In her bedroom in Clacton-on-Sea, on the Essex coast, 16-year-old Somer Lawrence perfects her Tim Burton-themed Halloween costume. By the time the night is done, Lawrence will have downed a 70cl bottle of vodka. The Corpse Bride is drunk.
In the Cotswolds village of Wotton-under-Edge, 29-year-old Lee Peters manages to play the piano in his flat, despite having consumed an entire bottle of gin.
In Malia, Crete, 18-year-old Stuart Marshall celebrates the end of his lads’ holiday by drinking five half-pints of spirits.
Meanwhile, 23-year-old Rebecca Charles enjoys the sunshine with friends at the beach. They bring cider, beer and wine. By nightfall, she will have drunk 35 units of alcohol.
What all these stories have in common is what happened next. Charles woke up at 5am and was sick straight away. Marshall’s friends found him curled up in a ball. Lawrence was rushed to hospital. Peters was carried out of his house on a stretcher to a waiting ambulance after a neighbour called 999.
They had all developed pancreatitis, a disease brought on by excessive alcohol consumption that can turn one night in the pub, or a day at the beach, into a life-altering illness – it can often be fatal.
“You can get pancreatitis after a single binge,” says Dr Sarah Jarvis of the campaign group Drinkaware, although she explains it’s more common to develop it after repeated binges.
The pancreas, a small organ behind the stomach, plays an essential role in digestion. Pancreatitis occurs when it becomes inflamed, usually as a result of too much alcohol. Individual binges can lead to flare-ups of acute pancreatitis, from which the patient can recover after a few weeks. But continued drinking can turn this into chronic pancreatitis, meaning that the pancreas can be permanently damaged, and may fail entirely. Between 70% and 80% of cases of chronic pancreatitis are caused by alcohol abuse, according to the National Institute for Health and Care Excellence (Nice).
After the sudden death of the Swedish DJ Avicii, pancreatitis is becoming better known. He had been afflicted by the condition after abusing alcohol during exhausting world tours and, after his death, his family issued a statement saying “he could not go on any longer”. His death has forced us to pay attention to a condition we would perhaps rather ignore.
In the UK in 2016, 7,327 people died of a range of conditions that could be directly attributed to alcohol abuse. While the number of direct alcohol-related deaths have been relatively constant since 2013, they are higher than they were in 2001, when 5,701 people died as a direct result of alcohol abuse. English alcohol-related hospital admissions are at a record high – up two-thirds from a decade ago – while spending on alcohol support services has been cut.
Binge drinking – defined as drinking more than six units of alcohol in one go – is so normalised in the UK that the head of NHS England, Simon Stevens, has said hospitals are becoming the “national hangover service”. But it is easy to be in denial; evidence shows that people consistently underestimate how much they consume, particularly when drinking at home.
Peters, Lawrence and Charles all now have chronic pancreatitis. “In the town I lived in, drinking was a massive part of the culture,” says Charles, who is now 31. “Everybody else was doing it. But I wasn’t getting up in the morning and drinking – the way people imagine alcoholics behave. I was just too much of a party girl.”
“I was stupid and young,” says Lawrence, who is now 20. Although she went to hospital several times after the incident at her Halloween party, Lawrence continued drinking, and developed chronic pancreatitis at 17. She began drinking aged 14 because it eased her anxiety and depression. “I’d turn to alcohol as a coping mechanism,” she says. “I’d always be the one at the party who’d had the most to drink. It gave me liquid confidence.”
She isn’t alone. “Wine had this lovely, numbing quality to it,” Peters says. Now aged 34, he began binge drinking after being violently assaulted at 16. “It was absolutely a response to trauma. It was the self-medication tool I used when things got stressful.”
Alcohol abuse is often linked to mental ill health. “Drug and alcohol use can lead to mental health problems, and vice versa,” says Dr Cyrus Abbasian, a consultant psychiatrist at St George’s, University of London, who specialises in mental health and substance abuse. He explains that alcohol is an anxiolytic, meaning that it has a sedative effect. “You’re self-medicating your mental health condition,” he says. “Alcohol leads to short-term relief of anxiety, but it doesn’t treat the underlying problem.” Over time, a person may develop alcohol dependency, alongside their existing, untreated mental health issues.
