Do I have a drinking problem? The signs to look out for and what to do about it

Plus, how many units of alcohol you can consume each week and the risks of drinking too much

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If your recent relationship with alcohol has got you wondering 'do I have a drinking problem?' our experts are here to help. Alcohol has become a part of our everyday culture, with one in 10 women drinking more than recommended, according to Drinkaware. Whether it's a glass of wine with dinner or a bottle of bubbly to celebrate a work success, we're drinking more causally than ever before, with very few of us having an alcohol-free week.

Reflecting on your relationship with alcohol may feel daunting, but it's one of the easiest at-home health checks you can do for yourself. After all, alcohol can impact everything from our liver health to our skin. To help you better understand your relationship with alcohol we spoke to experts. They shared with us top tips for spotting a drinking problem, and what you can do to overcome it, plus the resources out there to support you in cutting down your alcohol consumption, so you can enjoy the benefits of not drinking alcohol

How many alcohol units per week should we be drinking?

The NHS alcohol guidelines says men and women who drink regularly should consume no more than 14 units a week. This is the equivalent of six pints of beer or seven glasses of wine. It also says if people drink, it should be moderately over three or more days and that some days should be alcohol-free.

How many of us have a drinking problem? 

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A YouGov survey in 2015 found “empty nester” mothers were at the forefront of the middle-aged drinking epidemic in Britain, with 28% of women over 45 admitting they drank as much or more than their grown-up children. Because they don’t get drunk, they often don’t see it as a problem. Yet NHS figures in 2017 showed those aged 55 to 64 are now the most likely to be admitted to hospital because of alcohol-related diseases and injuries.

In the US, the American Addiction Centers report more than seven percent of the American population aged 18 and over have a drinking problem. And, millions more take part in risky consumption that could lead to alcohol abuse. 

How different is drinking culture around the world?

According to Dr John Larsen, director of evidence and impact for alcohol education charity Drinkaware, one of the causes of the escalating consumption of alcohol in the UK is wanting to be a generous host or hostess. “It’s part of the British culture to keep topping up glasses and to expect large serving sizes. It’s seen as being a great host to not leave them empty. People want to be hospitable but it may mean some people get to drink larger volumes than they perhaps intended to.”

On the continent, it’s more common to serve smaller sizes. In France, for example, a standard glass of wine is 100ml, whereas in Britain it’s 175ml for a medium. It’s important because serving size influences how much and how quickly people consume. At social gatherings, far more thought goes into the alcohol available than tempting soft drinks or homemade non-alcoholic cocktails. “We need to give the message it is OK not to drink—it doesn’t mean you’re not fun or a great guest, or a mean you're a poor host,” Dr Larsen emphasizes.

What are the risks of drinking too much?

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So what are the risks associated with drinking too much, especially as we get older? Unfortunately, they make for pretty grim reading. It’s tougher for our bodies to process alcohol as we get older and it increases the risk of: 

  • Breast, liver, bowel, mouth, and oesophageal cancer
  • Dementia 
  • Heightened menopause symptoms
  • Poor sleep and insomnia
  • Weight gain 

Not only does alcohol consumption affect fertility but it can make menopause tougher to deal with too. “When women reach menopause their bodies are affected by changing hormones. Alcohol can trigger some symptoms such as hot flushes and night sweats,” explains Dr Larsen. “Menopause can disrupt your sleep because of night sweats and cause you to gain weight. Alcohol often makes both of these issues worse. It can also increase the risk of osteoporosis."

Too much alcohol can also affect women’s sex lives. While it’s often thought that a few glasses of wine can be relaxing, the reality is it's a common cause of vaginal dryness, making sex uncomfortable and even potentially painful. According to Drinkaware, it can reduce lubrication, a problem for many menopausal women anyway (especially those with vaginal atrophy), making it harder to orgasm and reducing the intensity of climax. If that’s what it does to the inside of our bodies, what about the outside?

“Alcohol interferes with the normal sleep process so you often wake up feeling—and looking—like you haven’t had much rest. Alcohol dehydrates your body, including the skin. It’s also thought to deprive the skin of certain vital vitamins and nutrients," says Dr Larsen (see our guide to common signs of a nutrient deficiency and what else you can do to help).

“With two large glasses of wine containing the same calories as a burger, it’s easy to see why regular drinking can lead to weight gain," says Dr Larsen. "Alcohol also reduces the amount of fat your body burns for energy. Because we can’t store alcohol in the body, our systems want to get rid of it as quickly as possible, and this takes priority over absorbing nutrients and burning fat.” No matter how many HIIT treadmill workouts you're doing, if you're not fueling your body with a nutritious diet and less or no alcohol, you won't reap the full benefits of exercise. 

How to tell if you have a drinking problem

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If you're concerned you might be drinking too much or have a drinking problem, you could keep a journal of how often and how much you're drinking—and reflect on how this makes you feel and compares with alcohol guidelines. 

Below are also some questions you can ask yourself to help you reflect on your relationship with alcohol. 

  • Look at your glass recycling. Are you surprised by the number of empty alcohol bottles in there?
  • Do you find it hard to imagine a night out with friends without drinking?
  • When was the last time you were the designated driver or do you always suggest getting a taxi?
  • Do you wake most mornings feeling dehydrated?
  • Have you at least one bottle of wine chilling in the fridge—just in case?
  • Do you always count down the minutes to wine o’clock?
  • Have you avoided honestly counting the units you drink because you suspect you’re way over?
  • Do you dread running out of your favorite alcohol when you go to a party?

How to stop drinking and get back on track

So what can you do if you are worried you have a drinking problem? And what happens when you give up alcohol? The trouble with drinking more is your tolerance goes up, meaning you can drink greater quantities without feeling its effects or getting that pleasant buzz.

“People tend to think of alcohol dependency as black or white and presume they know what it looks like,” says Dr Nick Sheron, a liver specialist from Southampton University. “But everybody who is drinking on a regular basis, reasonably heavily, will have a degree of alcohol dependence.

“For most people, you can ‘reset’ your whole system by having an alcohol-free period. And people feel better after it. I can tell as soon as they walk through the door by their facial appearance. The difference is dramatic.”

If you want to stop drinking and get back on track you should seek professional medical advice from your doctor or a specialist, especially if you believe you have a high alcohol dependency. You may also wish to speak with a mental health professional about your experience and confide in those you trust about what you're doing. 

Support and resources in the US

  • Alcohol Help—offers a free hotline, guidance and treatment options for those struggling with alcohol addiction. Call on 866-930-5077.
  • Alcoholics Anonymous—hosts in-person and online meetings for those recovering from alcohol addiction. 
  • SMART Recovery—offers free support meetings to help you stop drinking alcohol and feel empowered. 
  • SAMHSA’s National Helpline—has a free hotline available in both English and Spanish for those struggling with substance abuse. Call on 1-800-662-4357.

Support and resources in the UK

  • NHS—has a list of resources and more information on how to stop drinking alcohol safely.
  • Frank—helps you find local and national services that provide counseling and treatment in your area. 
  • Drinkline—free helpline for those worried about their own alcohol use or that of a loved one. Call on 0300 123 1110 (weekdays 9am-8pm and weekends 11am-4pm).
  • Alcoholics Anonymous—online and in-person meetings for those who need support with their recovery and sobriety. Helpline: 0800 917 7650.

w&h thanks Dr John Larsen, director of evidence and impact for alcohol education charity Drinkaware and Dr Nick Sheron, a liver specialist from Southampton University for their time and expertise.