How many is too many? If you feel that drinking is affecting your productivity, Sally Brown suggests strategies for cutting down
At times, travelling can feel like entering a parallel universe, especially when it comes to drinking – it’s perfectly acceptable to have a glass of champagne in an airport lounge at 10.30am, for instance.
Even if you’re usually teetotal during the week, you can find yourself saying yes to mojitos on a Monday night simply because you’re in a hotel bar in another country. And keeping the wine flowing over a dinner meeting is less an indulgence and more a tool for overcoming language and culture barriers.
Of course, you don’t have to leave the country to have a drink. Recent statistics show that, in the UK, over-40s drink more than teenagers.
Duncan Selbie, head of government body Public Health England, has said the people he is most concerned about are workers who pour themselves a large glass of wine every evening, unaware that it’s the equivalent of three shots of vodka.
According to Dr Sarah Jarvis, spokesperson for charity Drinkaware (drinkaware.co.uk), being a frequent traveller puts you in a risk category all of your own.
“If you are abroad for work, you are less likely to be driving and more likely to be eating dinner in a restaurant with colleagues, which may mean you’re more likely to drink,” she says. “Even if you’re not eating out and are on your own in a hotel room, you have the option of the minibar.”
For many business people, a couple of drinks is the most convenient, prescription-free way to deal with jet lag and the stress of travel.
“Drinking alcohol is often a form of self-medication – there’s a perception that it helps you to relax or sleep,” says Emily Robinson, spokesperson for charity Alcohol Concern (alcoholconcern.org.uk).
Then there’s the “entitlement factor” – for some, a glass of wine or two over lunch or dinner goes some way to compensate for the many inconveniences of being away from home.
According to liver specialist Sir Ian Gilmore, there is a growing group of people who treat heavy drinking as a “lifestyle choice, like a pair of Armani jeans”. The problem is a lack of awareness of the health risks involved.
“Alcohol is the second-biggest risk factor for cancer after smoking,” says Dr Nick Sheron, liver specialist at Southampton General Hospital and co-founder of Alcohol Health Alliance UK, a coalition that lobbies for evidence-based policies to reduce alcohol-related harm in the UK.
While it’s well-known that alcohol abuse causes cirrhosis of the liver, what’s less publicised is that liver damage is symptomless until the late stages, and a build-up of fat cells in the liver, the first stage of permanent damage, can start after a few weeks of heavy drinking. A quarter of patients with liver disease drink three bottles of wine or less a week, Sheron says.
It’s a myth that wine is good for the heart, Robinson adds. “The research on the health benefits of red wine is very contentious,” she says. “Alcohol is more likely to raise blood pressure, increasing the risk of heart disease and stroke.”
It can also reduce your body’s sensitivity to insulin, which puts you at greater risk of developing type-two diabetes, makes you more prone to depression and anxiety, and increases your vulnerability to dementia.
In 20 years’ time, we’ll view daily drinking in the same way that we now view smoking ten cigarettes a day, Sheron believes.
“It’s virtually impossible to drink every night and still stick to the safe lower limits, unless you are one of those rare people who really does have a half-glass of wine,” he says. “We have survey results from 20,000 people and what it showed was that people who drink on a daily basis and stay within the safe limits simply do not exist.”
If you stick to the recommended limits, you shouldn’t encounter any health problems, Jarvis says, but knowing how many units there are in your usual drinks is crucial.
“Most people underestimate how much they drink and how many units are in them. One glass of wine is not one unit, it’s more like three or four,” she says.
Current guidelines advise women not to regularly drink more than two to three units a day (the equivalent of a 175ml glass of wine), and men more than three to four units a day
(a pint and a half of 4 per cent beer). Still, you shouldn’t treat the limits as an allowance, Robinson says.
“The original advice was to drink a maximum of 21 units a week, but people took that as a licence to drink all the units in one session. So the advice was changed to three to four units a day, but some took that as permission to drink daily,” she says.
