They say alcohol makes you tell the truth. But when it comes to admitting to a doctor how much they drink, it seems more than a third of them cross their fingers behind their backs.
A recent study showed that 38% of patients lied to health care professionals about their drinking habits. Two in five people even lie about how much they drink when filling out medical forms.
Meanwhile, 27% made their own decisions about how much they drank simply because they didn’t know how much they drank. But with the NHS recommending 14 drinks a week, most of us drinkers can easily finish it off on a social weekend. A pint of strong beer contains three units, while a medium 175ml glass of Prosecco contains more than two units.
Here, two healthcare professionals reveal whether this is a case wine truth With patients in the clinic…
Doctor: ‘I can tell when a patient is likely to lie’
Dr Nikki Ramskill is a GP in Milton Keynes and founder of Women’s Health Doctors Clinic. she can be in Documented website
John Lawrence
A few years ago, I worked for a private health company doing healthcare assessments, and I had to ask patients about their lifestyles – including how much alcohol they drank. I noticed that about 70% of people said they didn’t drink at all.
I found this so confusing that I started to worry about my drinking habits. I didn’t drink too much, but I even asked a few co-workers: “Is it me? Did I drink too much? Because surely I can’t be the minority here?”
I realized these patients were probably lying.
I totally threw my hands up. I’m also one of those people who will exaggerate the truth slightly and say “only 14 units per week” when in reality, sometimes, it’s more.
Because, let’s face it, when you go to see your GP, you don’t want to be sitting there discussing your drinking habits. No one wants to be judged. Like the patient is overweight. The last thing they want to talk about is losing a few pounds, they just want to talk about their specific medical issues.
Today, in my GP surgeries and clinics, I find that some patients will not blatantly lie to me about the amount of alcohol they drink, but tend to downplay the figure, or only talk “honestly” about their “14 units a week”.
But I can tell when a patient might be lying because the patient, usually the woman, will giggle nervously. Men tend to be more matter-of-fact and admit that they are not telling the truth, saying, “Everyone does it, it’s normal.”
However, sometimes “misjudgment” is simply due to a lack of knowledge. I asked patients to break down these 14 units cup by cup and found that they drank approximately 14 units pint a week or “two to three bottles of prosecco a week.” Then I told them it was actually more like 28 units. You can see their surprise.
The pandemic has also led to an increase in alcohol consumption. Six years on, I’ve noticed that some patients now admit to me that, yes, they do drink, “but not as much as I did during lockdown”.
You can’t really tell if someone is drinking too much just by looking at them. But when I do a liver test or a complete blood count, obviously if some of the markers are a little “off,” I can spot them.
Sometimes this can be the wake-up call they need. If I tell them there’s something wrong with their liver or their red blood cells are a little swollen, you sometimes get a little more honesty – “Oh, yeah, I probably drank more than I should have.” Sometimes you still get outright denial: “No, no, there must be something else going on.” As a doctor, you have to be careful about how you approach the issue because the last thing you want is for the patient to feel judged. You are here to help them.
Of course, occasionally I’ll see a patient and it’s obvious they’ve been drinking that day. Often, their partner makes the appointment and stays with them, worrying about them. Unfortunately, this depends on the patient admitting there is a real problem and being willing to seek help – which, unfortunately, is not always the case.
We probably all drink more than people in any other country, but we just don’t like to admit it. The good news is that I don’t see too many people having serious health problems from alcohol these days.
Dentist: ‘You don’t have to wait for them to open their mouth’
Dr Tarun Nagpal is a dentist and specialist oral surgeon working in private practice and hospitals in London, Surrey, Kent and Oxford
Jeff Gilbert
I would say maybe a third or even half of my patients underestimate how much they drink. While I would never say they outright lied, there was definitely some generous “rounding” going on.
Men tend to underestimate more than women, not realizing that “a pint here” and “a pint there” can quickly add up. But again, women who say they just had a glass of “wine” don’t realize that a small glass of wine is a unit.
I’ve noticed that most of my Gen Z patients don’t drink at all – they all wear smart watches that tell me their heart rate before they even sit in a chair, and I measure their heart rate. They are so in tune with their bodies and health.
Elderly patients who have retired drink far more than they realize. They have time to party and drink with friends, or drink in their free time. When you add up the amount of alcohol they drink, they’re usually shocked.
I don’t see this very often, but if the patient has had a lot to drink, I can smell the alcohol almost as soon as they walk in – you don’t have to wait for them to open their mouth.
But even if they didn’t drink that day, dentists can usually tell the difference between drinkers and non-drinkers. People who drink regularly tend to experience dry mouth, affected areas of healing, and more bleeding, all of which are noticeable. People who drink alcohol regularly tend to grind their teeth (“grind their teeth”) more frequently because alcohol disrupts sleep. So we notice wrinkles on the inside of the cheeks and even on the tongue.
Drinkers’ teeth can also experience more acid damage from carbonated wine or champagne, or staining from the tannins in red wine. In the short term, alcohol has little effect on the mouth other than drying. But in the long run, it can cause damage. While alcohol alone is not a major driver of the increase in oral cancer, when combined with other bad habits such as smoking or chewing tobacco, the risk of cancer roughly doubles. The first sign is usually an ulcer that doesn’t heal within two to three weeks, and I always recommend people get checked out by a dentist rather than a doctor.
I have never turned away a drunk patient. I have specialized in treating many patients with anxiety over the past eight years, but I have always made it clear that a little “Dutch courage” doesn’t help. If anything, a glass of whiskey may actually counteract the sedative effects of the medication we give, so it’s very important that they don’t try to self-medicate before treatment.
But I never judge patients and their drinking. I just want them to be honest so I can care for and treat them right.
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