Drinking too much can damage physical and mental health in the short and long term.

As well as affecting our weight, skin and how well we sleep, drinking above the low risk guidance of no more than 14 units per week can lead to a wide range of medical conditions including high blood pressure, liver disease, stroke, cancer and brain damage.

Drinking any amount of alcohol increases the risk of damage to health and that risk generally increases in line with how much you drink.

Binge drinking, drinking large amounts of alcohol in a short space of time, is associated with additional health risks, such as accidental injury. Being drunk also raises the risk of being injured from a fall, road traffic accident, house fire, or violence.

Alcohol and your physical health

Alcohol is linked with more than 200 diseases, injuries and other health conditions.

Alcohol poisoning

Alcohol poisoning occurs when you drink large amounts of alcohol, usually over a short period of time. Drinking too much too quickly can slow or even shut down automatic functions such as breathing, heartbeat and gag reflex (which prevents choking). Without emergency medical treatment, alcohol poisoning can be fatal.

Liver

Drinking at heavy levels can cause a range of problems for the liver. Drinking a lot of alcohol can cause a build-up of fats in the liver. This in itself is not harmful and quickly reverses when alcohol consumption is stopped, but it is an indication of liver damage.

Alcoholic hepatitis is more serious liver damage and occurs when drinking heavily over a longer period of time causes the tissues of the liver to become inflamed. While this damage is reversible, severe alcoholic hepatitis is a life-threatening illness.

Liver cirrhosis occurs as a result of continuous damage; the liver becomes permanently scarred and stops functioning normally.

Cancer

Alcohol is classified as a group 1 carcinogen, meaning it can cause cancer in humans. Tobacco and asbestos are other substances in this group.

Alcohol is a recognised risk factor for cancers of the breast, liver, bowel, mouth, throat, larynx (voice box) and oesophagus (gullet).

Around a quarter of deaths caused by alcohol in Scotland are from cancer.

Heart disease and stroke

Regularly drinking too much can raise blood pressure over time. This in turn increases the risk of heart disease and stroke.

Weight gain

Alcoholic drinks are high in calories. A large glass of wine and pint of lager both contain around 200 calories. Being overweight carries a number of health risks including high blood pressure and diabetes.

Gastrointestinal system

Short, heavy bouts of drinking as well as heavy drinking over the longer term, may result in the development of gastritis (where the lining of your stomach becomes inflamed), causing nausea, vomiting and stomach pain. Too much alcohol also makes it more difficult for the body to absorb valuable nutrients.

Pancreas

The pancreas produces digestive enzymes and the hormones which aid digestion and regulate blood sugar levels. Heavy drinking can result in the development of acute and chronic pancreatitis (inflammation of the pancreas).

Fertility

Regularly drinking too much can affect fertility for both men and women. It can also be a cause of miscarriage and stillbirth. Alcohol should be avoided when pregnant or trying to conceive.

Dementia

Heavy drinking has been found to be one of the biggest risk factors for developing dementia. Despite some recent claims, there is no reliable evidence that moderate drinking protects against dementia. You should not start drinking alcohol as a way of reducing dementia risk.

Alcohol-related brain damage

People with a history of drinking at very high levels may have symptoms including confusion and memory loss. This occurs as the result of the damage that alcohol does to brain tissue, and nutritional deficiencies from heavy drinking. If alcohol consumption is stopped it may, in milder cases, be reversible. More severe alcohol-related brain damage, such as Wernicke-Korsakoff syndrome, may present like dementia, with people struggling with day-to-day activities.

 

Alcohol and your mental health

There are strong links between alcohol use and poor mental health.

Many people drink alcohol to relax and combat feelings of stress. It is true that drinking very small amounts of alcohol can make us feel more relaxed in the short term. However, heavier drinking, or drinking over the long term can actually make stress worse.

Using alcohol to cope with emotions or regulate mood can cause problems because alcohol is a depressant drug. Drinking a lot dulls the 'feel good' systems in the brain so more alcohol is needed to achieve the same effects. In the long run, drinking can reduce mental wellbeing and contribute to feelings of anxiety and depression, rather than relieving them.

When someone is drinking too much, relationships, work and finances can suffer. This can further contribute to feelings of anxiety and depression. Alcohol lowers our inhibitions and may result in us doing or saying things we later regret – which may also affect our mental health.

Heavy drinking can lead to impulsive, irrational behaviour. There are strong links between alcohol use, self-harming behaviour, suicidal thoughts and completed suicides.

If you are experiencing thoughts about ending your life, or feel unable to keep yourself safe, please call 999 or go to A&E and ask for the contact for your local mental health crisis team.

You can also speak to the Samaritans 24 hours a day on 116 123 or visit their website for further information and support.

 

Alcohol dependence and stigma

Alcohol dependence refers to types of drinking behaviour where a person can come to depend or rely on alcohol in some way.

Typically, people may talk about people who are ‘addicted’ to alcohol or refer to ‘alcoholics’. They may take this to mean people who are physically dependent on alcohol in order to function or get through the day. They typically think that people who are dependent on alcohol drink (and drink heavily) every day.

Some people can become physically dependent on alcohol over time with prolonged, regular or heavy drinking. This results in changes in the brain leading to cravings for alcohol and severe withdrawal symptoms if a person either substantially reduces their drinking or stops altogether. For those who are physically dependent, it can be dangerous to stop using alcohol immediately without medical supervision or ‘detox’.

However, dependence on alcohol could more broadly refer to needing alcohol in order to be able to cope with different life events – e.g. stress or social situations. People who are dependent on alcohol in this way may not drink every day, but when they experience certain situations, they may feel the strong impulse or trigger to drink alcohol as a coping mechanism. This can also come about due to changes in brain ‘pathways’ that prompt a person to drink when they encounter specific situations.

Risk of alcohol dependence

Research shows that the earlier someone starts to drink alcohol, the higher the risk of developing alcohol dependence. This is why the Chief Medical Officer’s guidance recommends that it is best to have an alcohol-free childhood. Despite some claims, it is not a good idea to introduce children to alcohol. There is no evidence that this results in safer drinking patterns in adulthood.

Drinking regularly or heavily can also increase your risk for alcohol dependence. Over time you may build up tolerance to alcohol and have to keep drinking more to get the same effect.

You may also be at higher risk of developing a form of alcohol dependence if you regularly use alcohol to cope with events in life like stress or social situations. This can cause changes in the brain, creating neural pathways that mean you may feel the impulse or trigger to drink alcohol every time you experience a certain situation.

Stigma

What people mean when they talk about ‘alcohol dependence’ can vary widely and can be potentially problematic, unclear or unhelpful.

The term ‘alcoholic’ can be particularly controversial because it can be stigmatising (or self-stigmatising) – applying a permanent label to a person that often has highly negative associations. Labels like these can change how we view a person, or how they view themselves, often not for the better. People may also end up not seeking help for fear of being labelled and stigmatised as an ‘alcoholic’.

Stereotypical views of how people with alcohol problems look or behave may stop us from identifying that our own drinking is causing us harm, or harm to the people around us . For example, even if people don’t drink every day they make still have an unhealthy or dependent relationship with alcohol.

Notwithstanding this, many people find it helpful to self-identify as ‘alcoholic’ as a way of accepting that their alcohol use has become problematic, finding peer support and connection through mutual aid groups (such as Alcoholics Anonymous) and protecting themselves against relapse.

The figures

24%
of Scots drink at hazardous or harmful levels (more than 14 units a week)
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