Are you just a social drinker or are you now an alcoholic?
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The image of alcoholics as broken-down old wrecks drunk on a park bench in the middle of the day is dangerously outmoded, campaigners said in the wake of Charles Kennedy's admission.
Problem drinking comes in many forms and large numbers of people continue to hold down jobs and families despite habitually exceeding safe drinking levels. In England alone, a recent report from the Department of Health found that eight million drinkers were currently at risk, with 38 per cent of men and 16 per cent of women suffering some form of alcohol-use disorder. In Scotland where the problem is worse, two in five men and a quarter of women regularly exceed safe levels.
The danger signs are varied, ranging from the obvious - regularly getting drunk, losing a job through drunkenness - to the more subtle: an increasing tendency to drink alone or persistent feelings of guilt after drinking. The DoH recommends that men should consume no more than four units of alcohol a day - the equivalent of three to four glasses of wine or two pints of standard beer. Women should limit their intake to between two and three units.
"There are different types of problem drinking," said Helen Symons of Alcohol Concern. "There is dependency - the need to have alcohol to get through day-to-day life physically. Then there is psychological dependency when someone needs alcohol to cope with the everyday issues of life."
The symptoms vary a lot, she said. And even among problem drinkers there are two further categories. Hazardous drinkers regularly exceed safe alcohol limits and run the risk of experiencing health problems. Harmful drinkers consume significantly more than the recommended intake and are likely to be suffering negative health effects. It is estimated that 1.1 million people in England alone fit into one of these two categories.
When it comes to treatment, the statistics are more disquieting. According to Ms Symons: "People tend to think there are two options. The first is to do what the celebrities do and check into an expensive private clinic. The other is to follow the Alcoholic Anonymous 12-Step Programme." However, the vast majority of people who seek help turn instead to the NHS and only one in 18 problem drinkers ever receives any help.
There is also a pernicious post-code lottery in alcohol treatment. In the North-east for example, only one in 102 are treated. For those lucky enough to receive help, the first step towards recovery is normally a visit to the GP and a referral to the alcohol treatment service. Counselling is the frontline treatment, either in a group session, one on one or with friends and family. Many require more than one session and regularly return over the years for more help. Some quit drinking completely while others learn to moderate their behaviour and cut down, able to continue drinking sociably. There are no figures on how successful NHS treatment is.
Professor Roger Williams, the liver specialist who treated the former footballer George Best, believes that will power is the key. He believes that you have got to see what it is that makes you drink, be determined not to drink and know the harm it does.
"When people realise just how harmful it is, that is the biggest factor in my experience that makes them stop, when they know how much they are damaging themselves," he said.
Support of loved ones also plays a vital role. "It is very important to have support of colleagues, of families, husbands, wives, children - all this matters, the support you get. But, at the end of the day, it is the person's own decision whether they drink or not," Professor Williams said.
Danger signs
* Getting drunk regularly: Not able to enjoy life without a drink
* Can't stop: Can affect people who drink only now and agin
* Increasing tolerance for drink
* Losing interest in hobbies
* Letting people down: Drink more important than friends
* Drinking alone: A tipping point for problem drinkers
* Finding excuses to drink
* Smelling of alcohol by day
* Guilt: Ashamed of drinking
* Shaking
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