How much is too much

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					How much is too much?

 Most adult Australians have a good idea of what a ‘standard drink’ is, how much we can drink before being
 over the legal limit for driving, and even the recommended ‘safe’ level of drinking per day. So why do many
 of us continue to drink at unsafe levels?

 There are a lot of myths and preconceptions surrounding              and the next 20% is consumed by the next 20% of the
 the widespread problem of alcohol misuse in this country.            population. While, on the one hand, this means that 70% of
 Perhaps one of the greatest is perpetuated by a drinking             the population is consuming 30% of all alcohol sold, on the
 culture which is, for some, entirely at odds with scientific and     other, it means that a lot of us continue drinking too much
 biological fact.                                                     for our health.

 This may best be illustrated by the way so-called ‘safe’             Clearly, then, some people’s idea of how much is too much
 drinking levels are viewed by many ‘ordinary’ Australians -          are very different from others. However, when it comes to
 and borne out by many statistics (see: ‘Sobering facts’).            matters of science, the facts are, well, just the facts.

 Paul Dillon is information manager of the National Drug and          As a simple matter of biology, what we do know is that, if
 Alcohol Research Centre.                                             you drink consistently over recommended safe levels, many
                                                                      health problems are very likely to happen.
 “One of our great problems is that we have these safe levels
 which, for many people who do drink at higher levels, simply         Hand in hand with the ‘how much is too much’ confusion is
 do not fit in with their reality. I go into schools, for example,    another ‘Aussie’ characteristic. And that is, seeing critical
 and they look at me when I outline what is harmful or risky          warning signs that drinking is causing significant damage as
 and they say - ‘but I do that all the time and I’m still standing,   ‘par for the course’. Loss of memory is a case in point. While
 still operating. Where is the harm?’”                                some may joke about ‘how did I get home, what did I do,
                                                                      what did I say?”, on the neurological front, there is very clear
 Paul goes on to explain that using concrete examples of the
                                                                      cause for concern.
 ill effects of long-term, high level drinking is more helpful in
 getting the message across.                                          There is increasing neurological research about how alcohol
                                                                      affects the brain at various stages and, if you have several
 “The safe drinking guidelines talk about concepts like ‘harm’
                                                                      episodes of memory loss, that is likely to be indicative of
 and ‘risk’ which sound abstract, especially in a context where
                                                                      long-term brain damage.
 the drinker looks and feels fine. So we do need to point out
 in graphic terms what the harm is. Brain damage, memory              Compounding the cultural confusion between what’s all right
 loss, cognitive impairment, liver damage and so on.”                 and what’s not is the fact that some people have a drink or
                                                                      two and become quite silly; others can knock back five or six
 Dr Alex Wodak is director of Alcohol and Drug Services at
                                                                      and appear unaffected. This is a classic case of appearances
 Sydney’s St Vincent’s Hospital and has had a long career in
                                                                      being deceiving. Again, it’s a question of biology.
 the area of alcohol and drug use.

