Alcohol addiction – a killer illness

Accidental death due to alcohol

When I was at university – 40 years ago – I had my first contact with alcohol as a killer. This was not due to its addictive nature but rather due to its immediate effect: the brother of a close friend of mine (whom I also knew) was celebrating post exam success and fell off a wall some distance to the ground below. He died on impact. It was such a waste of a promising young life and such a shock and devastating loss to his family and all who loved and cared about him.

This is just one example of alcohol as a killer – its contribution to accidental death – and I suspect that most people know of someone who may have been killed or seriously injured in a drink driving related accident. If they do not know anyone personally, people over a certain age must remember the death of Princess Diana and the role of Henri Paul, the driver that night who was over the drink drive limit. Around 666 people die each year in the UK in drink driving accidents.

That is a shocking statistic in itself and does not include the many more people who suffer life limiting injuries or emotional health problems as a result of these incidents. The bald statistic does not take account of the people left behind who loved these individuals and have to forever come to terms with the shock and sudden nature of their loss. And of course there are many other accidental deaths as a result of the killer alcohol – from accidents in or outside the home including falls and accidental  alcohol overdose. 

Death from alcohol induced disease

Most people have a lot longer to come to terms with the killer nature of alcohol as there are many more alcohol caused deaths from illness (sometimes long drawn out) rather than from accident. Excessive alcohol consumption is a direct cause of conditions such as liver disease, stroke and some cancers. Many people are aware of the effect of alcohol on the liver, and many people with alcohol addiction issues put this as their priority health concern. It is of course a serious consequence though more people will also suffer from the mental health consequences of addiction rather than just the physical ones – stress, anxiety and depression are all well known effects of excessive alcohol consumption and alcohol addiction.

A worsening situation

If we first look at the death rate, data published earlier this year (published February 2021) relate to 2018 – 2019, a year before the Covid-19 pandemic. Up until 2019, the alcohol related death rate had been relatively stable for the past 10 years, at about 46 – 48 deaths per 100,000 population. Men are a little over twice as likely to die from alcohol related causes as women.

However, all the evidence is that the situation has worsened since the pandemic with lockdowns and additional stress causing more and more people to turn to drink as a way of relieving their feelings. In 2020 in England and Wales alcohol killed more people than any other year on record, with 7423 dying specifically from alcohol addiction and misuse, up about a fifth on the previous year. This excludes the deaths attributed to alcohol related cancers such as cancers of the mouth, oesophagus and liver. Similarly in Scotland, in 2020 the number of deaths specifically attributed to alcohol addiction rose by almost a fifth (17%) to 1190. This is despite there being a minimum unit price for alcohol in Scotland introduced in May 2018 which was designed to at least in part to assist the country’s chronically unhealthy relationship with alcohol.

Most of the deaths throughout Great Britain were due to long term dependency. We can therefore possibly expect the rate to go even higher if the increase in alcohol use recorded during the pandemic is sustained, leading to even higher prevalence of alcohol addiction in the population. Around 80% of these deaths were due to liver disease, 10% due to mental and behavioural alcohol induced conditions and 6% from accidental alcohol poisoning.

Alcohol is a dangerous toxin

If introduced to the UK today, alcohol would not be legal. Aside from directly killing people, alcohol causes untold misery in its impact on physical and mental health and also on fuelling alcohol related aggression, violence and other associated abusive behaviours. It costs people their marriages, their families and their livelihoods. There is also a financial cost, and not just on the pockets of the drinkers and their families. Alcohol misuse and addiction is estimated to cost the NHS £3.5 billion each year and society as a whole £21 billion annually. The rate of hospital admissions that were related to alcohol consumption has increased over time, from 1,639 per 100,000 population in 2008/09 to 2,367 per 100,000 population in 2018/19. With increasing alcohol consumption in the past 12 – 18 months, it is hard to see these statistics improving.

Consequences of alcoholism

As noted above, many people who know they drink too much worry about the effect on their liver and it is true that around 80% of alcohol specific deaths are from liver disease. Many of them cannot deny (although they may try to) the effects of alcohol on their finances, jobs and family life. However, there is one more insidious effect of sustained heavy drinking and alcohol addiction which is alcohol induced brain damage. Known as Wernicke’s encephalopathy which can lead to the even more serious Wernicke-Korsakoff syndrome, the cause of this disease is alcohol consumption preventing sufficient vitamin B1 / thiamine reaching the brain. The consequences are rather like dementia, leading to poor memory, confusion and disorientation, poor balance and an unsteady gait, loss of weight and possibly uncoordinated eye movements. Not all of these symptoms will necessarily manifest themselves in all sufferers but Korsakoff’s can lead to a slow painful death.

It has been estimated that about 0.5% of the adult population may be affected by alcohol related brain damage. To put another way, around 600 people a month may present to hospital acute services as a result of this.

If you, like me, have seen people with liver damage as a result of alcohol addiction, and also met people with alcohol related brain damage, I know which of the two conditions I would rather have as a result of heavy drinking.

Despite the comment above – that alcohol would not be made legal if introduced now – there is not a great deal wrong with alcohol in the hands of most people who drink irregularly and in moderation when they do. The problem is when moderate drinking becomes regular and heavy, leading to alcohol addiction, and then it can be the killer that statistics demonstrate that it is.