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Alcohol Advice and Information

Alcohol & Health | Intervention & Treatment | Crime and Antisocial Behaviour | National Policy Framework

Alcohol can play a positive role in British culture as part of social and family life through sensible drinking. However, excessive alcohol consumption among some groups in society is a cause of serious concern and is reflected by both the Government and the general public. The concern covers a number of related issues such as health implications or crime and disorder levels. The Oxfordshire Alcohol Strategy looks to address the concerns of alcohol misuse.

Alcohol and Health

Alcohol misuse is directly linked to deaths from certain types of diseases such as liver cirrhosis, and associated with other causes of death such as stroke and coronary heart disease.

The NHS recommends that you should not regularly drink more than:
3-4 units of alcohol a day for men,
2-3 units of alcohol per day for women.

What is a unit?

Click here for chart

See the 'Know Your Limits' website for more information.

For men who are regularly drinking more than 8 units a day and women regularly drinking more than 6 units a day (50/35 units per week respectively) the risks of various diseases, such as liver disease or stroke, are significantly higher. In 2005, 4160 people in England and Wales died from alcoholic liver disease; an increase of 41% since 1999 according to the Department of Health.

Effects

The alcohol you drink travels to your stomach. Unlike food, alcohol doesn't need to be digested and can pass quickly and easily into the bloodstream (about 20% of the alcohol that enters the stomach is absorbed immediately). After entering the bloodstream the alcohol travels very quickly, in only a few minutes, to every part of the body.

Your brain will be the first part of the body to be affected: the alcohol will dull the parts of the brain that control how your body works, affecting your actions and your ability to make decisions and control your actions.

On average, it takes the liver about one hour to break down one unit of alcohol. Contrary to some myths, there is no way to speed up this process and only time will sober you up.

Long-term effects

As well as the recognised immediate effects of drinking too much, like nausea, vomiting and hangovers, binge drinking and prolonged heavy drinking over longer periods of time can affect you in many different ways.

Brain damage:
Binge drinking can cause blackouts, memory loss and anxiety. Long-term drinking can result in permanent brain damage, serious mental health problems and alcohol dependence or alcoholism. Young people's brains are particularly vulnerable because the brain is still developing during their teenage years. Alcohol can damage parts of the brain, affecting behaviour and the ability to learn and remember.

Cancers:
Drinking alcohol is the second biggest risk factor for cancers of the mouth and throat (smoking being the first). People who develop cirrhosis of the liver (often caused by too much alcohol) can develop liver cancer.

Heart and circulation:
Alcohol can cause high blood pressure (hypertension) increasing the risk of having a heart attack or stroke. It also weakens heart muscles, which can affect lungs, liver, brain and other body systems and can cause heart failure. Binge drinking and drinking heavily over longer periods can cause the heart to beat irregularly (arrhythmia) and has been linked to cases of sudden death.

Lungs:
People who drink a lot of alcohol have more lung infections and can be more likely to get pneumonia and for their lungs to collapse. When a person vomits as a result of drinking alcohol they may choke if vomit gets sucked into their lungs.

Liver:
Drinking too much alcohol initially causes fat deposits to develop in the liver. With continued excessive drinking the liver may become inflamed resulting in alcoholic hepatitis which can result in liver failure and death. Excessive alcohol can permanently scar and damage the liver resulting in liver cirrhosis and an increased risk of liver cancer.

Stomach:
Drinking above recommended limits can lead to stomach ulcers, internal bleeding and cancer. Alcohol can cause the stomach to become inflamed (gastritis), which can prevent food from being absorbed and increase the risk of cancer.

Pancreas:
Heavy or prolonged use of alcohol can cause inflammation of the pancreas, which can be very painful, causing vomiting, fever and weight loss, and can be fatal.

Intestine:
Heavy drinking may result in ulcers and cancer of the colon. It also affects your body's ability to absorb nutrients and vitamins.

Kidneys:
Heavy drinking can increase your risk of developing high blood pressure – a leading cause of chronic kidney disease.

Fertility:
In men: impotence (lowered libido/sex drive) and infertility.
In women: infertility. Drinking alcohol when pregnant can seriously damage the development of the unborn baby.

Bones:
Alcohol interferes with the body's ability to absorb calcium. As a result, your bones become weak and thin (osteoporosis).

Weight gain:
Alcohol is high in calories. Weight for weight, the alcohol in a drink contains almost as many calories as fat. The average bottle of wine contains 600 calories while four pints of average strength lager contains 640.

Skin:
Alcohol dehydrates your body and your skin; it also widens blood vessels causing your skin to look red or blotchy.

Sexual health:
Binge drinking makes you lose your inhibitions and affects your judgement. This might make you less likely to use a condom, increasing your risk of getting a sexually transmitted infection such as Chlamydia, HIV or hepatitis or result in an unplanned pregnancy.

Mental health:
People may think alcohol helps them to cope with difficult situations and emotions, to reduce stress or relieve anxiety, but alcohol is in fact associated with a range of mental health problems including depression, anxiety, risk-taking behaviour, personality disorders and schizophrenia.
Alcohol has also been linked to suicide.

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Intervention and Treatment

Individuals who consume excessive amounts of alcohol may benefit from some kind of intervention or treatment, and can fall into four general categories of alcohol misuse. These have been identified by Models of Care of Alcohol Misusers (MoCAM) 2006.