The UK’s chief medical officer is reviewing the guidelines to incorporate regular alcohol-free days, and Public Health England recently released a statement advising against drinking on consecutive days.
If you find it hard to stop at one, there is a drug that could help you. Taken an hour or two before drinking, nalmefene (brand name Selincro) blocks the opiate-receptors in the brain, reducing both the desire to drink and the “buzz” that alcohol gives, making it easier to limit your intake. In clinical trials, it was found to reduce alcohol consumption by about 60 per cent after six months of treatment.
“It’s not a quick fix and should never be prescribed without counselling to help change your mindset, such as CBT [cognitive behavioural therapy],” Jarvis says. “But if you’re motivated to cut down, it could help.”
Going dry for short periods on a regular basis could also help to reduce long-term damage and lower tolerance levels – in a study carried out at University College London Medical School in 2013, ten participants who abstained for a month showed a significant reduction in liver fat, blood glucose and cholesterol levels.
According to research from the University of Sussex, 72 per cent of people who took part in Alcohol Concern’s Dry January campaign last year maintained reduced drinking habits six months on, even if they didn’t manage to go teetotal for the whole month. Some 4 per cent were still dry.
“Sometimes, changing your drinking means changing your lifestyle, if your social life revolves around certain patterns of drinking,” Jarvis says. “But some people find cutting down relatively easy, especially if they notice the benefits, such as better sleep, more energy or weight loss.”
For some, the solution is to drink on weekends only. Government figures show that between 2005 and 2012, the percentage of UK males questioned who said they hadn’t drunk at all in the week rose from 28 per cent to 36 per cent, and the proportion of women non-drinkers rose from 43 per cent to 48 per cent.
“We need to think of alcohol in the same way as we think of a box of chocolates,” Sheron says. “You wouldn’t have a box every night, and we shouldn’t be drinking every night.” That’s a rule worth sticking to, both home and away.
CASE STUDY: ‘Why I gave up’
John Stapleton, 50, is co-founder of the New Covent Garden Soup Company and Little Dish. He lives in Munich but spends up to four days a week in the UK.
“Social drinking has long been part of doing business for me – I’ve never liked drinking during the day, but would enjoy a bottle of wine over dinner with clients.
“My typical work pattern involves flying to a country and having a week of back-to-back meetings and evening events or dinners. As the week progresses, I’ll feel more tired, and the last couple of days can begin to take their toll.
“Early last year, I spent some time in both Saudi Arabia and Pakistan, where alcohol was taken out of the equation, and I noticed that I wasn’t exhausted by the end of the working week. It was a light-bulb moment – I realised that alcohol consumption was actually contributing significantly to my tiredness. I also realised I wasn’t becoming as stressed and I was far more productive.
“It was a no-brainer from that point to give up alcohol. It’s made a noticeable difference to my health – as well as becoming leaner, I no longer need my asthma medication, which I’ve been using for more than 12 years. I’m also fitter because instead of a pre-dinner drink in the bar, I’ll fit in 45 minutes in the gym.
“I still pack my weeks with meetings but now I’ve got the stamina to be as productive at the end of the week as I am at the beginning. I also find flying far less exhausting.
“Most people don’t really bat an eyelid when you turn down a drink at a business dinner, but social events can be tougher. I’ve found that some things aren’t so enjoyable without alcohol, such as the Oktoberfest here in Munich. Last year I went away when it was on.
“I didn’t set myself a time limit when I gave up but after six months alcohol-free, I really can’t imagine drinking again.”
CASE STUDY: ‘I drink about once a month’
Sarah Rowley, 29, from London, is head of partnership communications for language technology company Swift Key.
“One of the first things I had to do when I joined the company two years ago was fly to a conference in Barcelona, then on to another in New Orleans with some senior colleagues.
