What is Alcohol?

In England there are an estimated 602,391 people who are dependent on alcohol and only 18% of those are receiving treatment. An estimated 24% of adults in England and Scotland regularly drink over the guidelines of low-risk alcohol use and 27% binge drink on some days.

In the UK, data shows that there were 8,974 alcohol-specific deaths in 2020. This is an 18.6% increase from 2019. Alcohol misuse is the biggest risk factor for death, ill health and disability among 15- to 49-year-olds in the UK. There are 200 diseases and injury conditions where alcohol is a factor.

What is alcohol?

The type of alcohol in alcoholic drinks is a chemical called ethanol. Ethyl alcohol, or ethanol, is an intoxicating ingredient found in beer, wine and spirits. Alcohol is produced by the fermentation of yeast, sugars and starches.

It is a psychoactive substance which has dependence producing properties. It is regularly used in many cultures across the world and has been used for centuries. Chemical evidence from fragments of pottery in China suggests that people were brewing alcoholic drinks at least 9,000 years ago.

What is alcohol used for?

Alcohol has been used for centuries in social, religious, cultural and medical settings. It is believed that alcohol can be used responsibly by adults in social settings and therefore it remains a legal substance. However, alcohol can also be used to excess resulting in health, social and legal problems.

Alcohol is also used in medicines, cleaning and household products, mouthwashes and essential oils.

Alcohol in various forms is used in medicine as an antiseptic, disinfectant and antidote. Alcohol is applied to the skin in order to clean and disinfect it before an operation or any other medical procedure. This stops the affected area becoming dirty and getting infected. Alcohol should also be used on the hands of the healthcare provider in order to disinfect their hands.

Alcohol is used in the pharmaceutical industry in various manufacturing processes. It is often used as a topical disinfectant and is widely used as a solvent and preservative in pharmaceutical preparations.

Isopropyl alcohol is a potent antimicrobial. It is used in household cleaning products in order to inhibit and stop the spread of microorganisms. It kills 99.99% of germs within 10-30 seconds of its application. This makes it one of the best sterilisation tools.

Is alcohol a drug?

A drug is a medicine or other substance that when ingested or introduced to the body in another way has a physiological effect. It is something that changes someone’s mental or physical state. Drugs can change how you feel, think or behave.

Alcohol is a drug. It is classed as a central nervous system depressant. Consuming alcohol slows down brain functioning and neural activity and reduces the functioning of various other functions within the body. After you drink alcohol, it is absorbed into the blood where it then travels to the brain. When someone drinks small quantities of alcohol, it can typically make them feel relaxed, animated and disinhibited. It can also impair coordination which is why it is considered unsafe to drink and drive or operate machinery.

When someone consumes large quantities of alcohol, it results in depressant effects in the body. This is because the body is not equipped to process large amounts of alcohol.

The depressant effects can include:

• Delayed reaction time.
• Slurred speech.
• Cognitive impairments.
• Poor coordination or lack of motor skills.
• Unsteady/unable to walk properly.
• Distorted judgement.
• Distorted perceptions.
• Poor coordination.
• Lack of motor skills.
• Decreased inhibitions.
• Sedation.

At higher concentrations, the effects of alcohol become more severe. People may become more prone to losing control of their emotions and potentially becoming aggressive. Alcohol can often be a factor in violent crimes or anti-social behaviour for this reason.

Although alcohol is classed as a depressant, it also has stimulatory effects. This depends upon the amount and rate at which the alcohol is consumed. If consumed in smaller quantities, alcohol is more likely to have a stimulatory effect.

This can include:

• Improvements in mood.
• Increased confidence.
• Talkativeness.
• Euphoria.
• Increased heart rate.
• Increased blood pressure.

Alcohol also affects the regulation of bodily fluids, causing people to urinate more and become dehydrated. If you drink excessively, you may get a hangover. Symptoms of this vary from person to person.

 These may include:

• A headache.
• Tiredness.
• Dry mouth.
• Nausea.
• Low mood.
• Impaired memory.

Alcohol is the most commonly used drug or addictive substance in society. As alcohol is a legal drug, it is widely accepted as being a social norm.

Although alcohol is legal, it may have other restrictions based on:

• Age.
• Location of where you can use it.
• Driving laws.
• Point of sale restrictions.

There are many other types of drugs; some are legal and others are illegal. Some drugs are referred to as controlled substances. It is a term used to describe chemicals that are turned into drugs. Controlled substances require more advanced looking after than other drugs.

What are the different types of alcohol?

The three different types of alcohol are:

• Ethanol.
• Methanol.
• Isopropanol.

Ethanol is the only type of alcohol that is safe to drink.

Methanol is a component used in fuel for cars and boats. It is also used in anti-freeze, paint remover, windscreen wiper fluid and other household products.

Isopropanol is the chemical name for rubbing alcohol which is used for cleaning and disinfecting.

Methanol and isopropanol are both poisonous substances and cannot be consumed, even the smallest amount could cause liver failure and be fatal.

How is alcohol made?

In alcoholic drinks, the type of alcohol is ethanol. Grains, fruits and vegetables are put through a process called fermentation. Alcohol fermentation is a biochemical process where yeast converts sugars to ethanol, carbon dioxide and other metabolic by-products.

Wine and cider are made by fermenting fruit and beer and spirits are made by fermenting cereals, for example, barley and rye. The alcohol content is determined by how long it has been left to ferment.

Liquors and spirits are distilled alcoholic beverages. They contain more alcohol by volume than non-distilled drinks.

