Drink?: The New Science of Alcohol and Your Health

by David J. Nutt

According to the government, alcohol is the third leading risk factor for death and disability after smoking and obesity. That’s a pretty scary list, right?

This is the – pretty long and scary – list of other cancers for which alcohol is known to be a significant risk factor: breast, colorectal, oesophageal, pharynx and larynx, lip and oral cavity and nasal. Some cancers are dose-dependent (see box overleaf) but some aren’t.

Firstly, there is the acute toxic effect of alcohol on the skin of your mouth and gullet, where it burns and damages the tissue. This chronic inflammation leads to cancer through changing DNA, particularly once it has led to persistent mouth ulcers that last for months. While it’s not known why some people go on to develop, for example, mouth cancer, it is known that drinking is a major contributory factor (others are smoking and the human papilloma virus or HPV). The second way is by a more indirect route, which will vary for each type of cancer . This process is thought to involve the production in cells of molecules called free radicals, which then leads to the DNA damage that promotes cancer .

That is why when anyone seeks help with their drinking, we give them high doses of vitamin B1 – up to 1g per day.

if you get depressed after drinking, be very careful. If you feel high when drinking and then low when hungover, be careful. These are both risk factors for becoming alcoholic, as they can be a driver to getting you into a cycle of drinking.

If the mood problems continue in the absence of drinking, you may need treatment, perhaps a mood stabiliser or antidepressant. See your doctor and discuss it with them.

The feminisation is also partly due to a drop in IGF1 – insulin derived growth factor – which leads to less muscle, less testosterone and less sperm. Male alcoholics also lose muscle mass. Besides not eating properly, one of the reasons is that they don’t manufacture enough HGH (human growth hormone).

You could also try cognitive behavioural therapy; there are some good introductions to it online, such as the Sleepio app.1 This is free from GPs in some parts of the country; but even if you have to pay, the cost will probably be offset by your savings on alcohol.

There is no such thing as an addictive personality. But there are individuals who are more vulnerable to becoming addicted.

Even though they may start off the evening wanting to drink normally, the alcohol changes how their brains work.

There’s an anthropological theory that alcohol was a crucial element in the development of organised societies, in our species making the switch from nomadic hunter-gathering to farming.

It says that crop cultivation may have begun in order to grow wheat to make alcohol as well as for food.1

In a study, when strangers were put together in groups of three, those given alcohol were more likely to smile fully, and smile at the same time as each other. The drinking groups were also more likely to have everyone joining in the discussion.7

One study found that there were four main motives for drinking more in a group: copying (automatically copying another’s drinking behaviour and how much they drink), conformity (fitting in with the group), hedonism (escape and having a good time) and winding down (relaxation).

NB: don’t binge: remember the data suggests bingeing is more dangerous in terms of brain effects and safety risks, among other health harms.

Surround yourself with non-drinkers

Don’t use energy drinks as mixers A 2016 study showed that caffeine makes you drink more, probably by increasing the rewarding properties of alcohol.5 And a study the following year showed that energy drinks make you drink faster, too.

You could say: ‘I don’t want to get drunk because I don’t want to embarrass myself.’

Bear in mind that statistics show the earlier your child drinks, the more likely they will have problems with alcohol later in life

But as you can also see, deaths from liver diseases (80 per cent of which are caused by alcohol) have increased fivefold. Successive governments have had access to this data. I can only assume they all decided not to take any steps to cut the rate of liver disease because they didn’t want to stand up to the drinks industry. Instead, what they did or didn’t do

the relationship between alcohol intake and harm shows an exponential curve; drinking a litre of wine each day is five times more harmful than drinking half a litre, not twice.

When David Cameron came into power in 2010, he said he wanted to reduce the problems of alcohol. And one of the measures he supported was MUP. So the Department of Health set up the Responsibility Deal Alcohol Network (RDAN), which was designed to bring together the drinks industry, local authorities and health

experts to encourage drinking within recommended guidelines. The problem was, the government decided this group was to be made up of 50 per cent health experts and 50 per cent representatives of the drinks industry .

The figure shows the remarkable fall in standardised death rates (SDRs) from alcoholic liver disease over the past 50 years in France as they cut their consumption by half over this period. In stark contrast over the same period UK death rates nearly tripled as our alcohol consumption nearly doubled.

To be Saffy to our collective Edina, as in the BBC TV series Absolutely Fabulous.