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Family
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Preview of Understanding Alcohol & Drinking Problems
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What is alcohol?
Beer, wine, spirits, cider – and the scores of
other drinks fermented or distilled around the world – all contain
ethanol. Ethanol, which belongs to a group of chemical substances called
alcohols, is produced when yeast assists the fermentation of sugar to
form ethanol and carbon dioxide. The amount of ethanol produced is controlled
by the quantity of sugar added, or until the ethanol level reaches 14
per cent by volume, after which the yeast cannot survive. The carbon
dioxide produced forms the ‘head’ on a glass of beer, and the
bubbles in champagne.
The process of distillation – boiling off and
concentrating the ethanol part of the beverage – was discovered
in the Middle East in ad 800 by a man called Jahir ibn Hayyan. Distillation
allows more concentrated and potent alcoholic drinks to be produced.
Other constituents (sometimes called congeners) contribute to the taste
we may enjoy, but can also cause headache and hangover if we have drunk
a lot. The amount of congener varies – drinks with a dark colour
such as red wine or brandy contain more congeners, and so cause more
hangover than pale drinks.
Although other constituents give drinks their colour,
taste and character, it is ethanol that causes a change in our brain.
This change can, if the circumstances are right, lead us to feel merry
and talkative, or relaxed and sleepy. It is ethanol that helps us let
our hair down. Celebrating, marking special events and meeting up with
friends have become occasions for drinking. The advertising and marketing
of the drinks industry are designed to make sure that we continue to
believe in the good things about alcohol.
Ethanol also causes some of the unpleasant effects
of being intoxicated – such as slowing our thinking and our reactions,
irritability and the tendency to do things on the spur of the moment
which may be regretted later.
What are common measurements of alcohol?
Many people nowadays talk in terms of ‘units’
of alcohol, to measure amount. Most British pub measures of spirits –
1/6 or 1/5 gill – is about one unit, and contains the same amount
of alcohol as the items in the box.
The strength of a drink is measured as alcohol content
in percentage, or percentage by volume (%v/v).
For purposes of measuring alcohol concentration in
blood, we use the amount of alcohol (in milligrams) found in 100 millilitres
of blood. This is written as ‘mg per 100 ml blood’ or ‘mg%’.
As a very rough guide, one unit of alcohol drunk on
an empty stomach results in a peak alcohol level of 15 mg% in a man.
This figure will be up to 30 per cent higher in a woman, for reasons
we explain below. The present legal limit for driving is set at 80 mg%.
At this level, the risk of having a road accident is more than doubled.
In experiments, bus drivers with alcohol levels of only 50 mg% (below
the legal limit) thought that they could drive through obstacles too
narrow for their buses. Concentrations of 400 mg% could block the brain’s
breathing control centre and be fatal, especially if sedative drugs have
been taken as well.
In breath tests, the units used are micrograms (µg) per 100 ml
of breath. The breathalyser measures the alcohol contained in each 100
ml of breath. The present legal limit for driving is 35 mg per 100 ml
breath.
On average, the body removes alcohol at about 15 mg%
or one unit per hour. This means that a person who drinks eight pints
one night may still be over the legal limit to drive to work the next
day.
Are we drinking more than we used to?
Compared with 100 years ago, the British are probably
drinking less. Gin and beer used to be cheap, and we were great importers
of brandy and wine. In 1914 Lloyd George, the British Prime Minister,
was worried about the effect of alcohol on the industrial effort needed
for the war, so restrictions were increased on the sale of drink. Consumption
fell dramatically and remained low in the depression years between the
wars. It began to increase in 1950, as prosperity in Britain returned.
Tax on alcoholic drinks had limited drinking, but less
so from 1950 to 1980 as the tax imposed was a smaller proportion of people’s
wages. In real terms, alcohol became cheaper. From 1965 to 1987, the
amount each adult was drinking, on average, doubled. Spirits made up
less of the total and wine became more popular. The steepest rise was
among women.
Today, although the average amount consumed per person
has levelled off, the number of deaths from alcoholic liver disease is
still climbing.
Our European neighbours, except for the Scandinavians,
drink more per person than we do in Britain. The French and Italians
have now reduced their total consumption a great deal as drinking wine
each day at meals is going out of fashion. So their wine producers are
glad to be selling more to the British!
What affects individual drinking habits?
Genetics
Some people dislike the effects or taste of alcohol
– they can either avoid it or train themselves to drink. Others
like the effect from the start. Drinking problems run in families. This
is partly because a child who grows up with one or both parents drinking
heavily may learn to do the same. However, there is also a genetic factor.
Children who are fostered or adopted at birth have a drinking problem
more often than other adopted or fostered children if one of their real
parents had a drinking problem.
Identical twins, who share an identical chemical blueprint,
tend to drink in a similar way because differences between people’s
liking for alcohol are partly due to differences in body and brain chemistry.
In pairs of twins where one has a drinking problem, the other twin is
more likely to have a drinking problem if they are an identical pair
(exactly the same genes) rather than a non-identical pair (whose genes
are only as alike as those of other brothers and sisters). There is probably
a genetic factor involved in whether people enjoy the effects of alcohol
or not, and also in whether or not alcohol causes problems or addictions.
Social factors
Our pattern of drinking tends to be similar to that
of our friends. For many people their circle of friends develops in their
teenage years and changes little. People like to drink for the sociability
and humour that goes with it, and because it helps them break their routine.
Second to watching TV, going for a drink is Britain’s favourite
leisure activity.
A new job or getting married can alter an established
pattern. Spouses can have an influence on their partners’ drinking.
For instance, when two sisters who are identical twins stay unmarried,
they are likely to go through adult life drinking in a similar pattern,
whereas if one or both marry, their drinking patterns may begin to differ.
In their later years, many people drink less than they did when they
were 18 to 25.
Case history: Janet
Moira and Janet are identical twins and even lived
together when they both got office jobs in the centre of London. Janet’s
manager was an extrovert golfer who loved the club life. At first she
was resentful when his bachelor lifestyle continued after they were married,
but she joined in with him rather than try to change him. Janet had not
liked alcohol as a teenager and Moira became distressed as her sister
gradually extended her pattern of drinking to become someone who, it
seemed to Moira, always had a drink in her hand.
Work patterns
A person’s job influences his or her drinking.
Jobs with high exposure to alcohol include the building industry, the
drinks trade, hotels and restaurants, and work which takes people away
from home – such as the armed services and sales travelling.
Religious beliefs
Some faiths recommend strict moderation or even total
abstinence and the faithful adhere to this. There are religious writings
going back thousands of years about the problems alcohol can cause. Some
religions give a specific place to alcohol, such as wine in Jewish family
ceremonies. Occasionally members of strict communities such as Moslem
societies may drink but risk disapproval. They may run into difficulties
controlling their intake because they have not learned moderate drinking
in their family.
Those who practise a religion are able to meet friends
and take part in social gatherings without alcohol. This is in contrast
to most social occasions and even some sporting events in our society,
which usually involve drinking.
Drinking ‘to cope’
Alcohol is our favourite drug. Occasionally people
drink more because they feel it helps them cope with a problem or blots
it out. However, one problem can become two, as the individual gets into
the vicious circle called dependence, and the drinking escalates. Dependence
on alcohol can be a major problem, because drinkers begin to be unable
to control how much or how often they drink, and find it very difficult
to change. We explain this later.
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KEY POINTS
- How much we drink depends partly on the
genes that we inherit from our parents
- Some occupations lead to heavy drinking
- Drinking to solve a problem can lead to two problems
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