In fact, if ever there was a time for people to be warned about the dangers of drinking excessively it is now. The statistics relating to medical and social consequences of alcoholism in the UK are staggering. The estimated cost of alcohol related crime is £7.3billion and health costs are £1.7billion – per year! Alcohol is responsible for 150,000 hospital admissions and accounts for one third of attendances at Accident & Emergency clinics.

Of particular concern is the younger age at which people are beginning to drink. The number of 14yr old children buying alcohol under the age of 18yrs in the UK has doubled over the past fifteen years. According to one survey, 50% of girls and 42% of boys who had drunk alcohol in the previous week, had been drunk and the number of children illegally buying alcohol has doubled in the last 15yrs.

And this is also an increasing problem in the adult population: 25% of adults - 11 million people in the UK – binge drink regularly. During the 1990s, the cirrhosis mortality rates for men increased by 104% in Scotland and 69% in England and Wales, and for women those figures were 46% and 44% respectively. Alcohol related crime costs the UK an estimated £7.3 billion per annum and the healthcare costs are in the region of £1.7 billion. Alcohol related illnesses account for 150,000 hospital admissions a year and up to one third of all A&E attendances are directly related to alcohol abuse. And while these figures are rising in the UK, they are falling in other European countries, particularly southern Europe. All the statistics show that alcohol consumption across all age groups has increased significantly. This is related to affordability. By and large people have more money in their pockets and the amount spent on alcohol is directly related to this. There is also greater access to alcohol through supermarkets and convenience stores as well as off-licenses. And recent changes to licensing laws can only add to the problem. It has been repeatedly shown that the prevalence of heavy drinking in a country is closely related to the average alcohol consumption. Reducing the latter therefore lowers the number of people drinking to harmful levels.

Getting drunk can be really hazardous to life, with death occurring from heart beat irregularities and depression of breathing quite apart from the risk of inhaling vomit and injuries sustained by accidents or getting involved in a fight. The consequences of exceeding safe weekly limits of alcohol – of which more later – are equally dire, with hardly an organ in the body escaping damage. Liver disease – known as cirrhosis – may be the best known but as well there can be damage to the pancreas, causing severe attacks of pain, and to the heart leading to heart failure of various types. To the list has to be added damage to the nerves in the legs and to the brain itself and various cancers - all of which are life threatening as well as affecting the capacity of people to properly enjoy daily life and normal activities. Also, while alcohol in moderate quantities is a relaxant, in excess it is a depressant which means it slows down the body's responses and can seriously affect mood. Indeed, depressive illness is made worse, not better, by alcohol.

One of the difficulties in people appreciating the risks of drinking to excess is that organ damage may take years to develop and reach the point where the damage cannot be reversed. There is always the feeling - amongst young people particularly - that heavy drinking is not going to affect them as they recover from the hangover soon enough. Another comment I get from patients, particularly in the working environment, is that they don’t drink anywhere near as much as their colleagues, who don’t seem to be affected. It is certainly true that some people are more susceptible than others to alcohol related organ damage. Women particularly have a much lower tolerance than men in terms of developing injury to their organs and women can become ill after relatively short periods of heavy drinking.

Unlike smoking, where so-called passive smoking can cause long term harm to the individual, all the evidence is that if the amount of alcohol consumed is kept within safe limits the body can deal with it and no harm will result. Indeed there is evidence that in middle aged men 1-2 glasses of red wine a day may decrease the risk of heart disease.

So, what are safe limits? For adult men, it is up to 21 units a week and for adult women, less than 14. The recommendation is to have one or two days without drinking each week so that if the 14 or 21 units can be spread over a number of days, then – in the writer’s view at least – this gives quite a reasonable consumption to enjoy. However, difficulties come in defining a unit. As shown in table one, 1 unit is equivalent to 1 small glass of alcohol. Many of the new alcopops have much higher concentrations of alcohol and also glasses are getting larger – a large glass of wine, for instance is equivalent to 3 units. And contrary to general belief there is no difference between spirits, wine or beer in the capacity to be harmful – it all depends on the quantity of alcohol consumed. Remember also, it takes your body 1 hour to process 1 unit of alcohol, so if you are drinking faster than that, you will end up drunk.

