For National Alcohol Awareness Week. 15-22 November
There is no lack of awareness in our society about alcohol. But what is so often is lacking is the personal commitment to use that awareness to change our behaviours. As we approach National Alcohol Awareness Week 15-22 November, we look at our relationship with alcohol, compare the UK to global trends and address some of the more sobering facts as well as the positives of drinking less. We’re not saying ‘don’t drink’ but rather, drink more safely.
Our relationship with alcohol
Alcohol references are everywhere; in our day to day lives and on our TV screens. We talk about going out for a drink, being a ‘bit tipsy’, even planning entire evenings around where and when to drink. Those that would prefer not to drink are made to feel they are missing out on the fun and the recent health campaigns of ‘Dry January’ or ‘Stoptober’ are treated as something to ‘get through’. We drink when we are happy, we drink when we are down in the dumps. We celebrate success with a glass or two or three; we commiserate when something goes wrong with, guess what, another glass or two.
Despite many of us being aware of the long-term impact of alcohol abuse, or actually knowing someone who’s health has been adversely affected by alcohol, we still find it hard to treat alcohol consumption seriously and our attitude to our own drinking remains complex and contradictory. But there are encouraging signs that our alcohol awareness is beginning to slowly change our behaviours.
Changing attitudes to alcohol
We abhor drink-drivers, of course, but it took decades to bring in and enforce legal limits on driving and alcohol consumption. As late as the 1970’s some people would feel it acceptable to get behind the steering wheel knowingly over the limit. Never mind the dangerously inebriated journey home, their judgement seriously impaired. But today we still take risks, nearing that legal limit or hoping a heavy night’s drinking had shifted through our bloodstream in time for us to drive for work the next morning.
Changing the law, legislating against the dangers of excessive alcohol, and driving, was an unpopular move and social attitudes were slow to change but at long last that improvement has led to a predominantly responsible attitude to drink-driving for most people. The great danger, of course, is this may lead to complacency, hence the ongoing need for large-scale public health initiatives to keep driving the message home.
Alcohol consumption in the UK and global data
The UK consumption of alcohol is declining, albeit slowly and from a very high level. There are other countries in the world who consume more alcohol on an annual basis than the UK and in fact our own consumption levels, particularly among younger people, has declined during the last decade. In the fascinating statistics produced by the World Population Review [i] the top ten countries worldwide in terms of alcohol consumption per person at:
- Latvia (13.19 litres/year)
- Moldova (12.85 litres/year)
- Germany (12.79 litres/year)
- Lithuania (12.78 litres/year)
- Ireland (12.75 litres/year)
- Spain (12.67 litres/year)
- Uganda (12.48 litres/year)
- Bulgaria (12.46 litres/year)
- Luxembourg (12.45 litres/year)
- Romania (12.34 litres/year)
The UK was in the top quartile of alcohol consumption worldwide at an average of 11.45 litres per head per year. However, note a staggering difference in consumption levels between male (17.74 litres/year) and female consumption (5.4 litres/year). The wide gap between male and female consumption levels exists in all countries worldwide.
Globally, the total volume of alcohol consumed is up 70% from 1999 to 2017. Alcohol consumption increased the most in middle-income and low-income regions, such as China, India, and Vietnam; however, it decreased across Europe, which once had the highest consumption levels.
Alcohol and the pandemic
Attitudes and consumption levels are declining, particularly among younger people, but there were significant indications during COVID-19 that consumption levels for some groups, for example people over 65 had increased. What we may expect to see, therefore, is a continuation overall of the downward trend, but with some specific population groups continuing to indicate significantly higher than average levels.
That said, during the pandemic, research published by Public Health England (PHE) shows an increased consumption, particularly amongst heavy drinkers and this is driving an unprecedented acceleration in alcoholic liver disease deaths [ii] up by 21%. Other deaths from mental and behavioural disorders due to alcohol increased by 10.8% between 2019 and 2020 and deaths from alcohol poisoning increased by 15.5% for the same period.