In a difficult relationship, and with postnatal depression after the birth of her daughter, Charles fell in with a party-loving crowd. “You think the alcohol is making things better,” she says. “But it’s actually making things worse.”
Some argue that minimum-unit pricing, implemented in Scotland earlier this month, would tackle the problem of at-home drinkers who take advantage of cheap supermarket offers. “Minimum unit pricing is an excellent idea,” Abbasian says, “because it’s an evidence-based public health intervention. With any drug, you need to limit supply and increase price to reduce use. If something is cheaply and easily available, people tend to use it.” In some instances, supermarkets had been selling alcoholic drinks more cheaply than the same quantity of water.
But would minimum-unit pricing have deterred Lawrence, who would drink a bottle of vodka because she was too young to get into bars? Possibly. “When you’re young, you can’t get into pubs, so you get a bottle of vodka for seven or eight pounds,” she says. “I don’t know why we thought it was necessary to be drinking spirits. Why were we drinking vodka at 15 or 16? It’s what everybody did, so it’s what I did.”
We all have friends who push things too far. They’re the ones with cracked phone screens and jeroboam-sized hangovers on Sunday mornings. Their anecdotes of drunken misadventures make you laugh, but also make you queasy.
Or maybe you’re that friend. “People drink so much because it’s our culture,” adds Lawrence. “The sun comes out and you go to a beer garden. It’s what we do. Everything is just an excuse to drink. Life is hard for everybody, so it’s nice to have an escape.”
But Jarvis believes if people were aware of the health consequences of binge drinking, they would drink less. “Most people have no idea that you may be doing yourself damage now that can last a lifetime.”
Here’s something to make binge-drinkers pause mid-sip: pancreatitis hurts. “It’s like the worst stomach ache you’ve ever had,” Marshall says.
“The pain is incredible,” says Charles.
When your pancreas begins to fail, the pain never goes away. After her pancreatitis turned chronic, Charles’s pancreas stopped producing the enzymes she needed to digest food, causing her to become malnourished. Her weight dropped to 29kg (63lb). She can’t work full-time or look after her 10-year-old daughter. On good days, she showers and does laundry. The bad days are dark. “I think: ‘I wish I could go to sleep and never wake up.’”
Life becomes small. Drinking buddies melt away faster than ice in a spritzer on a warm summer day. “It’s lonely,” Charles says, “when you’re surrounded by people who party the whole time and you don’t want to be a part of that any more. It’s like they don’t want to know you.”
Peters also lives alone. A kindly neighbour checks up on him. “She has dug me out of some dark places,” he says. When he goes out, his emaciated frame attracts pitying looks. “It’s difficult because I used to be a good-looking chap with a decent body that people would comment on.” But not being able to work takes the biggest toll. “I feel quite ashamed by it,” Peters, a former accountant, says. “Having to go from being fiercely independent to being dependent on the state doesn’t sit well with me.”
After we talk on the phone, Peters emails me a list of the 14 medicines he takes daily, and the 25 symptoms he experiences. (“Constant, debilitating pain … regular sepsis.”) “I can sense the grim reaper approaching,” Peters writes, before signing off with a cheerful reminder not to work too hard.
How does he bear it? Keeping his mind occupied helps. So do antidepressants. Knowing that he caused his disease, Peters says, “is difficult to cope with”. After his first bout of pancreatitis, Peters kept drinking. “It’s difficult to explain why,” he says, pointing to the trauma of his early attack as a partial explanation. He also felt that doctors were possibly exaggerating the severity of his condition, out of overcautiousness.
“It’s hard to explain what makes people unable to stop drinking,” says Abbasian. “With some patients, I have a conversation with them, and they say: ‘Yes, doctor, if I drink, I’ll have pancreatitis and I’ll die.’ But they don’t find other things as pleasurable and, because of their underlying anxiety disorder, they continue to self-medicate.”
