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If you drink alcohol during pregnancy you risk causing harm to your baby. Sometimes this can result in mental and physical problems in the baby, called foetal alcohol spectrum disorder (FASD).
FASD can happen when alcohol in the mother's blood passes to her baby through the placenta.

Your baby cannot process alcohol well, which means it can stay in their body for a long time. Alcohol can damage their brain and body and stop them from developing normally in the womb.

This can result in the loss of the pregnancy. Babies who survive may be left with lifelong problems.

Characteristics of foetal alcohol spectrum disorder (FASD)

FASD can cause problems with:

movement, balance, vision and hearing

learning, such as problems with thinking, concentration, and memory

managing emotions and developing social skills

hyperactivity and impulse control

communication, such as problems with speech

the joints, muscles, bones, and organs, such as the kidneys and heart

These problems are permanent, though early treatment and support can help limit their impact on a child's life.

The type of FASD symptoms a baby has and how severe they are is different depending on how often, and how much, the mother drank during pregnancy. The greater the amount of alcohol consumed, the more severe the symptoms tend to be.

What to do if you think your child has foetal alcohol spectrum disorder (FASD)

Speak to a GP or health visitor if you have any concerns about your child's development or think they could have FASD.

If the condition is not diagnosed early and your child does not receive appropriate support, they're more likely to experience bigger challenges associated with the condition.

For example, they may have difficulties with learning, have challenging behaviours, mental health problems, and find it difficult to get a job and live independently as an adult.

A doctor or health visitor will need to know if your child was exposed to alcohol during pregnancy to help make a diagnosis of FASD.

Your child may be referred to a specialist team for an assessment if there's a possibility they have the condition.

This usually involves physical examinations and blood tests to rule out genetic conditions that have similar characteristics to FASD.

Treatment and support for foetal alcohol spectrum disorder (FASD)

There is no particular treatment for FASD, and the damage to a child's brain and body cannot be reversed. But an early diagnosis and support can make a big difference.

Once the condition has been diagnosed, a team of healthcare professionals can assess your child's needs and offer appropriate educational and behavioural strategies.

You may also find it helpful to contact a support group for people with FASD. These can be a good source of advice and they may be able to connect you with other people in a similar situation.

Find support from:

You might also want to ask your care team if they know of any local groups in your area.

Preventing foetal alcohol spectrum disorder (FASD)

FASD is completely avoidable if you do not drink alcohol while you're pregnant.

The risk of FASD is higher the more you drink. There's no proven "safe" level of alcohol in pregnancy. Not drinking at all is the safest approach.

If you're pregnant and struggling with an alcohol problem, talk to a midwife or doctor.

Confidential help and support is also available from:

Drinkaware has a national alcohol helpline called Drinkline; if you're worried about your own or someone else's drinking, call the free helpline on 0300 123 1110 (weekdays 9am to 8pm, weekends 11am to 4pm)

We Are With You - a charity providing free, confidential support for drugs, alcohol and mental health problems, and a directory of drug and alcohol services around the UK

Alcoholics Anonymous (AA) - a free self-help group; its "12-step" programme involves getting sober with the help of regular support groups

National Organisation for FASD has a helpline - 020 8458 5951 (you leave a message and someone returns your call)

You can also find your nearest alcohol support services or read advice on cutting down your drinking and alcohol in pregnancy.

Page last reviewed: 04 April 2023
Next review due: 04 April 2026

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Find out about foetal alcohol spectrum disorder, which is a range of mental and physical problems that can affect a child if their mother drinks alcohol while pregnant.

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The gold standard 'Identification' tool is the AUDIT (Alcohol Use Disorders Identification Test).

However many shorter versions of the AUDIT allow a shorter initial screen. These shorter tools, although less accurate, save time by not asking further questions for those likely to be lower risk drinkers and therefore not likely to need a brief intervention/Brief Advice.

: A score of 5 or more indicates increasing or higher risk drinking, so should be followed with the remaining 7 AUDIT questions to identify level of risk or potential dependence (i.e 10 questions totalled).

: Found to be the most accurate shorter screening tool, this 4 item questionnaire is commonly used in Primary Care. A score or 3 or more should be followed with the remaining 6 AUDIT questions to identify level or risk or potential dependence (i.e 10 questions totalled).

: This is the 1 question 'Modified Single Alcohol Screening Questionnaire, which has proven useful for very busy settings such as Emergency Departments. A score of two or more on the M-SASQ should be followed up with the remaining 9 AUDIT questions.

Some further screening tools are available here on the Alcohol Learning Centre.
'Brief Advice' tools
As described under About IBA, practitioners must be careful not to 'advise' too much, rather than encourage at-risk drinkers to think of their own reasons or ways of cutting down. However a useful 2-sided Brief_Advice_Tool is available ( PDF version) and youth version here. It includes the key elements of 'Brief Advice' and includes useful pointers for the practitioner to show the client. Although not designed specifically to be given to the client, it may be useful to do so if other resources are not available, such as those below.
Information booklets & materials
IBA includes giving the at-risk drinker some further information to take away with them. This is important because the drinker may have only just begun, or will soon begin to, contemplate their alcohol use. Therefore to be able to read or re-visit the information will be likely to help them decide a goal for their drinking. In the SIPS research, a 'Patient Information Leaflet' (PIL) was used know as 'How much is too much?'

Other options may also be considered, such as 'Your Drinking and You' , which offers a six-step plan to cutting down. It is important to be able to offer information on accessing local treatment services, or at least the Drinkline number 0800 917 8282 which can help.
Guidance and standards
Brief intervention comes in a variety of shapes and sizes, with research still unclear on what forms may be most suitable when. In England, most IBA delivery has been modelled around a simple brief intervention, including at least screening, simple brief advice and leaflet. However 'lite' versions have seemed increasingly popular, as explored in the 2013 Clarifying Brief Interventions paper.

A set of 'National Standards' for drug and alcohol works are known as 'DANOS', which outline the skills needed for IBA as AH10 Employ techniques to help individuals to adopt sensible drinking behaviour.

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Identification (screening) tools The gold standard 'Identification' tool is the AUDIT (Alcohol Use Disorders Identification Test). Download the AUDIT (or PDF version) However many shorter versions of the AUDIT allow a shorter initial screen. These shorter tools, although less accurate, save time by not asking further questions for those likely to be lower risk drinkers and...

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Brief Interventions In Alcohol - Training DVD

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How to make brief interventions a natural part of consultations

Brief interventions take a supportive, non-confrontational approach, which empowers the patient to recognise the risks associated with their drinking patterns, the benefits of reducing intake, and motivates them to adjust their lifestyle. By including alcohol consumption in routine assessment and management in a range of consultations, including chronic disease management, it can become a natural part of the consultation. When time is an issue, it is worth reinforcing your message by handing the patient written advice to take-away and read before returning for their next appointment.

Opening questions you could use

You might find it helpful to have an armoury of opening questions and comments to help you to raise the subject with your patients. Motivational interviewing principles have been shown to be effective, but they are counterintuitive to much traditional medical training.

Some of the principles include:

Respect the patient's ability & responsibility for determining what's best for themselves,

Don't try to persuade, cajole, scare - that is likely to have negative impact

Ambivalence is to be expected, and is at the core of patient resistance to change

It's THEIR job to articulate their ambivalence

It's yours to elicit, clarify, and resolve that ambivalence.

Here are some ideas for questions to include³:

Asking permission:
"Do you mind if we spend a few minutes talking about...?"

Normalising:
"A lot of people are concerned about changing their drinking patterns..."

Identifying patient's level of motivation:
"Are you interested in learning more about...?" "What do you know about the benefits of sticking to moderate levels of drinking?"

Exploring patient health beliefs:
"What do you know about the (CMO guidelines/impact of alcohol on your health etc)?" or "What do you know about how your alcohol intake affects your health (or a specific health concern the patient has)?"

Follow up with advice on health risks, if possible tailored to patient's responses.

Once the patient has identified a health impact, gauge the patient's priorities:

"On a scale of 1 - 10, with 10 being the most important, how important is it for you to reduce your alcohol levels?" "How do you feel your life or health would improve if you moderated your drinking?"

"What barriers do you think there might be to you achieving this?"

"What practical ways can you think of to overcome any barriers?" (you might prompt the patient here if, for instance, they have identified social events or their social life as a barrier by asking whether enlisting help of friends or family, or adjusting their social schedule to remove the habit of drinking every night, might help).
Open ended questions:
"What do you feel would happen if you do not change your drinking patterns?"
With practice, delivering interventions will become easier for you and your colleagues
Some practitioners may feel that it is futile to discuss alcohol with their patients, believing that many people don't want to change their drinking patterns. It is important to remember that people's motivation to change is not fixed - the techniques employed in brief interventions are designed to increase a person's willingness to change.

As you and your colleagues become more comfortable and confident, broaching the subject and having structured conversations about alcohol harm becomes easier.

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Brief interventions take a supportive, non-confrontational approach, which empowers the patient to recognise the risks associated with their drinking patterns, the benefits of reducing intake, and motivates them to adjust their lifestyle. By including alcohol consumption in routine assessment and management in a range of consultations, including chronic disease management, it can become a natural part of the consultation.

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Motivational Interviewing - Good Example - Alan Lyme

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Brief intervention alcohol: others are concerned

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If you smoke, you might be more at risk of having high blood pressure. If left untreated, high blood pressure can increase your risk of a heart attack or stroke.

High blood pressure does not usually have any symptoms, so the only way to know if you have it, is to get a check. If you are 40 or over, live in England and haven't had a check in the last 6 months, you can get your blood pressure checked for free at your pharmacy today.

If your blood pressure is high, then it can be managed through lifestyle changes or medication.

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When you stop smoking, good things start to happen to your health. Get free support from the NHS to become smoke free and help build a smokefree generation.

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Electronic cigarettes are significantly less harmful than smoking but are not risk-free, a report from the Committee on Toxicity of Chemicals in Food, Consumer Products, and the Environment (COT) has concluded.1

COT, which is made up of independent experts, was commissioned to produce a report by the Department of Health and Social Care and Public Health England to review electronic nicotine delivery systems and devices that use an e-liquid that does not contain any nicotine.

