The health advisory body Nice has recommended a new drug, Nalmefene to help problem drinkers cut down on alcohol.
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Are you a problem drinker?
There are a number of questionnaires designed to tell you whether you’re drinking too much. The gold standard is called Audit – the Alcohol Use Disorders Identification Test.
It consists of 10 questions about boozing behaviour like: “How often during the last year have you been unable to remember what happened the night before because you had been drinking?”
A score of eight points or above puts you in the “at risk” group. As regular readers will know, government researchers have the used the cut-off point of 20 points to define people as “dependent drinkers”.
Other definitions of risky drinking simply use the alcohol consumption – counted in units – as the measure.
Alcohol dependence – which most experts seem to prefer to the term alcoholism – can be a slippery thing to pin down.
The charity Drinkaware defines it as “regular excessive drinking which has a more tangible negative effect on people’s lives” and stresses that there are different levels of dependency.
“If you find that you ‘need’ to share a bottle of wine with your partner most nights of the week, or always go for a few pints after work, just to unwind, you’re likely to be drinking at a level that could affect your long-term health. You could also be becoming dependent on alcohol.”
How much booze is in my drink?
Most questionnaires and surveys talk about units of alcohol, which can be difficult to visualise. One unit is 10ml of pure ethanol – the amount in a single pub measure of spirits in England.
FactCheck always thought a pint of beer or a glass of wine counted as two units, but it’s not as simple as that.
The popularity of premium lagers and large glasses of wine mean the units can creep up on you. A pint of 5 per cent beer and a large glass of wine can clock in at 2.5 units. A 250ml glass of 14 per cent wine contains a surprising 3.5 units of alcohol.
The best (rough) guide to units that we have seen is published by the Royal College of Psychiatrists:
How much is too much?
Government guidelines say men shouldn’t drink more than 3-4 units regularly (every day or most days). For women it’s 2-3 units.
The NHS and the Office for National Statistics define binge drinking as getting through double the recommended daily limit in one session. For men that’s eight units and just six for women.
Note that a man who drinks more than three pints of strong beer and a woman who necks two large glasses of strong wine are officially bingeing on booze.
Can’t booze be good for you?
There is evidence of moderate regular alcohol consumption reducing the risk factors of a number of conditions including heart disease and diabetes.
Harvard University’s School of Public Health gives an overview of some of the positive effects of moderate drinking, but says the potential health risks and benefits have to be balanced carefully and are different for different groups of people.
For a 30-year-old man, the increased risk of having an accident outweighs the cardiovascular benefits of moderate drinking.
For a 60-year-old man the heart-protective effects probably make moderate drinking worth it, but for a woman the same age it’s more complicated. Pregnant women and people with liver disease probably shouldn’t drink anything.
Are we drinking more?
ONS statistics suggest British adults have been drinking less since about 2005.
In 2012 In 64 per cent of men and 52 per cent of women drank at least once in the week before being interviewed, down from 72 and 57 per cent. People are drinking less frequently and consuming less in their heaviest session of the week.
OECD figures also show the total consumption of alcohol in the UK has been in decline since the mid-2000s.
But NHS statistics show that the numbers of alcohol-related hospital admissions and deaths are rising steadily.
And heavy drinking remains very common. Among adults who had drunk in the last week, 55 per cent of men and 53 per cent of women drank more than the recommended daily amounts.
Some 31 per cent of men and 24 per cent of women drank more than twice the recommended amounts and could be classed as binge drinkers.
Who is the new drug for?
Nice says Nalmefene could help an estimated 600,000 high-risk drinkers who may have become dependent on alcohol but do not have “physical withdrawal symptoms and who do not need immediate detoxification”.
Being “high-risk” is defined here as drinking more than 7.5 units a day for men and 5 for women. So a man polishing off three pints of Heineken or a woman drinking two large glasses of wine every day is potentially in the danger zone.
Only people who are drinking at this level two weeks after being assessed qualify. Nice guidelines say the drug should only be offered “alongside psychosocial support”.
But studies show that Nalmefene can cut alcohol consumption by 1.8 units a day and lead to three fewer days of heavy drinking a month compared to a placebo.