Distillation is where a proportion of the water is removed, leaving a stronger flavour and a more concentrated alcohol content. Distillation happens after fermentation. The process converts a fermented substance into one with an even higher concentration of alcohol. Distillation concentrates alcohol by separating it from the water and other components of a fermented substance.

What are the harmful effects of alcohol?

Alcohol is a psychoactive substance and people can become alcohol dependent.

Excessive alcohol use can cause disease and has social and economic consequences.

• Alcohol consumption is linked to mental health and behavioural disorders.
• Alcohol is a causal factor in more than 200 diseases.
• Alcohol causes injuries due to accidents while people are under the influence.
• Alcohol is related to other health conditions and is responsible for 5.1% of the global burden of disease and injury.
• Injuries as a result of alcohol use include road traffic accidents, violence and suicide.
• Young people are more at risk of accidents and injuries as a result of alcohol consumption.
• In people aged 20-39 years, approximately 13.5% are linked to alcohol use.
• Alcohol consumption during pregnancy can cause foetal alcohol syndrome and can lead to early labour.
• Worldwide, 3 million deaths each year result from harmful use of alcohol. This accounts for 5.3% of all deaths.
• The harmful use of alcohol brings social and economic losses to individuals and society at large.
• Drinking large amounts of alcohol in a short space of time can put you at risk of alcohol poisoning.

Steps can be taken within society to reduce the harmful effects of alcohol.

These include:

• Restricting and regulating the availability of alcohol.
• Strict drink driving laws.
• Regulating advertisement campaigns in relation to alcohol.
• Raising awareness of health issues.
• Raising awareness of societal issues.
• Providing treatment for people with alcohol dependency.

By reducing your alcohol use to safer levels, you reduce the risk of some health conditions.

These include:

• Liver disease.
• Heart disease.
• Brain damage.
• Dementia.
• Diabetes.
• Various cancer types.
• Raised blood pressure.
• Stomach ulcers.
• Reproduction problems.
• Depression, anxiety and other mental health problems.
• Stroke.

How much alcohol is too much?

The UK chief medical officer’s low-risk drinking guidelines state that it is recommended to drink no more than 14 units of alcohol per week, spread across 3 days or more. This is to keep health risks low as a result of alcohol consumption, for both men and women.

The idea of counting alcohol units was first introduced in the UK in 1987 to help people keep track of how much they were drinking. Units of alcohol is a clear and simple way of counting the quantity of pure alcohol in a drink.

One unit equals 10ml of pure alcohol which is what the average adult is able to process in the space of an hour. This means that in an hour there should be little or no alcohol left in the blood. This obviously varies from person to person.

In a single shot of a spirit there is 1 unit of alcohol, one small glass of wine has 1.5 units of alcohol, a small bottle of lager has 1.7 units of alcohol and a standard glass of wine has 2.1 units of alcohol.

Alcohol can have harmful effects on the body. Ethanol, the type of alcohol in drinks, is toxic. It damages the liver, the brain and other organs over time.

As alcohol is a drug, regular alcohol use can lead to alcohol abuse. The most severe form of alcohol abuse is alcoholism.

Alcoholism is an addiction to alcohol. Alcoholism is the most serious type of problem drinking. It describes an often uncontrollable and strong desire to consume alcohol. Alcoholism is known by a variety of terms such as alcohol addiction, alcohol dependence or alcohol abuse and it has been more recently referred to as alcohol use disorder. It occurs when a person drinks so much that their body becomes physically dependent on, or addicted to, alcohol.

People who suffer from alcoholism will often be unable to prioritise anything else above their need to drink; this can include their work commitments and their family and friends. Even when their drinking is having a negative and often devastating impact on their life and relationships, this is still not enough to make them stop as the pull to use alcohol is so strong.

UK Government and NHS statistics show that there are an estimated 589,000 people who are dependent on alcohol in England and in 2018/2019 there were 358,000 estimated admissions to hospital, where the main reason for admission was attributable to alcohol.

In England in 2018, there were 5,698 alcohol-specific deaths. A further 1,920 deaths were also due to unspecified hepatitis and fibrosis and cirrhosis of the liver. These deaths are not included in the alcohol-specific charts because they are defined as only being partially attributable to alcohol.

People who are struggling with alcoholism often feel like they cannot function properly without alcohol. This can impact on health, relationships, work and day-to-day functioning.

Common signs of alcoholism include:

• Being unable to control alcohol use.
• Regularly craving alcohol.
• Being unable to stop drinking.
• Putting alcohol above personal responsibilities.
• Spending a substantial amount of money on alcohol.
• Alcohol use impacting upon your relationships, work or any other aspect of your life.
• Other people are concerned about your alcohol use.

Recognising that you have a problem with alcohol is the first major step on the road to accessing support and recovering from alcohol addiction. If you feel like your alcohol consumption is impacting negatively on your life, you should seek support for this.

You can make an appointment to speak to your GP. Try to be as accurate and honest as you can about your drinking habits and any problems it may be causing you. Your GP may suggest different types of support options available in your local area. If you are physically dependent on alcohol, stopping completely without professional support could be dangerous. You should get some advice about this and any medication you may need to do this safely.

Symptoms of being physically alcohol dependent may include:

• Sweating.
• Tremors.
• Nausea or retching in the morning.
• Vomiting.
• Having hallucinations.
• Anxiety after waking up.
• Having seizures or fits.

Some useful contacts if you are concerned about alcohol use are:

• Alcoholics Anonymous is a free self-help programme with support groups.
• Smart Recovery groups help people decide if they have a problem and offer tools and techniques to support recovery.
• Adfam is a national charity working with families affected by drugs and alcohol.
• We Are With You is a treatment agency that helps individuals, families and communities manage the effects of drug and alcohol misuse.