Alcohol

barrels

Beer barrels

Alcoholic drinks consist mainly of flavoured water and ethyl alcohol (ethanol). They are made by the fermentation of fruits, vegetables or grains.

Safe Drinking levels

In January 2016 the government produced new guidelines on drinking. The guidelines state that there is no completely safe level of alcohol consumption. Unit guidelines are the same for men and women and both are advised not to regularly drink more than 14 units per week.

Pregnant women are advised not to drink at all.

According a 2021 report by Local Government Association there are 10 million adults in England who drink above the guidelines, including more than two million who drink at higher risk and an estimated 587,000 who are dependent on alcohol.

What is a unit?

  • One pint of normal strength lager (3 – 3.5%) is equivalent to 2 units
  • One 275ml bottle of alcopop (5.5%) is 1.5 units
  • a 175ml glass of 12% wine is 2 units
  • a single measure of spirits (40%) is 1 unit 

These are measures of alcohol as might be bought in a restaurant or pub. Many drinks poured at home will be more generous and so contain more units of alcohol.

DrinkAware graphic on the 2016 guidelines:

DrinkAware

Types of alcohol

Alcopops

Most of these have an ABV of 4 – 5.5% with a range of units from 1.5-1.75 per bottle. The most well-known brands are the alcoholic lemonades and there are also alcoholic colas, fruit flavoured drinks and those using spirits such as vodka and tequila.

Spirits

Most standard 700 ml bottles of whisky, vodka or rum have an ABV of around 40% containing 25-30 units of alcohol.

Wine

Wine

Most wines are produced with an ABV of around 10-13% in a standard 750ml bottle containing 7-10 units of alcohol. Wines from hotter climates such as Italian and Californian wines tend to be stronger at 12 to 13% ABV

Fortified wines are stronger, with drinks like Buckfast and Eldorado being as strong as 17%. Sherry is usually produced with an ABV of 15-20% giving around 13-14 units of alcohol for a typical 750ml bottle

Cider

This varies in strength from the low alcohol varieties such as Strongbow LA with an ABV of just 0.9% up to the white ciders’ with an ABV of around 8.4%. A can of one of the stronger ciders contains around 2.5-3.5 units of alcohol.

Beer and lager

Most popular types of bitter beer are around 3.5 to 4.1% ABV – giving around 2 – 2.25 units for a pint and 1.5 to 1.75 units for a 440 ml can.

The strength of lager beers can vary widely and ranges from very low strength drinks like Barbican (0.02% ABV) to super strong’ lagers at anything up to 10%. But like bitter beers, many popular lagers are around 3.5-4% ABV providing 1.5-1.75 units in a 440ml can and 2-2.25 units in a pint.

A different type of alcohol produced from wood (methyl alcohol) is used in methylated spirits and surgical spirit. Some alcoholics (‘meths’ drinkers) drink this type of alcohol because it is cheap. Methyl alcohol is poisonous and can cause blindness, coma and death.

Unlike most drugs, alcohol has food value and supplies calories. One gram of alcohol supplies seven calories, almost twice the number of calories as one gram of carbohydrate. A pint of beer can supply as many calories as six slices of bread. Beer provides very little protein or vitamin and distilled spirits provide none at all.

Effects/risks

Alcohol is absorbed into the bloodstream and starts to have an effect within 5 to 10 minutes. The effects can last for several hours, depending on the amount consumed.

The effects of alcohol also depend on:

  • How quickly it is drunk, whether there is food in the stomach and the person’s body weight.
  • How used to drinking someone is, in other words, what their tolerance level is.
  • How people feel before drinking. People who feel relaxed and in a good mood are less likely to become aggressive. Some people ‘drown their sorrows’ in drink and find that they feel worse after.

Alcohol is a depressant drug. It acts on the central nervous system to slow the body down. Usually people will feel more relaxed and less inhibited when drinking. This can make socialising easier.

