Alcohol and drug use

Alcohol

Did you know that men and women are advised not to regularly drink more than 14 units of alcohol per week? 

By reducing your alcohol intake to less than 14 units a week, this is considered low-risk drinking. It's called "low risk" rather than "safe" because there is no safe drinking level.

The NHS also advises having several drink-free days each week, especially if you drink more than 14 units a week on a regular basis.

If you're pregnant or think you could become pregnant, the safest approach is not to drink alcohol at all to keep risks to your baby to a minimum.

Benefits of Cutting Down

There are so many benefits to reducing your alcohol consumption, some you may expect and others that may be a welcome surprise. The immediate effects of cutting down include:

  • Feeling better in the mornings
  • Being less tired during the day
  • Better looking skin
  • Feeling more energetic
  • Better weight management

Longer term benefits include better mood, sleep and improved immune system and heart functioning.

Drugs

A drug can change the way the brain works. This effect will vary depending on the type of drug being taken, the person and the environment. Drugs can be:
• illegal substances such as heroin, cocaine and cannabis
• misused household products, like gases, glues and aerosols
• medicinal drugs
• alcohol and tobacco

Illicit drug use can be dangerous for three main reasons:
• you could become addicted to the drug
• the drug could cause you physical and psychological harm. Health-related problems caused by drug use include mental health problems, lung damage, cardiovascular disease, blood-borne viruses, liver damage and overdosing.
• drug use can have a negative effect on your quality of life and relationship

Because of the wide range of health problems associated with drug use, people experiencing drug-related harms might seek help from a wide range of health and care professionals, including acute medical, primary care and psychiatric services.

Drug use might not be the main problem that a person is seeking help for, or even immediately obvious as a potential contributing factor to their ill health.

Very Brief Intervention

Ask

Do you mind if I ask you a question about alcohol?

  • This question may be promoted from some verbal or visual prompts i.e. the person has stated that they have a hangover or there is evidence of drinking in the home etc

How often do you have a drink containing alcohol?

  • If the answer given indicates around 4 or more times a week you may wish to consider asking how many drinks do they have on each of these occasions, explain that unit measures can be quite confusing and offer to explain a simple unit measurement guide.
  • The principle behind understanding units and applying these to the guideline is important. Essentially, the greater the dose consumed, the greater the chance of unwanted effects.
  • The diagram below helps illustrate unit measurements:

 

The Chief Medical Officers (CMO) guideline for both men and women states that:

  • To keep health risks from alcohol to a low level it is safest not to drink more than 14 units a week on a regular basis 
  • If you regularly drink as much as 14 units per week, it's best to spread your drinking evenly over three or more days 
  • If you wish to cut down the amount you drink, a good way to help achieve this is to have several drink-free days a week. 

Frontline professionals are advised to use the questions within the Alcohol Use Disorders Identification Test Consumption (AUDIT C)

The Alcohol Use Disorders Identification Test Consumption (AUDIT C) 

Do you mind if I ask you a question about drugs?

 

Having a conversation about drugs can be challenging but meaningful, especially if your goal is to offer support and guidance. 

You can help someone by listening to what they're going through, and helping them decide what their next steps should be. Let them know you’re there to help, and you’re not judging or blaming them.

This might include encouraging them to seek help for the first time.

  • Reassure them that it is OK to seek help.
  • Help them find out what services are available locally, see Assist

Assist

Your response indicates you may be drinking at a level that could be harmful to your health. How do you feel about that?

What might be the benefits of cutting down/reducing your drug use?

Below are some of the benefits that somebody might state (or you may wish to highlight these to the individual yourself):

  • Save money 
  • Improved relationships
  • Reduce calorie intake/lose weight
  • Improved fertility if you are trying for a baby
  • Improved sleep
  • Reduced risk of injury
  • Fewer hangovers
  • More alert and higher performing at work
  • Reduced risk of high blood pressure
  • Reduced risk of cancer
  • Reduced risk of liver disease

What would work for you to help you cut down?

  • Affirm the person's suggestions, be non-judgemental and supportive

Act

It sounds like you want to cut down on your drinking/drug use, what do you think your next step is?

Would you like more information on the support that is available to help you cut down on your alcohol/drug use?