“There was a lot riding on it and I wanted to make a good impression, so I decided not to drink until the last night, when there was a big celebration. Even though I didn’t drink that much, the flight home with a slight hangover was much harder work, as was the jet lag. I realised then that drink and travel don’t mix.
“I’m not teetotal, but as I’ve got older I’ve gradually drunk less. I’m ambitious and it’s an exciting time to be working for a tech start-up, but even with a mild hangover I’m much less productive. It has a big impact on my energy levels and mood the next day, and that feels like such a waste of time.
“I will have a vodka and tonic or two if it’s a big night, or sometimes I use a bit of stealth – no one knows there’s no vodka in my tonic if I’ve bought the round. It’s a simple equation for me – the less I drink, the healthier and more focused I feel.”
TEN TIPS, TOOLS AND TECHNIQUES TO PUT YOU BACK IN CONTROL
1. Keep an online drink diary
The unit calculator at drinkaware.co.uk is an easy and accurate way to keep track of your drinking and lists many beverages by brand. Sign up for free and it will create personal graphs that show your drinking patterns, and help you set goals to cut down consumption.
2. Assess your drinking
Drinkulator (on drinksafely.info) is a free online assessment from the University of Southampton’s liver specialists to find out if your drinking is harming your health. It’s a comprehensive questionnaire that takes about 15 minutes to complete.
3. Do a dry month
“Taking a month off alcohol can give insight into your drinking habits and motivate you to cut down,” says Emily Robinson from Alcohol Concern, which runs a Dry January campaign every year.
If you missed it last month, you can Go Sober for October to support Macmillan Cancer Research (gosober.org.uk). Or just start now.
4. Read up
The Sophisticated Alcoholic is a self-help guide for high-functioning problem drinkers by psychotherapist David Allen, himself a reformed over-drinker (£11 from amazon.co.uk). Beat the Booze, by Edmund and Helen Tirbutt, is a practical, well-researched guide to cutting down or completely cutting out alcohol, which also draws on personal experience (£8.50 from amazon.co.uk).
5. Join sober cyberspace
Hip Australian site Hello Sunday Morning (hellosundaymorning.org) puts an aspirational spin on being teetotal. You’re encouraged to keep your own blog about your experiences. Soberistas.com is a social network for women who see non-drinking as a positive lifestyle choice.
6. Have regular AFDs (alcohol-free days)
An increasing number of experts believe that having consecutive days off drinking is the key to preventing liver damage and cutting down your weekly intake. “Don’t drink during the week and you can enjoy a couple of glasses on Friday and Saturday,” Dr Nick Sheron says. “Your tolerance levels will lower, which means you can drink less and get the same effect.”
7. Download an app
Spruce (spruceapp.co.uk) is a free iPhone app developed by the British Liver Trust – in a study, Spruce users were more likely than non-users to stick to three alcohol-free days a week. You can keep an accurate count of your units with Change 4Life Drinks Tracker (free for Apple and Android users). Quit Drinking – Andrew Johnson (£1.89 for Android, or Stop Drinking with Andrew Johnson for Apple, £2) is a relaxation programme for beating cravings from a top hypnotherapist.
8. Check out your liver
Fibroscan is an ultrasound test for the liver that shows fatty deposits (the stage before cirrhosis), scar tissue from past damage or areas where fibrosis (stiffening of the liver) has set in. It costs from £325 at the London Clinic (thelondonclinic.co.uk) and private UK hospitals. The British Liver Trust offers free fibroscan tests at pop-up locations throughout the UK – see loveyourliver.org.uk.
9. Try hypnotherapy
Georgia Foster’s 21-day programme is aimed at drinkers who want to cut down rather than give up. Sign up for an online course, or one-to-one or group therapy (georgiafoster.com).
10. Stock up on alternatives
A chilled non-alcoholic drink can help to curb cravings. Many bars and restaurants now serve booze-free beers and cocktails. Check out drinks company Lo No (lono.co.uk) for a wide range of
zero per cent beers, ciders, wines and fizz.