Many people jokingly say they "need a drink" after a stressful day. But for some, a few seemingly harmless glasses of wine after work can turn into a stress-relieving habit that can be hard to break.
If you envisage someone with a drink problem, you might picture them reaching for the bottle as soon as they wake up in the morning, or getting the shakes if they go without. The truth though, is that dependency on alcohol comes in many different forms and affects more people than you might think.
It is thought that more than two million Brits could be mildly reliant on alcohol, with growing numbers now seeking treatment for drink problems.
The National Institute for Health and Care Excellence (NICE) this week formally recommended the use of a new pill called Selincro (nalmefene), which is designed for those who feel they need help to cut down and reduces the desire for alcohol. We've been able to offer it at the Pharmacy2U Online Doctor Service for some time, but patients will now be able to access it via the NHS too.
The pill works by blocking the brain's opioid receptors to reduce the pleasant effects of alcohol. This is combined with a programme of self-help to encourage change in drinking behaviour. It's intended for those who regularly drink heavily, but are not at a stage where they have physical withdrawal symptoms.
How much is too much?
As a GP, I frequently need to ask patients how much they drink, but it often tends to be a tough one to answer. To give you some idea of how much you usually drink in terms of units of alcohol, a single measure (25mm) of spirits is one unit, a regular glass of wine (175mm) is two, a pint of strong beer is about three and a full bottle of wine could rack up as many as ten.
It quickly mounts up, particularly when you bear in mind that the NHS recommends not regularly exceeding three to four units a day for men and two to three for women. In fact, a man who consumes more than 50 units a week, or 35 units for a woman, would likely be considered as a 'high risk' drinker.
Alcohol generally tends to be a socially acceptable and enjoyable part of life. A relaxing drink while you unwind can feel like a much needed treat, but for those who regularly drink too much, it's a relationship that can easily turn sour.
According to a report by Public Health England, alcohol is the leading risk factor for preventable death in 15 to 49 year olds, with nine million British adults believed to drink at levels which increase their risk of harm.
It can impact your general wellbeing and health, but can also have some daunting long term effects - including cirrhosis of the liver, damage to the brain and increased risk of developing certain types of cancers. The Health & Social Care Information Centre (HSCIS) revealed that more than a million hospital admissions were linked to alcohol last year.
Recognising there's a problem
Forget stereotypes. Anyone who drinks can develop an unhealthy relationship with alcohol. It's sometimes like a silent assassin, playing havoc with your life before you recognise the source of the problem. It can have a knock-on effect in terms your health, as well as work performance and personal relationships.
I've spoken to many patients who have fallen into a pattern of habitual heavy drinking, but felt they had it under control because they only drank in the evenings. Often, it wasn't until a family member or friend raised the issue that they decided to seek help.
Accepting your drinking habits are having a negative effect can therefore be one of the biggest challenges.