In 2015 a review commissioned by Public Health England, which concluded that e-cigarettes were 95% less harmful than tobacco, led to widespread criticism with many questioning the evidence and the authors' conflicts of interest.2 3 4 The COT report did not give any overall ...

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E-cigarettes are safer than smoking but not without risks, concludes toxicity review

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Electronic cigarettes are significantly less harmful than smoking but are not risk-free, a report from the Committee on Toxicity of Chemicals in Food, Consumer Products, and the Environment (COT) has concluded.1 COT, which is made up of independent experts, was commissioned to produce a report by the Department of Health and Social Care and Public Health England to review electronic nicotine delivery systems and devices that use an e-liquid that does not contain any nicotine.

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Tell us whether you accept cookies

We use cookies to collect information about how you use GOV.UK. We use this information to make the website work as well as possible and improve government services.

This guide is for local government and partners such as the NHS, emergency services and third-sector to support people to have healthier behaviours.

Documents

Details

Based on the Behaviour Change Wheel framework this can be used to help:

develop behaviour change interventions from scratch

build on or modify existing interventions

choose from existing or planned interventions

The guide provides a framework for understanding behaviour in its context and developing interventions and policies to change behaviour.

It can be used flexibly according to need and circumstance, rather than necessarily following a fixed sequence of steps. It introduces tools and provides case examples for each of these processes which can be used all together or as required during the development process.

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Behaviour change: guide for local government and partners

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We use cookies to collect information about how you use GOV.UK. We use this information to make the website work as well as possible and improve government services. This guide is for local government and partners such as the NHS, emergency services and third-sector to support people to have healthier behaviours.

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Take the drinks meter survey, enter your details and get instant information on how you measure up against our community

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30 Seconds to save a life

This short film demonstrates how simple brief interventions to change smoking behaviour can be.

Please watch this film as it powerfully demonstrates the capacity and effectiveness of Very Brief Advice on smoking to change lives.

If you want subtitles when watching the film clips in this module, please click on the grey CC icon on the film screen toolbar and select English.

If you want to proceed straight to the training, please click next.

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30 Seconds to save a life This short film demonstrates how simple brief interventions to change smoking behaviour can be. Please watch this film as it powerfully demonstrates the capacity and effectiveness of Very Brief Advice on smoking to change lives.

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If you want to stop smoking, you can make small changes to your lifestyle that may help you resist the temptation to light up.

Think positive

You might have tried to quit smoking before and not managed it, but don't let that put you off.

Look back at the things your experience has taught you and think about how you're really going to do it this time.

Make a plan to quit smoking

Make a promise, set a date and stick to it. Sticking to the "not a drag" rule can really help.

Whenever you find yourself in difficulty, say to yourself, "I won't even have a single drag", and stick with this until the cravings pass.

Think ahead to times where it might be difficult (a party, for instance), and plan your actions and escape routes in advance.

Consider your diet

Is your after-dinner cigarette your favourite? A US study revealed that some foods, including meat, make cigarettes more satisfying.

Others, including cheese, fruit and vegetables, make cigarettes taste terrible. So swap your usual steak or burger for a veggie pizza instead.

You may also want to change your routine at or after mealtimes. Getting up and doing the dishes straight away or settling down in a room where you don't smoke may help.

Change your drink

The same US study as above also looked at drinks. Fizzy drinks, alcohol, cola, tea and coffee all make cigarettes taste better.

So when you're out, drink more water and juice. Some people find simply changing their drink (for example, switching from wine to a vodka and tomato juice) affects their need to reach for a cigarette.

Identify when you crave cigarettes

A craving can last 5 minutes. Before you give up, make a list of 5-minute strategies.

For example, you could leave the party for a minute, dance or go to the bar.

And think about this: the combination of smoking and drinking raises your risk of mouth cancer by 38 times.

Get some stop smoking support

If friends or family members want to give up, too, suggest to them that you give up together.

There's also support available from your local stop smoking service. Did you know that you're up to 4 times more likely to quit successfully with their expert help and advice?

You can also call the NHS Smokefree helpline on 0300 123 1044, open Monday to Friday, 9am to 8pm and Saturday to Sunday, 11am to 4pm.

Get moving

A review of scientific studies has proved exercise, even a 5-minute walk or stretch, cuts cravings and may help your brain produce anti-craving chemicals.

Make non-smoking friends

When you're at a party, stick with the non-smokers.

"When you look at the smokers, don't envy them," says Louise, 52, an ex-smoker.

"Think of what they're doing as a bit strange - lighting a small white tube and breathing in smoke."

Keep your hands and mouth busy

Nicotine replacement therapy (NRT) can double your chances of success.

As well as patches, there are tablets, lozenges, gum and a nasal spray. And if you like holding a cigarette, there are handheld products like the inhalator or e-cigarettes.

When you're out, try putting your drink in the hand that usually holds a cigarette, or drink from a straw to keep your mouth busy.

Make a list of reasons to quit

Keep reminding yourself why you made the decision to give up. Make a list of the reasons and read it when you need support.

Ex-smoker Chris, 28, says: "I used to take a picture of my baby daughter with me when I went out. If I was tempted, I'd look at that."

Read more about the stop smoking treatments available on the NHS.
Community content from HealthUnlocked

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If you want to stop smoking, you can make small changes to your lifestyle that may help you resist the temptation to light up. You might have tried to quit smoking before and not managed it, but don't let that put you off.

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Page not found - Brighton & Hove City Council

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This map shows where you can access our stop smoking services at city pharmacies (green pins) and GP practices or surgeries (blue pins).

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Updated: 11 June 2020

This is a really difficult time and you might be noticing that you're drinking more than usual to help you cope. It's normal to look for ways to feel better at a time like this, but it's also easy for your drinking to gradually get out of control.

We can help you cut down or stop drinking in a safe way. Please choose from the options below to read the right advice for you.

Am I dependent on alcohol?

If you're worried you might be becoming dependent on alcohol, this is a useful guide. You are likely to be dependent if:

You drink more than 15 units of alcohol every day (about half a 70cl bottle of vodka, 1.5 bottles of wine, 6 pints of regular strength beer, 3 cans of 9% super lager or 2 litres of strong cider.)

You have had withdrawal symptoms in the past when cutting back or stopping drinking alcohol.

You regularly drink alcohol soon after you get up to stop the shakes and/or sweating.

Important: if you are dependent on alcohol, do not stop drinking suddenly. The withdrawal symptoms can be serious and potentially fatal.

Advice for people who are dependent on alcohol

I want to cut down or stop drinking

Please speak to us - we can help you make a plan to cut down and/or stop drinking in a safe way.

If you are already getting support from one of our services, please give your worker a call or phone the main service number. You can find contact details for all our services via our 'find a service' page.

If you haven't been to a service before, there's lots of support available. See if we have a service near you via our 'find a service' page. If not, you can search for other services on the NHS website (England), NHS inform (Scotland) or NHS Direct Wales. You might not be able to visit a service in person for a while, but you should still be able to get support over the phone or via video call.

Important information for people who drink more than 30 units of alcohol a day

Do not stop drinking without speaking to a doctor or nurse from your local alcohol service if:

You usually drink more than 30 units of alcohol a day

You suffer from epilepsy or have had alcohol-related fits or delirium tremens (DTs) in the past.

30 units is about 1 bottle of vodka, 3 bottles of wine, 12 pints of normal strength beer, 7 cans of 9% super lager or 4 litres of strong cider.

Try and keep your drinking steady, without having heavy binges or days completely without alcohol.

Our doctors and nurses are available to support you over the phone or by video call. You can find contact details for all our services via our 'find a service' page.

Important: if you are dependent on alcohol, do not stop drinking suddenly. The withdrawal symptoms can be serious and potentially fatal.

What withdrawal symptoms might I notice when I start cutting down?

People often experience sweating, shaking, and feeling sick and anxious. These typically last around a week.

Withdrawal symptoms often peak on days 2 and 3. Try and make sure you have support - from your worker or a friend or family member - on these days.

If symptoms such as sweating, shaking or anxiety are very uncomfortable, or you are vomiting, you are probably reducing too quickly, and you may need to slow the reduction down.

Be aware that some symptoms of alcohol withdrawal might be the same as coronavirus symptoms. You can check to see if you have coronavirus symptoms on the NHS 111 website.

Serious symptoms to look out for

If your symptoms get worse, such as severe shaking and heavy sweating

Seizures (fits)

Seeing, hearing or feeling things that aren't there (hallucinations)

Feeling confused about where you are, what time it is, or who you are with

Problems with your coordination and feeling unsteady on your feet

If you get any of these more serious symptoms, or you notice a family member experiencing them, call 999 immediately or go to A&E.

Looking after your physical and mental health

Here are some tips that might help you while you're cutting down:

Stick to a sleep routine. Avoid using sleeping tablets.

Pay attention to your diet - eat foods that have plenty of vitamin B1, like peas, fruit, eggs and shreddies and bran flakes cereal. Try soups if it's hard to keep food down.

Drink lots of water or tea (not coffee). Avoid energy drinks.

Keep in touch with family and friends, and your alcohol worker if you have one.

What should I do if I can't get hold of alcohol?

If you have a dependency, you might be worried about getting alcohol during the coronavirus pandemic. You might have underlying health conditions, or a disability. Maybe you don't have enough money to buy alcohol right now.

It's important to have a plan in place - this might include asking family or friends to buy alcohol for you, or arranging home delivery from a supermarket or off licence.

If you're dependent on alcohol it's important you don't stop drinking suddenly. Pacing yourself and spacing out how much you're drinking over a period of time can help you avoid this if you can't get as much alcohol as usual.

You could alternate between alcoholic and soft drinks, or decide how to space out your drinks over the day - for example, morning, lunchtime and evening.

Advice for anyone who's worried about their drinking, or someone else's

If you think you might be drinking too much, but you are not dependent on alcohol, here is some advice to help you.

Am I drinking too much?

If you are regularly drinking more than 14 units of alcohol a week, you are drinking above the recommended alcohol guidelines. This means alcohol may be causing you harm.

14 units is equivalent to 6 pints of average-strength beer or 10 small glasses of low-strength wine. Check your weekly units here.

What are the signs I should cut down on my drinking?

