50 Ways to leave your lager
29 - 35
Cutting Down

1. Tips for people who care for heavy drinkers

Unfortunately it does not matter what you do; you have no control over a problem drinker’s behaviour. It can be difficult to accept you have no control over their actions because it may make you feel like they do not care about you. When someone is addicted to something, some of his or her behaviour seems very uncaring and selfish. Alcohol or drugs are the most important things in their life. They do care about you, but at that time the drug is the most important thing. When they are no longer addicted they will show as much disbelief as you about their selfish behaviour, and they will probably be unable to answer why, other than they wanted to get drunk or high.

Do not make excuses for the drinker and do not protect them. They are adults – they have to take responsibility for their behaviour.

Do not feel guilty or judged by others because of the behaviour of someone you are close to. You have no control over it, only they do.

Some people will not accompany the drinker to any events where alcohol is served. Any threat like this has to be carried out. Again, do not support their drinking behaviour by helping them out of situations, such as picking them up when they can't get home. This sort of threat rarely works, but it may help you. Do not feel guilty, they are responsible for themselves. As more and more negative things happen to the drinker, he or she may eventually want to change. But you may have a long wait. You have to look after yourself, not them. You can only make changes to your own way of thinking and coping. You cannot change the drinker’s behaviour – only they can do that.

Children of problem drinkers can feel like they have to become perfect daughters or sons, and so they become high achievers. Some partners feel they have to become exemplary parents and carers, taking on all responsibilities and covering up their partner’s behaviour.

Al-anon and Alateen offer support and help to family and friends of problem drinkers. This help may be about finding out how you can get on with your life; that you are not responsible for the drinkers’ behaviour. It may also be very therapeutic to be able to speak to others who have been through similar experiences.

Al-Anon Family Groups UK & EIRE
Tel: 020 7403 0888 (10am–10pm daily)
Website: www.al-anonuk.org.uk

2. Alcohol and pregnancy

The advice on drinking alcohol whilst pregnant has changed slightly over the years. It has ranged from advocating complete abstinence to advising that consuming two units twice per week in the later stages of pregnancy will not cause any harm to the baby. If in doubt, abstain from alcohol whilst pregnant. The advice on heavy drinking is consistent: it does cause permanent damage to the baby.

Mothers who drink alcohol during pregnancy can have a baby with foetal alcohol syndrome (FAS) or foetal alcohol effects (FAE). Babies born with FAS have cranio-facial malformations, such as reduced skull size, small upper lip and nose, small lower jaw and contracted eyelids. The brain does not develop normally, and the baby may have learning difficulties. He or she may also have concentration difficulties, be clumsy, or have organ, joint and limb problems. The incidence of FAS is thought to be around 1.9 per 1,000 live births. FAE may occur in 1 in 300 live births. It is, at present, not reliably recognised or diagnosed. Three times more babies are born with FAS than Down’s syndrome, and eight times more than those with spina bifida. It is incurable, yet 100% preventable by not drinking alcohol whilst pregnant. The mother drinking alcohol later in pregnancy is associated with children with ADHD (Attention deficit hyperactivity disorder). So cutting out alcohol whilst pregnant saves lots of sweat and tears in childrearing.

Some women do not want to tell anyone that they are pregnant in the early stages of their pregnancy. So to avoid raising suspicion that they are pregnant, some women drink 0% lager in a glass (or with the label torn off the bottle), or juice or a soft drink that could be mixed with alcohol.

3. Blood test results

Blood test results include:

AST (aspartate aminotransferase)

Normal levels are 5–45. Raised levels indicate liver damage, such as fatty liver. Levels may be normal in chronic liver disease, including cirrhosis.

ALT (alanine aminotransferase)

Normal levels are 5–45. Raised levels indicate long-term liver disease.

ALP (alkaline phosphatase)

Normal levels 90–120. Raised levels indicate cirrhosis and chronic liver damage.


normal levels are 5–21mmol/l. Raised levels indicates liver disease, hepatitis or cirrhosis.

CDT (carbohydrate deficient transferrin)

Normal levels are up to 20. Raised levels indicate heavy drinking. Used to test whether someone is complying with treatment.

GGT (gamma-glutamyltransferase)

This is the enzyme that breaks down alcohol. Normal level is up to 60; raised levels indicate long-term heavy drinking. Levels may not be affected by binge drinking.

MCV (erythrocyte mean corpuscular volume)

Normal level is 80–98. Raised levels indicate long-term heavy drinking, and B12 and folate deficiencies.


Normal albumin level is 35–50. Reduced levels indicate chronic liver disease due to alcoholic cirrhosis or persistent hepatitis.

Prothrombin time

Measures blood clotting. Normal time is 15 seconds; slower clotting is linked with deteriorating numbers of platelets in the blood. This may cause bleeding in the stomach or brain.

4. Potential causes of alcohol abuse

Genetic factors

The Mid-Atlantic School Age Twin Study reports that the risk of developing alcoholism for men is about half due to genetic factors, and about half due to experiences that are unique to individuals. This study also concludes that religious beliefs and good parent/child communication are protective factors against drug and alcohol use. Whether friends use or not is also an important factor. Other factors
There are other factors that can influence susceptibility to alcohol abuse: traumatic childhood experiences, such as sexual abuse, may lead to drink problems later in life. Certain occupational groups are also more likely to be prone to heavy drinking, such as publicans, catering jobs, soldiers, the construction industry and journalists. Stressful life events such as bereavement, relationship breakdown or redundancy may lead to drink dependency. Some people can start to abuse alcohol when they retire. People suffering from psychological problems, such as depression and anxiety, may try to alleviate their symptoms by resorting to drink.

Cultural influences

Culture definitely appears to influence attitudes to drinking alcohol. In countries such as the UK, Scandinavia, Australia, and the USA, where more people have negative or inconsistent beliefs and expectancies, there is a culture of binge drinking and this causes problems such as alcohol-related violence and anti-social behaviour. However, in Mediterranean countries and some Latin American cultures, drinking is viewed more positively as a harmonious, social activity and subsequently behaviour is largely more peaceful. These variations are not attributable to different levels of consumption or genetic differences, but to the different social norms, cultural beliefs and expectancies about alcohol. Research concludes that alcohol-related social and psychiatric problems (with the exception of liver cirrhosis) are not related to consumption per head of population.

However, occasionally, genetic factors can be an important influence on drinking levels. Many Asian people carry a gene that inactivates the enzyme aldehyde dehydrogenase-2 (ALDH2), which is required to breakdown alcohol. After drinking, they experience symptoms such as flushing of the skin, nausea, and headache. Studies have shown that these symptoms cause people with this gene to drink a lot less.

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