Summary: Drink? The New Science of Alcohol and Your Health by David Nutt
Summary: Drink? The New Science of Alcohol and Your Health by David Nutt

Summary: Drink? The New Science of Alcohol and Your Health by David Nutt

When you’re hitting the booze, what you’re drinking really is a mixture of psychoactive substances – chemicals that change your brain chemistry – as any other drug. By far the most abundant alcohol in the bottles on off-license shelves is ethanol.

Even what’s sold to the public as the so-called purest alcohol (for example vodka) contains a cocktail of various alcohols. The only pure alcohol is ethanol that’s been synthetically produced. Interestingly enough, every recreational psychoactive substance was banned except ethanol, caffeine, nicotine and tobacco. 


Stages of drunkenness: what happens as you drink more and more

As your blood alcohol content rises, it affects the way you feel and act.

20mg% – relaxed, slightly altered mood

50mg% – less inhibition, louder speech, more gesturing

80mg% – drink-driving limit, loss of coordination, balance, speech, hearing and reaction times

100mg% – slurred speech, reduced reaction times and physical control

150mg% – euphoria, coordination reduced so much that you may fall over

250mg% – confusion, stupor, disorientation, loss of pain response, hard to stand

300-400mg% – possibility of falling unconscious

400mg% – stupor

500mg% – coma

600mg% – breathing stops and death


The hidden dangers of tolerance

The toxicity of alcohol varies depending on your genetics as well as your past drinking experience. Tolerance usually builds up very fast because your brain quickly gets accustomed to alcohol. A high tolerance always has its dangers. You might end up pouring yourself more and more and in the end, the amount of alcohol will become enough to poison you.


Why do I get drunk but my friend doesn’t?

There are likely more than one reason. First, your friend might be used to drinking a lot more than you, so they’ve developed a high tolerance. Second, if a man and woman drink the same, the woman’s blood alcohol level will be higher (not only because women tend to be smaller also because women have a higher percentage of fat and lower percentage of water, and alcohol is diluted in the body’s water content). Third, how much your friend has eaten and what they’ve eaten makes a difference as food delays alcohol uptake from the stomach.

Finally there are genetic factors. Their genetics might allow them to metabolize alcohol faster than you. Some have trouble metabolizing alcohol and this inability is most common in people of Japanese, Chinese and Korean descent. The result is they get the bad effects fast, in particular flushing and feeling very drunk quickly.


How to prevent a hangover

  1. Drink less. 
  2. Pace yourself – drink slowly and let your body process the alcochol
  3. Drink water with your alcoholic drinks – dilute alcohol with ice, soda, lemonade or mixers
  4. Drink smaller measures – shrinking your glass means less booze over the course of the evening
  5. Drink clear spirits – they contain fewer congeners which are thought to make hangovers worse


Less is always safer

Alcohol, just like any other drug, carries risky activities. Looking at the satistitics, if you want to maximize your life, one rule is to not drink at all because there are no health benefits to it. But if you want the sociability benefits alcohol brings, you need to decide what risks you’re willing to accept.

The risks are determined by how old you are, your sex, your genetics and above all, how much you drink and how often you drink. What you can do is work out the best dose that gives you the best fun but with a reasonable amount of risk… in your opinion. It really is your call because there’s no one-size-fits-all solution.


But alcohol provides protection against stroke?

It used to be thought that way. In the past, countless headlines suggested the benefits of red wine. But there’s now controversy over whether alcohol provides any sort of protection. One leading medical journal backs this up by saying ‘No Level of Alcohol Consumption Improves Health’. They concluded that any protection would be more than cancelled out by the negative effects of alcohol.


Stop drinking immediately when…

As the amount you drink increases and you develop tolerance to alcohol, chances are more and more of your liver dies. So instead of being a soft, squidgy organ that’s full of blood, it becomes dry, hard and woody. It loses its capacity to make things such as enzymes and hormones. In fact, when your liver starts to pack up, your tolerance completely disappears because it can no longer metabolize.

That is when you start to get drunk on small amounts of alcohol. If it becomes clear this is happening to you, you must stop drinking immediately. You’re facing terminal liver failure. 


How much more can I drink before I drive?

The 80mg% limit means little because it’s impossible to say how many drinks will take you to reach that limit. It depends on your weight, age, sex and metabolism, as well as your past experience.

The problem is people tend to over-guesstimate how much they can drink. Some, very sensibly, decide not to drink at all when they drive. The rule of thumb is an average-sized man can drink up to four units of alcohol and a woman two before they exceed the UK legal limit. However, who is average? It’s extremely hard to know how fast your body processes alcohol on any one particular day.


What alcohol does to your mental health

There’s no denying that alcohol can numb out negative emotions while you’re drunk. And as you withdraw from the effects of alcohol on your brain, you’re likely to get psychological symptoms such as anxiety, sandness, lack of sleep and a short attention span. That’s especially true after a night where you’ve been impulsive or behaved with a lack of judgement (aka drinker’s regret).

In fact, anxiety the day after drinking is so common, it even has its own nickname – hangxiety or in some countries, boozanoia.

The relationship between alcohol and mental health is a complex one. It’s a bit of a chicken and egg situation. Are patients using alcohol as a form of self-medication? Or has alcohol changed their brains and deteroried their mental health? There’s another conundrum: as a doctor, which one should you treat first?


Which comes first?… alcohol addiction or mental health conditions

The problem now is people concerned with alcohol and mental health issues get pushed between mental health services and addiction services, with experts in each saying they should get the other problem treated first. One interesting study from Norway suggested a possible association between drinking and mental health problems. It may be that some people with mental health conditions don’t drink as a result. The same study also found heavy drinkers were more likely to have both anxiety and depression.


What if there’s an alcohol that’s not toxic?

Over the past 15 years, David has been working on this with a small team. He refers to this concept as Alcarelle, which involves developing compounds that are more selective than alcohol. The goal is to replicate the social and relaxation effects of alcohol without its unwanted effects. Alcarelle will focus on the science and the drinks companies will be able to license the technology, formulate their own flavoring, branding and market their own range of new-generation beverages.


Bonus: Sensible drinking rules you might want to stick to

  1. Don’t drink when you’re thirsty. Don’t drink on an empty stomach.
  2. No shots, cocktails, champagne or any other sparkling wine.
  3. Don’t wash down food with wine.
  4. Refuse aperitifs.
  5. Only have two drinks. Count before you go out. 
  6. Volunteer to drive.
  7. Take a week off drinking. Adopt a curfew. Book on drink-free days.
  8. Alternate your drinks.
  9. Buy expensive alcohol. Avoid cheap alcohol.
  10. Substitute with low- and no-alcohol drinks you like.
  11. Change your patterns. Find new activities.
  12. Don’t pre-drink.
  13. Don’t drink at home. Don’t drink alone.
  14. Only buy booze as needed. Don’t get alcohol delivered. Don’t buy alcohol at the supermarket.
  15. Don’t eat salty snacks.
  16. Treat your stress first.
  17. Practice saying ‘no thank you’.
  18. Order the smallest measure.
  19. Turn down the music.
  20. Use straight glasses. 
  21. Talk to your GP.
  22. Surround yourself with non-drinkers.
  23. Go out later.
  24. One unit an hour.
  25. Get an app.
  26. Don’t use energy drinks as mixers.