How much alcohol is risky?
The risk of harm from drinking alcohol gradually increases with higher consumption, and the current body of research suggests that there is no clear limit for risk free alcohol consumption. That said, for otherwise healthy people, the risks are considered low if the alcohol consumption doesn't exceed 10 drinks per week. Binge drinking always poses a risk, which is why the recommendation is to drink less than four glasses per occasion. A blood alcohol concentration (BAC) of over 0.6 mg/ml always counts as binge drinking, regardless of whether you feel drunk or not. Daily drinking, no matter the amount, can increase the risk of developing an alcohol dependence. For weekly consumption levels, recent research suggests that there is no “safe” level of drinking, and that the recommendation should be to drink as little as possible.
So, there are no clear cut distinctions when it comes to determining the risk of drinking alcohol, and the recommendations for what level of drinking is harmful or risky vary across countries. That said, the levels mentioned above can be useful benchmarks if you have experienced negative consequences and want to reduce your drinking.
One drink is the equivalent of one small bottle of strong beer (33 cl), one glass of wine (10-15 cl) or one drink/shot of 4 cl of spirits. Half a litre (50 cl) of strong beer is the equivalent of 1.5 glasses. One bottle of wine (75 cl) contains 6 glasses. A bag-in-box of wine contains 24 glasses. One bottle of spirits (75 cl) contains 18 glasses.
It is important to consider the alcohol content of the drink you are having, if you want to control your drinking. For example when considering the large assortment of beers now available, some of which contain as much alcohol as the strongest wines do.
Can drinking a small amount of alcohol be good for your health?
Many people have read that a moderate amount of alcohol consumption may even be good for your health. It is thought that older people who drink small amounts of alcohol may reduce their risk of cardiovascular disease and diabetes. Researchers today do not agree on whether alcohol really does provide such protection. The truth is that alcohol has far too many damaging side-effects for it to be recommended for health reasons. Drinking in moderation, without becoming drunk, means in most cases only a small medical risk – assuming that you are not pregnant, depressed, suffering from a liver complaint or taking certain medicines. In these cases you should not drink any alcohol at all.
How does drinking alcohol affect you?
If you go into a bar on a Friday night, it is likely that many of those you meet will have a BAC above 0.8 mg/ml. However, research shows that you feel at your best before you exceed 0.5 mg/ml. The mistake we often make is to believe that we will enjoy ourselves even more if we drink more, despite past experience telling us otherwise. See below the way feelings and behaviour are affected* depending on your BAC level.
0.2 mg/ml: You notice the initial effect of the alcohol. You feel warm and relaxed and are in a good mood. You feel good about yourself.
0.5 mg/ml: You feel elated and less inhibited. Your reflexes slow down and you move with less precision. Your judgement becomes clouded and your ability to absorb information is affected.
0.8 mg/ml: You become louder and start to gesticulate more. You look worse than you normally do. You smell of alcohol and are overly self-confident. 1.0 mg/ml: Your speech is slurred and you have less control over both your muscles and your feelings.
1.5 mg/ml: You are starting to have difficulty keeping your balance and you may fall over. You may get emotional outbursts and get nauseous.
2.0 mg/ml: You have difficulty speaking and walking upright. You see double.
3.0 mg/ml: You don't know what is happening and are close to losing consciousness.
4.0 mg/ml: You are unconscious. You breathe slowly and risk dying of alcohol poisoning.
*It is impossible to say precisely what effect the amount of alcohol in the bloodstream will have on an individual, since a person who has drunk a lot of alcohol over a long time will have acquired alcohol tolerance and will not be affected as much. Bear in mind that the risk of alcohol-related harm and health problems does not decrease just because you have a higher tolerance level.
How does high alcohol consumption affect one's health?
Alcohol reaches all the organs and affects the entire body, both inside and out. According to the World Health Organisation (WHO), more than 60 diseases are linked to high alcohol consumption. People do not need to be dependent on alcohol to fall ill a a result of an alcohol-related disease; heavy drinkers without dependence can be affected too.
The brain
Even small amounts of alcohol will affect your judgement, ability to think, memory and ability to react. You won't sleep as well and your feelings will be affected. In cases of very high and long-term consumption, the brain shrinks and you may suffer from epileptic fits, dementia or another kind of brain disorders.
Depression
The risk of suffering from depression increases sharply as a result of high alcohol consumption. Half of all suicides in Sweden are alcohol-related.
The heart and blood vessels
Light to moderate alcohol intake has little impact on the heart and blood vessels. Drinking large amounts of alcohol does, however increase the risk. Your pulse and blood pressure are raised when you drink alcohol. There is an increased risk of cardiac arrhythmia of different kinds, such as atrial fibrillation. Alcohol consumption cannot be recommended for the prevention of coronary heart disease.
Pregnancy
There is a decrease in fertility in cases of high alcohol consumption among both men and women. The foetus is affected if the mother drinks alcohol during all stages of her pregnancy, and especially during the initial stage – even before she knows for sure that she is pregnant. If you are a woman and are pregnant or planning to become pregnant, it is best to abstain completely from alcohol.
The liver
Alcohol increases the risk of liver cancer and is a common cause of fatty liver, hepatitis and cirrhosis.