Some people may become aggressive and argumentative after drinking. A lot of violence on the streets and in the home is associated with alcohol use.

Short term effects

After about 4 pints of average strength lager people may find their bodily coordination is affected. They may have blurred vision and slurred speech and their memory may be affected.

Drinking alcohol makes accidents more common.Lowering of inhibitions can make it more likely that people will put themselves in sexual situations which they later regret. They are also less likely to practice safe sex.

Drinking too much in one go (alcohol poisoning) can lead to vomiting, losing consciousness and death by respiratory failure or choking on vomit. A fatal dose is around 500mg of alcohol per 100ml of blood.

Drug interactions

Alcohol can be very dangerous to take in combination with other drugs, especially other depressant drugs such as barbiturates, heroin, methadone or tranquillisers and drugs such as antidepressants, anti-histamines and painkillers. Mixing these drugs and alcohol has led to fatal overdoses.

Long-term effects and dependence

Drinking more than the government’s recommended guidelines increases your risk of developing serious health conditions, including:

  • heart disease
  • stroke
  • liver disease
  • various cancers
  • Pancreatitis
  • brain damage

For more information on the health effects of long-term alcohol use see the NHS website.

Physical dependence and tolerance develop so that people need to drink more and more to achieve the same effects and suffer withdrawal symptoms, such as trembling, sweating, anxiety, delirium and insomnia if they try to stop. When someone loses control over their drinking and has an excessive desire to drink, it’s known as alcoholism.

Dependent drinking usually affects a person’s quality of life and their relationships. Severely dependent drinkers are often able to tolerate levels of alcohol that would dangerously affect or even kill other people.

” I was dry for almost a month but at my cousin’s wedding I felt different from the others. I decided to have one drink. I thought I could control it …… I drank without restraint for the next five days. In a blinding flash of drunken logic I saw how bad I was. It was a shattering thunderbolt. I took a handful of pills, not as a cry for help but because of the hopeless position I was in.”
N. Kessel and H. Walton Alcoholism Penguin 1965.

Getting help

If you are concerned about your levels of drinking or those of someone else visit your GP.

You may also find the following organisations helpful to contact:

Prevalence

From Statistics for England published by NHS Digital in February 2020:

  • 65% of men and 50% of women had drunk alcohol in the last week.
  • The proportion of men and women usually drinking over 14 units in a week varied across age groups and was most common among men and women aged 55 to 64 (38% and 19% respectively).
  • The proportion of men who drank more than 8 units in a day dropped from 24% in 2006 to 19% in 2018, with a gradual decline since 2009.
  • The proportion of women drinking more than 6 units in a day decreased between 2006 and 2018 from 16% to 12%.
  • Across all age groups, men were more likely than women to drink at increasing and higher risk levels.
  • In 2018/19, 76,000 were treated for problematic drinking alone which was similar to the previous year.
  • In 2018/19, 29,000 were treated for non-opiate and alcohol problems.

Binge drinking

Binge drinking is defined as more than 8 units of alcohol in a single session for men and 6 units for women. 

In their survey over 16 year olds, the ONS Adult drinking habits in Great Britain: 2017 reports that:

  • 27% of drinkers in Great Britain binge drink on their heaviest drinking days
  • 28.7% of men and 25.6% of women surveyed binged alcohol on their heaviest drinking day. 
  • Those aged 16 to 24 years were most likely to binge drink when they drink.
  • Drinkers aged 65 years and over were the least likely to binge. Male respondents aged 65 years were nearly twice as likely to report binging (14.7%) than females of the same age (7.6%).

Teetotalism (complete abstinence from alcoholic drinks)

The proportions of men and women who had not drunk alcohol varied across regions. Among both men and women, the highest proportions of non-drinkers were in London (28%) and the lowest proportions in the East of England (9%) (Statistics for England published by NHS Digital in February 2020).