There are lots of reasons you might want to take a look at your drinking habits, and you don't have to be drinking every day for it to be an issue. Someone might have told you they're concerned, or you might find it hard to stop drinking once you've started.

You might find that you are turning to alcohol whenever you're bored, or drinking to help you cope with the challenges of childcare.

It can be hard to take that first step, but making changes can help you to be happier and healthier, and keep your family safe too.

How can I cut down?

Here are some things you can try:

Start a drink diary. Every time you have a drink, write down what you're drinking, how much you have, how you are feeling at the time and what the situation is. This will help you see patterns and make changes.

Set yourself a weekly limit, and stick to it. Don't stockpile alcohol, just buy the amount you need for the week.

Choose at least three alcohol-free days a week - stick to the same days each week.

Make yourself a rule for the earliest time you'll have a drink - avoid drinking during the day.

Don't drink on an empty stomach. Always have something to eat first.

Have a soft drink between each alcoholic one. This will help you pace yourself and make sure you're not drinking more alcohol because you're thirsty.

If you start having cravings, distract yourself for a few minutes. Meditation apps and videos are good distractions.

If you have children, always wait till they've gone to bed before you have a drink. It can be scary for children when a parent has been drinking. If there are two of you at home, make sure one of you always stays sober.

You can also look at the links and helplines below for more support.

What should I do if I'm worried about someone's drinking?

Talking is one of the most important ways you can help someone with an alcohol problem. It can help both of you understand what they're going through, and encourage them to take positive steps towards being safer and healthier.

Here is some advice on how to talk to someone about their drinking.

It's important to look after yourself too - it's not selfish. To support someone you love, you need to make sure you are taking care of yourself too.

Information for people who use our services

Can I go to my service?

Our workers are still here for you. The best way to get support and information is by calling your worker or the main phone number for your service. You can also speak to a member of our online team for advice.

Our groups aren't running for a while, but we have switched to video conference and phone calls as much as possible to help you keep in contact.

Please don't come to the service or pharmacy if you think you might have symptoms of coronavirus.

What if I want to cut down or stop drinking? Can I have a detox?

We can still support you to reach your goals. Please give your worker or service a call and we can help you create a plan. It's likely that we'll be helping you by phone or video call, rather than in person.

Please don't try and cut down or stop drinking on your own - speak to us first so we can help you do it safely. If you are dependent on alcohol, do not stop drinking suddenly.

Can I still get medication to help with withdrawal symptoms?

If you have been prescribed medication to help you manage alcohol withdrawal symptoms, you will still be able to get this. You will only need to go to the pharmacy once to collect it.

If necessary, someone can collect your medication for you. If you don't have anyone that can do this, if possible your worker will collect your medication and deliver it to you.

The pharmacist or nurse will also give you advice on how to store your medication safely and keep any children in your house safe. They will give you a safe storage box if possible.

Other organisations that can help

For family members and children

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Coronavirus alcohol advice - Change Grow Live

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Updated: 11 June 2020 This is a really difficult time and you might be noticing that you're drinking more than usual to help you cope. It's normal to look for ways to feel better at a time like this, but it's also easy for your drinking to gradually get out of control.

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A quarter of Brits admit to having lied about how much they drink. The person they're most likely to lie to is their doctor

It's been said that GPs use an 'alcohol multiplier' when asking a patient how much they drink: whatever they say, multiply it by two.

A new YouGov Omnibus survey produced for the podcast " Britain Is A Nation Of " asked people to come clean on how often they lie about their drinking habits, and to whom.

'Fess up: one in four Brits have lied about their drinking habits

The results show GPs are right to be suspicious: among those who admit to having lied about how much they drink, which is only a quarter of the population, most have lied to their doctor.

A quarter of Britons (27%) say they have told someone that they drink less alcohol than they actually do or did. Six in ten (58%) say they haven't.

There is next to no difference in the proportion of men and women who say they have lied about how much they drink (29% of men vs 24% of women). Older people are slightly more likely than young people to say they have not lied, with 62% of those aged 55 and over saying so compared to 51% of 18 to 24 year olds.

One in fifteen Brits (7%) say they have never drunk alcohol.

Who we lie to about drinking: GPs and our parents

The survey asked those who said they have lied about how much they drink who they lied to, and how many times.

Among those who have ever lied about drinking, two thirds (60%) lied to their GP - one in six (14%) have done so more than 5 times.

Four in ten (43%) have lied at least once to their parents, with one in five (21%) having lied five times or more. 18 to 24s are most likely to say they've lied to their parents, with almost 60% saying they have.

Among people with children, a quarter (25%) of those who have previously lied about drinking habits have told their kids they drink less than they actually do.

And in terms of discussing drinking at work, a third (32%) have lied to their colleagues, and a quarter (25%) have lied to a line manager.

Men are around twice as likely to have lied five times or more about drinking to their partners or friends

Four in ten of those who've lied about drinking have lied to their friends (40%) or partners (37%). Here, men are considerably more likely than women to have lied multiple times.

Women are almost twice as likely as men to say they have lied once to friends (10% of men vs 17% of women) or partners (9% of men vs 14% of women), and men are twice as likely as women to say they have lied five times or more (15% of men vs 9% of women to a friend, 18% of men vs 8% of women to a partner).

Photo: Getty

See the full results here

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Brits most likely to lie about alcohol to GPs | YouGov

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It's been said that GPs use an 'alcohol multiplier' when asking a patient how much they drink: whatever they say, multiply it by two. A new YouGov Omnibus survey produced for the podcast " Britain Is A Nation Of " asked people to come clean on how often they lie about their drinking habits, and to whom.

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‎Are you looking to cut down how much you drink? If so, we can help. Drink Less is a super-easy to use app that allows you to keep track of how much you drink, set goals to drink less, get feedback on whether what you're doing is working and access some unique and fun ways of changing your attitude t...

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Our fact sheets set out the latest evidence to help you find out more about alcohol.

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The advice from England's Chief Medical Officer is that " Children and their parents and carers are advised that an alchohol-free childhood is the healthiest and best option. However, if children drink alcohol it should not be until at least the age of 15 years".

Children's bodies and brains are still developing well into the teenage years and beyond. The CMO guidance outlines some of the risks to children's physical and mental health from drinking alcohol, from risky behaviour to low mood and depression.

As parents we have more influence than we might think in setting boundaries for our children. Balance has produced a free Guide for Parents which covers the Chief Medical Officer guidance, the myths and the facts, and gives advice on how parents can talk to their child about alcohol.
Download our Parents Guide

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The advice from England's Chief Medical Officer is that " Children and their parents and carers are advised that an alchohol-free childhood is the healthiest and best option. However, if children drink alcohol it should not be until at least the age of 15 years".

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Our fact sheets set out the latest evidence to help you find out more about alcohol.

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Alcohol, drugs and substance misuse: an introduction

The misuse of drugs, including alcohol and other substances, can be a serious problem for the abuser, co-workers and the organisation itself.

Alcohol, drugs and other substances have a strongly negative effect on the brain and the body, impairing judgement and concentration and putting the abuser and co-workers at risk.

Staff who misuse drugs or alcohol are more likely to take time off, display poor performance and increase the risk of accidents. These factors weaken an organisation's overall performance.

Click here for more about accidents at work.

Most drugs are illegal, which means that anyone in possession of drugs at work may risk prosecution or disciplinary action.

Employers' responsibilities

Employers have a legal responsibility to look after employees' wellbeing, health and safety. A good employer will want to help employees. In some cases, alcohol or drug misuse may be used to help cope with work-related stress. If there is a problem with alcohol or drug misuse in your workplace then this may be part of a wider stress problem.

Some employers treat alcohol and drug misuse as a medical rather than a disciplinary matter. In this case, the chances of overcoming the problem is assessed and a reasonable period of time off for recovery is agreed.

They may also consider appropriate help to treat the employee (for example, by contributing towards the cost of counselling), treat any absence for treatment and rehabilitation as normal sick leave and review the person's work to ensure that their workload is not contributing to the problem.

Policy

Even if there is no evidence of their use, organisations can benefit from a policy on drugs, alcohol and other substances in consultation with staff or health and safety representatives.

Any policy must be suitable for the organisation. In some workplaces it will form part of the overall health and safety policy but may also be part of an occupational health policy. In some organisations a separate policy on alcohol and drugs is developed.

Click here for more about risk assessments.

ACAS has produced the following checklist on what should be included within a policy on drugs misuse at work:

the purpose of the policy - for example: 'This policy is designed to help protect workers from the dangers of drug and other substance misuse and to encourage those with a drugs problem to seek help';

a statement that the policy applies to everyone in the organisation;

the rules on the use of drugs and other substances at work;

a statement that the organisation recognises that a drugs problem may be an illness to be treated in the same way as any other illness;

the potential dangers to the health and safety of drug misusers and their colleagues if a drugs problem is untreated;

the importance of early identification and treatment;

the help available - for example, from managers, supervisors, company doctor, occupational health service or outside agency;

the disciplinary position - for example, an organisation may agree to suspend disciplinary action, where drug misuse is a factor, on condition that the worker follows a suitable course of action;

the provision of paid sick leave for agreed treatment;

the individual's right to return to the same job after effective treatment or, where this is not advisable, to suitable alternative employment wherever possible;

an assurance of confidentiality;

whether an individual will be allowed a second period of treatment if he or she relapses;

the provision for education on drug misuse;

a statement that the policy will be regularly reviewed, has the support of top management and that, where appropriate, worker representative have been consulted.

Read the full text of the ACAS booklet Health and Employment.
Having an agreed policy helps ensure the issues are dealt with as legitimate workplace matters in a non-judgemental way.

It is important that managers and staff all know how the organisation will deal with drug and alcohol related issues. It will also help staff gain the confidence to come forward and seek help either for themselves or others without fear of disciplinary action.

Screening

Employers who decide to adopt alcohol or drug screening as part of their alcohol and drugs policy should ensure this is done lawfully and fairly. Screening is the way of testing whether employees have alcohol, drugs or other substances in their body. Usually this involves providing a urine sample.

UNISON has some concerns about the testing of workers. This is because while it is fairly straightforward to test for alcohol consumption and measure this against a legal limit, drug testing can be more complex.