National support

  • A GP is a good place to start. They can discuss your problems with you and get you into treatment. They may offer you treatment at the practice or refer you to your local drug service. If you're not comfortable talking to a GP, you can approach your local drug treatment service yourself (details of local services can be found in the section below).
  • If you're having trouble finding the right sort of help, call the Frank drugs helpline on 0300 123 6600 (24hrs a day, 7 days a week). They can talk you through all your options. FRANK gives confidential information, advice and support for anyone concerned about alcohol and illegal drugs.
  • If you are concerned that you or someone you care about has a problem, you can also contact Drinkline on 0300 1231110 (Mon-Fri 9am - 8pm, weekends 11am - 4pm). The Drinkline service provides free and confidential information and advice to callers who are concerned about their own or someone else's drinking.
  • As well as the NHS, there are charities and private drug and alcohol treatment organisations that can help you. Visit the Adfam website to see a list of useful organisations. Private drug treatment can be very expensive, but sometimes people get referrals through their local NHS.
  • Alcoholics anonymous support the recovery and continued sobriety of individuals. Meetings are available online and in person. Helpline: 0800 917 7650 or email help@aamail.org or live chat via their website at www.alcoholics-anonymous.org.uk.
  • National Association for Children of Alcoholics (NACOA) provide information, advice and support for children of alcohol-dependent parents and anyone concerned with the welfare of a child. Helpline: 0800 358 3456 or email helpline@nacoa.org.uk 
  • Whether you want to cut down on your alcohol or go totally alcohol free, download the Try Dry app by Alcohol Change UK. The app is available on Android or Apple and can help you track your drinking and set goals.
  • You can also get further information on drugs and alcohol from the NHS website: Alcohol advice - NHS and Drug addiction: getting help - NHS

Self-care (alcohol)

Tips on cutting down

Make a plan
Before you start drinking, set a limit on how much you're going to drink.

Set a budget
Only take a fixed amount of money to spend on alcohol.

Let them know
If you let your friends and family know you're cutting down and it's important to you, you could get support from them.

Take it a day at a time
Cut back a little each day. That way, every day you do is a success.

Make it a smaller one
You can still enjoy a drink, but go for smaller sizes. Try bottled beer instead of pints, or a small glass of wine instead of a large one.

Have a lower-strength drink
Cut down the alcohol by swapping strong beers or wines for ones with a lower strength (ABV in %). You'll find this information on the bottle.

Stay hydrated
Have a glass of water before you have alcohol and alternate alcoholic drinks with water or a soft drink.

Take a break
Have several drink-free days each week.  

Self-care (illicit drugs)

Illicit drug use has risks but there are ways to reduce the risk of harm, overdose or infection when using drugs.

Avoid being alone

If you’re using drugs alone it’s important to be extra cautious around how much you take and how often you take it.

Be cautious

If you’re using drugs, start low and go slow. Start with a small amount (sometimes called a test dose) and wait at least 2 hours before taking any more.

You should start low and go slow as the drug may:

  • not have taken full effect
  • not always be what you’re expecting it to be
  • contain adulterants
  • be mis-sold
  • contain a different amount than you’d expected

If you don’t feel the effect as quickly as you’d expect, don’t assume the drugs are bad quality. They may contain another substance that takes longer to kick in.

Avoid mixing drugs

Avoid mixing drugs (including alcohol and medicines). Mixing drugs can cause unexpected and unpredictable results. This is a major risk factor in drug related deaths in England.

Drugs and driving

It’s illegal to drive if either:

  • you’re unfit to do so because you’re on legal or illegal drugs
  • you have certain levels of illegal drugs in your blood (even if they have not affected your driving)

Remember, drugs can be detected long after the effects have worn off. The detection period will depend on factors including the:

  • drug type
  • dose
  • frequency of use

Dealing with an overdose

There’s a greater risk of overdose if you:

  • mix drugs
  • take drugs alone
  • take drugs after a break
  • take higher purity drugs
  • inject drugs

When someone overdoses it’s important to get them help as soon as possible.

Phone 999 or go to A&E if:

You or someone else has taken drugs and has symptoms like:

  • unconsciousness
  • seizures or fitting
  • rapid heart beat
  • low or undetectable heart rate
  • chest pains
  • difficulty breathing (snoring or rasping)
  • pinpoint pupils
  • blue or pale tingling of knees, hands and lips
  • severe nausea and vomiting
  • hyperthermia (overheating)

The call handler will talk you through what to do. If the patient isn’t breathing, they’ll tell you how to do chest compressions.

Naloxone: get it, carry it, use it

Naloxone is an emergency medication used to reverse the effects of overdoses caused by opioid drugs such as heroin, fentanyl, morphine, methadone and oxycodone.

  • if someone overdoses: act fast, don’t wait to see if they will recover – you could save their life
  • remember, call an ambulance immediately
  • check the person is breathing
  • put them in the recovery position: on their side with their head resting on their arm
  • give them naloxone as soon as possible

You can contact your local drug treatment and support service for a free naloxone pack for yourself or for someone else who may need it. You will also receive training on how to use the naloxone pack.

 

Local Support and Contact Details