The ONS Adult drinking habits in Great Britain: 2017 publication where they surveyed 16 year olds found that

  • 20.4% of survey respondents reported that they were teetotal (they did not drink alcohol at all). 
  • Women were more likely to report being teetotal (22.6%) than men (18.1%).
  • Since 2005, teetotalism has increased for those aged 16 to 44 years and fallen for those aged 65 and over.

Deaths and hospital admissions

From statistics published by ONS in Alcohol-specific deaths in the UK: registered in 2020 (published December 2021):

  • In 2020, there were 8,974 deaths (14.0 per 100,000 people) from alcohol-specific causes registered in the UK, an 18.6% increase compared with 2019 (7,565 deaths; 11.8 per 100,000 people) and the highest year-on-year increase since the data time series began in 2001.
  • Between 2012 and 2019, rates of alcohol-specific deaths in the UK have remained stable, but a statistically significant increase was seen in 2020.
  • Consistent with previous years, the rate of alcohol-specific deaths for males in 2020 remained more than double the rate for females (19.0 and 9.2 deaths per 100,000 people respectively, registered in 2020).  
  • Scotland and Northern Ireland had the highest rates of alcohol-specific deaths in 2020 (21.5 and 19.6 deaths per 100,000 people respectively).
  • Comparing with 2019, the alcohol-specific death rate has risen across all four UK constituent countries, but statistically significant increases were only seen in England and Scotland. 

History

Making and drinking alcohol goes back many thousands of years to the earliest days of civilisation. This probably first happened in the Middle East where grapes grow wild without cultivation. Alcohol is mentioned in the Old Testament when Noah plants a vine yard after the Flood and becomes drunk. The ‘evils of getting drunk’ are recorded on Egyptian papyrus from 3500BC. The population of ancient Greece was noted for heavy drinking. In ancient Rome getting drunk was almost a national pastime but it was an offence to be drunk in charge of a chariot.

Many societies and religions have allowed the use of alcohol. The Roman Catholic and Jewish religions include wine in their ceremonies. However, the Islamic faith (Muslims) and some Christian groups such as the Mormons do not allow its use.

For centuries ‘ale houses’ and beer drinking have been a part of everyday life in Britain. Because of the lack of pure drinking water, beer was commonly the main drink to have with a meal.

In the 15th century there was concern that ale houses were meeting places for working class political radicals, and magistrates were given powers to close down houses that were seen as causing trouble.

In America, the Temperance movement had far more effect. In the early 20th century alcohol was banned in many southern states and in 1919 Prohibition was introduced, banning alcohol in all of America. However, because there was no widespread public support for Prohibition, it did not stop the manufacture or drinking of alcohol. Poor quality ‘bootleg’ alcohol was sold in illegal drinking clubs called ‘speakeasies’. These were run by gangsters such as Al Capone, and crime and violence flourished. Eventually in 1933 the law which banned alcohol in America was repealed. By then gangs (including the Mafia) had learnt how to make and sell illegal alcohol. Many then switched to drug dealing.

Alcohol is now a major source of government revenue in the UK and continues to grow. According to the latest Alcohol Bulletin commentary (May 2021 to July 2021), the provisional total for alcohol duty receipts between May and July 2021 is £3,398 million, an increase of £199 million (6%) compared to the same period last year. The duty to pay on alcohol is dependent on its strength and whether it is still or sparkling. For spirits, £28.74 of Spirit Duty per litre of pure alcohol is paid. See the full duty rates on the gov.uk website.

Examples of duty:

  • For a pint of 5% strength lager there is just over 54p of duty
  • For a litre of 12% still wine there is just over £2.97 of duty
  • For a ​​1 litre bottle of 40% ABV vodka there is £11.50 duty

During the 1990s new alcoholic drinks seemed to be being targeted at young people. These included strong lagers and ciders and ‘alcopops’, high alcohol content drinks which do not taste of alcohol, such as lemonades. As well as possibly leading to more young people drinking at a younger age this may result in increased drunkeness, with more alcohol being consumed in a short space of time.

