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Changing Scotland's relationship with alcohol: a discussion paper on our strategic approach



Alcohol by Volume ( ABV): is an indication of how much pure alcohol (expressed as a percentage of total volume) is included in an alcoholic beverage.

Alcohol misuse: Often based on value judgements, but objectively it can refer to heavy consumption of alcohol on an individual occasion or the persistent use of alcohol above sensible drinking guidelines.

Alcohol dependence: A person with alcohol dependence may be characterised by some or all of the following: a strong desire to drink, difficulties controlling their use of alcohol, persistent use of alcohol despite being aware of the harmful effects, a preoccupation with alcohol, an increased tolerance for alcohol, and signs of withdrawal when without alcohol. The problems associated with alcohol dependence are wide ranging, and can be physical, psychological, and social.

Alcohol problems: This refers to a whole spectrum of harm to work, relationships, physical or mental health caused by alcohol misuse.

Binge drinking: The terms 'binge drinking' or 'binge' have no standard definition, although they are generally understood to mean drinking too much alcohol over a short period of time. The Scottish Health Survey has defined a 'binge' as drinking over twice the recommended guidelines for daily drinking. This equates to drinking over 6 units a day for women or over 8 units a day for men. In reality, many binge drinkers are drinking substantially more than this level.

Blood alcohol concentration: Blood alcohol concentration ( BAC) is the concentration of alcohol in blood. It is measured either as a percentage by mass, by mass per volume, or a combination. In the United Kingdom, BAC is reported as milligrams of alcohol per 100 millilitres of blood. The current legal drink driving limit is 80mg per 100ml.

Brief intervention: A short, evidence-based, structured conversation with a client/patient that seeks in a non-confrontational way, to motivate and support the client/patient to think about and/or plan behaviour change.

Drunkenness: A state where an individual has drunk alcohol to the extent that it impairs significantly functions such as speech, thinking, or ability to walk or drive.

Excessive drinking: There is no standard definition of excessive drinking. It can be described as drinking at levels in excess of recommended sensible drinking guidelines.

Problematic drinking: Drinking at levels which cause physical or psychological harm to the individual, or which have adverse social consequences.

Problem drinkers: Can be identified using the CAGE questionnaire. CAGE is a validated screening tool named after its four questions (attempts to Cut back on drinking, being Annoyed at criticisms about drinking, feeling Guilty about drinking, and using alcohol as an Eye-opener). Two or more positive statements on CAGE is taken as an indicator of potential problematic drinking.

Sensible drinking guidelines: Sensible drinking is drinking in a way that is unlikely to cause individuals or others significant risk of harm. UK Government sensible drinking guidelines recommend that:

  • adult women should not regularly drink more than 2-3 units of alcohol a day;
  • adult men should not regularly drink more than 3-4 units of alcohol a day; and
  • pregnant women or women trying to conceive should avoid drinking alcohol.

UK sensible drinking guidelines were recommended by an expert government group and were based on an extensive review of the evidence of the effects of alcohol on health. 77 The risk of harm from drinking above sensible levels increases the more alcohol is drunk, and the more often an individual drinks over these levels. Sensible drinking also involves a personal assessment of the particular risks and responsibilities of drinking at the time.

Unit: Alcoholic drinks can be described in terms of units. In the UK, a unit corresponds to 8 grams or 10 millilitres (ml) of ethanol (pure alcohol). The number of units in a given quantity of alcoholic drink can be calculated by strength of alcohol (% ABV) x volume (millilitres) divided by 1000. One unit roughly equates to half a pint of ordinary strength beer, lager, or cider (3-4% ABV), or a small pub measure (25ml) of spirits (40% ABV). There are approximately one and a half units of alcohol in a small glass (125ml) of ordinary strength wine (12% ABV).