FMP Research: Alcoholism and Lack of

Control
What is Alcoholism?

Although the term alcoholism is commonly used in our society, it is not a clinical descriptor of
alcohol addiction. Generally, alcoholism is described as the most grave form of problematic drinking.
According to drinkaware.co.uk, alcoholism is a ‘strong, often uncontrollable desire to drink. Sufferers
from alcoholism will often place drinking above all other obligations, including work and family, and
may build up a physical tolerance, or experience withdrawal symptoms if they stop.’

This is a very general term due to the fact that there is still not a unanimous consensus on what
should be considered alcoholism or the different levels of alcohol use. The Diagnostic and Statistical
Manual of Mental Disorder – a publication from the American Psychiatric Association provides a
method in which to diagnose mental disorders such as alcoholism.

Often, you are considered a sufferer of alcoholism or alcohol dependant if most of these symptoms
apply to you:

High concentration of alcohol in the blood can cause:

- Slurred speech

- Slowed reflexes

- Difficulty concentrating

- Lack of control over motor skills or movement

- Gaps in memory or blackouts

- Poor decision making/ the inability to think logically

In extreme states of intoxication, alcohol in the blood may cause breathing problems, coma or
death. However, many people use alcohol without these effects, instead experiencing lesser
symptoms such as vomiting and hangovers.

The Symptoms of Alcohol Abuse Include:

- Drinking to relax

- Driving under the influence of alcohol

- Social relationships being damaged because of drinking

- Neglecting Responsibilities

- Legal problems due to consumption of alcohol

Alcoholism and Alcohol Abuse are diagnosed by evaluating these symptoms:

- Impact relationships

- Causes harm or injury

 - Affects quality of life

Alcoholism is a multi-faceted disease. Although it often manifests physically, it begins as a mental

health issue – alcoholism stems from people using alcohol as a coping mechanism for underlying
problems such as depression, anxiety, loneliness or emotional stress.

Alcoholism may also run in families, though after studies it has been found to be unrelated to
genetics, instead it relies on the culture and attitudes created around alcohol and that parents who
do not deal with their problems in a healthy way cannot teach their children how to do so, or put
stress onto the child. The exact causes of alcohol abuse is often unknown.

Alcohol abuse is more common at certain points in life. Males, college students, and people going
through serious life events or trauma are more likely to abuse alcohol.

Your doctor may ask you about drinking habits and health history. They may also use blood tests to
assess your overall health, paying special attention to areas of the body most impacted by alcohol,
including the brain and other parts of the nervous system, as well as the heart and liver.

Sources:

- Drinkaware.com

- The Diagnostic and Statistical Manual of Mental Disorder

- Healthline.com

Complicati ons Caused by Alcohol:

As well as having short term effects, such as slowed reactions and slurred speech, excessive
consumption of alcohol has very detrimental long-term effects, such as:

- Alcohol poisoning

- Liver damage

- Sexual dysfunction

- Brain damage

- Cirrhosis

- Increased risk of heart disease

Attempting to get a hold of this addiction may cause withdrawal symptoms that are just as severe,
for example, someone who relies heavily on alcohol may experience these during the withdrawal
period:

- Nausea

- Shaking/Convulsing

- Sweating

- Irritability/Anxiety

- Seizures
 - Severe vomiting

- Hallucinations

- Fevers

Why Is Alcohol Addicti ng?: Source – The Guardian

It’s widely known that alcohol reduces stress temporarily, and many people use it for just that
purpose. It reduces stress by increasing the uptake of a neurotransmitter called GABA, the brain’s
primary inhibitory molecule. (And by “inhibitory” I don’t mean that it makes you feel inhibited. Quite
the opposite, of course.) By sending more GABA to your brain cells, alcohol works much like
common tranquillising drugs such as Valium and Xanax. That’s why you start to stumble and slur if
you drink too much. But alcohol acts on many other neurotransmitters too.

While alcohol increases GABA, it reduces the uptake of glutamate, the brain’s premier excitatory
molecule. Less excitation and more inhibition? That sounds like simple summation, but GABA and
glutamate have different effects on different brain regions, and that’s where things get complicated.
In the prefrontal cortex, the part of the brain you use for thinking and planning, the net effect is
inhibition. That’s why your judgment is flawed, your decision-making is set to “whatever” and your
ability to see things from any perspective other than your own approaches nil. The remarkable side
effect of this general dimming is that your thoughts seem amazingly clear – which is nice – while in
reality they are just amazingly limited. Meanwhile, GABA is also busy turning off the brakes on a
system that releases dopamine, the molecule that takes centre stage in all varieties of addiction.
What’s that again? Well, when you take off the brakes, the car starts to move. So what you get is a
stream of dopamine coursing into the striatum (or reward system), the brain part that generates
desire, anticipation and (once you’ve finally brought the glass to your lips) pleasure.

