Alcohol And heAlth
DYING FOR A DRINK
AN OVERVIEW OF THE DAMAGE DONE
The annual number of‘ alcohol-specific’ deaths in the UK currently stands at well over 7,000, while alcohol-related hospital admissions number more than a million. Alcohol may have become ingrained in our society but, clearly, it is a far from benign substance
Alcohol has been consumed by humans for thousands of years, and many people use it responsibly and without significant adverse effects. However, it is also an addictive psychoactive substance. According to the World Health Organization( WHO), alcohol consumption is a‘ causal factor in more than 200 disease and injury conditions’.
The UK government’ s revised guidelines for alcohol consumption, published in January 2016, state that‘ drinking any level of alcohol increases the risk of a range of cancers’ and recommend that men and women consume no more than 14 units of alcohol per week. A major international study published in The Lancet in April 2018 found the‘ minimum mortality risk’ to be around or above 100g of alcohol per week, or 12.5 UK units.
According to the latest figures from the Office for National Statistics( ONS) there were 7,327‘ alcohol-specific’ deaths in the UK in 2016, and while the death rate has remained unchanged for around three years it is still higher than 15 years ago. Using a‘ broad measure’ for alcohol-related hospital admissions – where an alcohol-related disease, injury or condition was either the primary reason for admission or a secondary diagnosis – there were an estimated 1.1m admissions in 2015-16.
In addition to the potentially serious acute effects of drinking a large quantity of alcohol on a single occasion, such as accidents, injury or alcohol poisoning, prolonged alcohol consumption can lead to a wide range of physical and mental ill health conditions, and can seriously damage many of the body’ s organs.
LIVER AND PANCREAS
As the human body metabolises most alcohol in the liver, this is the organ that is particularly at risk from alcohol consumption. Heavy drinking can lead to alcoholic fatty liver and liver inflammation, the scarring from which can cause cirrhosis and stop the organ from functioning properly. As the liver is a resilient organ, however, often no symptoms will manifest until the damage is at an advanced stage. Most cases of liver cancer are also associated with cirrhosis.
Heavy drinking can also cause the pancreas to become inflamed, a condition known as pancreatitis. Drinking too much alcohol can be a cause of both acute – short-term – and chronic pancreatitis, which is usually caused by years of excess alcohol consumption.
HYPERTENSION
Drinking too much alcohol is a cause of hypertension( high blood pressure), which is a risk factor for heart attacks, heart disease and heart failure, stroke, aneurysms, kidney disease and other conditions.
CANCER
Alcohol is also a risk factor for a range of cancers – as well as cancer of the liver these include cancers of the bowel, breast, larynx, mouth, oesophagus and throat. The body converts alcohol into acetaldehyde, which damages DNA and inhibits the ability of cells to repair themselves. Alcohol also increases the body’ s levels of hormones such as oestrogen – which have an effect on cell division – and makes it easier for the mouth and throat to absorb the carcinogenic chemicals in cigarettes.
MENTAL HEALTH
Alcohol is a depressant, which means that in the short term it can help to relieve stress and relax inhibitions, the latter making it appealing to some people with social anxiety issues. Regular drinking, however, can increase both anxiety and depression, meaning that people who drink as a form of self-medication can become trapped in a vicious circle.‘ Alcohol affects the chemistry of the brain, increasing the risk of depression,’ says the Royal College of Psychiatrists, while the anxiety that can accompany the physical symptoms of an alcohol hangover can lead people to drink more to feel‘ normal’ again – and so risk developing both mental health problems and alcohol dependency. Heavy drinking also increases the risk of self-harm or suicide, while dependent drinkers can be more prone to psychosis.
OLDER DRINKERS
While issues such as loneliness, retirement and bereavement mean older people may be more likely to drink at unhealthy levels, physiological changes also mean that alcohol can have a more detrimental effect
The UK has an aging population and much has been written about the habits of members of the‘ baby boomer’ generations, many of whom have grown up in a culture of heavy drinking. People aged 55-64 are currently the most likely to be drinking at‘ higher’ or‘ increasing’ risk levels, and are likely to continue these habits into older age. Of the‘ alcohol-specific’ deaths in the UK in 2016, most male deaths were in the 60-64 age range and most female deaths in the 55-59 age range. The alcohol-related death rate among men aged 70-74, meanwhile, has increased by around 50 per cent since 2001.
Retirement, boredom, bereavement, isolation and loneliness can all mean that older people may be likely to develop problematic drinking habits, but as people get older their bodies also start to process alcohol more slowly. This means that the effects can be more pronounced, and overall tolerance will be lower. As people age, the ratio of body water to fat decreases meaning there is less water to dilute the alcohol consumed, as well as decreased flow of blood to the liver and decreased liver enzyme efficiency. Slower reactions mean that older people are also at more risk of injuring themselves in alcohol-related falls or other accidents.
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