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What Two Nights of Heavy Drinking a Week in Your Twenties Does to You

Will two to three nights of drinking really make much of an impact in the long term? I must know.
Hannah Ewens
London, GB

I am very fearful for my health because I never want to physically suffer in any way or die. I also love drinking. Here, I believe, lies a problem.

But what sort of damage will two to three nights of heavy drinking a week in our twenties inflict?Is it having serious short and longer term effects that I don't know about? Do I need to ignore free wine at events because it's a "weeknight"? Do I have to start really logging my pints on this stupid Fitbit I bought because I'm an idiot? Do I have to start to exercise some maturity and self-control?

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I called up three booze experts for them to answer all the above, while hopefully also saying something that would enable my behaviour.

VICE: Does it really matter to my health RIGHT NOW if I get on the sesh, say, twice a week?
James Morris, Alcohol Policy UK: Obviously there's the risk of obesity from the calorie intake. But the biggest problem with young people in their twenties doing this is the risk of social problems: accidents and injuries, arguments, failure to do things they are expected to do or planned to do, whether that is work or relationships. It doesn't mean you can't or won't get serious related health consequences; it's just that they're more likely to manifest over a longer term period rather than in your twenties. But you do see early or mid-stage liver damage in people in their twenties, and alcohol does kill brain cells, affect your memory and the brain's longer term development. Andrew Misell, Alcohol Concern: The Chief Medical Officer's recommendation is that you don't have more than 14 units of alcohol in a week, which is a bottle and a half of wine, so having a whole bottle in one night is quite a lot. It's interesting how ideas have shifted as well, because I think probably 20 or 30 years ago the idea that someone would've drank a whole bottle of wine would've been quite remarkable, whereas it's quite common these days – if you're going to a dinner, or something – that a bottle of wine is a single person's serving of alcohol for that evening – and possibly two bottles. So yeah, that's not good. Dr Sarah Jarvis, Medical Advisor to Drinkaware: I'm thinking about alcohol as a depressant here – you start off euphoric because it fuels the part of your brain that loosens inhibitions, but binge drinking and depression, for example, are linked. We know too that the vast majority of suicide attempts happen when alcohol is involved. It greatly increases your risk of accidental and purposeful harm.

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I can live with that for now, but if you carried on drinking like that through your thirties and onwards, what would the cumulative effect be?
James Morris: It's quite rare to see liver disease in people in their twenties, but once you start getting towards the forties then it becomes much more prevalent. It depends on a lot of variables, but we know that if you are a high risk drinker – someone who drinks double the recommended weekly guidelines, so about 30 units or more a week – then you are 13 times more likely to get alcohol-related liver disease than someone who drank within the guidelines. You could have real short or long-term memory impairment by then, too.

Andrew Misell: We're finding these days that we're seeing cases of alcohol brain damage in people in their forties, which used to be considered a condition of the sixties and seventies. I think it's not a matter of saying everyone who routinely gets hammered on the weekend is going to suffer brain damage, but we previously thought this was a condition of later life, and we're now seeing people in early middle-age with symptoms similar to dementia as a result of long-term heavy drinking.

How about cancer?
Dr Sarah Jarvis: Already we know that if you binge drink in your twenties, you are more likely to get cancer in your forties and fifties. Andrew Misell: There are numerous links between alcohol consumption and certain forms of cancer, but this isn't to say that everyone who ever drinks or everyone who ever drinks heavily will develop certain cancers. Those links are not as strong as, say, the link between smoking tobacco and lung cancer, but they are there. It's difficult, because as adults we weigh up situations. There are certain things we don't do because we just think they're too dangerous, but how many of us would actually sit down and think, 'Ah, I'm going to weigh up my potential risk to cancer in ten years time before I have this glass of wine or pint of beer'? Life is full of risks, and if you never took any risks in life you'd hide under your bed or something. And that's probably a risk to your mental health anyway.

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Is drinking spread out across the week really that much better than having it all on the weekend? Because I have to say I'd rather do that.
James Morris: Well, I wouldn't say it was, actually. If you are spacing it out then you are more likely to develop dependency, so even if you drink one glass of wine and a very moderate amount of alcohol on a regular basis, you are still increasing your risk of developing dependency, because your tolerance goes up so you feel fewer effects from the same amount of alcohol, and are more likely to drink more to get the same type of effects. You might start off drinking one glass of wine every evening to relax, then you might realise that having one glass of wine doesn't have the same effect it used to, so that's the reason why so many people start having two glasses of wine – and then dependency becomes a more entrenched and serious problem. Andrew Misell: The jury, I think, is out on this. There's a certain amount of evidence that drinking in bouts gives your liver a certain amount of time to recover. On the other hand, however, if you're putting a large amount of alcohol into your body – even if you're only doing it once or twice or week – your organs are going to feel the effect of that, and there's only so much that your liver will recover.

"You should try to set yourself some kind of limit, rather than just say, 'I am not going to drink as much tonight.'"

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Would you just suggest to young people who do drink it all in one go to keep the week alcohol-free if they know they're going out that weekend? Or would the best advice be: just don't drink loads in the first place?
James Morris: I'd try and say a bit of both. If you have drunk very heavily, do try and give your body – and liver, particularly – a break after a heavy session. It can be very punchy on the body to drink on Friday and then do the same on Saturday. I would also encourage people to be mindful of what they drink when they do go out. If you have ten drinks, are you are significantly reducing your risk by having two less? When I used to go out with people, the last few drinks were the ones that I regretted, which I didn't really get any added benefits on. So you should try to set yourself some kind of limit, rather than just say, "I am not going to drink as much tonight."

Do you think the long-term health risks will be a much bigger problem for people of my generation and we'll only find out about it when it's too late?
James Morris: We don't really know. We are a binge-drinking nation – more than most countries in Europe. I'm 35, and it was in the 90s that all those ready-to-drink drinks, like WKD, came out, as a direct result of the industry trying to target a new generation of younger drinkers. People who became teenagers in the 90s and early-2000s are certainly heavier drinkers. Some people have described 2004 as "peak booze" – as in, consumption has been rising so much and for so long that it just had to hit a peak at some point and has been falling since. But it might start to go up again because of Theresa May's cuts. Dr. Sarah Jarvis: One of the problems we've got is that these big health risks take years and years to develop, but younger people are not thinking about liver cirrhosis in their twenties. You really may well be storing these problems up for later. I would say we have a real problem in this country with young people thinking they're immune to the negative effects of alcohol.

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@hannahrosewens

More on the sesh:

This Is Why Gen-Z Doesn't Do Drugs Or Drink As Much As You

How Much Is Your Casual Drug and Drink Habit Really Hurting You?

How Your Job and Music Taste Affects What Booze You Drink