Alcohol

Alcohol is a drug and comes in many forms, including beer, cider, wine, and spirits such as whisky, gin and vodka, as well as premixed drinks such as ‘alcopops'.

Alcohol is legally available in the UK from licensed outlets to people aged over 18 years and is enjoyed and used safely by many people. However, alcohol is also a major cause of health and social problems and, after tobacco, causes more deaths in the UK than any other drug.

Alcohol relaxes the brain and body, and is normally drunk for its pleasant effects. Because of its power to alter mood and cause physical changes in your body, it can also lead to physical and psychological health problems as well as social problems.

Health agencies recommend that men should not drink more than three to four units of alcohol per day. For women, the daily limit is two to three units. This advice applies regardless of whether you drink daily, weekly or somewhere in between. You can use this ‘unit calculator’ on the NHS Choices website to find out how many units there are in different types of alcohol.

Many people find that moderate drinking (a unit or two of alcohol per day) helps relieve stress, encourages relaxation and acts as an appetite stimulant. However, drinking all your weekly limit in one session (often called binge drinking) can lead to poor co-ordination, vomiting, exaggerated emotional reactions (including sadness, tearfulness, anger and aggression), a reduced sex drive, and can even cause unconsciousness. Women who are pregnant, or planning to become so, are advised to drink no more than one to two units per week.

A hangover the next day – headache, dry mouth, feeling sick and tired – is a very common consequence of heavy drinking the night before. These effects are caused by dehydration and toxicities, so if you drink alcohol, you should drink plenty of water as well.

As even small amounts of alcohol can have an effect on your co-ordination, reactions and judgments, you should never drink even small amounts of alcohol and then drive or operate machinery.

Extremely heavy drinking can lead to coma and even death.

Long-term heavy alcohol consumption (ten or more units a day in a man, or six or more in a woman) can cause ill health, affecting the liver, heart and brain. Drinking every day can also lead to physical and psychological dependence on alcohol.

In addition, people who drink heavily often don't eat well and this can cause further health problems.

Alcohol is a depressive drug and can cause or make worse mental, psychological or emotional problems. Used in conjunction with other drugs, such as over-the-counter painkillers like paracetamol, alcohol can have more serious effects.

What about alcohol and HIV? There is no evidence that moderate drinking (a unit or two of alcohol a day) does any harm to people with HIV. However, in some situations, you may be advised to cut down your alcohol consumption or stop drinking alcohol altogether.

Heavy drinking can affect your immune system and may slow down recovery from infections.

Heavy alcohol use can have potentially serious consequences for people taking anti-HIV drugs. Alcohol is processed by the liver and a healthy liver is necessary for the body to process medicines effectively. The blood fat increases caused by some anti-HIV drugs can be made worse by heavy drinking. And drinking too much can make it harder for you to remember to take your drugs in the right way, at the right time (this is often called ‘adherence’).

People whose liver has been damaged by drinking too much alcohol (especially if they have hepatitis) are more likely to experience side-effects from anti-HIV drugs, particularly protease inhibitors.

Alcohol can react badly with certain medicines (for example some anti-TB drugs and some antibiotics), so it is a good idea to check with your pharmacist whether it is safe to drink alcohol with any new medicines you may be prescribed. However, there is no significant interaction between any of the currently available anti-HIV drugs and alcohol.

Alcohol can cause vomiting. If you vomit within an hour of taking a dose of your anti-HIV drugs or any other medicine you are on (or less than four hours if you are taking Eviplera or rilpivirine), or if you see the pills, or remnants of them, in the vomit., you should retake the dose.

People who have hepatitis as well as HIV are advised not to drink alcohol at all, or to keep alcohol consumption to an absolute minimum. Even moderate alcohol consumption – as little as one or two drinks a day – has been shown to increase the risk of serious illness and death for people with chronic hepatitis C infection.

If you are concerned about your drinking, speak to a member of your healthcare team, who will be able to direct you to somebody who can help.

Alcohol Concern, one of the UK's largest alcohol charities, has information and a directory of services at www.alcoholconcern.org.uk/concerned-about-alcohol, or phone Drinkline on 0800 917 8282 (weekdays 9am to 8pm, weekends 11am to 4pm). More information on Scottish support services is online at the DrinkSmarter website, or you can contact Drinkline in Scotland on 0800 7 314 314 (8am to 11pm, 7 days a week).

Contact NAM to find out more about the scientific research and information used to produce this section.

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.