Why middle-aged Scots are struggling to give up the booze

“I wasn't someone who drank during the week." she said, recalling her old drinking days. "But my problem would be that when I start drinking I can’t stop. I would go out at lunchtime on a Saturday and I’d be able to drink till maybe 2am. There’s a term called grey-area drinkers and that’s what I am really.”

As a sober midlifer, Hunter Murray is bucking the trend seen in the Scottish data, which shows how middle-aged Scots are frequently persisting in hazardous levels of drinking.

Across the wider population, if we include all ages,  Scots are drinking less than they used to and, over the past two decades, the prevalence of hazardous or harmful drinking has decreased, with levels dropping from 34% in 2003 to 22% in 2022. But one demographic stands out as stubbornly hanging onto its high level of drinking, despite being at a point where the health impacts are more likely to hit home: 55-64-year-olds.

Sober Leigh Hunter Murray with her husband (Image: Leigh Hunter Murray)

Those in younger middle-age are trailing not that far behind, with 45-54-year-olds knocking back an average of 13.7 units a week, significantly more than the 10.7 units of 25-34-year-olds.

Alcohol, in other words, is increasingly a middle-age problem. Wine o’clock, a couple of pints at the pub, a gin and tonic just to switch off. The sly multiplying units of grey-area and problematic drinking.

I see it among my peers and friendship groups. Though we hear the health messages, we carry on drinking, either dismissing the harms it might do, or weighing things up and favouring its pleasures.  I often say  tell myself I'm a moderate person and a moderate drinker, but still the units stack up.

One friend, David, aged 57, for instance, who still drinks regularly, sometimes five pints and a spirit shot on a biggish night, said he enjoyed it too much to stop “unless under doctor’s orders”. ”I did Sober October in 2022 to prove to myself I could,” he said. “It genuinely had no mental health benefits, probably the opposite as I was missing my Friday night beer. That first November beer was one of the best ever though!”

Another pal, with whom I've spent many evenings in bars, 52-year-old Vroni Holzmann, has felt forced recently,  sometimes, to put alcohol on pause because of menopause-related migraines. She said: "I always say the menopause is trying to make alcohol my enemy, but it's actually only making the menopause my enemy."

"The reason I have no intention to stop drinking is because I think it's really fun. I don't worry about health.  I don't know the units that are recommended, nor do I have any idea how many I am drinking. This desire to measure everything often takes the fun out of things."

Vicky Allan and her friend Vroni Holzmann (Image: Gordon Terris)

Amg the worst groups for hazardous drinking across the entire population are men in the  55-64 year old category. In this group, levels of hazardous drinking seem to have barely changed in recent years, and, in the latest Scottish Health Survey, were a massive 37%. 

Meanwhile women in this age group had slightly lower levels of hazardous drinking than previous years and their non-drinking percentage was, at 18% in 2022, up from the 17% of 2022.

The nature of the drinking culture amongst men in midlife is one that Professor Carol Emslie, lead of  the Substance Research Group at Glasgow Caledonia University, has studied.

The project found, she said:  “Drinking pints and buying rounds in the pub was seen as an integral part of making and maintaining male friendships in midlife. “You’re in a group, you stand your round."  Buying another man a drink was seen as an act of friendship. Buying a drink only for yourself was seen as anti-social and against the communal attitude of the group.”

She added: “The men in our Scottish study talked about aiming for an ideal level of intoxication (staying ‘in the zone’), where they matched their intoxication level with others . They felt that by midlife they knew their own bodies, how to achieve the desired level of intoxication & sustain this level. Part of the difficulty for people trying to drink less is that they are then seen as out of sync with the others in the group.”

But it’s not just men who experience the pressure to fold into drinking culture, Emslie said: “For both men and women in midlife, there was continued social pressure to drink. As one participant said: “It’s not just socially accepted that people drink – it’s socially expected”.

