From wine o'clock to the infamous "one for the road", there are countless opportunities for us to booze on a regular basis.

But have you crossed the line from a "harmless" drink to dependency? And would you be able to spot the signs?

According to the Daily Mail, experts are warning that millions of us are overdoing it - and it could be more difficult to cut down or quit than we think.

Not only can heavy drinking devastate our livers, bones and brain cells, it also increases the risk of depression, divorce and redundancy.


• Scroll down to take the quiz

Indeed, the Royal College of Psychiatrists has stated that alcohol causes much more harm than illegal drugs like heroin and cannabis. "It is a tranquilizer, it is addictive, and is the cause of many hospital admissions for physical illnesses and accidents," experts there warn.

What's even more concerning is that many of us vastly underestimate how much we drink - and the effect it has on us.

"Heavy drinking has become normalised - alcohol is ingrained in so many areas of our lives and there is a lot of pressure to drink," says Dr Iqbal Mohiuddin, a consultant psychiatrist with a special interest in addictions and clinical lead at Serena House a medical detox and treatment center in London's Harley Street.

"Many people I see either don't realize or are in denial about their alcohol consumption - I often suspect it's double what people admit to.

"Part of the problem is many of us have no idea how many units are in various drinks - its nearly always more than you think - and can vary widely even among different types of wine and beers."

But when do your long lunches, after-work drinks or that "decompression" glass of wine at home become a cause for concern?

"Not everyone who drinks heavily will become dependent, or an alcoholic," explains Dr Mohiuddin. "But some of us are definitely predisposed to it.

"It's a mixture of genes and environment. Many people with a drinking problem have a family history of it - a parent, aunt/uncle, a grandparent. It doesn't mean everyone in a family will suffer.

"However, if the environment is there - perhaps a job with a heavy drinking culture - a problem can develop."

"It's easy for many people to get through a bottle of wine a night, and over time, this can creep steadily upwards, to two or even three," says Dr Mohiuddin.

"In my experience, a lot of heavy drinkers - both men and women - steadily move onto harder things.

"They may start with beer or perhaps wine and then progress on to heavy spirits such as vodka or whiskey.

"However it's not necessarily what you are drinking or where, it's the amount and the effect it's having on your life (see below). Some people will be able to cut down, while others will try and then realise they can't - a sign of dependence.

"There is a significant proportion of heavy drinkers who don't realise or are in denial that they could be functioning - albeit progressively less functioning - alcoholics."


"The main problem is that it's quite easy for some people to slip into drinking regularly - and the soothing effect it gives you becomes like using a tranquilizing medication such as diazepam," explains Dr Mohiuddin.

"But over time, the benefits wear off quicker and you need more alcohol to get the same effect."

"Many people associate being an alcoholic with drinking in the morning, the old adage of 'vodka on the cornflakes' or sitting on a park bench with a can of cider - but there are many more subtle signs of dependence and/or alcoholism."

The Royal College of Psychiatrists has produced a list of classic symptoms that show your drinking has stepped up to a worrying level. These include:

You regularly use alcohol to cope with anger, frustration, anxiety or depression - instead of choosing to have a drink, you feel you have to have it.

You regularly use alcohol to feel confident

Your drinking affects your relationships with other people - they may tell you that, when you drink, you become gloomy or aggressive. Or, people around/with you look embarrassed or uncomfortable when you are drinking.

You stop doing other things to spend more time drinking - these other things become less important to you than alcohol.

You carry on drinking even though you can see it is interfering with your work, family and relationships.

You hide the amount you drink from friends and family.

Your drinking makes you feel disgusted, angry, or suicidal - but you carry on in spite of the problems it causes

You start to drink earlier and earlier in the day and/or need to drink more and more to feel good/get the same effect.

You start to feel shaky and anxious the morning after drinking the night before.

You get "memory blanks" where you can't remember what happened for a period of hours or even days.


One screening tool used widely by medical professionals is the AUDIT (Alcohol Use Disorders Identification Tests). Developed in collaboration with the World Health Organisation, the 10-question test is considered to be the gold standard in helping to determine if someone has alcohol abuse problems.

To complete it, answer each question and note down the corresponding score.



You are within the sensible drinking range and have a low risk of alcohol-related problems.

Over 8: Indicate harmful or hazardous drinking.

8-15: Medium level of risk. Drinking at your current level puts you at risk of developing problems with your health and life in general, such as work and relationships. Consider cutting down (see below for tips).

16-19: Higher risk of complications from alcohol. Cutting back on your own may be difficult at this level, as you may be dependent, so you may need professional help from your GP and/or a counsellor.

20 and over: Possible dependence. Your drinking is already causing you problems, and you could very well be dependent. You should definitely consider stopping gradually or at least reduce your drinking. You should seek professional help to ascertain the level of your dependence and the safest way to withdraw from alcohol.

Severe dependence may need medically assisted withdrawal, or detox, in a hospital or a specialist clinic. This is due to the likelihood of severe alcohol withdrawal symptoms in the first 48 hours needing specialist treatment.


In general, a score of 1 or more on Question 2 or Question 3 indicates consumption at a hazardous level.

Points scored above 0 on questions 4-6 (especially weekly or daily symptoms) imply the presence or the beginning of alcohol dependence.

Points scored on questions 7-10 indicate alcohol-related harm is already being experienced.


Set yourself a target to reduce the amount of alcohol you drink.

Avoid high-risk drinking situations and work out other things you can do instead of drinking.

Opt for lower-strength options, such as 4 per cent beers or 10 per cent wines.

Involve your partner or a friend who can help agree a goal and keep track of your progress.


If you are drinking heavily, do not stop suddenly - see your GP or another medical professional, says Dr Mohiuddin.

"Some people manage to stop suddenly without any problems, but others may have withdrawal symptoms such as nausea, vomiting, shakiness, sweating, increasing anxiety, headache and even hallucinations. In fact, going 'cold turkey' if you're a very heavy drinker is highly risky and could be fatal. Hence, it is not recommended."

And if you fear you can't stop or cut down on your own, there are many specialist alcohol workers who can help. Your GP should be able to tell you about services available in your area.

Some people, especially those with a possible or real dependence, will need more comprehensive help and treatment. For example, says Dr Mohiuddin, if you've been using alcohol as a de-stressor, or to try and block out your worries, therapy can help you address these issues and find other, non-destructive ways of dealing with them.

In the case of alcohol and certain drugs a medical detox is essential - there can be serious health implications linked to sudden withdrawal.

There are also a wide range of tests to help staff ascertain the damage done to the body by drugs and alcohol, allowing patients to get tailored treatment plans that suit their needs with the help if therapists, doctors and a full nursing team.

"Another option is to attend a support group for drinking problems, such as Alcoholics Anonymous, where there are other people in your situation who understand and can give you support," says Dr Mohiuddin.

"There are meetings all over the world and they're free to attend."

To add on the bottom of any suicide or depression stories:

Where to get help:

Alcohol Drug Helpline: 0800 787 797 and free txt service (txt 8681)

If it is an emergency and you feel like you or someone else is at risk, call 111.