In 2007, the Sunday Times suggested that UK limits on recommended limits were "really plucked out of the air... it was sort of an intelligent guess by a committee."
If you go out onto the street and ask how much it is safe to drink, you will probably be faced with a few shrugged shoulders and even more replies of "as much as I want, so mind your own business".
When I co-wrote a report on substance misuse in older people in 2011, I slipped in a paragraph on why is would be worth adopting guidelines from the United States that lowered the upper limit for recommended weekly drinking limits in older people. The media was all over it like a rash.
The very thought of it was ridiculed to the extent that on the BBC programme Any Questions, there was a loud round of applause when it was suggested that such limits were no more than a nanny state imposing puritanical values. Yet it generated both heated debate and some degree of self -contemplation from the public. Not only did it result in three documentaries on drinking in older people, but also provided the impetus to the formation of a working group.
In 2011, a statement from the Department of Health confirmed that "a group of independent experts tasked with developing alcohol guidelines for the UK chief medical officers are currently researching and developing a proposal on these guidelines and expecting to consult on them in autumn 2015". After three years of hard scientific scrutiny, the government publishes its findings on recommended limits for alcohol intake today (8 January 2016).
So, is there really a large evidence base to support any new recommendations? Perhaps they might even stay the same, or recommend different limits for different populations. Surely there is no safe limit in pregnancy or for older people?
About one and a half 'units' in the UK is equivalent to one 'drink' in the US. There is now evidence of an increased risk of death from accidents, cancer, and stroke from drinking more than 1.5 units of alcohol a day. In older people, drinking more than three units a day or 11 units a week is associated with the development of drinking problems. Drinking more than three units of also alcohol a day is associated with an increased risk of bowel cancers, high blood pressure and liver cirrhosis.
If we can really make anything of all this, the public needs to know at what level of drinking will their risk of certain conditions be increased compared with the overall population. If we are to be convinced, we need the hard science. It's not that difficult to do. After all, alcohol is a drug and a toxic one at that. Looking at death rates and rates of physical illnesses is relatively straightforward but there is a sticking point. Drinking also leads to a number of mental health problems such as depression and brain damage and alcohol misuse is commonly accompanied by presentations of suicidal behaviour. We need to think imaginatively if we are to come up a way of measuring mental health 'damage'. I'm already seeing alcohol-related brain damage mushroom in my everyday clinical practice.
This will be the first major change in drinking guidelines for 20 years. Let's hope that it was worth the wait, only three months later than expected!