Alcoholism in Men
Introduction
There has been a growing trend in recent years toward increased consumption of alcohol in many developed countries, including the UK. This increased consumption of alcohol is especially pronounced among older age groups (Office for National Statistics 2015), a development that has raised concerns for public health. There has also been an increase in alcohol consumption among various age groups in various developed countries. Alcohol consumption constitutes an essential aspect of social, occupational, and family life for many individuals. Although there are fewer risks associated with low to moderate consumption of alcohol (Lotfipour et al. 2015), on the other hand, excessive consumption, and more so among young people, has been a cause for concern to the public, policy-makers, and social and health care professionals. In recognition of the growing problem of alcohol consumption, the UK Government deemed it necessary to initiate the harm reduction strategy in an effort to promote sensible consumption of alcohol in the population and possibly curtail the increasing risks linked to excessive consumption of alcohol (Department of Health et al. 2007). The goal of this essay is to examine alcohol consumption in the UK, focusing mainly on the male gender. Specifically, alcohol consumption statistics in the UK are examined, along with the factors that enable men to tolerate larger quantities o alcohol than women. Causes of alcoholism are also explored, as the effects of alcohol consumption on men. Policies developed to address the issue of alcoholism are also examined, as well as the treatment for alcoholism.
Alcohol consumption statistics in the UK
Alcohol use and abuse constitute a considerable is an issue of considerable public health concern not just in the UK, but also across the globe. Individuals who consume alcohol in large quantities over a long period of time in their lives are more predisposed to the burden of disease linked to alcohol. Patel et al. (2010) opine that alcohol consumption contributes to health, safety, and social problems through chronic immediate or acute consequences or long-term and chronic outcomes. To begin with, alcohol is a form of psycho-active drug which impairs an individual's ability to undertake complex tasks or make safe or suitable decisions, and more so when faced with stress. In addition, regular consumption of alcohol especially in large amounts could lead to direct harm to the body. In particular, long-term heavy consumption of alcohol impairs the function of the liver, thereby predisposing the individual to develop liver cirrhosis, and hence shortens his life.
Alcohol policy is broadly described as any public attempt by public health to minimise alcohol problems by changing the economic, social, as well as physical environment that affects the manufacturing, distribution, marketing, sale, and consumption of alcohol.
Alcohol consumption constitutes a key component of British culture. In a 2013 survey on the lifestyle of Britons, 21% of the respondents identified themselves as teetotallers, indicating that the larger majority consume alcohol, albeit in varying quantities. The per capita alcohol consumption in England and Wales last peaked in 2004 but since then, it has considerably reduced, but the figures are still higher than the historical figures recorded in the mid-twentieth century (Office for National Statistics 2015). In England, there has been a 38% rise in alcohol-related hospital admission since 2003. On the other hand, there has been a 47% decrease in drunk driving casualties over the same period. In 2014/15, the number of hospital admissions recorded across the healthcare sector in the UK as a result of alcohol-related injury, diseases, or conditions was estimated at 1.1 million. This represented a 3% increase in admission, compared to 2013/14 (Statistics Authority 2016). Of these, almost two-thirds of these were men. Almost half of the admissions were as a result of cardiovascular disease due to alcohol, while behavioural and mental disorders induced by alcohol consumption accounted for 19% of the hospital admissions.
OECD analysis reveals a rise in heavy episodic drinking and hazardous drinking among women and young people. Additionally, men of higher socioeconomic status are less likely to consume alcohol in large quantities in comparison with their counterparts of low socioeconomic status (OECD, 2015). The latest data on alcohol consumption show that the average individual in OECD countries consumes 8.9 litres of alcohol annually, as of 2013. The highest individual consumption rates were recorded in Estonia, Lithuania, Austria, and the Czech Republic, at 11.5 litres (OECD 2015). On the other hand, such countries as Israel, Turkey, India, and Indonesia reported low consumption rates, which were largely attributed to cultural and religious traditions which prohibit alcohol use. Alcohol consumption in the UK ranks higher than the average rate of consumption in all the OECD countries. This is in spite of the quantity of alcohol consumed in the UK has reduced between 2000 and 2013.
Although more men than women consume alcohol at higher rates and numbers, this gap appears to be closing. According to OECD (2016), slightly more than half of the women consumed alcohol in the previous week, in comparison with almost two-thirds of the men. A survey conducted by the Office for National Statistics (2016) showed that in the week leading up to the survey, nearly two-thirds of the men (64%) admitted to having drunk alcohol, and more than half (52%) indicated that they had consumed over 4.67 units on the day they drunk the heaviest. Conversely, slightly over half of the women (53%) indicated that they had consumed alcohol in the week leading up to the survey, and 37% of them admitted to having consumed over 4.67 units on the day they drank the most. The study further revealed that 12% of the men were more likely to have consumed more than 14 units on the day they consumed alcohol the heaviest, in comparison with 4% of the women.
