We're German. We drink beer in the morning

During my 20-odd years in Germany, I have often struggled to understand why it seems so normal for people to drink alcohol - usually beer - so early in the morning.

When I first moved to the country in 1992 - I have come and gone a few times - I worked as a night porter in a small hotel. The owners were an oldish married couple who lived out of town. They would arrive each morning to relieve me at about 6.30 a.m., and when it was just the husband, the first thing he would do was head for the fridge behind a counter in the breakfast area, pull out a cold bottle of König's Pilsner, crack it open, take a refreshing swig and proclaim, "Ah, the sweet water of Cologne!"

I was shocked. But I needn't have been. He was so normal (ordinary?) in every other way.

Occasionally I found it difficult to sleep after a shift. A friend of the family, whose own son was an alcoholic living in a care home, suggested I try drinking a can of beer when I got home. It would help, she said, but, erm… don't overdo it. I tried it once but it was no fun.

As medical advice matures

This advice from the family friend, while strange from the mother of an alcoholic, seemed as normal as the sight of my boss drinking at 6.30 a.m. To observers back then, German culture rested securely on the ancient pillars of beer and sausage.

Medical advice was also less advanced.

It's harder now to ignore what the US National Cancer Institute calls a strong scientific consensus of an link between alcohol abuse and certain types of cancer. These include head and neck cancer, which contributed to the recent death of Lemmy, a rock musician and public alcoholic.

Other cancers include esophageal cancer, liver cancer, breast cancer and colorectal cancer.

As this kind of advice has become more common - and accepted - even the Germans have toned down their drinking habits. But Europe as a whole still drinks more alcohol than the global average.

Beer before work

In the UK's proposed new guidelines on alcohol, the chief medical officer says the effects from drinking alcohol on cancers "was not fully understood in 1995" [when the previous guidelines were published] - and that these risks start from any level of regular drinking and then rise.

So drinking in the morning, whether you're an alcoholic or not, is probably a bad idea.

Years after my hotel gig, I narrowly survived student life and became a journalist. On early shifts I would regularly notice laborers drinking a brew as they waited for their tram. Were they nursing a hangover with the "hair of the dog," I wondered. But, no, it seemed so perfectly normal: one man's coffee is another man's Kölsch. And there was none of this brown paper bag nonsense to cover the bottle as in the US. Theirs was the epitome of transparency.

I found it odd. Still do.

The other morning, while waiting at Cologne's main train station, I spotted a man in the window seat of another train. His reading glasses were perched intellectually at the end of his nose as he carefully perused the contents of his phone. In front of him stood a fresh bottle of beer on a tray. And it seemed so normal. Certainly there was no hint of embarrassment on his part, or any visible indication of his being an alcoholic.

But then what does an alcoholic look like?

The season of stupor

Well, if you want to find out, base your research at Cologne for the next few days. The city, as I was once instructed by a bank employee, is celebrating its holiest days of the year - "Karneval."

People of all backgrounds and ages will - traditionally - start drinking at 11 a.m. this Thursday ("Weiberfastnacht") and, no doubt, not stop, apart for involuntary phases of sleep and random unconsciousness, until next Tuesday.

Many people bemoan the commercial nature of Karneval - that it's now only about selling beer. And they have a point.

But Kölsch - the local brew - is considered such a cornerstone of Rhineland culture that it may well be, as my boss at the hotel insisted, purer than water. I'm not trying to be funny. Kölsch is not generally categorized in the same way as other beers, or wines and spirits, even though it boasts a rather standard 4-5 percent alcohol content.

And that's a problem, because it makes it hard for people to know when to stop.

Don't be fooled

Luckily, though, as your blood alcohol content (BAC) increases, your behavior changes too, so perhaps - and I stress perhaps - you can use that as a gauge. Obviously if you're looking after children, driving, or doing other potentially dangerous things, such as working with heavy machinery, just don't drink at all. Not a drop.

That said, BAC is the percentage of ethanol in the blood in units of mass of alcohol per volume (or mass) of blood.

At a BAC of about 0.001-0.029 you appear normal, with only mild behavioral impairment. At 0.030 you begin to lose concentration, you relax and lose inhibition. By the time your BAC reaches 0.100 you slur your speech, reaction times slow, you may stagger and experience erectile dysfunction, and vomit. At BAC 0.200 you may experience mood swings, such as anger and sadness, possibly resulting in violent behavior, memory loss, and loss of consciousness. At BAC 0.300 you're already risking your life. And these effects keep getting worse until you reach a BAC of more than 0.50 at which point you are at a high risk of poisoning and death.

Don't be fooled by the low-looking numbers...

There's no sure way of saying how many drinks are safe, or how many drinks equal, for instance, a "euphoric" state of BAC 0.030. It all depends on your individual constitution. So err on the side of caution.

But if you do go overboard - and are lucky enough to survive - forget about drinking a beer the next morning. It will only make it all seem so normal.