Alcohol misuse

Introduction

Alcohol misuse means drinking excessively more than the lower-risklimits of alcohol consumption.

Alcoholconsumption is measured in units .A unit of alcohol is 10ml of pure alcohol, which isabout:

half a pint of normal-strength lager
a single measure (25ml) of spirits

A small glass (125ml) of wine contains about 1.5 units of alcohol.

Lower-risk limits

To keep your risk of alcohol-related harm low, theNHS recommends:

not regularly drinking more than 14 units of alcohol a week
if you drink as much as 14 units a week, it's best to spread this evenly over three or more days
if you're trying to reduce the amount of alcohol you drink, it's a good idea to have several alcohol-free days each week

Regular or frequent drinking means drinking alcohol most weeks. The risk to your health is increasedby drinking any amount of alcohol on a regular basis.

Risks of alcohol misuse

Short-term

The short-term risks of alcohol misuseinclude:

accidents and injuries requiring hospital treatment, such as a Head injury, minor
violent behaviour and being a victim of violence
unprotected sex that could potentially lead to unplanned pregnancy or sexually transmitted infections (STIs)
loss of personal possessions, such as wallets, keys or mobile phones
alcohol poisoning this may lead to vomiting, seizures (fits) and fallingunconscious

People who binge drink (drink heavily overa short period of time) are more likely to behave recklessly and areat greaterrisk of being in an accident.

Long-term

Persistentalcohol misuse increases your risk ofserious health conditions, including:

heart disease
stroke
liver disease
liver cancer and bowel cancer
mouth cancer
pancreatitis

As well as causing serious health problems, long-term alcohol misuse can lead to social problems, such as unemployment, divorce, domestic abuse and homelessness.

If someone loses control over their drinking and has an excessive desire to drink, it's known as dependent drinking (alcoholism).

Dependent drinking usually affects a person's quality of life and relationships, but they may not always find it easy to see or accept this.

Severely dependent drinkers are often able to tolerate very high levels of alcohol inamounts that would dangerously affect or even killsome people.

A dependent drinker usuallyexperiences physical and psychological withdrawal symptoms if they suddenly cut down or stop drinking, including:

hand tremors "the shakes"
sweating
seeing things that aren't real (visual hallucinations )
depression
anxiety
difficulty sleeping (insomnia)

This often leads to "relief drinking" to avoid withdrawal symptoms.

They'll be able to discuss the services and treatments available.

Your alcohol intakemay be assessed usingtests, such as:

the Alcohol Use Disorders Identification Test (PDF, 224kb) a widely used screening test that can help determine whether you need to change your drinking habits
the Fast Alcohol Screening Test a simpler testto check whether your drinking has reached dangerous levels
the Severity of Alcohol Dependence Questionnaire this helps identifyhow severely dependent on alcohol you may be

As well as the NHS, there are a number of charities and support groups across the UKthat provide support and advice for people with an alcohol misuse problem.

For example, you may want to contact:

Alcohol Concern runs the national drink helpline, Drinkline on0300 123 1110
Alcoholics Anonymous helpline 0845 769 7555
Al-Anon Family Groups helpline 020 7403 0888

For a full list of charities and support groups, seeour page on alcohol support .

Treating alcohol misuse

How alcohol misuse is treated depends on how much alcohol a person is drinking. Treatment options include:

counselling including self-help groups and talking therapies, such as cognitive behavioural therapy (CBT)
medication
detoxification this involves anurse or doctor supporting you to safely stop drinking; this can be done by helping you slowly cut down over time or by giving you medicines to prevent withdrawal symptoms

There are two main types of medicines to help people stop drinking. The first is to help stop withdrawal symptoms, and is given in reducing doses over a short period of time. The most common of these medicines is chlordiazapoxide (Librium).

The second is a medication to reduce any urge you may have to drink. The most common medications used for this are acamprosate and naltrexone. These are both given at a fixed dose, and you'll usually be on them for 6to 12 months.