Causes of alcoholism
An individual's predisposition to alcoholism is not due to a single cause but rather, it is often a result of a combination of factors, usually both genetic and environmental factors. Even though heredity is regarded as playing a role in an individual's dependency on alcohol, it is important to note that so far, researchers are yet to isolate an alcohol addiction gene. One of the attributes influencing an individual’s risk for alcoholism is her or his sex. In such a case, there are a number of factors to consider. Several adoption studies have given evidence of likely sex differences in regard to an individual's heritability of alcoholism (Prentiss 2007). However, these findings are far from conclusive. Elsewhere, twin studies have time and again shown that genetics play a crucial role in the heritability of alcoholism, especially in men, while in women shared environmental factors are involved in their familiarity with alcoholism. Moreover, sex differences help to demonstrate how alcoholism is transmitted between family members. Nonetheless, the genetic epidemiology research carried out up until now on this issue is laden with various shortcomings, with ongoing and future molecular studies geared toward solving these.
Children of an alcoholic parent have a four-fold possibility of becoming alcoholics themselves, later in life (American Academy of Child and Adolescent Psychiatry 2011). In the same way, environmental factors also add to this likelihood so that children who grow up in a household where alcoholism is prevalent are also at a higher risk of becoming alcoholics themselves. Other environmental factors affecting alcoholism include peer pressure and the age at which one starts drinking. Individuals who use alcohol for the first time aged 15 years have a five-fold chance of becoming alcohol dependent or abusing alcohol, in comparison with their counterparts to take alcohol for the first time aged 21 years or older (National Council on Alcoholism and Drug Dependence n.d.).
Mental health is also a contributing factor to alcoholism. The National Alliance on Mental Illness reports that nearly 37 percent of alcoholics suffer from a serious mental health illness like bipolar disorder, while people with schizophrenia frequently abuse alcohol. While certain psychiatric syndromes may cause alcoholism, heavy drinking can also contribute to various psychiatric syndromes. Therefore, alcoholism can mimic or worsen virtually any psychiatric symptom.
Studies have pointed toward a link between alcohol intake and life events. Veenstra et al. (2006) reported contradictory findings, with some studies showing a decrease or increase in alcohol intake with certain life events, while others did not. A study by Dawson, Grant, and Ruan (2005) indicated that drinkers experiencing above 6 stressful life events were likely to consume 3 times the quantity of alcohol consumed by other drinkers who had fewer life events in a day. Elsewhere, Lloyd and Turner (2008) revealed a considerable positive association between alcohol dependence and cumulative adversities among young adults and adolescents in South Florida. According to Kestil et al. (2008) stressors that an individual experiences early in life could also impact their alcohol use later in life if at these stressors were not addressed adequately. Nonetheless, Kestil et al. (2008) further report considerable associations between children brought up by alcoholic parents and their propensity for heavy drinking as young adults. This finding was evident across both genders. Other factors that also influence alcohol use and have also been shown to impact the relationships between alcohol use and stress include social support, religiosity, and coping styles. In their study, Veenstra et al. (2007) found that active coping styles and high levels of social support enabled individuals to cope with stress and hence enabled the individuals to reduce their levels of drinking. Men were also shown to harbour strong alcohol expectancies, which were in turn positively associated with alcohol problems.
Gender differences in the ability to handle alcohol
Gender differences influence the rate at which alcohol is consumed in your body. Men have been shown to consume larger quantities of alcohol than women on average, and are also more tolerant of alcohol. This is partly the case owing to the issue of body water. On average, a man's body is approximately 55% to 65% water, in comparison with a woman's body which is about 45% to 50% water. This is because the higher fluid volume in men compared to women leads to lower alcohol concentration in their bloodstream. Therefore, even when a man weighs the same as a woman, women will have a higher concentration of alcohol in their bloodstream than men as they do not have as much water as men to dilute it. Consequently, women attain higher BAC (blood alcohol concentration) faster than men owing to more adipose tissues and less water (Nevid 2016).
Men also have a higher concentration of the enzyme alcohol dehydrogenase which is involved in alcohol metabolism in the stomach. On average, men have about 50% more of this enzyme than women. The enzyme is responsible for the metabolism of nearly 15% of all alcohol consumed. The implication made is that only a small percentage of alcohol reaches a man's small intestine in comparison with a woman. Consequently, for the same amount of alcohol, women record nearly 7% higher BAC than men of equal weight. Men tend to have a higher muscle-to-fat ratio in comparison with women. What this means is that the amount of blood flowing through muscle tissue is more than that flowing through fat. Consequently, the larger volume of blood in a man's body tends to dilute alcohol more than in women (Schulte, Ramo & Brown 2009).
