As new research reveals that people over 65 are the greatest daily drinkers, we examine the effects of alcohol and the impact that drinking can have on our health

Over 10 million adults regularly drink beyond the recommended guidelines, with 2.6 million drinking more than twice that, according to Alcohol Concern. Alcohol has been linked to the onset of around 60 diseases, with 8,748 deaths in 2011 being directly related to alcohol. The NHS spends around £3.5 billion each year treating alcohol-related ill-health, while alcohol misuse costs a staggering £21 billion in healthcare, crime and lost productivity in England alone. Yet research reveals that for every £1 invested in alcohol treatment, £5 is saved on health, welfare and crime costs.

Dangerous drinking is often associated with the young. However, recent research from Mintel reveals that it is the over- 65s who are the most excessive daily drinkers. The findings show that as many as one in five over- 65s (18 per cent) drink every day in their home, compared to just one in 10 people aged 18 to 24 (11 per cent). Those aged 45 to 54 are the lightest drinkers, with just eight per cent drinking every day at home. “When people drink at home they build up their tolerance, so it’s doing internal damage without any external evidence,” says Lauren Booker, workplace programme manager at Alcohol Concern.

“Older people are more at risk of other health conditions and they’re more likely to be taking medication that clashes with their drinking. We know that social drinking can increase dramatically among the recently bereaved or retired.”

Despite rising prices and greater alcohol awareness, experts believe our recent warm summer along with high-profile events like the football World Cup, has encouraged at-home drinking. “Drinking at home is easier,” says Lauren. “When you go out, you’re regulated by opening times and queuing. You also get through more at home as you’re less aware of the cost.”

So how does alcohol affect health? And how effective are measures to prevent excessive drinking?

One more won’t hurt…

The effects of alcohol vary, with sex, height, weight, diet and recent amounts of sleep all determining how susceptible we are. In the short-term, alcohol is dehydrating and slows brain functions, which affects balance and co-ordination. Although this may seem harmless, between 2011 and 2013, 360 people died from accidental alcohol poisoning in England. Alcohol also irritates the stomach and inhibits the function of the gag reflux, which can cause people to choke on their own vomit.

Alcohol can also significantly heighten the risk of developing serious, chronic diseases. Each year, an estimated four per cent of cancer cases are caused by alcohol, with its consumption being linked to cancer of the liver, bowel, breast, mouth, throat, larynx and oesophagus.

Indeed, The Million Women Study, a national study of women’s health, looked at 1.3 million women aged over 50 and found that the relative risk of cancer increases by six per cent for every 10g (around a unit) of alcohol drunk per day. Commenting on the study, Lauren said: “Six per cent is quite a small risk, but when you think a large glass of wine can have five units and a bottle 10, it adds up.”

Alcohol is also linked to liver disease, type 2 diabetes and high blood pressure, which can cause cardiovascular disease. Alcohol’s mood-enhancing effects are often short-lived and can end with drinkers turning aggressive, anxious or even depressive. Alcohol is a depressant that disrupts the brain’s neurotransmitters and lowers levels of serotonin – the ‘happiness hormone’. “There’s a very strong association between mental health and alcohol,” says Lauren. “Alcohol can prompt symptoms or sufferers may suppress their symptoms through drink, especially disorders like phobias, anxiety and depression.”

How much is too much?

There’s long been confusion over which is worse – moderate daily drinking or the occasional binge. Dr Sarah Jarvis, medical advisor at Drinkaware comments: “A small amount of alcohol is perfectly safe. There is no safe level of binge drinking. Even a single binge is connected with an increased risk of accidents, violent or aggressive behaviour and, in some cases, it can lead to brain damage.”

The Government guidelines advise that men drink a maximum of three to four units of alcohol a day and women stick to two to three units. “Most people are aware of units, but the big problem is many people are confused about how many units are in drinks,” says Dr Jarvis. “A recent survey suggested that two-thirds of people don’t recognise how many units are in a pint of beer or a glass of wine.” One unit is 10ml of pure alcohol, which roughly translates as:

• Half a standard glass of wine (175ml)
• Half a pint of lower-strength beer, lager or cider
• A small shot of spirits (25ml)

The trouble is, large wine glasses often hold around 250ml, and whereas a shot of spirit was once 25ml, many bars now serve 35-50ml measures.

