How much alcohol is “too much alcohol”?

We see it all the time – children separated from their parents because “excessive alcohol consumption” creates a risk in the family home.

But what is “excessive” – and what exactly is the risk?

There are no standard answers, because the truth lies with the individual parent. But that doesn’t stop courts from using one-size-fits-all definitions – which can be unhelpful when it comes to deciding in the best interests of the child.

Defining levels: where does excess begin?.

Every government has its own definitions of “social”, “excessive” and “chronic” drinking. As does every institute, professional body and regulator with a vested interest! All of which muddies the waters for the courts… as you can see:

  • The UK Government defines “excessive drinking” as 64 grams of pure ethanol per day for men, and 48 grams for women.
  • The National Institute for Health and Care Excellence (NICE) defines “chronic drinking” as 120 grams per day, regardless of gender.
  • The Society of Hair Testing (SoHT) makes no distinction between “excessive” and “chronic” – stating that 60 grams per day for either gender is “chronic excessive”.
  • The World Health Organisation (WHO) takes a firmer line, stating there is no safe amount of alcohol to drink.

To complicate things further, these catch-all definitions ignore the impact of binge drinking. A social drinker and binge drinker can show similar levels in a hair test, because a hair strand can only show the total consumed over a period of time (usually 3 months). The upshot being, labs can estimate an average daily intake, but can’t identify peaks and troughs.

This makes it impossible to gauge the risk to a child in the parent’s care, because the low even pattern of a social drinker can be perfectly safe – but the binge drinker with spikes of heavy consumption can pose a severe threat.

These inconsistencies point to a serious problem: it’s impossible to pinpoint the exact moment where safe consumption crosses the red line and places the child at risk.

So how can a court be expected to decide?

In extreme cases, where alcohol levels indisputably point one way or the other, no problem. But in cases where levels are open to interpretation, what then?

For the partisan, it may be tempting to pick whichever definition happens to fit the case! But that only leads to back-and-fore contradiction and more uncertainty for the judge, who’s expected to choose wisely between two or more rival assertions.

Hence the need to treat the parent as an individual.

Through medical interpretation, we can establish their history with alcohol and consider three critical factors:

FACTOR 1: Personal Tolerance
When does enough become too much, as defined for them individually? Whether the answer puts them above or below the common levels of excess, it’s far more meaningful as a way of measurement.

FACTOR 2: Personal Behaviour
How does alcohol affect their mood, their manner and actions – and how does this manifest as a risk, both to themselves and their family?

For example:

  • Does alcohol make them more affectionate or aggressive / neglectful?
  • Does alcohol limit their self-control and increase the risk of violent behaviour?
  • Does it impair their sense of responsibility, leading to neglectful habits like leaving children alone or spending money on alcohol rather than essentials?
  • Do they show mental health problems or anti-social traits that could increase the risk of abuse or neglect?

FACTOR 3: Personal Testimony
Claims of abstinence are common, especially among parents who are being monitored over time. If the claim is false, the lab will often disprove it by showing the levels of ethanol. But conversely, if the claim is true, there’s still a question mark – because a negative test can’t be taken as definitive proof of abstinence.

In these cases, where quantitative data comes up short, a qualitative assessment is the best tool at our disposal. When the medical expert assesses the parent’s history and patterns, they can gauge the truth and offer a more considered view to the court.

These three factors demonstrate the need for personal assessment. And this is why we do things differently here at Atkinson Lewis.

We see the initial test as a broad measure only – the first part of a rich evidential picture that points towards the truth. So our standard MIFA report (Medical Interpretation of Forensic Analysis) looks at evidence in the round to help judges make safer, more informed decisions – whether the case involves misuse of alcohol or drugs.

This is a critical matter. Parental drinking accounts for one in three childhood cases of death or serious injury, so it’s vital that we assess every risk with the utmost level of accuracy – and only a thorough personal assessment can achieve this.

Of course, we can barely scratch the surface of this topic in just a few hundred words. So our Medical Director Dr Catherine Pyves has put together a detailed talk for safeguarding professionals, to look more fully at The Evidential Picture in cases involving alcohol or drugs.

For full details and registration, click here.

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