What springs to mind? How is your relationship with alcohol?
Let’s look at the facts. Alcohol or Ethyl alcohol (ETOH) is a neurotoxin. Neurotoxins are poisons that target the nervous system. When we drink alcohol, our bodies have to turn it into a chemical called acetaldehyde in order to process it. Acetaldehyde can damage our cells and can stop cells from repairing this damage. Also, alcohol is a diuretic, a substance that makes us pass more water through urination, leaving us dehydrated.
Why do we drink?
Having a glass of wine in the evening is very common, especially within the 40-65yrs age group. Alcohol is linked in our minds through family and societal norms with celebrations, stress release, having fun, relaxing, and unwinding and (like food) is often something that we link with reward in our minds at the end of a challenging day. It’s important to remember our thoughts about alcohol may not be accurate. There are actually no psychological or physiological advantages of drinking alcohol.
We might drink out of habit. Habits are patterns of behaviour formed over time. We may have many habits we’re not aware of but perform religiously. For example, automatically having a glass of wine with dinner or a beer when you watch football.
As alcohol affects the part of your brain that controls inhibition people often report feeling more at ease and confident (in the short term) when drinking alcohol. Relying on alcohol for a confidence boost can become a habit. Alcohol and self-esteem tend to mutually impact one another. By reducing inhibitions, alcohol diminishes our awareness of potential social risks such as awkwardness or rejection. Building confidence without relying on alcohol is important for positive mental health. True confidence should be rooted in self-acceptance, self-awareness and personal growth. It is about embracing our authentic selves and cultivating a sense of internal self-assurance.
People often drink because they believe it helps them relax and/or sleep. Research shows that alcohol reduces the time it takes to fall asleep; giving people the perception it helps them to sleep. However, alcohol disrupts sleep in the 2nd half of the REM cycle. REM sleep is essential for memory consolidation and emotional processing. Early waking due to alcohol consumption is common and this is because, when the sedative effects of alcohol have worn off, increases in adrenaline wake you up. High amounts of alcohol (more than 2 drinks per day for men or 1 drink per day for women) decrease sleep quality by 39.2%.
What does ‘drink responsibly’ actually mean?
To keep health risks from alcohol low we should have no more than 14 units a week, have several alcohol-free days and never binge drink. More than 8 units of alcohol in a single session for males, or more than 6 units for females, is the technical definition of a binge.
The research defines ‘chronic drinking’ as drinking more than 14 units regularly over time (14 units equates to roughly 7 drinks spread over a week).
What if we don’t keep to these evidence-based guidelines?
Regularly drinking more than 14 units of alcohol a week risks damaging your health. Alcohol can kill liver cells, and lead to scarring called cirrhosis. Chronic drinking is also associated with increased risk of liver disease and also increases the likelihood of high blood pressure, high cholesterol, and heart disease.
Research indicates drinking alcohol increases the risk of cancer. The risks are higher the more alcohol you drink. There are 3 main ways alcohol can cause cancer. Alcohol can damage our cells and stop cells repairing the damage. Alcohol affects chemical signals which can make cells more likely to divide. This increases the chance that cancer will develop. Alcohol makes it easier for cells in our mouth and throat to absorb cancer-causing chemicals.
Drinking alcohol causes 7 different types of cancer. Including breast and bowel cancer, mouth cancer, some types of throat cancer and liver cancer. Some studies show that drinking 3 or more alcoholic drinks per day increases the risk of stomach and pancreatic cancers. There is also evidence that drinking alcohol increases the risk for prostate cancer.
Breast cancer is the most common cancer in the UK and drinking alcohol is one of the biggest risk factors for breast cancer. Around 1 in 10 breast cancer cases are caused by drinking alcohol, that’s about 4,400 cases a year. Unfortunately risk of breast cancer is increased even if you drink low levels.
Alcohol & mental wellbeing
Alcohol can literally change neuronal function and lead to neurodegeneration. Alcohol affects both “inhibitory” and “excitatory” neurotransmitters within the brain. Glutamate is an excitatory neurotransmitter that alcohol inhibits which results in us feeling slowed down and making life seem less chaotic. Gamma-aminobutyric (GABA) is an inhibitory neurotransmitter. Alcohol increases GABBA transmission making us feel calmer and more relaxed. Decreasing glutamate and increasing GABA at the same time is powerful! Our brain becomes flooded with feel-good chemicals, such as dopamine, in the short term.
When we drink regularly, we flood our brain with massive amounts of dopamine regularly, over time chronic alcohol use leads to our bodies producing less dopamine naturally. A large body of evidence Indicates that dopamine plays an important role in motivation, reinforcement, and feelings of happiness. Alcohol use effectively turns down our natural dopamine response. Research shows that when someone drinks alcohol often, normal levels of dopamine trend lower and levels of cortisol trend higher. This means the brain is releasing less dopamine naturally when doing things we enjoy, such as walking somewhere beautiful, exercising and socialising.
Long term by inhibiting glutamate and increasing GABA regularly over time we are impacting on chemical balances within the brain and brain functioning making it more difficult to deny strong urges. Ultimately alcohol is a depressive and long-term chronic drinking results in us being more susceptible to stress, and less emotionally resilient when we are not drinking.