Some employees, such as those who work in a safety critical area, may be automatically or randomly tested for alcohol or drugs due to the nature of their work.

Screening is a sensitive matter. Employers need the permission of employees and should only carry out screening when they have a reason for testing under health and safety policy.

Employers should ensure that:

no-one is singled out during random testing;

if a search for alcohol or drugs is carried out then it must be by someone of the same sex, with a witness present;

employees are made aware of any possible disciplinary action they may face if they refuse a test.

Alcohol, drug and substance abuse and the law

Employers could be acting illegally if they knowingly allow drug-related activities to go on at work but do not act. They should also know the implications of not tackling abuse.

It is illegal if:

an employee under the influence of excess alcohol is knowingly allowed to work (Health and Safety at Work Act);

controlled substances are produced, supplied or used on an employer's premises (The Misuse of Drugs Act);

drivers of road vehicles and transport system workers are under the influence of drugs while driving or unfit through drugs while working (The Road Traffic and the Transport and Works Act).

Counselling and support

Drug, alcohol or substance abuse is difficult for anyone. It is better for employers to find ways to support employees abusing these substances than to discipline them.

Employers could, for example, encourage employees to seek specialist support via their GP or local treatment service if they suspect they have a problem or addiction.

What to do if you feel that your alcohol consumption is affecting your working life

Alcohol makes you feel more relaxed in the short term. But according to independent UK charity Drinkaware, if you regularly drink more than three to four units a day if you are a man, or two to three units if you are a women you could be making yourself feel more stressed.

Some of the physical signs are:

sweating;

shaking;

loss of appetite;

stomach problems;

memory loss, blackouts.

Alcohol slows down the brain and the processes of the central nervous system's processes, which can affect your work performance badly.

If you feel alcohol is affecting your work, you should call a professional alcohol advice helpline. Browse a list of all national alcohol helplines.

What to do if you find someone is abusing alcohol or taking drugs at work

Speak to your UNISON rep immediately.

Action for UNISON reps

There is much that reps can do to raise awareness of drugs and alcohol misuse whether or not there is evidence that it is happening at work.

For example, reps could raise awareness of signs to look out for if alcohol, drug or substance abuse in the workplace is suspected, using guides from UNISON and specialist organisations. Many guides such as those from the HSE suggest consultation with union reps.

Reps could also:

negotiate a drugs and alcohol policy with your employer;

ask the employer to look at the workload of anyone suspected of misusing alcohol, drugs or other substances and review the risk assessment if necessary.

Key facts

Drug, alcohol and substance misuse has serious implications for employees' health, safety and performance in the workplace.

All organisations can benefit from a policy on drugs, alcohol and other substances in consultation with staff and health and safety representatives.

If drug or alcohol screening is to take place, employers must first get employees' consent.

Employers should encourage employees to use specialist support if they are misusing drugs or alcohol.

FAQs

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Alcohol, drugs and substance abuse | Health and safety | UNISON National

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Alcohol, drugs and substance misuse: an introduction The misuse of drugs, including alcohol and other substances, can be a serious problem for the abuser, co-workers and the organisation itself. Alcohol, drugs and other substances have a strongly negative effect on the brain and the body, impairing judgement and concentration and putting the abuser and co-workers at risk.

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Alcohol and drugs policies | Acas advice and guidance | Acas

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Any alcohol or drugs policy should be used to ensure problems are dealt with effectively, and consistently and early on in the process. They should protect workers and encourage sufferers to seek help. An education programme for managers is particularly important: it could include details of signs to look for, how to deal with workers who seek help, and where expert advice and help may be obtained.

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Alcohol in the workplace factsheet March 2014

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Are you going out tonight? A question which echoes around university campuses every evening as students conclude the academic side of their lives for the day and begin to consider another equally important aspect: their social lives. There's no doubt that going out and drinking is a custom deeply embedded in university culture - in 1945, an article was published in the Quarterly Journal of Studies on Alcohol, which described drinking as an "accepted symbol of good fellowship". But with more than one in five current university students describing themselves as teetotal, changing attitudes towards alcohol at university are bringing with them new alternatives for students who prefer to stay sober. These include the introduction of alcohol-free student halls, in which drinking is completely prohibited.

The first university in Scotland to offer this type of accommodation was St Andrews. A spokesperson described the university's aim to create a "safe, healthy and inclusive campus experience for all of our students." With 400 applications for only 132 available alcohol-free rooms, the idea has clearly proved popular. But does this kind of accommodation actually help to include sober students in university life, or does it only differentiate them further from their drinking peers?

For non-drinking students about to begin their university careers, drinking culture is clearly a concern - so much so that the online forum has countless threads created by anxious freshers, asking questions like "What's it like being teetotal at uni?", or even "How do I The Student Room survive university without drinking?". Concerns range from an inability to make friends as the only sober one in a crowd of drinkers to unwanted questions regarding their reasons for being teetotal. For these students, sober halls may represent a safe haven. However, as many responses to these threads indicate, these alcohol-related fears often prove to be unwarranted; not only are most people generally accepting of the choices of others, universities are already providing alternatives for sober students to socialise and make friends.

During the University of Edinburgh welcome week, societies offered daytime events, such as coffee crawls along with night-time activities, including themed game nights. Throughout the year, sports teams and societies give students the chance to meet friends without the aid of alcohol. With all these opportunities on offer to sober students, are alcohol-free halls a necessary option? In fact, could they even be detrimental to sober students looking for friends?

With university widely acknowledged as a place to expand horizons, meet a diverse range of people and prepare students for the real world, allowing students to live in an artificial environment where nobody drinks alcohol arguably prevents them from exposure to real life, and from learning to deal with these types of situations when they inevitably encounter them in the future. Furthermore, it could be said that by separating students into two categories of 'drinkers' and 'non-drinkers' creates an 'us and them' mentality, fostering mistrust and division between students. Instead of dividing these two kinds of people, perhaps it may be beneficial for both to bring them together, allowing them to learn to understand each other's' lifestyle.

Yet simultaneously, concerns about drunk flatmates crashing in at 3 am, having loud parties the night before a big exam or leaving a mess in the kitchen after making post-club snacks are entirely valid problems every student has experienced at least once. Nevertheless, these issues, although annoying at the time, are perhaps perfect opportunities to practice essential life skills not taught in lectures or tutorials -mediation, understanding and compromise. Swaddling students in the safety of sober halls rob them of these experiences, and thus of an important part of the university learning experience.

Ultimately, although universities should be introducing measures to ensure teetotal students are included in university life, it's important that these measures bring drinking and non-drinking students closer together rather creating further division.
Image Credit: Jirka Matousek via Flickr

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Alcohol-free student halls: do they provide safety or seclusion?

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Are you going out tonight? A question which echoes around university campuses every evening as students conclude the academic side of their lives for the day and begin to consider another equally important aspect: their social lives.

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Is harmful drinking an inevitable part of student life? What can be done to tackle it? Sarah Chapman investigates.
It's that time of year. Many of you will be seeing your newly grown-up children begin their 'university adventure' or, like me, spending these first weeks of the autumn going with them to university open days. Worryingly, this 'adventure' often seems to include consuming vast quantities of alcohol, but is that inevitable?

Student culture

The student culture won't be the same at all universities and I'm getting the distinct impression that the focus on drinking varies considerably from place to place. After hearing about Freshers' Week at one open day, inventive only in the number of different ways they could all get comprehensively hammered, it was music to my ears to hear at another that "this is a good place to come if you don't like drinking (though it's ok if you do)" and to learn of a vast range of social opportunities on offer, including membership of the, er, Hummus Appreciation Society. "That sounds lovely darling, you could join that..." Don't knock it. Turning up at the first meeting of a niche society taught my student self that archaic maths games weren't my thing and introduced me to one of my best friends, catching her eye and escaping at the same time as she did. We introduced ourselves and went to the bar... (Now she's a barrister dealing with licensing laws - neat!)

How much are young people drinking?

Actually, when I started to look at the statistics I was quite surprised by some of the trends here in the UK. A report on binge drinking from the Office of National Statistics showed that in 2015 people aged 16 to 24 were as likely as those aged 65+ to report that they were teetotal, while the proportion of those in this age group who reported binge drinking at least once in the previous week had fallen by more than a third since 2005 (from 29% to 18%) and frequent drinkers by two-thirds, down to 1 in 50 young adults.

This is perhaps most useful as an indicator of a trend. People are known to be unreliable in reporting how much they drink. Research by University College London found that about half the alcohol sold was unaccounted for in the amount that people reported drinking.

There's considerable regional variation, with London being the teetotal capital for adults of any age, while binge drinking is highest in Scotland and the north of England.

While binge drinking, and especially amongst young adults, is on the decline, alcohol-related hospital admissions in the UK have risen by 115% over the past decade.

An earlier survey of undergraduates in seven universities in England found very high rates of dangerous drinking, with 41% identified as 'hazardous drinkers', 11% 'harmful drinkers' and a further 10% as 'probably alcohol dependent'. One in five students were likely to have a diagnosable alcohol use disorder. The study authors themselves point out several limitations of their research and suggest that universities should carry out their own audits of drinking behaviour amongst their students and offer interventions such as motivational interviewing.

Supporting behavior change

I blogged here before about Cochrane evidence on motivational interviewing (MI) as an intervention used to tackle harmful drinking in young people through highlighting the negative consequences and supporting them to change their behaviour. The review has been updated with the latest research and now includes 84 randomized studies with almost 23,000 young adults. 51 of these studies took place in universities and colleges, with another three in other post-secondary educational institutions.

The conclusions of the review are unchanged, with the evidence suggesting that "there are no substantive, meaningful benefits of MI interventions for preventing alcohol use, misuse or alcohol-related problems". The authors note that "the quality of the evidence is not strong, but further higher quality research is likely only to strengthen the current findings as bias is reduced".

Tackling social norms

Correcting inaccurate perceptions about drinking behaviour is another approach used with university and college students, and whether this is effective has been investigated in another Cochrane review. It included 75 randomized studies with almost 45,000 students. Social norms information was delivered via web/computer or face-to-face, in groups and individually, and through campaigns on campuses. As with motivational interviewing, the evidence suggests that "no substantive meaningful benefits are associated with social norms interventions for prevention of alcohol misuse among college/university students".

