Alcoholics Anonymous Reviews: Are You drinking too much? Take our test to see if those 'couple of glasses a night' are wrecking your health

Over six million Britons drink more than 50 units of alcohol a week

Like many of us, Helen Tirbutt enjoyed a few glasses of wine each night without giving it a second thought.

Most of her colleagues and friends drank as much, if not more, and as someone who got tipsy occasionally, rather than blind drunk, she considered herself a moderate drinker.

Yet one night sitting across a dinner table from her husband Edmund, her brain numbed by the effects of "just a couple of glasses of wine" she realised she was drinking more heavily than she'd thought.

The 43-year-old was unable to recall what she was trying to say and noticed her speech slurring. The contrast with her husband, who doesn't drink, suddenly shocked her.

"Edmund was so sharp and full of energy. By contrast, I did not feel in control of my limbs, and my brain felt numbed."

At the peak of her drinking Helen was having around 25 glasses of wine a week — 50 or more units — well exceeding the recommended maximum of 14 units a week for women (21 for men).

It sounds like a lot, but millions of us drink just as much. The trouble is that like Helen, few of us realise that this is a sign of a drinking problem.

"Everyone thinks they drink less than they do and everyone has a picture in their head of what a heavy drinker does, and that is always different from what they do," says Dr Sarah Jarvis, of the Royal College of General Practitioners.

"However, people often have no idea how much they drink.

"It has been found that when people pour themselves a measure of spirits at home, in most cases that one shot is big enough to be three shots in a pub."

In fact, there are more than six million Britons who drink more than 50 units a week — another one million are alcohol dependent (or "alcoholics"), according to Dr Francis Keaney, a consultant addiction psychiatrist with the South London and Maudsley NHS Trust.

And as recent government statistics revealed, it's not only younger drinkers who have a problem: almost half of those aged 30-50 do not stick to safe drinking limits compared with 40 per cent of those in their 20s.

Sobering advice: Helen and Edmund

"They convince themselves they are not heavy drinkers but they are," says Dr Keaney.

"While they are not yet dependent — or alcoholic — some will show the features of dependence and some may go on to become dependent."

Helen's struggle with alcohol forms the background of a book she has written with her husband, himself a former heavy drinker.

Beat The Booze offers advice to others who want to cut down or cut out alcohol entirely.

It has earned the recommendation of one of the country's leading liver specialists, Professor Roger Williams, director of the Institute of Hepatology, University College London, who says the book "provides real practical help to those who have succumbed to heavy drinking".

Helen's story is one many will recognise. For most of her adult life her evenings revolved around alcohol.

With a career in public relations she habitually drank a few glasses of wine after work with colleagues, or at dinner with friends.

"To me three glasses of wine every night was my treat for working hard; it did not seemexcessive," she says.

"I ate well and went to the gym, the fact that everything I did involved alcohol was neither here nor there.

"I often felt tired but I did not put this down to booze. At the time I thought it was due to my busy lifestyle."

By her 30s Helen was drinking between half and a bottle of wine a night and her hangovers were getting worse (a sign that her liver was being affected); her skin was also drying out; but worse, she felt increasingly as if she couldn't think clearly.

"There are around 150 physical side-effects of habitual overdrinking such as interrupted sleep, leading to tiredness, and prematurely ageing skin," says DrKeaney.

"Some people will find it has psychological effects, and it can contribute to depression and paranoia."

Longer term, heavy drinkers are at risk of gastric problems including bleeding, cirrhosis or scarring of the liver — which is often fatal (only 30 per cent of those with liver cirrhosis are alive five years after their diagnosis), and certain cancers.

In 2002 Helen met her future husband.

Edmund, now 49, had been teetotal since 1986 after friends shocked the then 28-year-old by saying his drinking was out of control.

For him, a typical Saturday had once meant three bottles of wine and six cans of beer.

As he says now: "I would be on a park bench or dead now had I not given up."

By the time Edmund met Helen he had been sober for 15 years.

Although he never commented on her drinking, Helen found that spending evenings with someone who was always sober made her increasingly conscious of how alcohol dependent she had become.

"Nobody, including Edmund,ever said I had a drink problem," she says.

"I was not a drunkard but my brain was programmed to expect alcohol every day.

"As my relationship with Edmund developed I tried to cut down and restrict drinks to weekends but I just kept mentally extending the weekend days.

"However, after we married in September 2005 we moved to the country and it became clear how much a big part of my life alcohol was.

"I talked a lot about giving up, but kept putting it off. I was scared; I was Helen the party girl and was worried I'd have to completely redefine myself.

"Alcohol was linked to having good fun in my mind and I found it really hard to imagine life without it."

Her anxiety about giving up worried Edmund.

"He said it was clearly a big deal for me and asked if I thought I was more addicted to drinking than I'd originally thought.

"The answer was yes, I was.

"I realised I was psychologically addicted to the idea of having a drink, and the idea of dinner parties and seeing friends without alcohol was really, really scary."

But when in December 2005 she was prescribed a course of antibiotics for a throat infection, and was told not to drink, there was no excuse.