From 2010 to the present date there has been a resurgence in gin, with many flavoured varieties achieving popularity. The craft beer movement has also seen beer sales rise. However, 21 pubs have been closed everyday during the COVID-19 pandemic.

The law

The manufacture, sale, distribution and purchase of alcohol is mainly controlled by the 1964 Licensing Act.

There are different licences governing the sale of alcohol. Full ‘on licences’ are granted to pubs and clubs and mean alcohol can be drunk on the premises. ‘Off licences’ are granted to off- licences, shops and supermarkets where alcohol cannot be consumed on the premises. ‘Restaurant licences’ permit the sale of alcohol and consumption on the premises if accompanied by a meal. Licensing laws also restrict the times at which alcohol can be sold and consumed.

There are also rather complex laws about the age at which people can drink alcohol:

  • It is an offence to give alcohol to a child under 5 years old unless in an emergency or under medical supervision (Children and Young Persons Act 1933)
  • Children of any age can go into parts of pubs that are set aside for meals or as family rooms..
  • Young people are not allowed to drink alcohol in a bar or buy alcohol in a pub or off licence until they are 18 years old.
  • 16 year olds can buy and drink beer or cider (but not spirits) in a pub but only if they are having a meal.
  • There are slightly different rules in different parts of the UK In Northern Ireland, for example, nobody can enter any part of a pub if they are under 18 years old.
  • Anyone aged under 18 years old who tries to buy alcohol can be fined. A licensed vendor (pub landlord, off licence proprietor etc.) who knowingly sells alcohol to young people aged under 18 years can be fined and could lose their licence. Licenses have to be approved by magistrates and the police can object if they think vendors are not fit to sell alcohol.
  • Unlicensed ‘home brewing’ of beers, ciders and wines (but not spirits) is permitted but it is illegal to sell these products.

Under the Public Order Act 1986, it is an offence to possess or carry alcohol on trains, coaches or minibuses travelling to or from certain sporting events. Police also have powers to confiscate alcohol from under 18s, if they are drinking on the streets. Some cities, such as Bath and Coventry, have introduced by-laws making it an offence to drink alcohol on the streets in city centre areas at any age.

It is an offence to be drunk and disorderly in a public place, including within licensed premises. It is also an offence to drive whilst unfit to do so because of drink. Anything more than 80mg of alcohol in every 100ml of blood is over the legal limit. This usually works out at about two and a half pints of normal strength beer for males but varies from person to person and is usually less for females.

Minimum Unit Pricing

On 1st May 2018 Scotland was the first country to introduce Minimum Unit Pricing for alcohol. See Guidance on the Implementation of Minimum Pricing for Alcohol: For sellers of alcohol and enforcement authorities in Scotland (PDF)

The minimum price of alcohol is set at 50p per unit. Anyone with a licence to sell alcohol won’t be allowed to sell it cheaper than this.

A 2021 study from the National Institute for Health Research found that implementation of minimum unit pricing at 50p per unit was unproblematic with no evidence of beneficial or harmful impacts on the outcomes evaluated.

However, the final report published on the impact of MUP on people drinking at harmful levels: Evaluating the impact of Minimum Unit Pricing in Scotland on people who are drinking at harmful levels published June 2022, found no clear evidence of a change in consumption or severity of dependence for those drinking at harmful levels or people with alcohol dependence. Findings also showed that some economically vulnerable groups were spending more on alcohol due to the price rises and experienced increased financial strain as a result, and some people who were dependent on alcohol reduced other expenditures, such as food and utilities.

There was also an interim report published in June 2021, it can be accessed here.

Further reading

No place for cheap alcohol: the potential value of minimum pricing for protecting lives
Report from the World Health Organisation discussing minimum pricing on alcohol globally. 

Last updated: June 2022