So far, you’ve got physical relaxation, which diminishes stress, reduced judgment, allowing you to
talk and behave however you want, and stimulation of the brain’s reward system, which makes you
feel like something nice is about to happen. But the fourth neurotransmitter tops the bill: opioids.
Sometimes called endorphins or internal opiates, they get released by alcohol too. Everyone knows
that opiates feel good, but did you know that you can get your opiates legally by downing a stiff
drink? The American martini – which consists of three ounces of gin and little else – feels particularly
nice for a very simple reason. The faster the alcohol goes in, the more internal opiates get released.

But once people become addicted to alcohol, as many do, the fun of the high is eclipsed by two
opposing fears. The fear of going without, versus the fear of being unable to stop. That clash of
concerns comes from several sources. First there are the unpleasant bodily effects that plague big
drinkers when they stop for a few hours or, worse, a few days. Add to that the emotional emptiness,
depression, and increased stress responsiveness that overcome the drinker’s mood at the same
time. Taken together, these effects make up what George F Koob calls the dark side of addiction. But
I think the real bogeyman, the unbeatable Catch-22 when it comes to alcohol and other drugs, is the
realisation that the thing you rely on to relax is the very thing that stresses you out the most. It’s
hard to find a way out of the recurrent cycle of anxiety and temporary relief, over and over, and
that’s the epitome of a losing battle.
Stati sti cs on the Problems Caused by Alcoholism:

England and Wales:

Disturbing stats

35% of all Accident & Emergency (A&E) attendance and ambulance costs may be alcohol related in
England. 9

530 people died from alcohol poisoning in the UK in 2018. 1

Males accounted for approximately two-thirds of the total number of alcohol-related deaths in 2018
in the UK. There were 7,551 alcohol-specific deaths in the UK 5,077 (16.4 per 100,000 population) in
males and 2,474 (7.6 per 100,000) in females. 1

In 2018, it is estimated that there were 240 fatal drink drive accidents. 2

Being impaired by alcohol is thought to be a contributory factor in 13% of pedestrian road deaths. 11

For 16 – 24-year olds, 21% of deaths in males and 9% of deaths in females have been attributed to
alcohol consumption. 8

In the year ending March 2018, 39% of all victims of violence in England and Wales said their
attacker was affected by alcohol at the time. It is estimated that there were 561,000 violent alcohol-
related incidents in 2017/18. 3

Alcohol misuse is a factor in 30% of suicides each year.

Hospital admissions for young people under 18 in the 3 year period 2016/17-2018/19 were 11,233.
The admission rate for girls was 37.5 (per 100,000) compared to 25.9 (per 100,000) for boys. 4

In England, there were 357,659 estimated admissions where an alcohol-related disease, injury or
condition was the primary diagnosis or there was an alcohol-related external cause in 2017/18. 4

4% of 16 – 24 year-old men drink more than 50 units a week and 3% of women aged 16 – 24 drink
more than 35 units a week putting themselves at risk of alcohol dependency, mental and
behavioural problems and long term health risks such as liver disease. Among adults aged 16 – 74,
5% of men and 3% of women are estimated to be higher risk drinkers in England. 5

There were 12,180 exclusions for drug and alcohol offences in English schools last year – 17% up on
the year before and the highest since records began in 2006-07. 13

Reassuring stats

In England, only 6% of 11 – 15 year-olds drink at least weekly (down from 20% in 2003) – i.e. 94%
don’t (1% of 11 year-olds drink rising to 14% of 15 year-olds). 6

56% of 11 – 15 year-olds have never drunk alcohol (up from 41% in 2000). The proportion of pupils
who have had an alcoholic drink increases from 14% of 11 year-olds to 70% of 15 year-olds. 6

The proportion of pupils who think it is ok for someone of their age to drink alcohol has fallen in
recent years. In 2018, 27% of pupils thought that it was ok for someone of their age to drink once a
week, compared to 46% in 2003. 6
Among 16 – 24 year-olds in 2018, 22% of men and 15% of women said they binge drink. That means
an overwhelming majority of young adults (78 % of men and 85% of women) go out to enjoy
themselves and socialise, not to get drunk. 5

In 2018, 69% of men drank and 85% of women drank within the government low risk drinking
guideline (a maximum of 14 units for both women and for men). 5

Statistics are drawn from:

1. Alcohol-specific deaths in the United Kingdom: registered in 2018, published December 2019
(Office of National Statistics)

