This article originally appeared on VICE UK.
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 20s 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 how much I drink on this stupid Fitbit I bought because I'm an idiot? Do I have to start exercising some maturity and self-control?
I called up three booze experts for them to answer all the above, while hopefully, also saying something that would enable my behavior.
VICE: Does it really matter to my health right now if I drink, 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 20s doing this is the risk of social problems: accidents, 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 period of time rather than in your 20s. But you do see early or mid-stage liver damage in people in their 20s, 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 could drink 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 30s and onward, what would the cumulative effect be?
Morris: It's quite rare to see liver disease in people in their 20s, but once you start getting toward the 40s, 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.
Misell: We're finding these days that we're seeing cases of alcohol brain damage in people in their 40s, which used to be considered a condition of the 60s and 70s. 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. Jarvis: Already we know that if you binge drink in your 20s, you are more likely to get cancer in your 40s and 50s.
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 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.
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.
Morris: Well, I wouldn't say it was, actually. If you are spacing it out, then you are more likely to develop dependency. 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 realize that having one glass of wine doesn't have the same effect it used to. That's the reason why so many people start having two glasses of wine—and then dependency becomes a more entrenched and serious problem.
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.'"
Would you just suggest to young people who'd rather drink on the weekends to keep the week alcohol-free? Or would the best advice be: Just don't drink loads in the first place?
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?
We don't really know. The UK is 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 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.
Dr. 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 20s. You really may well be storing these problems up for later.
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