Are you drinking too much alcohol? Signs you need to cut down

Signs you need to cut back on alcohol
Signs you need to cut back on alcohol

‘Normalising’ is what happens when a group all does the same thing – and not joining in makes you feel like an oddball outlier. For many of us, that means moderate drinking. Only ex-addicts and weird clean-livers are teetotal, right? Everyone else enjoys wine with dinner, pints in the pub, cocktails to celebrate, and it’s not a problem… or so we like to tell ourselves.

In fact, a huge number of us are drinking far too much – to a level that’s affecting our health, mental and emotional functioning, relationships and work.

How much alcohol is too much?

The 2019 NHS Health Survey for England found that 48 per cent of adults reported drinking alcohol at least once a week. A 2021 NHS survey found that 36 per cent of people aged 55-64 drank more than the recommended maximum of 14 units per week, compared with 23 per cent of people aged 25-34.

A post-pandemic survey by Lunzer Wine found much higher numbers, with 71.2 per cent of people surveyed drinking at least weekly (a reminder that many of us lie about our consumption to the NHS).

The serious harm caused by alcohol can’t be fudged, however, and official government figures reveal that in 2021, in England alone, there were 20,970 alcohol-related deaths, over a third of which (7,872) were due to chronic liver disease. Hospital admissions because of alcohol came to 342,795 between 2021-22, with twice as many men than women admitted.

Meanwhile, the cost of living crisis has seen us drinking even more. A survey by Alcohol Change UK in December last year found that one in six people aged 18-34 are drinking more to ease anxiety compared with before the pandemic, and 14 per cent prioritise buying alcohol over any other ‘essential’ purchase.

​Anna Sudbury, a therapist and an accredited sobriety coach, believes many of us are in denial about how much we actually drink.

“It’s so easy to underestimate, especially with large glasses or double measures as standard,” she says. A large glass in a bar is now 250ml, which is the maximum recommended daily allowance of three units, or more if the wine is over 12 per cent ABV.

“We also judge our drinking by those around us,” she adds. ”If everyone is getting stuck into the third bottle of red, then it’s easy to justify. But that doesn’t mean it’s healthy.”

So perhaps it’s not surprising that many of us are thinking about reassessing our relationship with the booze. Here are the signs indicating it’s time to cut down. Remember, you don’t need to tick all six to give the booze a rest.

1. You make poor decisions

We’ve all ordered an extra bottle when we should have ordered a taxi. But if your drunken decisions have strayed into infidelity, fighting (physically or verbally) or putting your safety at risk, such as walking home drunk, losing keys, phone or cash-card, getting a lift with a drunk driver, or even ‘blackout’ online shopping you can’t afford, it’s a strong sign that you need to rein it in. Research from Utrecht University shows personality traits like impulsivity and sensation seeking are strongly tied to alcohol use, and people with ‘risk taking’ personalities are likely to drink more, thus multiplying the dangers of alcohol.

But poor decisions may not be so dramatic, they could also mean watching mindless TV instead of taking the children out, or missing an appointment because you’re hungover.

“If alcohol has become the reason you do or don’t do something, then it’s an indicator that it’s time to review your relationship with it,” says sobriety therapist and host of The Alcohol ReThink podcast Patrick Fox. “Particularly if you’re prioritising alcohol over responsibilities. As a parent, I realised how unavailable I’d become when I was feeling hungover. Drinking was taking me further from being the kind of dad I wanted to be.” Fox stopped drinking altogether in 2018.

2. You’re not functioning at your best

Coasting at work, feeling sleep-deprived, shelving discussions and plans at home, or cancelling the gym to slump on the sofa? It might just be middle age - but could your lack of enthusiasm be down to alcohol?

“People get used to feeling hungover, tired or anxious, so don’t realise how much better they could feel,” says Laura Drane, a psychotherapist who works with recovering addicts. “Being a ‘functioning drinker’ can keep people in denial for years because they’re still holding down a job and getting the kids to school.

“We all know about the post-alcohol anxiety that’s often a result of drinking,” she adds. “This combination can create a destructive cycle of ‘drinking to feel better’, which is only exacerbating the problem.”

It is not normal to wake up feeling ‘groggy’ every morning, warns Sudbury. “It’s not normal to have consistent low mood and low energy. But we accept these things and put them down to the menopause, ageing, or our busy lives. It takes consistent time away from alcohol to see what ‘good’ feels like.”

3. You have health issues

We tend to associate health issues caused by drinking with ‘it could never happen to me’ end-stage alcoholism - cirrhosis, stroke, or cancer. But most of us who drink regularly will see our overall health compromised - though we may not recognise it as a result of drinking.

“The body needs a variety of ‘good’ bacteria in its intestine to allow the immune system to work effectively,” says Navin Khosla, pharmacist at Now Patient a telehealth and online pharmacy. “However, alcohol can impact the number and variety of these bacteria, resulting in a weaker immune system.”

