Alcohol and your health
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.
Liver
Alcohol is toxic to the liver. You do not have to drink heavily to be at risk of liver disease caused by alcohol. Research has shown that consuming as little as 6 units of alcohol (equivalent to two large glasses of wine) in a single sitting once a week can increase double or treble your chances of developing liver disease.
Alcohol can cause a range of problems for the liver. 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.
We have produced a briefing with lots more information on how alcohol impacts on liver health.
Find out more
You can find out much more about alcohol related liver disease on the British Liver Trust website, where you can also find an online screening tool to find out whether you are at risk of alcohol related liver disease and what to do about it.
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.
Find out more about how alcohol increases cancer risk and how to keep your risks as low as possible on the Cancer Research UK website.
Heart disease and stroke
Drinking too much alcohol (more than the recommended 14 units) on a regular basis can cause:
- abnormal heart rhythms
- damage to your heart muscle
- stroke
- high blood pressure (which increases the risk of stroke and heart disease)
- palpitations (when you suddenly become aware of your heartbeat pounding or beating more quickly than usual)
- weight gain from the calories in alcohol and unhealthy food choices when drinking.
You can find out more about how alcohol can affect your heart health on the British Heart Foundation website.
The Institute for Alcohol Studies (IAS) has also produced an excellent explainer video on alcohol and the heart, including some really important myth busting around claims that some types of alcohol can be good for heart health.
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.
Symptoms start after drinking a lot of alcohol and may include:
- confusion
- slurring words or being unable to speak
- being unable to coordinate movement, for example, being unable to stand, walk, or pick things up
- being sick
- peeing or pooing yourself
- pale or blue-tinged skin - on black or brown skin this may be easier to see inside the lips, on the gums and under the fingernails
- slow or irregular breathing
- having a seizure or fit
- loss of consciousness
Find out more about alcohol poisoning and what to do if you think someone has alcohol poisoning on the NHS website.
Alcohol and the brain
Alcohol is neurotoxin which affects the brain both in the short and long term. The more you drink, the greater the risk of experiencing these effects.
Short term effects
Alcohol affects numerous parts of the brain including parts having to do with our motor functions (movement), speech and behaviour.
Short term effects of alcohol on the brain can include:
- Slower reaction time
- Poorer concentration
- Impaired motor functions
- Slurred speech
- Loss of balance
- Reduced impulse control
- Reduced ability to assess risk
The short term effects of alcohol on the brain increase the likelihood of having accidents or sustaining injuries. They also increase the likelihood of you doing or saying things you wouldn’t normally do, and might later regret by impairing functioning of the frontal cortex (the frontal cortex helps regulate our impulses and behaviour).
Alcohol also increases the risk of engaging in violence by reducing our ability to interpret facial or vocal expressions and reduces empathy.
Long term effects
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.
Find out more about Wernicke-Korsakoff syndrome on the Alzheimer Scotland website.
The Institute for Alcohol Studies has produced a useful short video outlining the various effects of alcohol on the brain.
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.
Find out more about the alcohol and dementia risk on the Dementia UK website.
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 (lasting less than 6 months) and chronic (lasting more than 6 months) pancreatitis (inflammation of the pancreas).
Chronic inflammation of the pancreas increases the risk of developing pancreatic cancer.
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.
Drinking when pregnant substantially increases the risk of children being born with Fetal Alcohol Spectrum Disorder (FASD). FASD is a range of conditions which are caused by exposure to alcohol during pregnancy. Not all cases of alcohol-exposed pregnancy result in FASD but as alcohol is a toxin, and crosses from mother to baby during pregnancy, drinking alcohol at any stage in pregnancy is always a risk.
Find out more about FASD on our dedicated FASD webpage.
Alcohol and sexual health
Alcohol can impact negatively upon our sexual health in numerous ways, including:
- Increased likelihood of unprotected sex: evidence has shown that alcohol directly impacts our intentions to have unprotected sex. This can increase the likelihood of sexually transmitted infections like gonorrhea, chlamydia and syphilis, as well as HIV
- Pregnancy: alcohol use can increase the likelihood of unintended pregnancy. Drinking alcohol during pregnancy, especially in the first three months, can increase the risk of miscarriage and puts unborn children at risk of fetal alcohol spectrum disorder
- Fertility: Alcohol can affect fertility in both men and women
- Sexual dysfunction: alcohol can cause sexual dysfunction in both men and women. It can increase the likelihood of erectile dysfunction in men and delay or prevent orgasm in men and women
- Consent: alcohol impairs communication and can make it difficult to establish consent
- Sexual assault: alcohol can make people more vulnerable to sexual assault. However, it is important to recognise never your fault if you are sexually assaulted whilst under the influence of alcohol.
- HIV treatment or PrEP: alcohol has not been found to interact significantly with HIV drugs, but it does weaken the immune system. It may also increase your chances of forgetting to take medication, which can also be a risk for those on Pre Exposure Prophylaxis (PrEP). Find out more about alcohol and HIV on the Terrence Higgins Trust website.
If you have been the victim of sexual assault you can contact Rape Crisis Scotland on 08088 01 03 02 or text 07537 410 027
Alternatively visit their website at www.rapecrisisscotland.org.uk/contact/
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.
