnourished. If this is the case, vitamin supplements may also be prescribed.
 
Further information
 
Alcoholics Anonymous Hong Kong
Address: G/F, 12, Borrett Road, Mid-levels, HK
Tel: (852) 2522 5665
http://www.hkaa.homestead.com/

Alcohol Concern
The national umbrella agency for 500 local agencies tackling alcohol problems and offering help to drinkers, their friends and families. Provides an information service including an enquiry service by phone, e-mail and post, a library, a bookshop, a series of 30 factsheets, and quarterly bulletins.
Address: Alcohol Concern, Waterbridge House, 32-36 Loman Street, London SE1 0EE.
Tel: 020 7928 4644
E-mail: contact@alcoholconcern.org.uk (please include your postal address with all enquiries )
Website: http://www.alcoholconcern.org.uk/

The Portman Group 'Unit Calculator'
Website: http://www.portman-group.org.uk/
 
Healthwise (Health Information Resource Centre)
Tel : (852) 2849 2400
Fax : (852) 2849 2900
Email : info@healthwise.org.hk
Homepage : http://www.healthwise.org.hk/

This leaflet is for information only. For a detailed opinion or personal advice, please consult with your own doctor
 
 
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