2. Estimates for reported road traffic accidents involving illegal alcohol levels: 2018 (Department for
Transport)

3. The nature of violent crime in England and Wales: year ending March 2018 (ONS) published 2019.

4. Local Alcohol Profiles for England (LAPE)

5. HSCIC Health Survey for England, 2018, published 2019

6. HSCIC Smoking, drinking and drug use among young people in England 2018 report, published
2019.

7. Statistics on Alcohol, England, 2017

8. John Moores University. Updating England-Specific Alcohol-Attributable Fractions report, 2013.

9. Nuffield Trust: Alcohol-specific activity in hospitals in England, 2015.

10. Alcohol-specific deaths by sex, age group and individual cause of death

11. Facts on Pedestrian Casualties June 2015 Department of Transport

12. Adult drinking habits in Great Britain: 2005 to 2016.

13. Permanent and fixed-period exclusions in England

Source: Alcholeducationtrust.org

Alcohol and Crime:

In 2015/16 in England, victims believed the offender(s) to be under the influence of alcohol in 39% of
all violent incidents.

In 2018/19, 39% of people in England and Wales said they witnessed any type of anti-social
behaviour in their local area. 11% of this anti-social behaviour was alcohol-related. 12% of people
said that there is a very or fairly big problem in their area with people being drunk or rowdy in public
places [27].

In 2018/19 in England and Wales, the area in which people perceived the greatest problem with
people being drunk or rowdy in public places was Northamptonshire (19%), followed by London and
the West Midlands (18%) and Cambridgeshire (17%). The places in which the fewest people
perceived this problem were Cumbria (4%), Nottinghamshire (5%) and Suffolk and North Wales (6%)
[32].

In 2017/18, in 39% of violent incidents the victim believed the offender to be under the influence of
alcohol [31].

In 2017/18 in England and Wales, in 24% (39,000 incidents) of robbery cases the victim believed the
offender to be under the influence of alcohol. This figure increased from 17% or 25,000 cases in
2015/16 [26].

In 2016/17 in England and Wales, 12.4% of theft offences, 20.6% of criminal damage and 21.5% of
hate crimes were alcohol-related [15].

 In England and Wales, alcohol-related violent incidents are more likely to be reported to the
police than those which are not alcohol-related [15].
 In 2016/17 in England and Wales, in 35.8% of sexual assault cases the offender was under
the influence of alcohol [15].
 In 2017/18 in England and Wales, victims of partner abuse reported that the offender was
under the influence of alcohol in 17% of incidents [33].
 In 2015/16 in England, victims believed the offender(s) to be under the influence of alcohol
in 39% of all violent incidents, down from a peak of 55% in 2009/10. In Wales, the figure is
higher, at 49% in 2015/16, down from a peak of 73% in 2006/07 [11].
 In 2014-2016 in England and Wales, alcohol-related violent incidents made up 67% of violent
incidents which take place at the weekend and 68% of those which take place during the
evening and night [12].
 In 2014-2016 in England and Wales, 91% of violent incidents which took place in or near a
pub or club were alcohol-related, and 67% of those which took place in public spaces were
alcohol-related [12].
 In 2017/18 in Scotland, in 46% of violent crime incidents the offender was under the
influence of alcohol [20].
 In 2018 in Great Britain, there were 8,700 drink-drive casualties and 5,900 drink-drive
accidents. In the long-term, these figures have been falling since 1979 from aIn England and
Wales, alcohol-related violent incidents are more likely to be reported to the police than
those which are not alcohol-related [15].
 Source: Alcoholchange.org

Young People and Alcoholism:

In 2016, 23% of 15 year olds reported having been drunk in the last four weeks.

In 2018 in England, 44% of pupils aged 11-15 in England reported having ever drunk alcohol. Of
these, 14% of 11 year-olds reporting ever having drunk an alcoholic drink, compared to 70% of 15
year-olds [29].

6% of pupils said they drank alcohol at least once per week, but for 15 year-olds this went up to 14%
[29].

In 2018 in England, pupils aged 11-15 who drank alcohol in the past week, consumed an average of
10.3 units [29].
21% of pupils who drank in the last week were estimated to have drunk more than 15 units [29].

Girls were more likely to have been drunk in the last four weeks than boys [29].

22% of 15 year olds reported having been drunk in the last four weeks [29].

Of pupils who obtained alcohol in the last four weeks, 71% were given it by parents or guardians,
49% were given it by friends and 48% took it from home with permission [29].

Of pupils who currently drink, 66% said they drank with parents and 58% said they drank with
friends [29].

61% of pupils who currently drink said that they never buy alcohol [29].

In 2009/10 in Wales, 17% of males and 14% of females aged 11-16 reported drinking alcohol at least
once a week [30].

In 2018 in Scotland, 71% of 15 year olds and 36% of 13 year olds reported ever having had an
alcoholic drink, but fell to 20% and 6% respectively for those who drank alcohol in the last week [21].

In Scotland an estimated 36,000 to 51,000 children live with a parent or guardian whose alcohol use
is potentially problematic [16].

Source: Alcoholchange.org