A drinker, Hugh Grant, at Sandy Bell's in Edinburgh (Image: Gordon Terris)

Strikingly, this behaviour and culture is persisting at exactly the stage of life when the harm of drinking hits home - and despite recommendations to keep drinking below 14 units.

“The long harm,” said Dr Alastair MacGilchrist, a liver consultant and chair of Scottish Health Action on Alcohol Problem, “really hits home in middle life. There’s often quite a lot of publicity about if someone young dies of alcohol. It hits the headlines and of course it’s a tragedy, but at the end of the day it’s middle-aged men who are the biggest group.”

Alcohol-related deaths divide into two types. One is what are called “alcohol specific” deaths and includes those in which diesases are 100% linked to alcohol – such as alcohol-related liver disease.

“Liver disease," he noted, " is by far the number one killer. As a liver doctor, that's what my wards are full of: middle-aged men who have liver failure due to alcohol.”

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But there are other diseases in which alcohol can be a contributing factor, though non-drinkers can also get them: specific cancers, cardiovascular disease, heard disease, stroke. These are often-called alcohol-related deaths and actually kill many more people every year.

“Although," said Dr MacGilchrist, "liver disease is responsible for 80% of alcohol-specific deaths, probably more people die as a result of cancer through alcohol than liver disease. But the data is slightly less hard. It’s a calculation based around the percentage of deaths affected by alcohol.”

"And these deaths are happening in middle age. If you think of most of the things that kill you, such as cancer, dementia, they kill people in old age. Alcohol tends to kill people in middle age.”

Dr MacGilchrist also counters the idea that those in mid-life should carry on enjoying drinking since the lifetime damage is already probably done. 

“The average middle-aged person,” he said, “who has been drinking all their life who might say what harm is it going to do to me? The huge problem with liver disease is you don’t get any symptoms until your liver actually fails – and by that time you’ve already got cirrhosis which is irreversible scar damage. You might feel fine today but next week you might be in hospital with liver failure.”

Among those with particularly perceptive insights into Scottish middle-aged drinking culture are the sober and alcohol-free. Hunter Murray, the former shots queen, described tricks she had learned from previous periods off alcohol.

“I learned when I was younger how to deal with people who were hassling me to have a drink. They'd say, 'Just have a drink.' So I changed from saying, ‘I don’t want a drink’ to ‘I can’t have a drink’.

43-year-old Lynsey Foster,  a health and hormonal coach to women of all ages, has similar experiences of the pressure even from loved ones to keep on drinking. At one family party, she took a bottle of Nosecco, only to be greeted by the phrase, "Oh never mind that hen, I’ve got you a real Prosecco."

Lynsey Foster enjoying a sober holiday (Image: Lynsey Foster)

“I feel,” she said, “it’s your closest friends and family that keep wanting you to drink and it’s the people you don’t know so well that support you more. I went out with two girls both of whom's mums were alcoholics - one died of alcoholism - and they both said to me, ‘You’re not an alcholic. Just have a wee cocktail. You’ll be fine.’”

Foster talked of her struggles over the last year and how she had managed to stay 90% sober. Like many, she  has shared some of her sober journey on Instagram. In one post, inspired by her own mentor Kirsty Mulcahy (founder of sobriety coaching community  Sober Buzz Scotland), she talks about how “you don’t have to be an alcoholic to have an alcohol problem”.

That struggle against not just alcohol but a drinking culture was echoed by 45-year-old Amy who stopped drinking seven months ago. "What I’ve found out is," she said, "that you are seen as abnormal if you don’t drink. Being sober in a drunken world is incredibly hard. I stopped because I saw myself disappointed with myself regularly, anxious and regretful, it impacted my relationship with my partners, friends and most importantly my daughter".

Both Foster and Hunter-Murray  also related heroic tales of being alcohol-free at major social events, parties, holidays or club nights.

Hunter-Murray described herself as a party animal. "I go to a thing called Southport Weekender. I went to that last year. Three days of a big music event that’s 12 hours a day, without any drink. One of the best Southports I’ve been to!”