What’s being done to tackle the problem?

One recommendation from the All Party Parliamentary Group on Alcohol Misuse in its 2015 manifesto is for all alcoholic drinks to carry health warnings, a move that is supported by the Faculty of Public Health. “Really graphic health warnings, like the ones on tobacco products, do make a real difference,” says Dr Jarvis. “But the current warnings don’t make some of the stark facts clear – for instance, the link between alcohol and cancer, liver damage and injury, and the million alcohol-related hospital admissions every year.”

A study by Sheffield University revealed that setting alcohol at a minimum unit price (MUP) of 45p per unit would impact heavy drinkers on low incomes without affecting moderate drinkers in any income group. Low income heavy drinkers spend around £2,700 a year on alcohol, 40 per cent of which costs under 45p a unit.

MUPs could force these drinkers to cut back by nearly 300 units a year, saving 860 lives and preventing 29,900 hospital admissions, according to the study. These findings are significant as, according to Alcohol Concern, the alcoholrelated mortality rate for the most disadvantaged people in society is several times greater than for the least disadvantaged.

However, plans to enforce MUPs in England were ditched following concerns about sensible drinkers being impacted. Instead, earlier this year, the Government banned ‘deep discounting’, preventing supermarkets from slashing the price of alcohol to below cost prices.

Yet the decision to ditch MUPs wasn’t without its critics. “There is good evidence that for the average moderate drinker, MUPs would have little or no impact on the amount they spend on alcohol over a year,” says Dr Jarvis.

“It’s estimated that hospital admissions and other costs from excess alcohol costs every adult in the country about £12 a week, of which £3 comes back to the economy from taxes on alcohol. That basically means that moderate drinkers and nondrinkers in the UK are effectively subsidising heavy drinkers to the tune of around £9 a week. If MUP reduces alcohol abuse, and there is good evidence from other countries that it does, you could argue that increasing the price of alcohol would save the average person in Britain money.”

Currently, a 440ml can of five per cent beer has a minimum price of 50p, a bottle of wine £2.24 and a standard bottle of 40 per cent vodka £10.16. Ministers hope this will discourage ‘pre-loading’ – drinking heavily discounted supermarket alcohol at home before a night out. “Banning the sale of alcohol below duty plus VAT will stop the worst examples of very cheap and harmful drink,” says crime prevention minister Norman Baker.

When people drink at home they build up their tolerance, so it’s doing internal damage without any external evidence

Get involved

Evaluations into healthy living pharmacies’ (HLP) health and wellbeing services, including alcohol advice, have produced positive customer feedback. An NPA spokesperson comments: “Health champions across the country have found innovative and creative ways to get the conversation going about health issues without threatening the individual or their fundamental right to make a choice.”

NPA alcohol scratch cards educate customers about the effects of alcohol on their health. A four-month campaign where 240 pharmacies throughout London issued scratch cards revealed that of those that were returned, 40 per cent classed the customer as a high-risk drinker.

Lauren recommends that pharmacies support customers by offering a validated screening programme and providing just five minutes of evidence-based advice. “Pharmacies are ideally placed to give simple messages in a way people can understand,” she adds. “Firstly, complete Alcohol Concern’s Identification and Brief Advice (IBA) course to develop the skills and confidence to talk to customers about their drinking. Put up stands to show what a unit is, display leaflets and download apps to increase your understanding.” 

Drown the habit

• Measure spirits, don’t pour them freely
• Drink from smaller glasses
• Try lower strength drinks
• Drink higher strengths in half measures
• Replace wine with spritzers
• Avoid shots – they take you over the daily limit quickly
• Alternate between alcoholic and soft drinks
• Go alcohol-free a few days a week
• Keep a drink diary or download the Drinkaware app to track units and calories, and set goals towards more moderate drinking.

Signposting

• Alcohol Concern
• Drinkaware