Alcohol Awareness
Fraser Hoggan, Stephen Hounsom & Neil
Strachan
May 2007
1
Aim of Session
To raise awareness of the Health &
Social Implications of alcohol use and
types of harm associated with alcohol
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Objectives
• Discuss cultural relationship with
alcohol
• Explore the effects of alcohol
• Explore the harms caused by varying
nature of alcohol use
• Identify harmful drinking patterns
• Increase awareness of sensible
drinking messages
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Accepted part of our culture?
• We‟ve been brewing alcohol since before
the Romans arrived
• Alcohol is deeply rooted in our culture and
national identity
• Used to celebrate, commiserate ....
• Most people who drink alcohol do so
without experiencing serious problems
• Binge drinking and drunkenness have
become much more common over the last
decade – particularly among young people
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Accepted part of our culture?
• In 2006, Scottish Exec research showed that:
– 1 in 5 Scots lie to avoid drinking
– 1 in 3 Scots drinking more than they want
– 1 in 2 young Scots have no idea how much
they drink
• Evidence would suggest that Scots are more
concerned about how they are perceived by
their peers, than they are by the effects of
excessive alcohol intake.
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Alcohol – is it a problem?
• Health:
– Alcohol related liver disease has increased
100% in the last 10 years.
– Emergency admission rates for people with
primary & secondary diagnoses of acute
intoxication and harmful use (associated with
binge drinking) shows admission rates for
Grampian are significantly higher than rest of
Scotland.
– Other health harm can be related to risk-
taking behaviours, for example unprotected
sex, transmission of STI and unwanted
pregnancy 6
Alcohol – is it a problem?
Alcohol Related Deaths:
• In 2004 Grampian had 107 alcohol related
deaths (from 2052 reported in Scotland).
• There has been a 21% rise in such deaths in
Scotland in only FIVE years.
• In 1990 alcohol related deaths accounted for 1
in 100 deaths in Scotland. In less than 10
years this had risen to 1 in 40.
• It is accepted that such figures are often
incomplete given miscoding of deaths or lack
of recognition of alcohol as a contributing
factor.
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Alcohol - Social harm
In Scotland the economic cost of alcohol related
harm was estimated at over £1.1 billion in
2002/03
Personal - impact on relationships, employability,
confidence, finances
Alcohol is a contributory factor in:
• 40% of violent crimes
• 39% of deaths in fires
• 15% of drownings
• 17% of road traffic deaths 8
Alcohol -short term physical
effects:
• Nausea and vomiting
• Slowed heart rate
• Coma
• Death
• Uncoordinated muscle movements
• Slurred speech
• Drowsy/sleepy
• Increased sexual arousal
• Decreased sexual performance
• Sensory impairment
• Headache
• Sweating
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Alcohol - long term physical
effects:
• Brain shrinkage
• Oesophageal varicies
• Liver damage – hepatitis, cirrhosis
• Skin dehydration
• Impotence
• Reduced kidney function
• Cancers – breast, throat, mouth, stomach,
colon
• Pancreatitis
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Long term physical effects
(continued)
• Fatty deposits on the heart
• Gastritis, stomach ulcers
• Inflammation of intestines, reduced ability to
absorb nutrients
• Peripheral neuropathy
• Foetal Alcohol Syndrome (FAS)
• Alcohol Related Brain Damage (ARBD)
• Physical dependency
• Alcohol tolerance
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Alcohol - mental/emotional
effects
Short term
• Lower reasoning ability
• Exaggerated state of emotions
• False self confidence
Long term
• Depression
• Anxiety
• Phobias
• Paranoia
• Psychological dependency
• Suicidal thoughts
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Harmful drinking patterns
• Chronic drinking – drinking large
amounts of alcohol regularly, often
associated with alcohol dependence
• Binge drinking – drinking excessive
amounts of alcohol in a short period of
time with the specific objective of
getting drunk. Some may do this
regularly or it may be occasional
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Alcohol dependence
• Drinking begins to take priority over other
activities. Becomes a compulsion
• Tolerance develops, it takes more alcohol to
produce drunkenness
• Withdrawal symptoms such as anxiety,
tremor develop and are reduced by taking
more alcohol.
