Context

In the UK, it is estimated that 24% of adults drink in a hazardous or harmful way[12] (for definitions of harmful and hazardous drinking see terms used in this guideline). Levels of self-reported hazardous and harmful drinking are lowest in the central and eastern regions of England (21–24% of men and 10–14% of women). They are highest in the North East, North West and Yorkshire and Humber (26–28% of men, 16–18% of women)[13]. Hazardous and harmful drinking are commonly encountered among hospital attendees; approximately 20% of patients admitted to hospital for illnesses unrelated to alcohol are drinking at potentially hazardous levels[14].

Continued hazardous and harmful drinking can result in alcohol dependence. An abrupt reduction in alcohol intake in a person who has been drinking excessively for a prolonged period of time may result in the development of an alcohol withdrawal syndrome. In addition, persistent drinking at hazardous and harmful levels can result in damage to almost every organ or system of the body.

This guideline covers key areas in the investigation and management of the following alcohol-related conditions in adults and young people (aged 10 years and older):

  • acute alcohol withdrawal, including seizures and delirium tremens

  • Wernicke's encephalopathy

  • liver disease

  • acute and chronic pancreatitis.

It does not specifically look at women who are pregnant, children younger than 10 years, or people with physical or mental health conditions caused by alcohol use, other than those listed above.

In the current update, we reviewed the evidence and updated the recommendation on corticosteroid treatment for people with severe alcoholic hepatitis.

More information

To find out what NICE has said on topics related to this guideline, see our web page on alcohol.



[12] The NHS Information Centre (2009) Statistics on alcohol: England. Leeds: The Health and Social Care Information Centre.

[13] North West Public Health Observatory (2007) Indications of public health in the English Regions 8: alcohol. Liverpool: Association of Public Health Observatories.

[14] Royal College of Physicians (2001) Alcohol – can the NHS afford it? Recommendations for a coherent alcohol strategy for hospitals. London: Royal College of Physicians.

  • National Institute for Health and Care Excellence (NICE)