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Alcohol misuse is a significant public health issue. The effects of alcohol impact on health and wellbeing of individuals but also on families and the wider population.

Public Health England estimate that 10.8 million people in England are drinking at levels which may impact on their health and 1.6 million have some level of alcohol dependence (Public Health England).

The Lancet Commission on Liver Disease in the UK, 2016 provides further context of the increasing issues associated with alcohol misuse being experienced by local communities, including the financial impact of this increasing burden. 

  • £2·1 billion is spent each year on the treatment of liver disease
  • Hospital admissions and mortality rates directly attributed to alcohol are rising
  • This is a condition that is largely preventable, and so positive changes can be made with low level, often brief interventions, meaning that alcohol related interventions are very cost effective 
  • 60% of UK police officers’ time is being spent on alcohol-related offences 
  • If cuts and freezes on alcohol duty were not in place and small rises had been allowed, this would have meant that £770 million could have been raised for the exchequer in 2016-17 according to HM Treasury’s figures 
  • Sally Davies, Chief Medical Officer for England, recently reduced safe limits for alcohol consumption for both women and men, on the basis of national and international evidence of the progressive increased risk of developing various cancers, including most common ones such as breast and colon
  • Alcohol use is related to many areas of social, physical, and mental health problems, triggering high rates of consultation in primary care
  • The proportion of alcohol consumed by extreme drinkers drinking more than 75 units a week has increased from 13% to 17% in recent years
  • Public Health post-2013,74 published by the Commons Health Select Committee, shows how local authorities have undergone cuts to public health budgets year-on-year, after assuming responsibility from central government. This in turn has led to issues with provision of responsive specialist provision for people with alcohol misuse issues 
  • Variations in mortality rate from liver disease persist between local authorities in England with a four-fold variation in mortality rates for men and women.

Short and long term effects of alcohol misuse 

1-2 units

After drinking 1-2 units of alcohol, your heart rate speeds up and your blood vessels expand, giving you the warm, sociable and talkative feeling associated with moderate drinking.

4-6 units

After drinking 4-6 units of alcohol, your brain and nervous system starts to be affected. It begins to affect the part of your brain associated with judgement and decision making, causing you to be more reckless and uninhibited. The alcohol also impairs the cells in your nervous system, making you feel light-headed and adversely affecting your reaction time and co-ordination.

8-9 units 

After drinking 8-9 units of alcohol, your reaction times will be much slower, your speech will begin to slur and your vision will begin to lose focus. Your liver, which filters alcohol out of your body, will be unable to remove all of the alcohol overnight, so it's likely you'll wake with a hangover.

10-12 units 

After drinking 10-12 units of alcohol, your co-ordination will be highly impaired, placing you at serious risk of having an accident. The high level of alcohol has a depressant effect on both your mind and body, which makes you drowsy. This amount of alcohol will begin to reach toxic (poisonous) levels. Your body attempts to quickly pass out the alcohol in your urine. This will leave you feeling badly dehydrated in the morning, which may cause a severe headache. The excess amount of alcohol in your system can also upset your digestion, leading to symptoms of nausea, vomiting, diarrhoea and indigestion.

More than 12 units

If you drink more than 12 units of alcohol, you're at considerable risk of developing alcohol poisoning, particularly if you're drinking many units over a short period of time. It usually takes the liver about an hour to remove one unit of alcohol from the body.

Alcohol poisoning occurs when excessive amounts of alcohol start to interfere with the body's automatic functions, such as:

  • breathing 
  • heart rate 
  • gag reflex, which prevents you choking. 

Alcohol poisoning can cause a person to fall into a coma and could lead to their death.

Long term effects of alcohol misuse

Drinking large amounts of alcohol for many years will take its toll on many of the body's organs and may cause organ damage. Organs known to be damaged by long-term alcohol misuse include the brain and nervous system, heart, liver and pancreas.

Heavy drinking can also increase your blood pressure and blood cholesterol levels, both of which are major risk factors for heart attacks and strokes.

Long-term alcohol misuse can weaken your immune system, making you more vulnerable to serious infections. It can also weaken your bones, placing you at greater risk of fracturing or breaking them.

There are many long-term health risks associated with alcohol misuse. They include:

  • high blood pressure 
  • stroke 
  • pancreatitis 
  • liver disease 
  • Cancer – around 4% of all cases of cancer in the uk are directly attributable to alcohol. 
  • depression 
  • dementia 
  • sexual problems, such as impotence or premature ejaculation 
  • infertility.

In addition to these issues alcohol is implicated in a number of social related issues, some examples of the impact of alcohol have been highlighted below.

There are also wider harms that are associated with alcohol misuse with 31% of men and 16% of women in England drink alcohol in a way that presents increasing risk or potential harm to their health and wellbeing. This proportion is higher for the 15 to 64 age group. The Global Burden of Disease Study 2013 revealed that, in England, alcohol misuse is the biggest risk factor for early death, ill health and disability for those aged 15 to 49 years. For all ages it is the fifth most important. In addition up to 17 million working days are lost annually through absences caused by drinking; up to 20 million are lost through loss of employment or reduced employment opportunities.