 He points out that, although overall alcohol consumption in
 Australia dropped from around 9.8 litres a head in the early
 1980s to 7.5 litres a head in the late 1990s, around 50%
 of all alcohol sold is consumed by 10% of the population,
    Although appearing sober, the brain and other organs              “We advise that person to, first and foremost, take
    are definitely still affected - this may just manifest itself     care of themselves physically and emotionally,” says
    differently from person to person. All the proven increased       one counsellor from a prominent government agency.
    risks still apply: risks of health, social and sometimes legal    “Open communication when the person is not affected
    problems (see: What are the risks?).                              by alcohol and not in a situation of conflict, where the
                                                                      focus is on the health facts, not other issues, can be a
    The good news is that, if you are concerned about your
                                                                      helpful approach. But do be aware that you cannot force
    drinking, there’s a lot of help to be had. At one level,
                                                                      someone to change.”
    simple recognition and reduction of consumption through
    ‘controlled drinking’ programs can help. Where drinking is        One feature that’s consistent in all approaches is
    causing greater concern, many different programs to suit          understanding that misuse of alcohol is a chronic,
    different situations are available, including drug therapy.       ongoing condition.
    Visiting your GP is an ideal first port of call. There are also
                                                                      There is no magic cure and relapse is a natural and expected
    many sources of help and support listed below.
                                                                      part of any treatment program. What is important is to seek
    If you are concerned about the drinking levels of a               treatment if you are concerned, because there is plenty of
    family member or friend, you are in a difficult situation.        help to be had.
    Sobering facts                                                    Source: an article published on the Internet by the Medical
    ó Approximately one in six Australians who consult their          Journal of Australia, www.mja.com.au * The Australian
      GPs drink above safe levels. In 1997, 4.15% of Australians      Prescriber, ‘The management of the heavy drinker in
      met the criteria for alcohol dependence - this rate was         primary care’ (2002;25:70-3)
      9.3% among the 18-24-year-olds.*
                                                                      What are the risks?
    ó At least 1% of the population (about 180,000 people)            Drinking at higher than safe levels causes many serious
      has a close family member with a serious alcohol                problems. Not all are immediately evident, some are.
      problem, resulting in isolation, neglect, aggression and
                                                                      Short-term risks, to name a few:
      disruption in the family.
                                                                      ó accident, assault, unwanted pregnancy, unwanted sexual
    ó Thirteen per cent of Australians aged 14 or over (more            contact and sexually transmitted infections and more.
      than one million people) have been physically abused at
                                                                      Longer-term risks, to name a few:
      least once by someone affected by alcohol, while 16%
      have had their property damaged at least once.                  ó social problems including family and relationship
                                                                        breakdown
    ó Alcohol has been implicated in one third of sexual
      assault cases.                                                  ó health problems including increased risk of heart disease,
                                                                        breast cancer, bowel cancer, liver disease, pancreatitis,
    ó Children are particularly affected by having an alcoholic
                                                                        depression and anxiety, memory and other neurological
      parent and they are more likely to become depressed,
                                                                        disorders, sexual dysfunction and more
      have a lower IQ and be alcohol dependent themselves in
      the future.                                                     ó legal and financial problems, for example, relating to
                                                                        driving under the influence or job loss.
    ó The financial burden of alcohol abuse to the Australian
      community is estimated to be $4.5 billion, or $250 for
      every man, woman and child.


2
How much = safe drinking levels?                               Alcoholics Anonymous: a self-help organisation for people
For men per day: up to 4 standard drinks per day, no more      with alcohol problems - www.aa.org.au. See your local
than 3 days per week                                           telephone book or call the General Service Office on
                                                               (02) 9599 8866 for your nearest local AA.
For women: up to 2 standard drinks per day, no more than 3
days per week                                                  Al-Anon: a self-help group for family, relatives and friends of
                                                               people with alcohol problems.
How much = 1 standard drink?                                   Visit www.al-anon.alateen.org/australia See your local
                                                               telelphone book or call the General Service Office on
Light beer: 1 schooner of 425ml, 2.7% alcohol/vol
                                                               (03) 9620 2166.
Beer: 1 middy of 285ml, 4.9% alcohol/vol
                                                               ACT Alcohol and Drug Help Line: (02) 6205 4545
Wine: 1 glass of 100ml, 12% alcohol/vol
                                                               NT Amity: 1800 629 683 or (08) 8981 8030
Spirits: 1 nip of 30ml, 40% alcohol/vol
                                                               Alcohol and Drug Information Centres (ADIS) in your
Is your drinking cause for concern?                            state (note, 1800 numbers are Freecall for regional
                                                               areas only):
The CAGE test is used by doctors to help determine whether
                                                               NSW: 1800 422 599 or (02) 9361 8000
a person is drinking at harmful levels. It consists of four
                                                               Qld: 1800 177 833 or (07) 3236 2414
questions:
                                                               SA: 1300 131 340 or (08) 8363 8618
1. Have you ever felt the need to cut down on your drinking?   WA: 1800 198 024 or (08) 9442 5000
                                                               Vic: 1800 888 236 or (03) 9418 1000
2. Have you ever felt annoyed by others asking you about
                                                               Tas: 1800 811 994 or (03) 6233 6722
   your drinking?
                                                               NT: 1800 629 683 or
3. Do you feel guilty about your drinking?                     Darwin (08) 8922 8399
4. Do you ever need an eye-opener in the morning?              Alice Springs (08) 8951 7580

A score of two or more ‘yes’ answers is taken as a sign that
drinking problems are likely.

Where to go for help and support
Your GP: there are many different ways to address the many
kinds of drinking problems that exist. Your GP can point you
in the right direction. Do keep trying new approaches if the
first doesn’t suit you.

The Australian Drug Foundation: (03) 9278 8100 or
www.adf.org.au

NSW Health Better Health Centre: (02) 9816 0452 for
useful NSW Health brochures and information or
www.health.nsw.gov.au and click on A-Z Health Topics


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