So the message is simple: keep to safe limits. If you think you might be drinking too much – or even if you don’t! - keep a diary for a week or two of just how much you are drinking; it can be very revealing. In this way you can enjoy the pleasures of drinking rather than the harm. There are moves to label bottles of alcohol with the number of units they contain and to have notices put in pubs explaining how to calculate your units and what are the safe limits and in this way people can know very clearly what they are consuming. One hopes too that there will be more programmes on television emphasising the dangers of drinking excessively. Educational messages – without them being too heavy – are important and advertising also has to be controlled because it is one of the most potent influences on people’s behaviour. Society and particular young people of school and university age, deserve better and if France and Italy have managed to halve their alcohol consumption (over the same period that ours has doubled in the UK!) then so can we.

Liver disease in general and alcohol-related liver damage in particular is a problem that we must address - and soon - as the scale of the problem is growing and the costs to individuals and society as a whole are too great to ignore.

Over the years that I saw George Best as a patient he was always so cheerful and positive but he was also very well aware that his illness was a result of the lifestyle he had lived and his addiction to alcohol. He wanted very much to help others to avoid the same problems that he had faced. George knew that I was involved with research into liver disease and that I worked with the Foundation for Liver Research, a charity that was established in 1973 in order to fund research into liver disease. Since 1997 the Foundation has supported a variety of research programmes at the purpose designed Institute of Hepatology, built by the Foundation and located within the biomedical campus of University College London.

At present there is a lack of provision of specialist liver services in the UK and in particular a lack of research into alcohol related liver diseases and this is because alcohol induced illnesses are so often seen as self-inflicted. George Best was keen to lend his name to the Foundation’s fundraising efforts and in particular to spearhead an Appeal specifically to fund research into the causes, effects and treatments of alcoholic liver disease. In 2001 the Foundation launched the George Best Appeal to raise £500,000 to fund a dedicated laboratory to be named after George, along with associated equipment and laboratory consumables, and to appoint a George Best Research Fellow. The Foundation also hopes to be able to support research into liver disease elsewhere in the UK, particularly Manchester, in view of all George’s long associations with Manchester United.

Liver damage frequently occurs without the person being aware. In some instances the damage can have developed to the stage of severe liver failure before first illness and presentation of the patient. It is known that the causes of this liver damage relate to a series of events following on toxic injury to the liver cells from alcohol. Various intermediary substances known as cytokines interact and release yet further damaging factors within the liver. This cascade of events can become self-perpetuating, even when exposure to alcohol has ceased. The patient may have stopped drinking yet liver damage can progress, leading to further serious illness and even resulting in death. Although improvement can occur at this stage it is invariably slow. However, recent research into these intermediary substances and consequent cell damage has shown that it is possible to block certain of the key processes involved by specific drugs known as monoclonal antibodies, some of which have been developed for clinical trials in other disorders.

The purpose of the proposed research will be to gain a better understanding of the processes involved in liver damage from alcohol and their influence on the progression of the liver injury and in particular how self-perpetuating processes can be halted once initiated.

George was very supportive of the Foundation’s Appeal and I know the Fund meant a lot to him. To fund research into the processes by which alcohol damages the liver with the aim of alleviating its effects and offering treatment to those afflicted, would be an appropriate way - apart from all the memories of his legendary skills on the football field - of commemorating the life of George Best.

Professor Roger Williams, CBE

Director, The Institute of Hepatology, UCL Medical School

Medical Director of the Foundation for Liver Research

Donations by cheque or postal order payable to:

The Foundation for Liver Research – George Best Appeal

The Foundation for Liver Research (formerly the Liver Research Trust).

Charity number 268211

c/o Professor Roger Williams, CBE

The Institute of Hepatology, 69 – 75 Chenies Mews, London, WC1E 6HX

Tel: 020 7679 6510 Fax: 020 7380 0405 email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

www.ucl.ac.uk/liver-research

The Foundation for Liver Research was established in 1973 in order to fund research into liver disease. Since 1997 the Foundation has supported a variety of research programmes at the purpose designed Institute of Hepatology, built by the Foundation and located within the biomedical campus of University College London.