Peters says: “I have tried very hard to come up with a rational reason as to why I was so neglectful and blase about my health, but there’s nothing I can come up with that will make sense to anybody. I’ve been very foolish. I made those decisions and I’m aware I made them. I thought: ‘Hell, sod it, I’ll think about it tomorrow.’ But tomorrow catches up with you. It caught up with me, big time.”
Chronic pancreatitis has no cure. Many people with the condition go on to develop pancreatic cancer. Surgical procedures are sometimes necessary. Charles’s gallbladder has been removed and doctors have performed a coeliac plexus block on her – an injection made using local anaesthetic to treat severe abdominal pain. Peters has advanced-stage chronic pancreatitis and takes prescription painkillers, including morphine, as well as enzyme replacement drugs, anti-sickness medication, anti-seizure medications, proton-pump inhibitors to reduce the acid in his stomach, anti-constipation tablets and meal-replacement drinks.
Despite all these interventions, about one in five people with pancreatitis will die within five years of their diagnosis. “I have a terminal prognosis,” Peters says quietly. “I have gone downhill quite rapidly in the last six months. Lots of treatments don’t work any more. I’m literally wasting away.” A few days after we speak, Peters experiences projectile vomiting, a fever and excruciating pain and is admitted to hospital with an acute flare-up of pancreatitis.
It’s easy to be judgmental about Peters’ situation. You may think: why didn’t he just stop drinking when his doctors warned him? But trauma makes people behave irrationally. Rape survivors become promiscuous, intelligent people ignore medical advice, the children of alcoholics binge-drink.
And even if you have never experienced trauma yourself, not drinking in our culture is hard. “My friends are drunk all the time and they’ll be in the club buying me drinks,” Lawrence says. “They don’t realise the severity of my illness because they don’t have to live with it.” Charles gets angry when she sees people being peer-pressured. “People will taunt someone who isn’t drinking,” she says. “It’s like: you’re a weirdo if you don’t drink.”
There are signs that Britain’s relationship with alcohol is improving, though. “We are slowly turning the tide,” Jarvis says. “Young people are drinking less.” A fifth of under-25s are teetotal, and today’s teens drink less than ever before, with only around 17% of 8-15-year-olds admitting to drinking alcohol – a change that has been attributed by some to the rise of social media. But only a sea-change will transform Britain’s binge-drinking culture. We have the second-highest levels of binge drinking in Europe, according to the Norwegian University of Science and Technology, with 7.8 million people a year admitting to bingeing on their heaviest drinking day.
“Humans are social animals, but we don’t like to be around a lot of people we’re not familiar with,” Abbasian says. “Socialising, going out on a Saturday, is anxiety-provoking. When you go to a bar or club, you drink to reduce anxiety levels so you can drink and talk to strangers. Alcohol disinhibits you.”
Forced sobriety at least helps you to see things anew, in a clear-eyed way. “I notice everything on nights out – I’m not blind to things any more,” Marshall says. “Even with some of my friends, I think: you turn into a wanker when you’re drunk.”
Abbasian says: “If alcohol were a relatively new drug introduced into our society, and not as socially acceptable, it would be a class A drug, similar to heroin or cocaine.” He urges those who regularly binge drink to seek assistance, before it’s too late. “There’s a lot of stigma and denial. A major first step is to accept you have a problem and not be ashamed getting help and treatment.”
All the people I spoke to wanted me to share their experiences. In fact, many of them reached out to me, desperate to warn others.
“My message is: be careful,” Charles says. “Just because you’re young and you only go on weekend benders, and don’t drink every day, doesn’t mean you’re invincible. Because you’re not.”
And the next time you drop a crate of sticky bottles off at a recycling bank, Peters would ask that you remember him and reconsider your drinking. “If just one person can read this and think that, it would be enough for me,” he says. “Just to make a difference to that person and their family. It would be my whole life’s work complete for me. I would be over the moon.”
Drinkaware is an independent UK charity working to reduce alcohol misuse and harm. Further information: drinkaware.co.uk
