Alcohol misuse: tackling the UK epidemic - London

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BMA Board of Science Alcohol use disorders A generic term used to denote mental, physical, and behavioural conditions of clinical relevance and associated with the use of alcohol. The disorders include acute intoxication, harmful use, dependence syndrome, withdrawal syndrome (with and without delirium), psychotic disorders, and amnesic syndrome. 2 Binge drinking The terms ‘binge drinking’ or ‘binge’ have no standard definition. Traditionally, a ‘binge’ has been used to describe a pattern of heavy drinking occurring over a prolonged period set aside for the purpose. Recent common use of the term ‘binge’ refers to a single drinking session intended to, or actually leading to, intoxification. A pattern of repeated ‘binge’ sessions is commonly therefore referred to as ‘binge drinking’ or ‘heavy episodic drinking’. Alternative definitions of a ‘binge’ focus on specific and objective quantities of alcohol; for example, the UK Prime Minister’s Strategy Unit (PMSU) defines a ‘binge’ as drinking over twice the recommended guidelines for daily drinking (see separate definition for recommended drinking guidelines). 3 Blood alcohol concentration Blood alcohol concentration (BAC) is the concentration of alcohol in blood. It is measured either as a percentage by mass, by mass per volume, or a combination. In the United Kingdom (UK), BAC is reported as milligrams of alcohol per 100 millilitres of blood (eg 80mg per 100ml). In many countries, BAC is measured and reported as grams of alcohol per 1,000 millilitres (1 litre) of blood (g/1,000 ml). For purposes of law enforcement, BAC is used to define intoxication and provides a rough measure of impairment. Most countries disallow operation of motor vehicles, boats, aircraft and heavy machinery above prescribed levels of BAC. Blood alcohol concentration is commonly referred to as blood alcohol content. Harmful drinking Harmful drinking is a pattern of alcohol use that causes damage to physical and/or mental health. 2 Harmful use commonly, but not invariably, has adverse social consequences. Social consequences on their own, however, are not sufficient to justify a diagnosis of harmful use. 2 Harmful drinking is included as a diagnostic term in the ICD-I0. Hazardous drinking Hazardous drinking is a pattern of alcohol use that increases the risk of harmful consequences for the individual. 2 In contrast to harmful use, hazardous drinking refers to patterns of use that are of public health significance despite the absence of any current disorder in the individual user. 2 Hazardous drinking is not included as a diagnostic term in the ICD-10. Heavy drinking A pattern of drinking that exceeds some standard of moderate drinking. In the UK, heavy drinking is defined as consuming eight or more units for men and six or more units for women on at least one day in the week. 3 Moderate drinking An inexact term for a pattern of drinking that is by implication contrasted with heavy drinking. It denotes drinking that is moderate in amount and does not cause problems. 2 Alcohol misuse: tackling the UK epidemic vii
viii BMA Board of Science Recommended drinking guidelines Guidelines set by the UK Government that provide advice on daily and weekly maximum alcohol consumption levels. The guidelines recommend that men should not regularly drink more than three to four units of alcohol per day, and women should not regularly drink more than two to three units of alcohol per day. In terms of weekly limits, men are advised to drink no more than 21 units per week and women no more than 14 units per week. These guidelines are commonly referred to as ‘sensible drinking guidelines’. Unit In the UK, alcoholic drinks are measured in units and each unit corresponds to 7.9 grams (g) or 10 millilitres (ml) of ethanol. The value of one UK unit does not necessarily correspond to a typical serving size. For example, one unit of alcohol approximates to half a pint of ordinary strength beer, lager, or cider (3-4% alcohol by volume), or a small pub measure (25ml) of spirits (40% alcohol by volume). There are one and a half units of alcohol in a small glass (125ml) of ordinary strength wine (12% alcohol by volume), or a standard pub measure (35ml) of spirits (40% alcohol by volume). There is also substantial variation in the standard measures used in bars and restaurants as well as measures poured in the home. Different methods are used to define standard measurements internationally none of which correspond to the UK unit. Alcohol misuse: tackling the UK epidemic
Page 1 and 2: BMA Board of Science Alcohol misuse
Page 3 and 4: ii BMA Board of Science Editorial b
Page 5 and 6: iv BMA Board of Science Acknowledge
Page 7: vi BMA Board of Science Glossary No
Page 11 and 12: x BMA Board of Science Alcohol misu
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Page 15 and 16: 2 BMA Board of Science shifting to
Page 17 and 18: 4 BMA Board of Science Consideratio
Page 19 and 20: 6 BMA Board of Science Alcohol misu
Page 21 and 22: 8 BMA Board of Science Measures to
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Page 25 and 26: Litres of pure alcohol per inhabita
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46 BMA Board of Science Alcohol mis
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48 BMA Board of Science The sub-sec
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50 BMA Board of Science Recommendat
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52 BMA Board of Science Legal age o
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54 BMA Board of Science Recommendat
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56 BMA Board of Science Box 5 - the
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BAC (mg/100ml) 58 100 90 80 70 60 5
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60 BMA Board of Science Understandi
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62 BMA Board of Science Early inter
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64 BMA Board of Science At present
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66 BMA Board of Science treatment s
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68 BMA Board of Science Internation
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72 BMA Board of Science Appendix 2
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74 BMA Board of Science Licensing i
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80 BMA Board of Science 23 Hughes T
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82 BMA Board of Science 67 Dex S &
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84 BMA Board of Science 118 Edward
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86 BMA Board of Science 164 McKnigh
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88 BMA Board of Science 209 Babor T
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90 BMA Board of Science 253 Scottis
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British Medical Association Board o
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Board of Science and Education This
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vi Contents Introduction...........
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viii
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2 heavier smoking, drinking and mor
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4 Nutrition, exercise and obesity N
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6 The data for 1998 shows a 21 per
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8 Interventions in adolescent nutri
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10 The efficacy of traditional educ
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12 The treatment of individuals wit
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14 Smoking, drinking and drug use A
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16 The use of illicit substances, a
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18 smoking prevalence was highest a
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20 Interventions in adolescent drug
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22 be expensive given the amount co
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24 is potential to use the media, n
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26 Summary Adolescents in the UK ar
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28 Mental health problems in adoles
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30 Risk factors for conduct, depres
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32 Currently, specialist mental hea
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34 Sexual health Adolescents and se
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36 interferes with the adolescent
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38 Interventions in adolescent sexu
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40 The timing of educational interv
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42 Helping adolescent parents The h
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44 are more difficult to reach than
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46 The way forward This report has
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48 Annex 1 BMA policy on adolescent
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50 References 1 Lobstein T J, James
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52 56 Social Exclusion Unit (1998)
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54 115 Charles Gallichan (2003) Pub
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56 173 NHS Centre for Reviews and D
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Subject: Young People and Alcohol D
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Call for Evidence: Children and You
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5. Do you know of any international
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