The authors don't believe that future research will change these conclusions, "especially in the face of widespread and pervasive alcohol availability and marketing". Another Cochrane review exploring the impact of alcohol advertising bans on drinking by adults and adolescents found that reliable evidence on this is lacking. The authors discuss what sort of research would be useful and we must hope that future updates of the review will have some robust evidence to include.

The review on social norms information "adds to growing evidence that information-based approaches to prevention and behaviour change in the drug and alcohol field are generally found to be of no or low effectiveness," its authors say. "However, it is plausible that as part of a broader prevention system that combines informational with developmental and environmental approaches to prevention, the whole could be greater than the sum of the parts."

What do students think works?

What do students themselves think are effective means of controlling alcohol use? The CALIBRATE study, which has explored attitudes to alcohol control policies in a sample students in European universities, has found that whilst restrictive policies are the most effective for reducing alcohol-related harm, students rate them as less effective than educational policies. Understanding why they hold these views, and what can be done to change this, is going to be important, says Dr Richard Cooke of the Department of Psychology at the University of Aston, as such attitudes could hinder schemes such as the National Union of Students Alcohol Impact scheme. You can read more here.

Alcohol Impact: tackling student drinking

Alcohol Impact takes a whole-institution approach to changing drinking behaviour in universities, and its initial focus for the pilot phase was on promoting responsible drinking and reducing alcohol-related crime and anti-social behaviour. Behaviour change initiatives are used in a variety of areas including accommodation, policy, campaigns and retailing. Working in partnership is a central feature of the programme, the student's union and university representatives working with community organisations.

The pilot project was conducted with seven UK universities and was completed in April 2015. Each partnership delivered at least one cultural norms intervention focusing on alcohol consumption at university, developed to address a need within the local context. Reported successes include a large reduction in the number of students being rejected from campus venues due to irresponsible drinking and an increase in the number of freshers events that don't focus on alcohol. Alcohol Impact is continuing and it will be really interesting to see what emerges from ongoing evaluation of the programme.

What's ahead?

Alcohol is embedded in UK student culture, and this isn't going to change overnight, but I feel hopeful for future students, seeing an initiative such as Alcohol Impact taking root in our universities. The evidence supports what common sense tells us, that tackling individuals is not going to be enough, but rather much wider institutional and cultural change is needed. I'm just hoping there are no harms from eating too much hummus...
Sarah Chapman has nothing to disclose. References and links may be found here.

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Student drinking: culture, change and Cochrane

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Is harmful drinking an inevitable part of student life? What can be done to tackle it? Sarah Chapman investigates. It's that time of year. Many of you will be seeing your newly grown-up children begin their 'university adventure' or, like me, spending these first weeks of the autumn going with them to university open days.

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The Down Your Drink website closed down in 2022 but the spirit of DYD lives on in a new venture from the creators of DYD - Drinkbreak

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Authors

Eileen FS Kaner,

Corresponding author

Newcastle University, Institute of Health and Society, Newcastle upon Tyne, UK

Eileen FS Kaner, Institute of Health and Society, Newcastle University, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK. e.f.s.kaner@newcastle.ac.uk.

Search for more papers by this author

Abstract

Background

Excessive drinking is a significant cause of mortality, morbidity and social problems in many countries. Brief interventions aim to reduce alcohol consumption and related harm in hazardous and harmful drinkers who are not actively seeking help for alcohol problems. Interventions usually take the form of a conversation with a primary care provider and may include feedback on the person's alcohol use, information about potential harms and benefits of reducing intake, and advice on how to reduce consumption. Discussion informs the development of a personal plan to help reduce consumption. Brief interventions can also include behaviour change or motivationally-focused counselling.

This is an update of a Cochrane Review published in 2007.

Objectives

To assess the effectiveness of screening and brief alcohol intervention to reduce excessive alcohol consumption in hazardous or harmful drinkers in general practice or emergency care settings.

Search methods

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and 12 other bibliographic databases to September 2017. We searched Alcohol and Alcohol Problems Science Database (to December 2003, after which the database was discontinued), trials registries, and websites. We carried out handsearching and checked reference lists of included studies and relevant reviews.

Selection criteria

We included randomised controlled trials (RCTs) of brief interventions to reduce hazardous or harmful alcohol consumption in people attending general practice, emergency care or other primary care settings for reasons other than alcohol treatment. The comparison group was no or minimal intervention, where a measure of alcohol consumption was reported. 'Brief intervention' was defined as a conversation comprising five or fewer sessions of brief advice or brief lifestyle counselling and a total duration of less than 60 minutes. Any more was considered an extended intervention. Digital interventions were not included in this review.

Data collection and analysis

We used standard methodological procedures expected by Cochrane. We carried out subgroup analyses where possible to investigate the impact of factors such as gender, age, setting (general practice versus emergency care), treatment exposure and baseline consumption.

Main results

We included 69 studies that randomised a total of 33,642 participants. Of these, 42 studies were added for this update (24,057 participants). Most interventions were delivered in general practice (38 studies, 55%) or emergency care (27 studies, 39%) settings. Most studies (61 studies, 88%) compared brief intervention to minimal or no intervention. Extended interventions were compared with brief (4 studies, 6%), minimal or no intervention (7 studies, 10%). Few studies targeted particular age groups: adolescents or young adults (6 studies, 9%) and older adults (4 studies, 6%). Mean baseline alcohol consumption was 244 g/week (30.5 standard UK units) among the studies that reported these data. Main sources of bias were attrition and lack of provider or participant blinding. The primary meta-analysis included 34 studies (15,197 participants) and provided moderate-quality evidence that participants who received brief intervention consumed less alcohol than minimal or no intervention participants after one year (mean difference (MD) -20 g/week, 95% confidence interval (CI) -28 to -12). There was substantial heterogeneity among studies (I² = 73%). A subgroup analysis by gender demonstrated that both men and women reduced alcohol consumption after receiving a brief intervention.

We found moderate-quality evidence that brief alcohol interventions have little impact on frequency of binges per week (MD -0.08, 95% CI -0.14 to -0.02; 15 studies, 6946 participants); drinking days per week (MD -0.13, 95% CI -0.23 to -0.04; 11 studies, 5469 participants); or drinking intensity (-0.2 g/drinking day, 95% CI -3.1 to 2.7; 10 studies, 3128 participants).

We found moderate-quality evidence of little difference in quantity of alcohol consumed when extended and no or minimal interventions were compared (-14 g/week, 95% CI -37 to 9; 6 studies, 1296 participants). There was little difference in binges per week (-0.08, 95% CI -0.28 to 0.12; 2 studies, 456 participants; moderate-quality evidence) or difference in days drinking per week (-0.45, 95% CI -0.81 to -0.09; 2 studies, 319 participants; moderate-quality evidence). Extended versus no or minimal intervention provided little impact on drinking intensity (9 g/drinking day, 95% CI -26 to 9; 1 study, 158 participants; low-quality evidence).

Extended intervention had no greater impact than brief intervention on alcohol consumption, although findings were imprecise (MD 2 g/week, 95% CI -42 to 45; 3 studies, 552 participants; low-quality evidence). Numbers of binges were not reported for this comparison, but one trial suggested a possible drop in days drinking per week (-0.5, 95% CI -1.2 to 0.2; 147 participants; low-quality evidence). Results from this trial also suggested very little impact on drinking intensity (-1.7 g/drinking day, 95% CI -18.9 to 15.5; 147 participants; very low-quality evidence).

Only five studies reported adverse effects (very low-quality evidence). No participants experienced any adverse effects in two studies; one study reported that the intervention increased binge drinking for women and two studies reported adverse events related to driving outcomes but concluded they were equivalent in both study arms.

Sources of funding were reported by 67 studies (87%). With two exceptions, studies were funded by government institutes, research bodies or charitable foundations. One study was partly funded by a pharmaceutical company and a brewers association, another by a company developing diagnostic testing equipment.

Authors' conclusions

We found moderate-quality evidence that brief interventions can reduce alcohol consumption in hazardous and harmful drinkers compared to minimal or no intervention. Longer counselling duration probably has little additional effect. Future studies should focus on identifying the components of interventions which are most closely associated with effectiveness.

Plain language summary
Effectiveness of brief alcohol interventions in primary care populations What is the aim of this review?
We aimed to find out whether brief interventions with doctors and nurses in general practices or emergency care can reduce heavy drinking. We assessed the findings from 69 trials that involved a total of 33,642 participants; of these 34 studies (15,197 participants) provided data for the main analysis.
Key messages
Brief interventions in primary care settings aim to reduce heavy drinking compared to people who received usual care or brief written information. Longer interventions probably make little or no difference to heavy drinking compared to brief intervention.
What was studied in the review?
One way to reduce heavy drinking may be for doctors and nurses to provide brief advice or brief counselling to targeted people who consult general practitioners or other primary health care providers. People seeking primary healthcare are routinely asked about their drinking behaviour because alcohol use can affect many health conditions.

Brief interventions typically include feedback on alcohol use and health-related harms, identification of high risk situations for heavy drinking, simple advice about how to cut down drinking, strategies that can increase motivation to change drinking behaviour, and the development of a personal plan to reduce drinking. Brief interventions are designed to be delivered in regular consultations, which are often 5 to 15 minutes with doctors and around 20 to 30 minutes with nurses. Although short in duration, brief interventions can be delivered in one to five sessions. We did not include digital interventions in this review.
Search date
The evidence is current to September 2017.
Study funding
Funding sources were reported by 60 (87%) studies. Of these, 58 studies were funded by government institutes, research bodies or charitable foundations. One study was partly funded by a pharmaceutical company and a brewers association, another by a company developing diagnostic testing equipment. Nine studies did not report study funding sources.
What are the main results of the review?
We included 69 controlled trials conducted in many countries. Most studies were conducted in general practice and emergency care. Study participants received brief intervention or usual care or written information about alcohol (control group).

The amount of alcohol people drank each week was reported by 34 trials (15,197 participants) at one-year follow-up and showed that people who received the brief intervention drank less than control group participants (moderate-quality evidence). The reduction was around a pint of beer (475 mL) or a third of a bottle of wine (250 mL) less each week.

Longer counselling probably provided little additional benefit compared to brief intervention or no intervention.