The skin
High alcohol consumption can make psoriasis, eczema and other skin ailments worse.
The stomach
High alcohol consumption increases the risk of dyspepsia and gastritis.
Bones and joints
High alcohol consumption increases the risk of osteoporosis and gout.
The blood
Alcohol inhibits the ability of the bone marrow to create blood cells and can result in anaemia.
Infection
The effect of alcohol on the bone marrow affects the white blood cells needed to protect the body from infection. This leads to further infection, such as frequent and prolonged colds.
Cancer
Alcohol increases the risk of cancer in a number of organs. There are clear links to mouth and throat cancer, liver cancer, breast cancer and colon cancer.
Which other risks are connected to drinking a lot of alcohol?
Accidents
Being drunk from drinking alcohol leads you to take greater risks. Every year about 3,000 people die in accidents in Sweden. In roughly a third of these cases, alcohol has been involved. People who normally are light to moderate drinkers but who drink enough to get drunk from time to time are involved in a large number of these accidents.
Violence
According to the crime statistics, many cases of both assaults and other violent crimes are related to alcohol consumption on the part of the perpetrator and/or the victim.
Relationship problems
High alcohol consumption can impair communication and harm or destroy relationships with people close to the drinker. Over a million people in Sweden who live in close proximity to someone who drinks too much state that it has had a negative impact on them.
Smoking and alcohol
Different drugs have a combined effect; for instance, alcohol and nicotine affect the brain's reward system in similar ways. Indeed, nicotine is believed to increase susceptibility to alcohol. Anyone wishing to alter his or her drinking behaviour may therefore find it beneficial to stop smoking or taking snuff at the same time. In the same way, it may be easier to stop smoking tobacco if you cut down on or stop drinking alcohol at the same time.
What is alcohol dependence?
Alcohol dependence means continuing to drink a lot of alcohol despite the negative effects its has on one's health, relationships and social life. Someone who is dependent often feels a craving for alcohol and has difficulty limiting its use. Often, but not always, he or she will acquire tolerance for alcohol, which will lead the individual to drink more to achieve the same effect. He or she may also develop withdrawal symptoms, which can involve a number of unpleasant symptoms on stopping drinking. Dependence also means in many cases that alcohol plays a big part in the life of the drinker at the expense of other things that were considered important in the past, such as relationships, one's career and leisure pursuits. Someone who is dependent will in many cases be aware that alcohol is a problem, but will still not be able to limit his or her intake or stop altogether. The six points listed below are criteria for alcohol dependence. In order to be diagnosed with alcohol dependence, the drinker must have experienced at least three of these at the same time over the most recent 12 month period.
- a strong desire or compulsion to drink alcohol; a feeling of craving
- difficulty in limiting the intake of alcohol, or impaired control
- the consumption of alcohol takes priority over other things such as work, leisure pursuits or socialising with others
- larger amounts of alcohol are needed to have the same effect as before (tolerance)
- shaky hands, sweating or anxiety after reducing or stopping one's intake (withdrawal)
- continuing to drink despite knowing that alcohol results in physical or psychological problems
Are you ready to change your drinking?
Many believe that it is very difficult to change one's drinking behaviour. However, for most people it is in fact comparable to stopping smoking, and can in many cases be compared to changing one's eating habits or starting to take exercise. You may find both advantages and disadvantages of drinking alcohol – this is the case for most people. But what matters the most? Only you can decide what is right for you and how you want things to be. Either you continue in the same way as before, or you alter your drinking. One positive step you can take, regardless of whether you have made your decision or are still unsure, is to clarify which arguments matter to you and the person you would like to be.
Set a goal
You don't need to make a decision for the rest of your life. If you want to make changes, a good idea is to have a clear goal over a set period of time. But what is reasonable? Are you going to limit your consumption and drink in moderation, or would it suit you better to cut out alcohol completely for a while?
Get going with the changes you want
See to it that you make some changes in your everyday life that will help you achieve your goal. These may involve not keeping any alcohol in the home, giving up alcohol for alcohol-free drinks, socialising more with friends who can support you, or starting some new, enjoyable activity at the times you have drunk alcohol in the past.
Chart your progress
Regardless of why you once started drinking too much, your alcohol consumption is now a part of your everyday life, your habits and your routines. If you find out which situations, thoughts and feelings you associate with alcohol, you will have a greater chance of influencing your alcohol consumption to go in the direction you want.
Find new alternatives
Alcohol may at times have acted as a short-term solution to other problems you have experienced (such as difficulties sleeping, stress or problems in relationships). By developing new habits and finding better solutions to the problems you have, it will be easier not to drink too much.
Get help
Having someone to talk to, who can help you examine your thoughts and feelings and will support the changes you are trying to make, is a good idea, whether this be a friend, family member or professional.
Don't give up too soon
Regard changed alcohol consumption as a long-term goal. Accept the fact that you may experience setbacks and steps in the wrong direction along the way, and don't attach too much significance to this or allow it to stop you. You can have as many attempts as you like to try to alter your drinking behaviour.
If you wish to talk to a health care professional about your alcohol consumption, you will be entitled to secrecy. You can also have an interpreter. You can read more about this on 1177.