PHE suggests that tackling harmful drinking must be an essential part of the COVID-19 recovery plan and that the new Office for Health Promotion will spearhead efforts to improve treatment. The findings echo data from the British Liver Trust who say that during the pandemic stress, loneliness and the lack of access to alcohol support services have resulted in many people drinking more alcohol and putting their livers at risk. 1 in 5 adults in the UK drink alcohol in a way that could harm their liver.
The dangers and risks of alcohol misuse
According to Mental Health First Aid England [iii] substance misuse is more common amongst adults with mental health issues than in the wider population. Many people use alcohol or drugs to relieve unpleasant emotions, but they can also cause problems in a person’s life (e.g., relationship, financial problems) and heavy use may exacerbate mental health issues.
Alcohol also makes people feel less alert and impairs concentration and coordination. Some people also use alcohol to reduce anxiety and other symptoms of mental ill health. In the short-term it may appear to help, and people can relax and lower their inhibitions, but it can cause alcohol intoxication and increase risks both in the short-term and long-term:
- Physical injuries – e.g., alcohol is a big contributor to road traffic accidents
- Aggression and anti-social behaviour which can lead to criminal activity
- Sexual risk taking or exposed to exploitation
- Suicide and self-harm – when a person is intoxicated they are more likely to act on suicidal thoughts or self-harm
- Alcohol dependence – people who regularly drink above the recommended limits or those who start drinking at an early age have an increased risk
- Depression and anxiety – alcohol is a depressant drug and can interfere with the central nervous system
- Social problems – family conflict, dropping out of education, unemployment, social isolation
- Physical health issues – liver disease, heart disease, stroke, and cancers, (especially liver, mouth, throat, larynx, and breast cancer in women), diabetes and weight gain.
The impact of excessive drinking is well known, and that awareness is beginning to lead to changes in behaviour, but very slowly. Meanwhile, the clinical impact is significant and continues to be one of the main contributors to ill-health and hospital referrals.
The benefits of drinking less
Doom and gloom, dire warnings and distressing personal stories do indeed raise our awareness but also often lead us feel guilty about our drinking rather than persuaded and strengthened to act. We need to focus as much on showing the benefits of drinking less, to raise awareness that longer periods free of alcohol drinking may improve our relationships, our finances, and our health. Raising awareness of those benefits should be an increasing focus for us all. Reducing our intake of alcohol can improve our health, boost our energy levels, help us to lose weight and save money i.e.
- Feeling refreshed when you wake up
- More energy
- Better-looking skin
- Lower blood pressure
- Lower risk of stroke, cancer, and liver disease
- Better mood and memory
- Helps to manage weight
- May well reduce personal expenditure and debt
- Improves relationships
In conclusion
We are now entering another season when the temptation or encouragement to drink more will be strong. Of course, it is a time to celebrate and to enjoy the company of our family, our friends, and our work colleagues and many will do so drinking safely. But, if you feel you could still party and get together without a glass of wine, gin, beer or lager in your hands – try it. You may be pleasantly surprised. And if you do want to start 2022 with a healthier outlook, there’s always Dry January – 6.5m took part this year via www.alcoholchange.org.uk
Help and Support
To find out if you are at risk take the British Liver Trust’s online quiz www.britishlivertrust.org.uk
Every Mind Matters – to get a Mind Plan https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/your-mind-plan-quiz/
Drinkline 0300 123 1110
Alcoholics Anonymous – https://www.alcoholics-anonymous.org.uk/
Alcohol Concern – www.alcoholconcern.org.uk
General advice can be found on the NHS website www.nhs.uk Better Health.
References
[i] https://worldpopulationreview.com/country-rankings/alcohol-consumption-by-country
[ii] Public Health England. 15 July 2021
[iii] Adult Mental Health: MHFA Manual
