With summer almost gone and fall just around the corner, I wonder how many of us are worried about how much we drank over the past few months. Perhaps you’re counting down the days until you take part in “Sober October”?
It seems like summer offers many people the perfect excuse to indulge themselves: picnics, barbecues, pub lunches, a Pimm’s in the garden before dinner, an espresso martini afterwards. There’s always a reason to crack open a bottle of something.
And some people know how to drink. I recently attended a brunch and most of the guests were legless by midday. Another friend had just returned from Spain and when I asked him how it went, he laughed and said, “I have no idea. I was pissing the whole time.”
There is a hidden epidemic involving middle-class, middle-aged and retired people who drink too much (photo posed by model)
Sound familiar? It’s around this time of year that many people are clearing their minds from the excesses of summer and realizing that they may have an alcohol dependency.
When we think about the problems society has with alcohol consumption, we tend to imagine young people drinking alcohol excessively.
It conjures up images of thugs fighting in the street or girls barely able to stand, hugging each other as they stagger to the next cocktail bar.
And when we think of alcoholics, images come to mind of homeless men, with a bottle in a brown paper bag, dozing on a park bench.
But there is another group that has a serious problem with alcohol, a problem that could very well shorten their lives. However, this group manages to go unnoticed because they are too respectable to appear drunk in any obvious or rude way.
The hidden epidemic I am talking about is among the middle class, middle-aged people and retirees. In my clinic I see many men and women in this category. When I ask them about their alcohol consumption, they often don’t realize they have a problem because things have not (yet) reached the point where they are physically dependent on it, where the body becomes dependent on alcohol and the tremors appear if they do not drink it.
Some may have started drinking alcohol as a way of managing stress. Others, as their children grow older and they find they have more free time, start drinking alcohol as a way of passing the time, relaxing and unwinding.
It usually starts slowly, with a glass of wine before lunch as a treat, especially in the summer months. After all, there’s not much else to do in the afternoon, is there? After that, a few glasses turn into a bottle. Or maybe that mid-morning gin and tonic turns into a lot more gin and tonic. And then you pour yourself another.
Rich, retired and bored is a lethal combination when it comes to drinking. Studies have shown that alcohol consumption among the over-50s has become a hidden phenomenon and that the higher a person’s income, the greater the risk they face.
According to NHS England, the latest figures from 2022 found that 23% of women aged 55-64 drank more than 14 units of alcohol a week. While these are just guidelines (and it is argued that any amount of alcohol increases the risk of diseases such as cancer, so there is really no “safe” amount), there is evidence that above 14 units the risks increase significantly.
One study examining this found that people who consumed one to two drinks four or more times per week had a 20 percent higher risk of premature death, compared to those who drank only three times per week or less.
And don’t be fooled if you can go days or even weeks without drinking alcohol. Many alcoholics delude themselves into believing that because they can abstain for a short period, they can’t become addicted.
One patient described it as similar to holding your breath underwater: you know that sooner or later you’ll have to surface and take a deep breath. Similarly, you can go for a while without drinking alcohol, but sooner or later you’ll know you’ll have to give in and drink something.
That’s why fads like “Dry January” and now “Sober October” worry me.
Cutting back on alcohol is always a sensible decision, but if the first thing you do in early February or November is reach for the corkscrew, it’s a good indicator that a month without drinking isn’t going to help things, and it might even be time to seek professional help.
So what do you do if you think you might have a problem?
People often think that because they function day to day and are not physically dependent on drinking, they shouldn’t bother their GP.
But a good doctor will recognize that someone asking for help needs intervention now, before the situation gets worse.
One of the ways doctors will screen for alcohol problems is through the CAGE system, which asks four key questions: Have you ever felt the need to cut back on your drinking? Have people annoyed you by criticizing your drinking? Have you ever felt guilty about drinking? Do you need to drink first thing in the morning to calm your nerves or relieve a hangover?
Answering “yes” to two or more of these questions means there may be a problem that can’t simply be explained away as summer fun or solved with a Sober October.
In his damning report on the state of the NHS, Lord Darzi made clear that the system was failing older people, something that has long been apparent to those working in the health service. It is shameful and I can’t help but blame ageism: there is no way we could be so blatant about such poor treatment of children.
The Prince and Princess of Wales announced that Kate has completed her chemotherapy treatment
Let’s give a thought to Wills
Over the past week there has been much admiration for the brave and dignified way in which the Princess of Wales has faced her cancer diagnosis and treatment. Whoever you are, whatever your background, cancer is incredibly scary and chemotherapy is particularly arduous, exhausting and unpleasant.
But I also want to spare a thought for Prince William, because being the partner of a person with cancer is also a very challenging and stressful experience. You love the person and hate to see them so vulnerable, anxious or upset. You long to bear some of their pain and fear, to halve their suffering, if only it were possible.
You are scared too, but you have to put on a brave face and be the “strong” one, especially if there are small children to protect and try to maintain a certain normality with, all while offering emotional support to a patient. Amidst the perfectly understandable display of compassion and understanding towards the cancer patient, it is important not to forget that the partner will also be going through a very difficult time.
I know I was not the only one who watched in horror and anger as 1,700 criminals were released early from prison.
After years of working with both criminals and people within the justice system, I know that a soft approach rarely works, especially with those who have a history of violence.
We must have punishments that fit the crime, not only as a deterrent but also to keep people safe and to make the public feel confident that when someone is convicted, justice will be done.
The Labour Party has always had a reputation for being a party that is lenient on crime, and I have often wondered whether that is fair or true. Yet here they are allowing hardened criminals to walk free after only serving a fraction of their sentence, and many more will follow suit.
The reality is that we need to approach the law the same way a good parent would when disciplining a child – by setting clear boundaries around their behavior and then enforcing them. By explaining what punishments can be expected if the rules are broken and by never bending that rule. We can also be kind and compassionate, but ultimately if we let people get away with it, we are sending the message that we are weak, easily manipulated, and that bad behavior is no big deal. Every little kid knows this, and now every criminal knows it too.