There are also other gender differences that make men more tolerant of alcohol than women. For example, when a woman is having her menstrual cycle and she drinks, the fluctuation of hormone levels leads to prolonged and higher intoxication levels. Psychological and social effects could also help to explain gender differences in terms of their expectations upon consuming alcohol. Studies reveal that men who consume alcohol in large amounts tend to have higher expectations that drinking results in physical and social pleasure, as well as a sexual enhancement (Schulte et al. 2009). On the other hand, women who take alcohol in large amounts are more likely to believe that alcohol reduces tension.
Effects of alcohol consumption on men
A higher percentage of men consume alcohol in excess than women. Excessive consumption of alcohol is linked to a considerable rise in short-term risks to safety and health. Such risks tend to increase with an increase in the amount of alcohol consumed. Also, men have a higher probability of engaging in risky activities after drinking than women, such as driving without a safety belt or over-speeding. This, in addition to excessive drinking, further enhances their risk of death or injury (Levy et al. 2004; Nolen-Hoeksema 2004). According to Baan et al. (2007), alcohol use enhances the risk of cancer of the oesophagus, mouth, colon, throat, and liver in men.
Men further report higher rates of hospitalisation and deaths as a result of excessive alcohol use than women (Minimo et al. 2007). Among the drivers involved in fatal car accidents, the level of intoxication in men is nearly twice that of women (National Highway Traffic Safety Administration 2008). Excessive alcohol intake has been shown to increase the level of aggression in an individual and hence, may also enhance the risk of physical assault on another individual (CDC 2016). Men who commit suicide are also more likely to have been under the influence of alcohol before committing this act, in comparison with women (Soukas, Suominen & Lonnqvist 2005).
According to various studies on alcohol consumption and alcohol-related injuries, age and gender-related trends are evident in the patterns of consuming alcohol (Lotfipour et al. 2012; 2013). Higher rates of alcohol consumption are reported among men and older adults than in any other age group. Moreover, males and young adults are more likely to report alcohol-related injuries than older adults and females (Lotfipour et al. 2015).
Excessive consumption of alcohol also interferes with men's sexual function and reproductive health. For example, excessive alcohol intake has been shown to affect male hormone production and testicular functions, leading to infertility, impotence, as well as a reduction in such male secondary sex characteristics as chest and facial fair (CDC 2016). Excessive consumption of alcohol is also common among men who are involved in sexual assault (Abbey 2002), while men who use alcohol are more predisposed to risky sexual behaviours such as having sex with multiple partners and engaging in unprotected sex (Nolen-Hoeksema 2004).
Alcohol misuse is directly associated with deaths from such diseases as liver cirrhosis and strokes. According to the Office for National Statistics (2016), some 6,831 deaths associated with the consumption of alcohol were reported in the UK in 2014. These deaths accounted for 1% of all the deaths recorded. However, it represented a 4% increase in comparison with the figures recorded in 2013. 63% (nearly two-thirds) of all alcohol-related deaths recorded in 2014 were attributed to alcoholic liver disease. Harmful consumption of alcohol is linked to considerable rates of mortality and morbidity in various parts of the world (Rehm et al. 2009).
According to the WHO (2014), alcohol use is linked to various undesirable social and health consequences, such as the increased risk of stroke, various forms of cancers, and liver cirrhosis, to name but just a few. When a pregnant woman consumes alcohol, this exposes the foetus to alcohol, thereby increasing the risk of intellectual impairment and birth defects. Alcohol use is also linked to disability and death through assault, homicide, injuries and accidents, violence, and suicide (OECD 2015). The WHO (2014) estimates that alcohol use is responsible for over 3.3 million death globally every year, and contributes to about 5.1% of all diseases globally. Bouchery et al. (2011) estimate that the United States incurs approximately USD 25.6 billion in the form of healthcare costs linked to excessive consumption of alcohol, while alcohol misuse played a key role in the sharp increases in premature deaths in the Russian Federation (OECD 2012). Alcohol consumption is also associated with broader societal consequences, such as reduced work productivity owing to premature mortality and absenteeism, not to mention deaths and injuries to non-drinkers such as when individuals driving under the influence of alcohol cause traffic accidents.