  • hazardous drinkers - 'are drinking at levels over the sensible drinking limits, either in terms of regular excessive consumption or less frequent sessions of heavy drinking. However, they have so far avoided significant alcohol-related problems.'
  • harmful drinkers - 'are usually drinking at levels above those recommended for sensible drinking, typically at higher levels than most hazardous drinkers. Unlike hazardous drinkers, harmful drinkers show clear evidence of some alcohol-related harm. Many harmful drinkers may not have understood the link between their drinking and the range of problems they may be experiencing.'
  • moderately dependent drinkers - 'may recognize that they have a problem with drinking, even if this recognition has only come about reluctantly through pressure, for example from family members or employers. The level of dependence of drinkers in this category is not severe.'
  • severely dependent drinkers - 'may have serious and long-standing problems. This category includes individuals described in older terminology as 'chronic alcoholics'. Typically, they have experienced significant alcohol withdrawal symptoms. They may have progressed to habitual significant daily alcohol use or heavy use over prolonged periods or bouts of drinking.'

Individual drinkers may sit within a number of different categories during their lifetime and may choose to engage with relevant treatment services or not.

Alcohol Brief Advice and Intervention

For those people who are not at the levels categorised above, but want to know how to cut down their alcohol use and the benefits it would bring, alcohol brief advice and intervention is suitable.

AUDIT Tool
FAST AUDIT
NHS Structured Alcohol Tool
Alcohol Effects Patient Leaflet
M-SASQ Tool
Primary care guidance

Alcohol Treatment

For those people who need a more enhanced intervention for their alcohol use, they can access the Harm Minimisation Service for advice and support or the Recovery Service for treatment.
Treatment Services

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Alcohol, Crime and Antisocial Behaviour:

Underage drinking and drinking by young adults is perceived as a real problem by the public. There are strong links between high levels of youth alcohol consumption and other risk factors such as youth offending, teenage pregnancy and exclusion from school, but the exact nature of this relationship is not fully understood. Neither is it clear to what extent alcohol influences criminal activity and specifically violent behaviour and the night time economy. According to various Home Office publications, around half of all violent incidents take place at the weekend and the majority occur at night (between midnight and 6am).

Various pieces of legislation have had an impact on alcohol and crime. The Crime and Disorder Act 1998 gave emphasis to 'partnership' working between a wide range of agencies (such as police, district councils, primary care trusts and fire and rescue services) to combat local concerns through community plans; alcohol misuse is always a key priority. The introduction of the Licensing Act 2003 saw licensed premises given greater flexibility in operating hours and licensable activities that they could offer as well as additional enforcement powers to authorities.

   
 

Oxfordshire's aim is to:

 


'Minimise the negative effects and costs associated with alcohol on individuals, families, local communities and public services in Oxfordshire, while ensuring that people are able to enjoy alcohol safely and responsibly.'

 
 

Purpose of the Oxfordshire Alcohol Strategy

This Strategy has been developed in order to identify and clarify the issues surrounding alcohol and the negative effects it can have on individuals and the wider community. This document is intended to have a strategic overview of the issues and sets out how the Oxfordshire Safer Communities Partnership intends to tackle the harm caused by alcohol misuse between April 2008 and March 2011 and links to the three year Community Safety Plans drawn up by the five Crime and Disorder Reduction Partnerships (CDRP's) for Oxfordshire (Cherwell, West, Oxford City, South and Vale of White Horse). This Strategy will be reviewed at the end of each year and updated. It will be a working strategy and will be revised as appropriate with the development of other policies in support of the overarching vision for Oxfordshire during the three years of the plan.

The development of the Strategy had been based on the national policy framework and local information gathering and consultation and builds on the original Oxfordshire Alcohol Harm Reduction Strategy 2006-2009. It is drawn up under 'Community Safety' but it is immediately acknowledged that the Strategy cuts across many other areas of responsibility, most obviously Health and Young People.

Themes

There are three overall themes or aims contained within the Alcohol Strategy. Others may be added as required and when appropriate to reflect wider policies which contribute to the overarching vision for Oxfordshire. A clear set of objectives has been developed under each aim supported by relevant action plans.

  • Health and Treatment
  • Community Safety
  • Young People

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National Policy Framework

Alcohol Strategy for England (2012)

In 2012 the Government introduced a new national Alcohol Strategy. The strategy focuses on tackling binge drinking and alcohol related crime, the price of alcohol and licensing responsibilities, and informing people to prevent them from drinking excessively.

(download pdf copy of Alcohol Harm Reduction Strategy document)


Models of Care of Alcohol Misusers (MoCAM) (2006)

This was produced by the Department of Health in conjunction with the National Treatment Agency (NTA) and provides a clear framework for the commissioning and provision of treatment for hazardous, harmful and dependent drinkers.

Choosing Health in the South East: Alcohol (2007)

This report makes some key points about the harm caused by alcohol in the South East. The report recommended a number of priorities:

  • Binge drinking in young people.
  • Workplace alcohol policies should be implemented.
  • High risk and vulnerable groups.
  • Additional treatment services should be commissioned.
  • Public health professionals should work together with local partners to tackle crime and disorder.

(Choosing Health document)

 

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