There’s also the mental health toll. “Alcohol can slow down how your brain processes information, which can lead to negative thoughts and feelings, and chemical changes leading to periods of anxiety and low mood.”

Typically health issues which are common in middle age, such as high blood pressure and Type 2 diabetes, can also be triggered or worsened by alcohol.

It even affects your skin. “About 20 per cent of ethanol is absorbed in the stomach,” says Williams, “but 80 per cent is absorbed after it passes into the small intestines. The liver will metabolise the ethanol using alcohol dehydrogenase and turn it into acetaldehyde. In some people acetaldehyde builds up in their system and causes an allergic reaction, where people appear flushed as a result of the chemical build up.”

The longer you spend drinking, the greater the risk is, Fox says. “While you may not see significant problems short term, the longer you drink regularly, the greater the risk of developing illnesses later in life. After 10-20 years as a regular drinker, the risk of various cancers increases, because alcohol is carcinogenic. The risk of strokes, heart and liver disease also increases exponentially. Even your brain will shrink.” This happens because alcohol use reduces brain volume by causing brain cells and cells in their connective tissue to expel water.

4. You struggle to have time off drinking

The idea of Dry January or Sober October seems ridiculous, and when anyone suggests “a few nights off” or “only drinking at weekends,” you can’t imagine why you’d bother. If you also plan your attendance at events based on their alcohol access, or factor in a visit to the pub before weddings and funerals to “get you through it,” it suggests that while you may not be addicted, you’re reliant on drinking to help you feel “normal.”

“A good indicator that your drinking is problematic is if you struggle to moderate how much you drink once you start,” says Drane.

Sudbury defines dependency as: “Making pledges not to drink but being unable to keep to them. Feeling anxious, frustrated and intolerant if you’re unable to have an alcoholic drink.”

If you’re never the designated driver by choice, and you always know where to lay your hands on the next bottle, it suggests your drinking is no longer a casual habit but an entrenched need.

5. Your relationships are affected

You may enjoy a glass or three nightly with your partner - but while it might offer a pleasant fuzziness, drinking too much together can also trigger rows, forgetfulness over arrangements and a sub-par sex life.

Busy mornings with a hangover can mean you’re far less tolerant of normal family strife and you’re more likely to cancel social arrangements. While alcohol also lowers your inhibitions, increases irritability because it impairs judgement and problem-solving abilities which make it seem as though anger is the right response in some situations, all of which makes an argument far more likely.

A 2017 study from The University of Tennessee found alcohol use was ‘negatively correlated’ with relationship satisfaction. “One reason for this… may (be) the increased relationship stress caused when one partner engages in hazardous drinking” said the authors.

“As with anything put into the body, dosage matters,” says Williams. “A very small amount of alcohol is unlikely to cause much physiological change to an adult. In small amounts, they may feel more social,” she adds.

But, Williams explains, because alcohol affects the brain’s cerebellum, which controls how we move and balance, “as the concentration increases... we see people start to lose inhibitions and fine motor control. Maybe they’ll knock over a glass of wine due to broader hand movements, or start to speak at a higher volume and show less discretion. In much higher doses, some people may exhibit aggression, agitation, or physical illness.”

Alcohol can also damage fertility, as it can reduce your testosterone, which can lower the quality and quantity of sperm. It can also make it more difficult for both people to orgasm, and is a major cause of impotence in men.

6. You drink faster than others

Because you’ve become reliant on the buzz of booze, you find you’re chasing it the moment the first glass is poured. You’re so eager to feel comfortable, you finish your drinks in half the time it takes other people. If you’re always the first at the bar, or wondering why the host is ignoring your empty glass, it’s time to ask yourself whether you’re increasingly dependent on alcohol to feel OK.

Alcohol dependence can be diagnosed by a doctor, and will be based on your symptoms and behaviour over a period of time, from three to 12 months,” Sudbury says. “Doctors look for impaired control over alcohol, giving increasing priority to alcohol, and unwanted physical or mental effects from drinking. However you don’t need to wake up in a gutter to reassess your relationship with alcohol.”

Williams explains: “There’s a finite amount of enzymes in your body that can break down the alcohol. When a person drinks a single shot of liquor, those enzymes are immediately overwhelmed. They can only work at a specific rate. Any alcohol consumed afterwards essentially ‘backs up,’ as the enzymes become available to break down more molecules. This is why some people appear to become more impaired or ‘drunk’ even an hour after they stop drinking - their enzymes haven’t had a chance to process all the alcohol they consumed.

“Quite often, people think they have a hangover in the morning following a heavy drinking session,” adds Williams,”when, in fact, they’re still drunk.” This can only be checked by a breathalyser test, so err on the side of caution if you are planning to drive the next day.

For help and support in cutting down: www.alcoholchange.org.uk, www.drinkaware.co.uk

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