One trial reported that the intervention adversely affected binge drinking for women, and two reported that no adverse effects resulted from receiving brief interventions. Most studies did not mention adverse effects.
Quality of the evidence
Findings may have been affected because participants and practitioners were often aware that brief interventions focused on alcohol. Furthermore, some participants could not be contacted at one-year follow-up to report drinking levels. Overall, evidence was assessed as mostly moderate-quality. This means the reported effect size and direction is likely to be close to the true effect of these interventions.

Ancillary

Version History

Version 4
Effectiveness of brief alcohol interventions in primary care populations
Eileen FS Kaner, Fiona R Beyer, Colin Muirhead, Fiona Campbell, Elizabeth D Pienaar, Nicolas Bertholet, Jean B Daeppen, John B Saunders, Bernard Burnand

Article first published online: 24 Feb 2018 | DOI: 10.1002/14651858.CD004148.pub4

Version 3
Effectiveness of brief alcohol interventions in primary care populations
Eileen F.S. Kaner, Heather O Dickinson, Fiona R Beyer, Fiona Campbell, Carla Schlesinger, Nick Heather, John B Saunders, Bernard Burnand, Elizabeth D Pienaar

Article first published online: 18 Apr 2007 | DOI: 10.1002/14651858.CD004148.pub3

Version 2
Brief interventions for excessive drinkers in primary care health settings
E Kaner, F Campbell, ED Pienaar, N Heather, C Schlesinger, J Saunders

Article first published online: 19 Apr 2004 | DOI: 10.1002/14651858.CD004148.pub2

Version 1
Brief interventions for excessive drinkers in primary care health settings
E Kaner, C Campbell, ED Pienaar, N Heather, C Schlesinger, J Saunders

Article first published online: 22 Apr 2003 | DOI: 10.1002/14651858.CD004148

Citing Literature

Authors

Eileen FS Kaner,

Corresponding author

Newcastle University, Institute of Health and Society, Newcastle upon Tyne, UK

Eileen FS Kaner, Institute of Health and Society, Newcastle University, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK. e.f.s.kaner@newcastle.ac.uk.

Search for more papers by this author

Ancillary

Version History

Version 4
Effectiveness of brief alcohol interventions in primary care populations
Eileen FS Kaner, Fiona R Beyer, Colin Muirhead, Fiona Campbell, Elizabeth D Pienaar, Nicolas Bertholet, Jean B Daeppen, John B Saunders, Bernard Burnand

Article first published online: 24 Feb 2018 | DOI: 10.1002/14651858.CD004148.pub4

Version 3
Effectiveness of brief alcohol interventions in primary care populations
Eileen F.S. Kaner, Heather O Dickinson, Fiona R Beyer, Fiona Campbell, Carla Schlesinger, Nick Heather, John B Saunders, Bernard Burnand, Elizabeth D Pienaar

Article first published online: 18 Apr 2007 | DOI: 10.1002/14651858.CD004148.pub3

Version 2
Brief interventions for excessive drinkers in primary care health settings
E Kaner, F Campbell, ED Pienaar, N Heather, C Schlesinger, J Saunders

Article first published online: 19 Apr 2004 | DOI: 10.1002/14651858.CD004148.pub2

Version 1
Brief interventions for excessive drinkers in primary care health settings
E Kaner, C Campbell, ED Pienaar, N Heather, C Schlesinger, J Saunders

Article first published online: 22 Apr 2003 | DOI: 10.1002/14651858.CD004148

Citing Literature

Authors

Eileen FS Kaner,

Corresponding author

Newcastle University, Institute of Health and Society, Newcastle upon Tyne, UK

Eileen FS Kaner, Institute of Health and Society, Newcastle University, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK. e.f.s.kaner@newcastle.ac.uk.

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Version History

Version 4
Effectiveness of brief alcohol interventions in primary care populations
Eileen FS Kaner, Fiona R Beyer, Colin Muirhead, Fiona Campbell, Elizabeth D Pienaar, Nicolas Bertholet, Jean B Daeppen, John B Saunders, Bernard Burnand

Article first published online: 24 Feb 2018 | DOI: 10.1002/14651858.CD004148.pub4

Version 3
Effectiveness of brief alcohol interventions in primary care populations
Eileen F.S. Kaner, Heather O Dickinson, Fiona R Beyer, Fiona Campbell, Carla Schlesinger, Nick Heather, John B Saunders, Bernard Burnand, Elizabeth D Pienaar

Article first published online: 18 Apr 2007 | DOI: 10.1002/14651858.CD004148.pub3

Version 2
Brief interventions for excessive drinkers in primary care health settings
E Kaner, F Campbell, ED Pienaar, N Heather, C Schlesinger, J Saunders

Article first published online: 19 Apr 2004 | DOI: 10.1002/14651858.CD004148.pub2

Version 1
Brief interventions for excessive drinkers in primary care health settings
E Kaner, C Campbell, ED Pienaar, N Heather, C Schlesinger, J Saunders

Article first published online: 22 Apr 2003 | DOI: 10.1002/14651858.CD004148

Citing Literature

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Effectiveness of brief alcohol interventions in primary care populations

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Excessive drinking is a significant cause of mortality, morbidity and social problems in many countries. Brief interventions aim to reduce alcohol consumption and related harm in hazardous and harmful...Effectiveness of brief alcohol interventions in primary care populationsWhat is the aim of this review?We aimed to find out whether brief interventions with doctors and nurses in general practices or emergency...

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The Drink Wise, Age Well programme supported people to make healthier choices about alcohol as they age.

Funded by The National Lottery Community Fund, the programme was based in five regions across the UK from 2015 to 2020.

The programme was designed to change attitudes, combat stigma and reduce alcohol harm in the over 50s so they can live longer, healthier lives.

To achieve this, the programme focused on four outcomes:

Raising awareness and changing attitudes about alcohol use in people over 50, influencing community norms about the use of alcohol

Increasing individual and community resilience in people over 50, reducing alcohol-related harm in this age group

Helping community service providers and employers to recognise and respond to risky drinking in people over 50

Publishing a body of evidence on preventing problem alcohol use in people over 50 which will inform future prevention work in the UK and internationally

The programme has been fully evaluated and is now in its legacy stage.

This site is Drink Wise, Age Well’s permanent digital legacy, preserving and sharing the programme’s most important research, insights and achievements.

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Drink Wise, Age Well was a programme of work bringing together six strategic partner organisations across the UK with funding from The National Lottery Community Fund.

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Drink Wise, Age Well helps people make healthier choices about their drinking as they age. For many people alcohol can have a positive impact on their lives including increased socialisation and relaxation. Many of us will enjoy alcohol as we get older and may never experience some of the negative effects.

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Alcohol advice | Health and wellbeing | Age UK

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Minimising your alcohol intake to the advised alcohol units each day will lead to a more rewarding and healthy lifestyle.

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Alcohol Screening Tools
AUDIT: Alcohol Use Disorders Identification Test
Used to assess whether or not there is a problem with alcohol dependence.
SADQ: Severity of Alcohol Dependence Questionnaire
Used where alcohol dependence has been identified, to measure the severity of dependence.
CIWA-Ar: The revised Clinical Institute Withdrawal Assessment for Alcohol scale assessment
Used to assess the severity of alcohol withdrawal syndrome.

Drug Screening Tools
DAST: Drug Abuse Screening Test
Used to assess drug use, not including alcohol or tobacco use, in the past 12 months.
COWS: Clinical Opiate Withdrawal Scale
Used by clinicians to rate common signs and symptoms of opiate withdrawal and monitor these symptoms over time.
SOWS: Subjective Opiate Withdrawal Scale
Used to allow patients to be involved in assessing their withdrawal symptoms.
OOWS: Objective Opiate Withdrawal Scale
Used to objectively measure of the severity of opiate withdrawal symptoms.
Amphetamine Withdrawal Scale
Used where the person has solely had an amphetamine use problem.
CIWA-B: Clinical Institute Withdrawal Assessment Scale - Benzodiazepines
Used to measure the severity of benzodiazepine withdrawal.
CUDIT-R: Cannabis Use Disorder Identification Test - Revised
Used as a brief measure of cannabis use.

Screening tools for Young People
CRAFFT
Used by a trained clinician as a brief interview with an adolescent patient.
DAST-A: Drug Abuse Screening Test for Adolescents
Used to screen the severity of drug use problems in adolescents.

Other useful screening tools
Leeds Dependence Questionnaire
Used for patients to self complete, to measure alcohol and opiate dependence.
GAD-7: Generalised Anxiety Disorder Assessment
Used as a screening tool and severity measure for generalised anxiety disorder.
PHQ-9: Patient Health Questionnaire
Used for screening, diagnosing, monitoring and measuring the severity of depression.
MMSE: Mini Mental State Exam
Used as a brief, quantitative measure of cognitive status in adults.
Fagerström Nicotine Dependence Scale
Used to assess the intensity of physical addiction to nicotine.
Glasgow Coma Scale
Used as a reliable, objective way of recording the conscious state of a person.

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Screening and assessment tools for drug and alcohol use - SMART

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AUDIT: Alcohol Use Disorders Identification Test Used to assess whether or not there is a problem with alcohol dependence. SADQ: Severity of Alcohol Dependence Questionnaire Used where alcohol dependence has been identified, to measure the severity of dependence. CIWA-Ar: The revised Clinical Institute Withdrawal Assessment for Alcohol scale assessment Used to assess the severity of alcohol withdrawal syndrome.

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Find links to all resources created for Alcohol Awareness Week 2017 here #AAW2017

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Background

We surveyed a representative sample of 6,174 UK adults aged 18 to 75 online, between 27th March and 18th April 2017, to investigate drinking behaviours, occasions and motivations, harmful drinking behaviours, and moderation techniques.
Read the full 2017 Monitor report here
Aims and objectives

The main aims of the research were:

to provide an overview of adults' drinking behaviour in the UK

to explore attitudes towards alcohol, moderation strategies and harmful drinking behaviour

to investigate drinking behaviour among different demographic groups and explore which may be at higher risk

to provide profiles of different types of drinkers, to help us target communications and tailor messages effectively.

Key findings contained in the report

Over a quarter (26%) of UK adults typically exceed the limit recommended by the UK Chief Medical Officers of 14 units per week.

