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It's the drink talking

Karen Gold worries about the current emphasis on alcohol concern

Guinness, it seems, is no longer good for you. We are surrounded by dire warnings about the dangers of drink. The government white paper, The Health of the Nation, gives tips about 'sensible drinking' and advises that: 'Too much alcohol can make you overweight, be bad for your circulation and your liver and cause problems at work and with family and friends.'

There is no doubt that chronic and severe alcohol abuse has long been connected with physical illnesses. Sclerosis of the liver, heart disease, chronic gastritis, anaemia, vitamin deficiencies, visual disorders and pancreatitis are all more prevalent in people prone to hit the bottle.

Women are thought to be more at risk from alcohol abuse than men. Since women have a lower percentage of body water, the alcohol they consume is less diluted. Evidence also suggests that women suffer more from the psychological effects of alcohol dependence, confusion, intellectual impairment and loss of control. It is also thought that alcohol stays longer in the body at certain stages of the menstrual cycle, with possible destructive consequences for the liver.

Men, we are told, can safely drink no more than 21 units a week, women are meant to stick to less than 14 units. One unit is equivalent to half a pint of lager, a small glass of wine or a single measure of spirits. Which means that a man who drinks a couple of pints a day is supposed to have an alcohol problem, as is a woman who regularly has two glasses of wine with her dinner.

But does the fact that alcohol in large quantities is bad for you really mean that it is also dangerous in moderation?

The logic behind the 'watch your units' theory goes as follows. If you drink 50 units of alcohol a week, you are at risk of liver problems; so if you drink half that quantity, you are half as likely to suffer the same problems. That seems a dubious proposition. Apply the same argument to smoking. If we smoke 40 cigarettes a day, it will affect our health, making us more breathless, more prone to lung problems and so on. Yet there is no statistical evidence that four cigarettes a day will present 10 per cent of these problems, or indeed any problem at all.

Just about anything 'in excess' is harmful. Excessive exercise can cause all sorts of muscular and joint problems, even temporary infertility in women. Excessive dieting would lead to muscle wastage and starvation. Yet we are told that dieting and exercise in moderation are beneficial.

Curiously, a recent study at the Bristol Royal Infirmary concluded that moderate drinking can even reduce the risk of heart disease. It found that female moderate drinkers had lower levels of bad cholesterol and higher levels of 'good' cholesterol than non-drinkers.

There is a real danger that now that drinking alcohol has been identified and accepted as a dangerous practice it can become a scapegoat for all kinds of health and social problems.

Fetal Alcohol Syndrome (FAS) is a case in point. Pregnant women are now routinely warned to cut out drinking altogether to prevent the risks of alcohol damage to the developing fetus. Fetal Alcohol Syndrome is a complex of birth defects that occur in some babies born to women who are apparently heavy drinkers. It is said to be present when one feature from each of the following categories is present: pre-natal and post-natal growth retardation; central nervous system dysfunction and major organ system malformation, abnormal features of the face and head. The name was coined in the USA where one in a thousand babies are said to be affected.

FAS is now used to guilt-trip every mother who enjoys an occasional drink. One leading gynaecologist recently told a women's magazine that women had come to him seeking an abortion because they were so concerned that they had indulged in a drinking session early in their pregnancy. Yet symptoms which are said to constitute Fetal Alcohol Syndrome may not even be due to drinking.

A study of births to mothers in the south east of Scotland in the early eighties showed that 'moderate' weekly consumption of alcohol was not associated with 'obvious harm'. When the role of alcohol was examined in combination with other variables, it was concluded that the impact of maternal drinking on birth abnormalities was only very minor indeed. Maternal age, social class, previous obstetric history, tobacco, drug use and diet emerged as having a far greater influence. American studies support these conclusions. In the USA, Fetal Alcohol Syndrome is found mainly in children born to women who are deprived in various ways, with particularly poor nutritional status.

Broader social conditions have a key role to play in relation to many medical conditions. If you live in a damp flat on £40 a week, living on peanut butter because it's all you can afford, you are more likely to develop frequent colds and chest infections than if you live in Hampstead and earn £500 a week. Yet in these circumstances you would expect the poverty and general living conditions to be blamed for your illness - not the peanut butter.

Nobody would argue that heavy drinking is to be recommended. But it's important to get the 'alcohol concern' issue into perspective. Most of us drink very little. The health editors of women's magazines can rest assured that their readers are not out getting legless and destroying their livers and lives. An estimated 93 per cent of women and 78 per cent of men drink less than the government's 'recommended sensible drinking' levels. Britain does not even rate in the top 20 of alcohol consuming nations.

The current round of alcohol concern is one more attempt to create an obsession with individual health. If you suffer liver problems - it's because you drink too much. If you have heart problems - it's because you eat the wrong food. If you get cervical cancer - it's because you slept around. If your baby has problems - it's because you took insufficient care when you were pregnant.

Gone are the days when you were considered plain unlucky if you 'came down with something'. These days it is the sins of gluttony, drunkenness, sloth and promiscuity coming back to haunt you. We live in a slump-ridden society that provides us with a steadily deteriorating standard of healthcare, and then tells us to blame ourselves when we fall ill. It's enough to drive anybody to drink.
Reproduced from Living Marxism issue 47, September 1992

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