[This article was first published in 2018]
We all know that as a society, we drink a lot. There’s always a reason to drink and there are always people encouraging you to do so. When many of us think of an alcoholic, we envisage someone waking up and swigging a bottle of vodka. But this isn’t always the case.
If you only drink at social occasions but you drink until you’re blackout drunk each time, are you an alcoholic? What about if you drink five or six nights a week, but just a glass or two of wine per evening?
The NHS says alcohol misuse is when you drink in any way that's harmful, or when you're dependent on alcohol. To keep health risks from alcohol to a low level, both men and women are advised not to regularly drink more than 14 units a week.
According to Dr Iqbal Mohiuddi, one of the consultant psychiatrists at 25 Harley Street Day Clinic, the number of functioning alcoholics is on the rise.
There are certain signs of functioning alcoholism to look out for. Experts use the acronym CAGE.
C – Cutting down - have you ever thought you should probably drink less?
A – Annoyance - do you ever get annoyed by people nagging you about your drinking?
G – Guilt - do you ever feel guilty about your drinking or what you do as a result?
E – Eye-opener - do you ever feel like you need a drink to feel better, especially in the morning to relax?
According to Dr Mohioddi, answering yes to just a couple of the above could suggest you have a problem with alcohol.
Of course, every person is different, these are just subtle signs and answering yes doesn’t necessarily make you an alcoholic, but it could be something to think about.
The NHS has a similar set of categories to consider whether you might be misusing alcohol: you feel you should cut down on your drinking, other people have been criticising your drinking, you feel guilty or bad about your drinking or you need a drink first thing in the morning to steady your nerves or get rid of a hangover.
It says: “Someone you know may be misusing alcohol if: they regularly drink more than 14 units of alcohol a week, they’re sometimes unable to remember what happened the night before, and they fail to do what was expected of them as a result of their drinking (for example, missing an appointment or work because they're drunk or hungover).”
Dr Mohiuddi estimates that a third to a half of the clients he treats for alcohol addiction don’t fit the stereotypical image we hold of an addict.
“They’re working in high-powered jobs, in the City or the media and drinking heavily is accepted, almost expected,” he told Healthista.
“They have carried on for years in this way but suddenly they’re getting physical symptoms such as feeling sick in the mornings and needing a drink and perhaps a partner has said they have had enough and it’s the drink or them.
“Conversely, as more companies become aware of drinking issues in the workplace, they may send people in for detox treatment to protect the health of their valued employee.”
Dr Mohioddi says functioning alcoholics can usually keep on top of all their responsibilities despite their drinking, and are usually in denial about their alcohol intake.
Many people think they’re OK because they have a few alcohol-free days of the week, but they then binge at the weekend, causing serious damage.
And it’s likely that you’re binge-drinking more than you realise - anything more than four units (one being a small glass of wine, half a pint of beer or a 1.5 ounce shot of a spirit) is classified as a binge.
“During a binge your body is literally saturated with alcohol and even though you think you can tolerate it, your body isn’t breaking it down any quicker,” Dr Mohioddi says.
“A good mantra to keep in mind is that human beings can only tolerate one unit of alcohol in an hour so try and stick to that.”
If you are worried about your drinking or even just curious, you can take the Alcohol Change drinking quiz to see if it's likely to be affecting your health.
You'll be asked a few simple questions about your drinking habits, like how often you drink and how many units you consume in an average week.
Alcoholics Anonymous helpline is open 24/7 on 0800 9177 650. If you would prefer, you can also email them at email@example.com or live chat via their website at www.alcoholics-anonymous.org.uk. Drinkline, a free, confidential helpline for people who are concerned about their drinking, or someone else's. Call 0300 123 1110 (weekdays 9am–8pm, weekends 11am–4pm)