• Often undetected for years – may be
masked by availability and acceptability
• May be a genetic component – alcohol
dependence clusters in some families, but
it‟s hard to be certain this is not learned
behaviour
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Delirium tremens (DTs)
• Caused by cessation or reduction in
alcohol intake
• Usually where prolonged heavy
drinking has been a feature
• Effects include, fast heart rate,
sweats, high blood pressure, marked
tremor, vivid hallucinations and
agitated behaviour
• Can lead to seizures
• Can be fatal if untreated
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Korsakoff’s syndrome
• Caused by lack of Vitamin B1 (Thiamine) which
affects brain & nervous system
• Alcohol use is often cause of this deficiency –
poor diet in heavy drinkers over longer term.
Alcohol also affects how well body absorbs key
vitamins
• Brain damage can occur if untreated (with Vit
B1)
• Results in severe short term memory loss,
difficulty acquiring new skills, lack of insight into
condition, talkative and repetitive behaviour
• Younger cases now being reported
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How can people get help?
• Prescribing – Antabuse,
Acamprosate, Naltrexone
• Talking based treatments – Cognitive
Behavioural Therapy (CBT),
Motivational Interviewing, Counselling
• Range of voluntary and statutory
services
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Confusion about units....
• Advice has been conflicting
• Awareness of units concept
• Interest in units concept
• In 2006 a Student Survey in Edinburgh
concluded that only 2% of females and 4%
of males understood the unit concept.
• 9 out of 10 did not use units to calculate
alcohol intake
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Sensible Drinking Guidelines
Women - up to 2-3 units of alcohol a day, not exceeding a total of
14 units per week – with at least 2 alcohol free days per week
• Men - up to 3-4 units of alcohol a day, not exceeding a total of
21 units per week – with at least 2 alcohol free days per week
• Young people – there’s no safe limit for young people
• Takes 1 hour for the body to process 1 unit of Alcohol
The emphasis is now on daily units to
discourage heavy binge or weekend drinking 19
How much is too much?
• Large glass wine (250 ml) at 13% ABV = 3 units
• Average glass wine (175 ml) at 13% ABV = 2.3 units
• Lager/beer (440 ml can) at 3.5% ABV = 1.5 units
• Lager/beer (440 ml can) at 5% ABV = 2.2 units
• Pint of strong lager (5% ABV) = 2.8 units
• 25 ml measure of spirit (e.g. gin, vodka etc.) = 1 unit
• 330ml bottle of beer/lager/alcopop at 5% ABV = 1.7
units
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Alcohol & pregnancy - new
recommendations from CMO:
“Avoid alcohol if pregnant or trying to
conceive”
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Foetal Alcohol Syndrome
(FAS) & Foetal Alcohol
Spectrum Disorder (FASD)
FAS:
• Characteristic minor abnormalities of the face
• Growth restriction – pre & post natal
• Neurodevelopmental problems
• Maternal alcohol consumption has been high
FASD:
• Studies have shown that elements may be present
where maternal alcohol consumption has been more
moderate
• 1 of 3 FAS features may be present, thought to most
commonly be neurodevelopmental problems
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ABV & Unit labelling
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Responsible drinking tips
• Remember - It is fine not to drink alcohol. 5-10% of
the population choose not to drink alcohol
• Drink water or soft drinks between alcoholic drinks
• Eat before or during drinking
• Drink tall mixers & avoid neat spirits
• Drink „purer‟ drinks. Clearer drinks have less
congeners
• Pace yourself, be wary of getting involved in rounds
• Keep an eye on the strength and volumes of drinks
• Home measures are often larger than pub measures
• Drink plenty of water before going to bed
• Plan your night out, think about how you will get
home etc.
• Look after your friends, if their in a bad way help
them out
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Source of further
information:
www.infoscotland.com/alcohol
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Thank You
fraser.hoggan@nhs.net
neil.strachan@nhs.net
Stephen.hounsom@moray.gov.uk
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