Alcohol has a significant impact on the gut-liver-brain axis so even relatively low to moderate alcohol use can have a detrimental impact on our mood and mental health. About 50% of our body’s dopamine is produced in our guts (not our brains). When we drink alcohol, we decrease the gut’s natural dopamine production by causing imbalances in our healthy gut microbes.
Science proves that even low levels of alcohol (1-2 units) can also disrupt our sleep waves. This in turn over time contributes to ‘adrenal fatigue’, a disruption of the adrenal hormone system that leads to hormone imbalance. For women within the perimenopausal or menopausal stages of life it is possible that alcohol’s effects will get worse as oestrogen levels decrease and increase symptoms such as anxiety and brain fog.
How do we reduce our alcohol intake for our physical & psychological health?
It’s normal to run into psychological and physiological barriers when working towards a changed relationship with alcohol. Understanding why we drink is critical in changing our relationship with alcohol. The better awareness of why we drink, the greater our ability to change our drinking patterns and habits.
You don’t have to have a problem with alcohol to benefit from reducing your intake.
- Keep track & be honest with yourself
- Make 1 change at a time
- Have drink free days
- Alternate alcoholic drinks with non-alcoholic drinks
- Don’t stock up on alcohol at home
- Use smaller glasses or measure out your drinks
- Freeze leftover wine for cooking
- Don’t top up your own or other people’s glasses
- Don’t buy rounds of drinks with people
- Buddy up with a friend or family member
- Use an app to help you
- Build up regular use of other strategies to help you relax and unwind such as, deep breathing, mindfulness, meditation, stretching, yoga and other gentle exercise.
Drinkline is the UK National alcohol helpline. If you’re worried about your own or someone else’s drinking, you can call this free helpline in complete confidence. Call Drinkline 0300 123 1110 (weekdays 9am to 8pm, weekends 11am to 4pm).
Resources & References
- Centre for Disease Control & Prevention
- Cancer Research UK
- National Institute for Health & Care Excellence
- Reframe App
Provided by Dr Sarah Jordan, Consultant Clinical Psychologist, Employee Psychology Service, Clinical Lead for Health and Wellbeing, Tees Esk & Wear Valley NHS Foundation Trust.
Real Life Experience
Hi, I’m Dr Sarah Jordan, the Clinical Lead for Health and Wellbeing. As part of the Better Health at Work Campaign I’ve decided to share the intentions I’ve set to consciously and actively keep my alcohol units down. This is not an easy thing to do, it feels like some kind of AA confession but thankfully I’m not alcohol dependent.
I’m sure we all know that to keep health risks from alcohol low we should have no more than 14 units a week, have several alcohol-free days and never binge drink. More than 8 units of alcohol in a single session for males, or more than 6 units for females, is the technical definition of a binge. So, if I am honest with myself (and everyone reading this) I know that I don’t always and consistently stay within these guidelines. The more I learn about the negative effects of alcohol on physical and mental health the more I wonder why I even drink at all? It seems at odds with my passion regarding health and wellbeing and my interests in nutrition and exercise. It’s something that with the onset of perimenopause I have become even more self-conscious of.
Having a glass of wine in the evening is very common, especially within the 40-65yrs age group. Alcohol is linked in our minds with celebrations, stress release, having fun, relaxing, and unwinding and (like food) is often something that we link with reward at the end of a challenging day.
My parents have one large glass of wine with their dinner every night and although I’ve never seen them drunk or go to the pub just for a drink, this regular drinking has been normalised for me. When we discussed this, they were surprised that they exceed the weekly recommended guidelines and that alcohol could have a detrimental impact on their health and they would be classed ‘chronic’ drinkers, according to research.
Chronic drinking (7 or more drinks spread over a week) has been linked with high blood pressure, heart disease, digestive problems and of course liver disease and some cancers. Unfortunately, the more I learn about the impact alcohol has on the gut-liver-brain axis the more I realise how detrimental even low to moderate alcohol can be on our mental health. About 50% of our body’s dopamine is produced in our guts (not our brains). When we drink alcohol, we decrease the gut’s natural dopamine production by causing imbalances in our healthy gut microbes. Ultimately alcohol is a depressive and long-term chronic drinking results in us being more susceptible to stress, and less emotionally resilient when we are not drinking, because of its impact on the gut-liver-brain axis. Alcohol literally can change neuronal function and lead to neurodegeneration. As a woman entering the perimenopause stage of life it is also possible that alcohol’s effects will get worse as my oestrogen levels decrease and increase symptoms such as anxiety and brain fog.
Although the research looks bleak, this is information that has helped me cut down. I am ambivalent about giving up alcohol completely, but I definitely want to keep my alcohol units low. I’ve found it helpful not to buy wine with my weekly shop and reduce drinking at home that had previously increased during the lockdowns. I find it helpful to do other things to relax and switch off in the evenings, such as reading, yoga and messaging friends. I remind myself that ultimately alcohol is a poison that my body doesn’t need after a hard day’s work. I’m starting to think ‘I’m so glad I haven’t had a glass of wine this week’ and noticing I’m sleeping well, and my energy and motivation levels are good.
If, like me, you’re interested in learning more about reducing your alcohol intake visit www.drinkaware.co.uk .Drinkaware’s mission is to use their expertise and knowledge to support individuals, communities and organisations make informed decisions about alcohol and how to reduce the harm it can cause.
Content added 18/09/2023.