People with true alcohol dependency — alcoholics — can suffer violent physical side-effects such as sweating when their blood alcohol levels drop.

They also feel a psychological compulsion to drink and a preoccupation with alcohol which overrides any feelings for family or loved ones.

As a heavy drinker rather than alcoholic, Helen suffered none of these, but did suffer cravings for alcohol.

"I tried to keep busy. I played tennis every day, I went to the gym and started meditating — anything to stop me thinking about drink, but all sorts of things would trigger a craving.

"It might be a meal — such as a barbecue or a sunny evening and suddenly I would think: “I want a drink.”

"I tried to convince myself that fruit smoothies really were a good substitute but would often end up feeling on the outside when I went out for dinner while everyone else was buoyed up by alcohol and I would end up going home early."

What made things even more difficult was the way drinkers felt that by her abstinence she was implicitly criticising their own drinking.

"The hardest thing was — and still is — being out with people who don't know you well. They almost take offence if you don't drink.

"Sometimes I'd lie and pretend I was on antibiotics because I hated how much people went on and on at me to have a drink. It really helped to have Edmund's support.

"Close friends were more supportive but bemused that I had given up booze. They would say: 'But you were fine – what was the problem?'"

Helen decided to try to give up for a year, but found herself counting down the days just a few months into her new regimen.

Experts say it takes around a month to adjust to new drinking habits and between one and three months for the body to start reaping the benefits.

Helen didn't start to feel physically better for six months, but then the benefits were "life transforming".

"I was sleeping better, the lethargy headaches and hangovers went and I felt that I looked better and felt more vibrant. I also started to realise that I could have a good time without alcohol.

"I did not lose weight, probably because I started drinking cocoa most nights as my treat instead of wine, but I felt more vibrant.

"As the year came to an end I considered going back to having the odd glass of wine, but deep down I knew that would never happen — that if I started again I would drink as much as ever.

"So I decided to give up for life.

"Edmund was really pleased that I had done it and friends have now got used to me not drinking.

"But best of all, my brain has finally lost its association with alcohol.

"For New Year's Eve I had a bottle of alcohol-free bucks fizz and thought how lovely it tasted. And I have just as much fun as before — but it's about me, not the alcohol!"

CUTTING DOWN YOUR ALCOHOL INTAKE:

■ Keep a drinking diary recording what you drink and when. This will help you assess how much you actually drink and what your triggers for drinking are. "Everyone's drinking patterns and reasons for drinking differ so try to be honest with yourself," says Dr Jarvis. "Once you have found your triggers you can try to avoid them or distract yourself by doing something else at that time. "A lot of my patients find that doing other things, such as taking up evening classes, really helps."

■ For many people drinking every day is not an addiction, it is a habit. Try to alter your routine so that the normal drinking times are full of other activities. An example might be meeting a friend at the cinema or a coffee shop instead of a wine bar.

■ Aim to have two or three alcohol-free days a week. This will naturally reduce your total alcohol consumption — as long as you do not drink to excess on the other days — and also gives your liver time to recover. Constant drinking causes the liver to become inflamed with the effort of processing the toxins in alcohol. Going without alcohol for a day or two gives the liver a chance to repair and regenerate itself.

■ Cutting down is better than doing nothing at all. "If someone finds the idea of an alcohol-free day too hard then they should try just having one drink a couple of days a week," says Dr Keaney.

■ Train yourself to sip not gulp alcohol and put your glass down after each sip to reduce the temptation of drinking too speedily.

■ If you are going out, try to set a limit to the amount you are going to drink before you go and stick to it.

■ Try alcohol "substitutes" — these are wines and beer which contain no alcohol. Most supermarkets stock realistic alternatives or see www.alcoholfree.co.uk or www.lono.co.uk These alcohol-free or low-alcohol drinks are exactly the same as their normal counterparts all the way through to the bottling stage, when the alcohol is removed.

This means the flavour and all the orginal characteristics remain but the drink has only between a third and a half of the calories of the real thing — therefore providing an additional benefit. Because all the anti-oxidants and other goodness remains, these substitutes are just as effective as alcoholic drinks in combating heart disease among middle-aged and older drinkers. There is even some evidence to suggest that non-alcoholic beer can help combat cancer.

All de-alcoholised drinks have an alcohol content of below 0.5 per cent alcohol by volume. You would need to drink 120 bottles in an hour to equate with drinking a bottle of alcoholic wine.

■ Enlist the help of a partner or a friend. "Support is vital, especially if someone is trying to give up," says Dr Jarvis.

TAKE THIS TEST AND FACE THE TRUTH

Take the following test, developed by the World Health Organisation. To calculate your score add the figures up in the left-hand column. A score of eight or more suggests a drink problem.

1.How often do you drink alcohol?

(0) Never
(1) Monthly
(2) 2-4 times a month
(3) 2-3 times a week
(4) 4 or more times a week

2.How many units of alcohol do you drink on a typical day?

(0) 1 or 2
(1) 3 or 4
(2) 5 or 6
(3) 7, 8 or 9
(4) 10 or more

3.How often do you have six or more units of alcohol on one occasion?