Policies on Alcohol Consumption
The UK has over the years developed various policies with the goal of minimising harm as a result of alcohol consumption. The previous government tried to reduce harm due to poor practice in such 'on trade' premises as nightclubs and bars. In 2010, the government enforced a compulsory code of practice that all alcohol retailers were expected to abide by (Parliament 2010). This code of practice banned irresponsible competitions and promotions, forcing retailers to provide smaller quantities of alcohol, compelling retailers to offer customers free drinking eater, and demanding that they possess proof of age policies.
The coalition government has also endeavoured to formulate much of the debate regarding the harmful effects of alcohol consumption in the form of anti-social behaviour, law, and order. For instance, the passage of the 2011 Police Reform and Social Responsibly Act was with a view to allowing local authorities to deal firmly with alcohol retailers who broke licensing rules.
The Public Health Responsibility Deal has emerged as an ideal vehicle for use by the coalition government to enable the alcohol industry to enlist several pledges aimed at minimising alcohol-related harm (Department of Health 2011). However, the process turned out to be quite controversial, forcing many interest groups in the public health docket7932 to decline to enlist. Claims have been made to the effect that the pledges given have no evidence base, that they failed to take into account such critical levels as the price of alcohol, and that there was no clarity regarding how the pledges would be assessed (The Royal College of Physicians 2011). The 2010 report by Sir Peter North provided his assessment of the likely reforms to the legislative laws on drink and drug driving. In this report, North (2010) endeavoured to have the alcohol driving limit reduced to 50mg for every 100ml of blood. Nonetheless, his recommendations were not approved by the Department for Transport.
Treating alcoholism
Even with the aforementioned policies in place, alcoholism is still a big problem in society today. While such policies would be very useful in preventing many people from becoming alcoholics, those who are already heavy drinkers need treatment to help them beat alcoholism (van Wormer & Rae 2012). This means that alcoholics need to be enrolled in an alcoholism treatment program. Such comprehensive programs target the individual as a whole, as opposed to their alcohol use alone. Many of these comprehensive programs encompass the following factors: Detoxification
Alcohol detoxification acts as the first step in the treatment of alcoholism. The step entails the complete elimination of alcohol from the individual's body (van Wormer & Rae 2012). Usually, the person experiences withdrawal symptoms, and these are usually severe during the first 24 to 48 hours after quitting drinking. The detox must be supervised by a professional medical team. This is because treatment specialists are in a position to provide the individual with proper medication to help alleviate the symptoms. Consequently, you get to focus your attention on getting better.
Rehabilitation
After successfully completing the detoxification phase, the person recovering is placed in an inpatient rehabilitation facility. Rehabilitation is aimed at treating alcoholism at its most severe (Monti 2002), and for this reason, individuals are required to remain on-site for a specified duration of time, say, 60 or 90 days. The treatment helps an individual combat drinking triggers and urges. Additionally, it helps the individual to use coping skills to overcome possible future relapse to alcoholism once they leave the rehab. However, the rehabilitation phase may also be conducted in an outpatient setting in case the patient's alcoholism is not so serious.
Maintenance
Following the successful completion of the rehabilitation stage, the recovering alcoholic starts to slowly acclimatize to their daily life. Individuals are encouraged to grow slowly on themselves so that they can find their groove back (Prentiss 2007). They are also encouraged to attend various support groups, including Alcoholics Anonymous, that provide engagement and encouragement to other recovering alcoholics. By attending support groups, recovering alcoholics also get to interact with sponsors and group leaders who give them support in terms of maintaining sobriety and positively changing their lifestyles.
Conclusion
Alcohol consumption is an issue of global health significance to the general public, policy-makers, and healthcare professionals. While more men than women take alcohol, the gap seems to be closing, especially among young adults. There appear to be gender differences in terms of the level of tolerance for alcohol. Women, on account of their less water and more adipose tissues than men, attain higher BAC faster than men. Heavy alcohol intake in men is associated with risks to their safety and health. For example, men are more likely to be hospitalisation or die due to excessive intake of alcohol than women while a higher number of men than women involved in fatal accidents are under the influence of alcohol. Some of the negative health effects of excessive consumption of alcohol in men include various forms of cancer and liver cirrhosis. Both genetic and environmental factors play a role in influencing an individual's likelihood of becoming an alcoholic. There is also evidence of a positive correlation between increased alcohol intake and a rise in life events, while alcohol intake could also trigger the development of such mental health conditions as bipolar disorder. So far, various governments have developed a number of policies to contain excessive alcohol consumption. For example, In the UK, the coalition government has endorsed the Public Health Responsibility Deal as a strategy to get the alcohol industry to commit to reducing alcohol-related harm. In addition, various programs have also been developed to treat alcoholism, many of which entail such key stages as detoxification, rehabilitation, and maintenance.
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