There’s been a decidedly sobering start to 2016 for Britain’s drinkers. First, the chief medical officers of the four UK nations joined forces to slash the official guidelines on recommended drinking levels. Then, a new survey shed light on whose health is most at risk from alcohol.
Contrary to popular belief, the UK’s real booze problem does not involve the inebriated youth who litter our urban landscape after nights of binge-drinking at weekends. Instead, it lies with the less visibly sozzled mature adults who regularly knock back more than is good for them behind closed doors.
New light was shed on older people’s drinking habits in a major survey commissioned by campaign group Drink Wise, Age Well. Its first state-of-the-nation report highlights the full scale of what it describes as a hidden problem: the increasing amount of drink-related harm among older adults. Alcohol-related hospital admissions among this age group have more than doubled in less than a decade; alcohol-related mental health problems are escalating quickly; and drink-driving prosecutions are soaring.
For the survey, 17,000 over-50s responded to a postal questionnaire about their alcohol use and behaviour. Of these, 80 per cent were identified as being in the lower risk category, 17 per cent were classed as at ‘increasing risk’, and 3 per cent were at high risk. Of the high-risk group, half reported drinking more now than in the past. The reasons they quoted were age-related and included retirement, bereavement and a loss of their sense of purpose. Among this 3 per cent, almost half said they drank because they were lonely, bored or had nothing else to do; a third cited depression; nearly a quarter reported drinking because they couldn’t sleep, and 16 per cent said they turned to the bottle because they were in pain.
With increasing numbers of people drinking at home more often, and that trend increasing with age, Drink Wise, Age Well says it is difficult to measure the amounts consumed. More than half of respondents said they were not fully confident that they could keep track of their alcohol units.
More than 80 per cent of those whose drinking was putting them at potentially increased risk of alcohol-related harm said that on no occasion had anyone — neither family members, friends nor health professionals – expressed concern about their drinking levels or suggested they cut down.
The Drink Wise, Age Well survey, the largest study into consumption and attitudes to alcohol ever undertaken, found that more than half of people over 65 believe that those with an alcohol problem have themselves to blame, and 25 per cent think they should feel ashamed. No wonder, then, that a quarter of respondents said they wouldn’t tell anyone if they felt they needed help.
Dr John Giles, medical director of Benenden, believes that this is an especially sad statistic. ‘There is a small minority of people who need specialist help for their drinking, and it is important that they can access it,’ he says.
Although a quarter of respondents said they would not know where to go to seek help for a drink problem, Dr Giles believes GPs ought to be the first port of call. Benenden offers members psychological counselling services, and access to a 24/7 GP helpline. ‘If you think you have a problem it is vital that you talk to someone who can support you,’ he says. ‘There is plenty that can be done.’
Supported by the Big Lottery Fund, Drink Wise, Age Well is a partnership between a range of charities and research organisations. It aims to help health and social care providers in five test areas across the UK to recognise and respond to older people who may be at risk of alcohol-related harm.
Its survey was conducted before the UK’s chief medical officers revised their advice on alcohol consumption. Updating guidelines that had remained unchanged for 20 years, they concluded that to minimise health risks neither men nor women should drink more than 14 units per week — a dramatic reduction from the 21-unit limit previously recommended for men.
England’s chief medical officer, Dame Sally Davies, found herself vigorously defending the new guidance against accusations of ‘nanny-statism’ and scaremongering. Not true, she says: the advice is based on hard science that now links alcohol with accidents and increased risk of developing a range of illnesses, including certain cancers.
Dr John Giles, a consultant radiologist, has a special interest in cardiovascular and interventional radiology and a healthy scepticism about the degree of behavioural change that the recent focus on alcohol consumption hopes to achieve.
‘Overall, levels of drinking per capita have been steadily falling in the UK in recent years regardless of the latest pronouncements,’ he says. ‘It is my personal view that, on balance, low doses of alcohol are probably better than none at all. There is plenty of research to back that up.’
Having taken into account all the available international evidence, the official advice is that the only people who may benefit from low levels of alcohol consumption are women over 55 who, if they drink five units a week and no more, are said to gain some protection from heart disease.
‘It is far more important not to smoke, to eat a healthy diet and to take exercise,’ says Dr Giles. ‘You can give people all the information and advice you want — ultimately, it is down to individual choice, and people are usually pretty good at making the right decisions for themselves.’
Dr Giles, who is in his late fifties, took his own straw poll of clinical colleagues of a similar age and concluded that none would change their behaviour as a result of the recent advice on alcohol consumption. ‘The vast majority of people are low-risk drinkers, and most of us are used to taking calculated risks,’ he says. ‘People are making informed decisions. If they are functioning perfectly normally, and they are happy, then they believe that they have no reason to change.’
Dr Giles does agree with the other official advice that drinkers should set aside a few days each week as alcohol-free. ‘That makes good sense to me,’ he says. ‘If it’s not possible for you, then it’s a pretty good indicator that you may have a problem that needs addressing. My guess is that the rest of us will carry on as normal — better informed, perhaps, but still determined to make our own choices.’