Having a small number of drinks at home with a partner as a couple is the most common situation in which adults drink overall; the graph below shows this split by age groups.

The most common motivations overall for drinking are social reasons with 84% of those who drink saying they do so for social reasons at least some of the time.

Coping reasons are an important, but less common, reason overall for drinking with 47% of UK drinkers saying they drink alcohol to cheer them up when they are in a bad mood.

One in 10 UK alcohol drinkers say that they have found that they had not been able to stop drinking once they had started at least once a month.

Almost a fifth say they are changing their drinking behaviors right now.

At least two-fifths have utilised certain scheduling or planning methods to cut down.

Younger people (18-34 year olds) are more likely to employ methods of avoiding alcohol altogether in certain situations, whereas older drinkers are more likely than others to limit themselves when they do drink.

Our new segmentation analysis revealed eight distinct groups of drinkers (depicted below).

Independent analysis

Drinkaware invites researchers to access the Drinkaware Monitor for independent analysis. For more information, please contact the Director of Research and Analysis, Dr John Larsen, JLarsen@drinkaware.co.uk

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Drinkaware Monitor 2017 UK adults drinking behaviours and attitudes

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We surveyed a representative sample of 6,174 UK adults aged 18 to 75 online, between 27th March and 18th April 2017, to investigate drinking behaviours, occasions and motivations, harmful drinking behaviours, and moderation techniques.

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In her bedroom in Clacton-on-Sea, on the Essex coast, 16-year-old Somer Lawrence perfects her Tim Burton-themed Halloween costume. By the time the night is done, Lawrence will have downed a 70cl bottle of vodka. The Corpse Bride is drunk.

In the Cotswolds village of Wotton-under-Edge, 29-year-old Lee Peters manages to play the piano in his flat, despite having consumed an entire bottle of gin.

In Malia, Crete, 18-year-old Stuart Marshall celebrates the end of his lads' holiday by drinking five half-pints of spirits.

Meanwhile, 23-year-old Rebecca Charles enjoys the sunshine with friends at the beach. They bring cider, beer and wine. By nightfall, she will have drunk 35 units of alcohol.

What all these stories have in common is what happened next. Charles woke up at 5am and was sick straight away. Marshall's friends found him curled up in a ball. Lawrence was rushed to hospital. Peters was carried out of his house on a stretcher to a waiting ambulance after a neighbour called 999.

They had all developed pancreatitis, a disease brought on by excessive alcohol consumption that can turn one night in the pub, or a day at the beach, into a life-altering illness - it can often be fatal.

"You can get pancreatitis after a single binge," says Dr Sarah Jarvis of the campaign group Drinkaware, although she explains it's more common to develop it after repeated binges.

The pancreas, a small organ behind the stomach, plays an essential role in digestion. Pancreatitis occurs when it becomes inflamed, usually as a result of too much alcohol. Individual binges can lead to flare-ups of acute pancreatitis, from which the patient can recover after a few weeks. But continued drinking can turn this into chronic pancreatitis, meaning that the pancreas can be permanently damaged, and may fail entirely. Between 70% and 80% of cases of chronic pancreatitis are caused by alcohol abuse, according to the National Institute for Health and Care Excellence (Nice).

After the sudden death of the Swedish DJ Avicii, pancreatitis is becoming better known. He had been afflicted by the condition after abusing alcohol during exhausting world tours and, after his death, his family issued a statement saying "he could not go on any longer". His death has forced us to pay attention to a condition we would perhaps rather ignore.

In the UK in 2016, 7,327 people died of a range of conditions that could be directly attributed to alcohol abuse. While the number of direct alcohol-related deaths have been relatively constant since 2013, they are higher than they were in 2001, when 5,701 people died as a direct result of alcohol abuse. English alcohol-related hospital admissions are at a record high - up two-thirds from a decade ago - while spending on alcohol support services has been cut.

Binge drinking - defined as drinking more than six units of alcohol in one go - is so normalised in the UK that the head of NHS England, Simon Stevens, has said hospitals are becoming the "national hangover service". But it is easy to be in denial; evidence shows that people consistently underestimate how much they consume, particularly when drinking at home.

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Lee Peters ... 'I have gone downhill quite rapidly in the last six months.' Photograph: Adrian Sherratt for the Guardian

Peters, Lawrence and Charles all now have chronic pancreatitis. "In the town I lived in, drinking was a massive part of the culture," says Charles, who is now 31. "Everybody else was doing it. But I wasn't getting up in the morning and drinking - the way people imagine alcoholics behave. I was just too much of a party girl."

"I was stupid and young," says Lawrence, who is now 20. Although she went to hospital several times after the incident at her Halloween party, Lawrence continued drinking, and developed chronic pancreatitis at 17. She began drinking aged 14 because it eased her anxiety and depression. "I'd turn to alcohol as a coping mechanism," she says. "I'd always be the one at the party who'd had the most to drink. It gave me liquid confidence."

She isn't alone. "Wine had this lovely, numbing quality to it," Peters says. Now aged 34, he began binge drinking after being violently assaulted at 16. "It was absolutely a response to trauma. It was the self-medication tool I used when things got stressful."

Alcohol abuse is often linked to mental ill health. "Drug and alcohol use can lead to mental health problems, and vice versa," says Dr Cyrus Abbasian, a consultant psychiatrist at St George's, University of London, who specialises in mental health and substance abuse. He explains that alcohol is an anxiolytic, meaning that it has a sedative effect. "You're self-medicating your mental health condition," he says. "Alcohol leads to short-term relief of anxiety, but it doesn't treat the underlying problem." Over time, a person may develop alcohol dependency, alongside their existing, untreated mental health issues.

In a difficult relationship, and with postnatal depression after the birth of her daughter, Charles fell in with a party-loving crowd. "You think the alcohol is making things better," she says. "But it's actually making things worse."

Some argue that minimum-unit pricing, implemented in Scotland earlier this month, would tackle the problem of at-home drinkers who take advantage of cheap supermarket offers. "Minimum unit pricing is an excellent idea," Abbasian says, "because it's an evidence-based public health intervention. With any drug, you need to limit supply and increase price to reduce use. If something is cheaply and easily available, people tend to use it." In some instances, supermarkets had been selling alcoholic drinks more cheaply than the same quantity of water.

It's like the worst stomach ache you've ever had

Stuart Marshall

But would minimum-unit pricing have deterred Lawrence, who would drink a bottle of vodka because she was too young to get into bars? Possibly. "When you're young, you can't get into pubs, so you get a bottle of vodka for seven or eight pounds," she says. "I don't know why we thought it was necessary to be drinking spirits. Why were we drinking vodka at 15 or 16? It's what everybody did, so it's what I did."

We all have friends who push things too far. They're the ones with cracked phone screens and jeroboam-sized hangovers on Sunday mornings. Their anecdotes of drunken misadventures make you laugh, but also make you queasy.

Or maybe you're that friend. "People drink so much because it's our culture," adds Lawrence. "The sun comes out and you go to a beer garden. It's what we do. Everything is just an excuse to drink. Life is hard for everybody, so it's nice to have an escape."

But Jarvis believes if people were aware of the health consequences of binge drinking, they would drink less. "Most people have no idea that you may be doing yourself damage now that can last a lifetime."

Here's something to make binge-drinkers pause mid-sip: pancreatitis hurts. "It's like the worst stomach ache you've ever had," Marshall says.

"The pain is incredible," says Charles.

When your pancreas begins to fail, the pain never goes away. After her pancreatitis turned chronic, Charles's pancreas stopped producing the enzymes she needed to digest food, causing her to become malnourished. Her weight dropped to 29kg (63lb). She can't work full-time or look after her 10-year-old daughter. On good days, she showers and does laundry. The bad days are dark. "I think: 'I wish I could go to sleep and never wake up.'"

Life becomes small. Drinking buddies melt away faster than ice in a spritzer on a warm summer day. "It's lonely," Charles says, "when you're surrounded by people who party the whole time and you don't want to be a part of that any more. It's like they don't want to know you."

Peters also lives alone. A kindly neighbour checks up on him. "She has dug me out of some dark places," he says. When he goes out, his emaciated frame attracts pitying looks. "It's difficult because I used to be a good-looking chap with a decent body that people would comment on." But not being able to work takes the biggest toll. "I feel quite ashamed by it," Peters, a former accountant, says. "Having to go from being fiercely independent to being dependent on the state doesn't sit well with me."

After we talk on the phone, Peters emails me a list of the 14 medicines he takes daily, and the 25 symptoms he experiences. ("Constant, debilitating pain ... regular sepsis.") "I can sense the grim reaper approaching," Peters writes, before signing off with a cheerful reminder not to work too hard.

How does he bear it? Keeping his mind occupied helps. So do antidepressants. Knowing that he caused his disease, Peters says, "is difficult to cope with". After his first bout of pancreatitis, Peters kept drinking. "It's difficult to explain why," he says, pointing to the trauma of his early attack as a partial explanation. He also felt that doctors were possibly exaggerating the severity of his condition, out of overcautiousness.

"It's hard to explain what makes people unable to stop drinking," says Abbasian. "With some patients, I have a conversation with them, and they say: 'Yes, doctor, if I drink, I'll have pancreatitis and I'll die.' But they don't find other things as pleasurable and, because of their underlying anxiety disorder, they continue to self-medicate."

Peters says: "I have tried very hard to come up with a rational reason as to why I was so neglectful and blase about my health, but there's nothing I can come up with that will make sense to anybody. I've been very foolish. I made those decisions and I'm aware I made them. I thought: 'Hell, sod it, I'll think about it tomorrow.' But tomorrow catches up with you. It caught up with me, big time."

Chronic pancreatitis has no cure. Many people with the condition go on to develop pancreatic cancer. Surgical procedures are sometimes necessary. Charles's gallbladder has been removed and doctors have performed a coeliac plexus block on her - an injection made using local anaesthetic to treat severe abdominal pain. Peters has advanced-stage chronic pancreatitis and takes prescription painkillers, including morphine, as well as enzyme replacement drugs, anti-sickness medication, anti-seizure medications, proton-pump inhibitors to reduce the acid in his stomach, anti-constipation tablets and meal-replacement drinks.

