​Alcohol: the good, the bad and the ugly

Alcohol is a source of pleasure to many and there is some evidence to suggest that drinking alcohol in light to moderate amounts may have beneficial effects [1]. However, the potential harms of heavy drinking or drinking in situations when it's best to abstain should be the focus as they can result in negative health consequences and high-risk behaviours.

Here, we will have all your questions about alcohol answered.

Kick your legs back, grab a glass of water and you are all set to find out all about alcohol.

What is a standard drink?

A standard alcoholic drink contains 10 grams of alcohol. This roughly equates to:

  • A can (330 ml) of regular beer with 5% alcohol content

  • Half glass* (100 ml) of wine with 15% alcohol content

  • A shot (30 ml) of spirits with 40% alcohol content

*Glass height = 15cm

Those who do decide to drink alcohol should take note of how much you drink, in addition to the percentage of alcohol in a drink.

How much alcohol is too much?

To lower the risk of alcohol-related harm over a lifetime, men should drink no more than two standard drinks per day, and women no more than one standard drink per day.

What is binge drinking?

Consuming 5 or more standard alcoholic drinks (if you are male), or 4 or more standard alcoholic drinks (if you are female), on one occasion is considered as binge drinking [2].

Binge drinking is a form of alcohol abuse.​

What is the difference between binge drinking and alcoholism? How would I know if I’m addicted to alcohol?

Binge drinking refers to the heavy consumption of alcohol over a short period of time, and is a form of alcohol abuse. Usually, abuse is the first step of addiction.​

Alcoholism is defined by an obsessive need for an alcoholic drink like beer, wine, and other hard liquors. The craving for alcohol is often so great that alcoholics can’t stop themselves from drinking. If someone who suffers from alcoholism does not get his/her drink, he/she will experience withdrawal symptoms such as nausea, sweating, shakiness, or anxiety. The majority of alcoholics need professional help to stop drinking [3].


What are some of the signs and symptoms of alcohol dependence (or addiction)?

  • Loss of control: the inability to limit one's drinking over time or at any given occasion.

  • Craving: A strong and continuing need to drink.

  • Tolerance: The need to drink increasing amounts of alcohol in order to "feel the buzz" or to "get high."

  • Physical dependence: Withdrawal symptoms when a person stops drinking after a period of heavy drinking. Such symptoms include anxiety, sweating, nausea, and "the shakes."

According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the presence of at least 2 of the following symptoms indicates Alcohol Use Disorder (AUD). The severity is defined as:

  • Mild: presence of 2-3 symptoms

  • Moderate: presence of 4 symptoms

  • Severe: presence of 6 or more symptoms

  1. Had times when ended up drinking more, or for longer than intended.
  2. There is a persistent desire or previous unsuccessful efforts to cut down or control alcohol use.
  3. A lot of time is spent in activities necessary to obtain alcohol, use alcohol or recover from its effects.
  4. Wanted to drink so badly that could not think of doing anything else.
  5. Important  occupational/educational, or family activities are affected, given up or reduced because of alcohol use.
  6. Persistent use of alcohol even though it was causing problems with family and/or friends.
  7. Given up or reduced social/recreational activities that were important or interesting to you, in order to drink.
  8. Alcohol use is continued making you feel depressed, anxious or adding on to a medical condition (e.g., continued drinking despite recognition that an ulcer was made worse by drinking), or experienced memory blackout as a result of alcohol use.
  9. Gotten involved in situations while or after drinking that increased chances of getting hurt e.g., operate dangerous machinery, drive etc).  
  10. Had to drink more than previous episodes to achieve the effect intended or that the usual number of drinks had less effect than before.
  11. Would experience withdrawal symptoms when the effects of alcohol wear off

Can people die from drinking too much alcohol?

Yes, they can.

Alcohol poisoning is the most life-threatening consequence of binge drinking. In alcoholic poisoning, the brain, breathing, circulation, etc is affected. It can eventually lead to loss of consciousness and death [5].

People who drink too much are also more likely to be involved in alcohol-related traffic accidents and violent crimes that can lead to death [5].

Are there any groups of people who should not drink at all?

The following groups should abstain from consuming alcohol altogether:

  • Pregnant women or those trying to conceive.

  • People on medication or have medical conditions such as alcohol allergy, alcohol addiction, liver disease and stomach ulcers.

  • Children and adolescents [2]. Research shows that drinking during adolescence can harm physical and brain development. Drinking alcohol during this time can bring about long-term impacts on learning and memory skills [6].

 

Are there types of alcohol that are safer, or less harmful than others, that people can choose if they really have to drink in a social setting?​

There are three main types of alcoholic beverages – beer, wine, and hard liquor. However, the amount of alcohol in alcoholic beverages, of even the same kind, may vary.  Drinking beer may not be necessarily safer than drinking hard liquor such as vodka or whiskey as what affects the body and mind is the amount of alcohol, rather than the type of drink consumed. Therefore, what needs to be taken into consideration is both the alcoholic content of the beverage and the amount consumed.  For example, 1 bottle of beer containing 3.5% alcohol has the same alcoholic content as 1 shot of hard liquor containing 40% alcohol


​Try a mocktail for a change

Drinks don't have to contain alcohol to be fun and enjoyable. Try these alcohol-free mocktails for a change.


​Sunny Day Daiquiri​​ ​Green Envy ​Blackcurrant Blush
​​​​
​

90 ml orange juice

90 ml carrot juice

Egg white (from 1 egg)

Top up with 5ml grenadine syrup

Blending method


​

90 ml lime juice

90 ml mango juice

5 ml of green mint syrup

Top up with plain soda

Building method

 ​

60 ml blackcurrant cranberry aloe vera juice

90 ml apple aloe vera juice

Top up with 5ml grenadine syrup and soda

Shaking method


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References

  1. Wannamethee S.G, et al. 1998, Alcohol, coronary heart disease and stroke: an examination of the J-shaped curve, Neuroepidemiology, 17(6); 288-95. Accessed from https://pubmed.ncbi.nlm.nih.gov/9778595/ on 1 Feb 2022.
  2. Centers for Disease Control and Prevention, 2021, https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm. Accessed 1 Feb 2022.
  3. Alcohol Rehab Guide "Alcohol Withdrawal" 2021, https://www.alcoholrehabguide.org/alcohol/withdrawal/. Accessed 1 Feb 2022.
  4. National Institute on Alcohol Abuse and Alcoholism, 2021, "Alcohol Use Disorder: A Comparison between DSM-4 and DSM-5", Accessed from: https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-use-disorder-comparison-between-dsm on 1 Feb 2022.
  5. National Health Service, "Alcohol Poisoning", 2019. https://www.nhs.uk/conditions/alcohol-poisoning/. Accessed 1 Feb 2022
  6. National Institute on Alcohol Abuse and Alcoholism, 2021, "Underage Drinking", Accessed from: https://pubs.niaaa.nih.gov/publications/AA67/AA67.htm on 1 Feb 2022.