(Top photo: Jake Lewis)
Do you drink too much? I do. Not quite enough to convince me to quit, but enough to treat the recommended weekly unit allowance – 14 units, AKA seven pints, AKA "Thursday" – with a sense of contempt. I have also taken drugs recreationally for a decade. Never the big kahunas – no heroin or crack, and I'm scared of acid – but everything else in peaks and troughs.
I never dwelt on it much until last year, when most of my favourite celebrities started dying. A thread that ran through many of the deaths was periods of substance use or abuse; from Bowie snorting so much coke he'd only consume red peppers and milk for sustenance, to Carrie Fisher's "coke nail" on the set of Return of the Jedi.
So seeing as it's January and there's nothing better than fear of an early grave to scare you into changing your habits, I called up a couple of experts to find out just what all the shit we put into our bodies is doing to our life expectancy.
"Of everything we're going to talk about, the single most significant thing that people could do is quit smoking," says Dr Adam Winstock, a consultant psychiatrist, addiction medicine specialist and founder of the Global Drug Survey, who seems to have a more intuitive grasp of my drinking and drug-taking than I do. "All the other health risks you have from the other substances increase by 50 percent if you smoke."
But let's say you don't smoke – according to Adam, 85 percent of us now don't – but you like a joint on those nights you aren't drinking. "One spliff rolled with tobacco is two-and-a-half to three cigarettes," says Adam. "I'd say the best thing that people who smoke weed can do is to get yourself a vape. Enjoy the weed without tobacco – that would be a huge thing to do."
"From a purely physiological point of view, alcohol is really linked to a lot of problems," says Harry Sumnall, Professor in Substance Use at the Public Health Institute. "The majority of deaths due to alcohol are due to alcohol-related cancers, and of course the risks will be increased with length of exposure."
"If I was in my early thirties and I was drinking 30 units a week," adds Adam, "I'd be thinking, 'If I continue, is this likely to significantly impact my health and well-being?' As a doctor, I would say yes. It will have quite possibly impacted on things like increased cholesterol, increased risk of a fatty liver, accelerating heart disease. For women, one in ten cases of breast cancer is alcohol-related."
So that's cleared that up then.
"Then loop in other risk factors," he continues. "If you're overweight and you smoke and you've got a poor diet, you whack all of those problems up hugely. If your mum or dad has had high blood pressure or a heart attack or strokes, then yes, you were born with it, you are more vulnerable to it and need to be careful."
But what about Dry January? I did ten days this year! I got a new perspective on life! I joined a reading club! I followed Joe Weeks on Instagram!
"The issue with Dry January is that most of the data suggests that the people who benefit most from it are low risk drinkers anyway," says Harry Sumnall. "It's not going to make much difference if, from February onwards, you fall back into your chronic patterns of alcohol use. I think the advice should be, 'Well, you don't really need to have a month off, though if you do, that's good. But have two or three days off throughout the year – spread your Dry January days out."
"Another uncomfortable truth is that it also depends on your economic status," says Adam. "If you are middle class, you've got a roof over your head, you've got support, you've got a job, you've got other connections, you've got access to a GP if you feel unwell or feel shit about your health, you're going to be much more resilient to the negative effects of heavy drinking than if you were an unemployed 32-year-old."
COCAINE AND MDMA
"I would be much more worried about coke than MDMA," says Adam. "That's because most people use MDMA less than ten times a year and don't generally end up developing a dependence. Some of the risks that people aren't aware of with cocaine is that it can accelerate the development of the hardening and ageing of the arteries in your heart and in your brain, so, basically, that accelerates the risk of heart disease at an earlier age and increases the risk of strokes. This increases in your forties and fifties. But if you're someone who does half a gram of coke once a month and you do that for three years of your life, is that likely to have a long-term effect? Probably not."
What about the prodigious level of drinking that tends to go hand-in-hand with taking coke?
"Well, of you take too much coke you're probably drinking too much as well," says Adam. "The postmortems on someone like George Michael aren't out yet, but I think a lot of people who are dying in their fifties who aren't opiate users – they've just done coke for 20 years, there's increased risk of heart attack, you drink a lot, your heart packs out. Honestly and truly, the general rule is: everything in moderation. Move a bit more and eat a bit less. Don't inject or smoke anything, because that is way more risky. If you want to play with excess, fine, but do that in moderation as well."
If you do want to get a handle on your drinking, the Drinks Meter app might be a good place to start.