Are we drinking ourselves to death?

PROFESSOR Nick Heather gets irritated when people talk about dangerous drugs but do not include a substance which causes more harm than heroin or ecstasy.

"When people mention the word drug these days, they mean illicit drugs, " says Prof Heather, who occupies the chair of alcohol and other drug studies at Northumbria University.

"They are not recognising that alcohol is also a drug, and the most harmful we know. Nicotine kills more people through smoking, but if you add up the total amount of damage in society, then alcohol leaves the rest behind."

Yesterday's report from Professor Liam Donaldson, the Government's Chief Medical Officer, that an alcohol epidemic is threatening a whole generation of young people with early death, deserves to be taken extremely seriously, according to the professor.

The worrying increase in binge drinking among young women, a product of the growth of so-called "ladette" culture, is particularly alarming. Social changes and an alcohol industry which targets young people are to blame, says the professor, whose title was chosen with care - to make the point that, despite alcohol playing a central part in our daily life for centuries, it is just another potentially-harmful drug.

Not that Prof Heather wants to be seen as teetotal killjoy - he's not. But he wants society as a whole to wake up to the siren song of alcohol. "I am not arguing for total abstinence and I recognise that alcohol is very enjoyable, I enjoy it myself, but what we have lost sight of is that it is a powerful, potentially harmful substance and we should be much more careful about how we promote it."

It has been known for some time that alcohol-related problems are increasing among women, particularly young women. Yesterday's report showed that the number of women dying from cirrhosis and chronic liver disease in the 35-44-year-old age group had increased seven times.

"If women regularly exceed safe limits they are more at risk, there is no question of that," says Prof Heather. "They are at greater risk of cirrhosis or liver disease and they also appear to become more dependent more quickly. It is not understood why, but it is a fact."

He says it is not difficult to understand why women's attitude towards drinking, and particularly binge drinking, has changed. "It is fairly obvious. Women's role in society has changed, there is much more personal liberation. Women insist on being free of constraints which were formerly imposed on them."

Some women demonstrate this by drinking as much as their boyfriends, husbands or male friends. For Prof Heather, there is a symbolic quality to this urge to match men drink for drink, although it is more likely to be alcopop for alcopop these days, rather than pint for pint. "It is a statement about one's view on life and relationships with other people," he says.

In Prof Heather's view, the way younger women view themselves is down to the alcohol industry. "The alcohol industry has realised where its profits are. It has put enormous resources into making alcohol glamorous, exciting and fun," he says. "While this may make for lively television ads, the end-product is more wrecked lives.

"I think the alcohol industry is incredibly irresponsible about the way it markets products and it has contributed to this problem. It needs to be checked, because we are not talking about toothpaste or an item of clothing. Alcohol is a potentially dangerous and potentially harmful, addicting drug."

In common with charities such as Alcohol Concern, the professor would like to see much stricter controls on the way alcohol is advertised and promoted in the UK. "Maybe the report is a good sign because it might lead to some action on the part of the Government. We need stricter controls and I think it is about time this Government realised that."

Among health professionals and academics interested in alcohol-related problems, there is growing impatience about the lack of action.

"We have been waiting for a national alcohol strategy for about three years. Everyone in the alcohol field, health promoters, educators, people treating alcohol problems have been getting really impatient with the Government. They want them to take some action and do something," Prof Heather says.

Next summer, Profession Donaldson is due to speak at a conference in Newcastle called Action On Alcohol: The Role of Primary Care, organised by Northumbria University.

The university is trying to encourage family doctors and other primary care workers, such as practice nurses and dieticians, to be more active in identifying people who are drinking above the recognised limits. It could be a model for nationwide action.

"We are not talking about alcoholism, we are talking about the very large number of people, maybe nine million in this country, to advise them to cut down their consumption to less risky levels."

Younger people are more problematic because many people in their teens and 20s rarely see their doctor. But, nevertheless, Prof Heather believes that GP surgeries and local health clinics are a good place to try to make connections with younger people, particularly at-risk young women. "We now have well-women clinics, sexual health counselling and other services which can be used to reach younger women," he says.

Many people are aware of the Department of Health's recommended weekly limits for drinking - 21 units for men and 14 for women, reflecting the different physical effects that alcohol has on men and women.

But Prof Heather says it is important to be aware of the potential risk of the steady drip-drip-drip effect of daily drinking. "A few years ago the Government issued daily limits of no more than three units for women, no more than four for men, but the word that often gets left out is regularly," he says.

"No one is suggesting that, on the few occasions when people exceed those limits, that people are going to drop down dead, but it is a question of increasing the risk."

Put simply, if a woman is drinking more than three small glasses of wine or a pint and a half of ordinary beer every day she is increasing her risk of medical damage, he says. The same applies if a man drinks more than four glasses of wine or two pints every day.

While most people associate heavy drinking with liver damage, Prof Heather says virtually every organ of the body is adversely affected by excessive, regular drinking, including the heart and circulation, the brain and mental functioning.

Stories about the healthy effects of a daily glass of red wine, part of the so-called Mediterranean diet which has been hailed as contributing to a healthy lifestyle, may be misleading. "What has got to be made clear to people is that the protective effect applies only at low levels of consumption, just one or two drinks a day. Once you start exceeding that then the risk begins to rise," warns Prof Heather.

While we should not get carried away with the idea that everyone is boozing more than ever before - levels of alcohol consumption have stayed relatively steady for the past 20 years - there has been a rise in alcohol consumption among young people, with a higher rate of increase among women aged from 16-24.

And what really worries Prof Heather is the growth of so-called "poly-drug" abuse. Binge drinking is bad enough but when it is combined with other, illegal, drugs, the risk of a tragic outcome is greatly increased.

"Heavy drinking combined with other drugs is a particular problem with young people in the North-East," says Prof Heather.

And, while many may be dismayed at the timing of the anti-drinking message so near to the festive season, Prof Heather believes it is always a good time to start a better lifestyle.