Despite all these interventions, about one in five people with pancreatitis will die within five years of their diagnosis. "I have a terminal prognosis," Peters says quietly. "I have gone downhill quite rapidly in the last six months. Lots of treatments don't work any more. I'm literally wasting away." A few days after we speak, Peters experiences projectile vomiting, a fever and excruciating pain and is admitted to hospital with an acute flare-up of pancreatitis.

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Stuart Marshall ... 'Even with some of my friends, I think: you turn into a wanker when you're drunk.' Photograph: Andy Hall for the Observer

It's easy to be judgmental about Peters' situation. You may think: why didn't he just stop drinking when his doctors warned him? But trauma makes people behave irrationally. Rape survivors become promiscuous, intelligent people ignore medical advice, the children of alcoholics binge-drink.

And even if you have never experienced trauma yourself, not drinking in our culture is hard. "My friends are drunk all the time and they'll be in the club buying me drinks," Lawrence says. "They don't realise the severity of my illness because they don't have to live with it." Charles gets angry when she sees people being peer-pressured. "People will taunt someone who isn't drinking," she says. "It's like: you're a weirdo if you don't drink."

There are signs that Britain's relationship with alcohol is improving, though. "We are slowly turning the tide," Jarvis says. "Young people are drinking less." A fifth of under-25s are teetotal, and today's teens drink less than ever before, with only around 17% of 8-15-year-olds admitting to drinking alcohol - a change that has been attributed by some to the rise of social media. But only a sea-change will transform Britain's binge-drinking culture. We have the second-highest levels of binge drinking in Europe, according to the Norwegian University of Science and Technology, with 7.8 million people a year admitting to bingeing on their heaviest drinking day.

"Humans are social animals, but we don't like to be around a lot of people we're not familiar with," Abbasian says. "Socialising, going out on a Saturday, is anxiety-provoking. When you go to a bar or club, you drink to reduce anxiety levels so you can drink and talk to strangers. Alcohol disinhibits you."

Forced sobriety at least helps you to see things anew, in a clear-eyed way. "I notice everything on nights out - I'm not blind to things any more," Marshall says. "Even with some of my friends, I think: you turn into a wanker when you're drunk."

Abbasian says: "If alcohol were a relatively new drug introduced into our society, and not as socially acceptable, it would be a class A drug, similar to heroin or cocaine." He urges those who regularly binge drink to seek assistance, before it's too late. "There's a lot of stigma and denial. A major first step is to accept you have a problem and not be ashamed getting help and treatment."

All the people I spoke to wanted me to share their experiences. In fact, many of them reached out to me, desperate to warn others.

"My message is: be careful," Charles says. "Just because you're young and you only go on weekend benders, and don't drink every day, doesn't mean you're invincible. Because you're not."

And the next time you drop a crate of sticky bottles off at a recycling bank, Peters would ask that you remember him and reconsider your drinking. "If just one person can read this and think that, it would be enough for me," he says. "Just to make a difference to that person and their family. It would be my whole life's work complete for me. I would be over the moon."
Drinkaware is an independent UK charity working to reduce alcohol misuse and harm. Further information: drinkaware.co.uk Topics

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Binge-drink Britain: how one weekend bender can ruin your life

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In her bedroom in Clacton-on-Sea, on the Essex coast, 16-year-old Somer Lawrence perfects her Tim Burton-themed Halloween costume. By the time the night is done, Lawrence will have downed a 70cl bottle of vodka. The Corpse Bride is drunk.

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On top of that, many of our routines will have changed, which might make it hard to keep on top of how much we're drinking.

Here are some ways to help you look after your mental health while keeping a happy, healthy relationship with alcohol.

Top tips for general mental wellbeing during the coronavirus (COVID-19) outbreak include:

Limit your time reading the news and on social media

Stay connected with your loved ones

Do things that help your mind and body, like exercise and eating healthily

There are more tips in this article from the BBC. You can also find many more resources on everything from sleep to low mood on the NHS Every Mind Matters website.

It might be that alcohol is your go-to treat when you need to relax. When things are tougher than normal, you might find yourself reaching for alcohol more often, so it's worth finding some alcohol-free treats too. You could try chocolate, a hot bath, playing video games, or anything else that helps you unwind. You deserve it! Here are some more ideas.

And if you're looking for an alcohol-free drink to hit the spot when you want a treat, we have reviews of the best low and no alcohol wines, beers, ciders and spirits.

If you're working from home or self-isolating you might have more time than usual to fill, and sometimes we use alcohol to do that. But there are lots of things you can do at home without alcohol! Check out just a few in this blog.

With normal routines out of whack and stress levels heightened, you might find yourself drinking more than usual without noticing. If you're worried about your drinking getting out of hand, there are tools available to help you keep track so you can make the decision to cut down if you notice your intake increasing.

You could keep track using an app. Ours is called Try Dry, and you can use it to track your intake with charts and graphs, plus see your units, calories and money saved when you cut down. You can also earn badges for days off or reducing your units. Download it for free.

Alternatively, you could check your drinking risk score to get a better idea of whether it would be a good idea to cut back.

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Coronavirus: top tips on alcohol and mental health | Alcohol Change UK

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On top of that, many of our routines will have changed, which might make it hard to keep on top of how much we're drinking. Here are some ways to help you look after your mental health while keeping a happy, healthy relationship with alcohol.

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Alcohol Concern Blue Light Project Manual Final

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Chronic heavy drinking should be recognised as a major risk factor for dementia, especially early onset dementia, say researchers. Doctors should screen patients for heaving drinking and offer brief interventions to help reduce alcohol consumption if necessary, they wrote in Lancet Public Health.1

The French retrospective cohort study, which included data from over 31 million people, found a strong association between alcohol use disorders and all types of dementia, even after they controlled for potential confounding risk factors.

The relation between alcohol and dementia has been widely studied, with some studies showing a possible benefit of light to moderate drinking, while others have found a detrimental effect of heavy drinking on dementia risk. The World Health Organization defines chronic heavy drinking as consuming more than 60 ...

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Large study is "robust" evidence of link between chronic heavy drinking and dementia

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Chronic heavy drinking should be recognised as a major risk factor for dementia, especially early onset dementia, say researchers. Doctors should screen patients for heaving drinking and offer brief interventions to help reduce alcohol consumption if necessary, they wrote in Lancet Public Health.1 The French retrospective cohort study, which included data from over 31 million people, found a strong association between alcohol use disorders and all types of dementia, even after they controlled for potential confounding risk factors.

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The recommendations now state that "for many, alcohol is a part of their social life', and that the rules are not meant to 'prevent those who wish to drink from doing so".

They also make it clear that the risks of drinking are no higher than other everyday activities such as driving a car. However, the rules say that it is safest for pregnant women or those trying to conceive not to drink at all.

Concerns about the equalisation of upper drinking limits for men and women were revealed in the government's response to a consultation on the alcohol guidance, published yesterday.

The document states: "A commonly cited objection was that the low-risk limits are now the same for men and women.

"In particular, what was seen as conflicting statements around the effects of alcohol on different metabolisms and body weights, and concluding that there should not be a single figure for the weekly guideline.

"In some cases, respondents felt this could encourage women to drink more, believing they can consume alcohol at the same levels as men, or that this might lead to people disbelieving the guidelines."

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New alcohol guidelines could encourage 'ladette' behaviour, experts fear

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The recommendations now state that "for many, alcohol is a part of their social life', and that the rules are not meant to 'prevent those who wish to drink from doing so". They also make it clear that the risks of drinking are no higher than other everyday activities such as driving a car.

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New guidelines issued by the UK's chief medical officers mean the country now has one of the one of the lowest recommended upper limits for alcohol consumption by men in the world.

The amended advice states that men should not consume more than 14 units of alcohol a week, which equates to five pints of beer at 5% ABV strength.

The guidelines update previous ones set in 1995, which said that men should be limited to 21 units or less of alcohol per week. The total recommended for women remains unchanged at 14 units.

Recommended alcohol

A unit in the UK is equivalent to 8g of pure alcohol. This means British men are now being told they should drink considerably less than those in Ireland (21.2 British units), Denmark (21), New Zealand (19) and much less than the recommended upper limit for men in Spain (35).

However, the 14-unit limit for women remains in line with international standards. It is higher than the advised limits in the US (12.3) and Denmark (10.5) and roughly on par with Ireland.

Britain now joins Australia, where the guideline amount is 2.5 units (20g of pure alcohol) on any given day, in being one of the few countries to have parity for men and women.

Making international comparisons between countries' recommended alcohol consumption is not exactly straightforward. A 2013 report by academics at the University of Sussex found a "remarkable lack of agreement" about what constituted harmful or excessive alcohol consumption across the world.

Not all countries are like Britain in having a government department issue advice on recommended alcohol consumption. For example, representatives from the French government told the Guardian they had no official guidelines. However, there are nationwide campaigns suggesting upper limits in the country.

Other countries vary in their wording of what they warn against. In Sweden the recommendation (21 British units per week for men) guards against hazardous consumption of alcohol whereas the limit in the UK aims to keep "health risks low".

The new British guidelines also state that drinking any level of alcohol raises the risk of a range of cancers. The full extent of this link was not recognised in the guidelines set out in 1995.

A similar position was recently set out by the Gezondheidsraad (health council) in the Netherlands. In November it released new dietary requirements, stating: "Do not drink alcohol or at least no more than one drink per day."

Their report admits that although there have been some reported health benefits of, for example, drinking wine, these do not outweigh the negative health risks of alcohol consumption.

A statement from the Portman Group, which represents the alcohol industry, said: "What is surprising is that the UK is breaking with established international precedent by recommending the same guidelines for men and women. It also means that UK men are being advised to drink significantly less than their European counterparts."

This article was amended on 8 January 2015 to remove references to "safe" alcohol limits. The government's advice is that "there is no level of regular drinking that can be considered as completely safe". Topics

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How do the UK's new alcohol guidelines compare with the rest of the world's?

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New guidelines issued by the UK's chief medical officers mean the country now has one of the one of the lowest recommended upper limits for alcohol consumption by men in the world. The amended advice states that men should not consume more than 14 units of alcohol a week, which equates to five pints of beer at 5% ABV strength.