Background
Although alcohol consumption has fallen since the late 1970s, Australians are still relatively high alcohol consumers. We spend over $400 each per year on alcoholic beverages. Sixty percent of us drink on at least one day per week and 10% of us drink daily. Approximately one third of young people between the ages of 14 and 19 consume at lease five drinks in one sitting, every two weeks.

What is safe to drink?
Alcohol is part of our way of life in Australia and is not a cause of ill health when used in moderation. However, excessive alcohol consumption is a major cause of physical ill-health as well as social and emotional problems. There are two patterns of drinking which cause harm: bingeing (drinking more than 5 drinks in a short time, such as 1-2 hours) may result in becoming intoxicated (drunk). Regular excessive drinking (see Table 1) can result in damage to many body organs, especially the liver. The National Health & Medical Research Council (NHMRC) advises that males consume less than 4 standard drinks (40g alcohol) and females less than 2 standard drinks (20g alcohol) per day (Tables 1 & 2). Women are more susceptible to damage from alcohol than men because they break alcohol down (metabolise it) more slowly. These recommendations are supported by a number of other bodies including the National Heart Foundation and the Australian Medical Association.

TABLE 1: GUIDELINES FOR RESPONSIBLE DRINKING

Why do some people drink too much?
Alcohol consumption is part of our lifestyle at celebrations, barbecues and other social occasions. Peer pressure, stress and advertising all encourage high consumption. Many use alcohol to change how they feel. For some with a strong family history of alcohol dependence, genetic factors influence drinking patterns. Once excessive alcohol use becomes a habit, this behaviour can develop its own momentum.

What are the early signs of health problems due to alcohol?
Some of the early indicators of dangerous drinking patters are

There may be symptoms such as morning nausea, diarrhoea, blackouts and difficulty sleeping. Frequent accidents or repeated lateness or absence from work may also be early warning signs.

What effect does alcohol have on the body?
IMMEDIATE EFFECTS

Intoxication (GETTING DRUNK)
The immediate effects of alcohol depend upon the amount of alcohol in the blood and whether the person is an experienced drinker. As the blood alcohol level rises drinkers feel more relaxed and are often more talkative. They become less aware of their behaviour and judgement is often impaired. Loss of co-ordination and drowsiness may occur. The risk of accidents rises, particularly for those involved in complex tasks such as operating machinery and driving cars. An individual with a blood alcohol level of 0.05 has twice the risk of having a motor vehicle accident as one with a blood alcohol of zero.

Similar effects on concentration and driving can occur when lesser amounts of alcohol are taken with medications such as sedatives and antihistamines.

LONG TERM EFFECTS (Table 3)
Long term excessive alcohol use can damage almost any part of the body and can cause a number of psychological and social problems. Social and psychological problems usually occur before physical (medical) problems.

People who do not drink may suffer some of these problems but the range of physical, social and psychological problems which can result from alcohol use is broad. In 1992 more than 6,000 Australians died due to harmful alcohol use (5% of all deaths).

ALCOHOL: LONG-TERM EFFECTS
ALCOHOL DEPENDENCE (Addiction)
 

PREVENTION
Alcohol use can be part of healthy lifestyle. Small amounts of alcohol have been shown to protect against heart attacks. Alcohol may stimulate the appetite and enhance the flavour of food. Table 4 contains some tips for drinking to reduce harm.

TABLE 4: DRINKING TIPS TO REDUCE HARM

• Don't drink alcohol to quench your thirst. Use non-alcoholic drinks.
   
• Use spacers (alcohol free drinks) between alcoholic drinks to prevent excessive alcohol consumption.
   
• Drink low alcohol beverages.
   
• Count your drinks, keeping within the recommended guidelines.
   
• Don't refill your glass until it is empty.
   
• Don't gulp drinks. Take smaller sips.
   
• Eat before drinking. Your drink will take longer to be absorbed.
   
• Don't drink if you are pregnant. It may damage the health of your unborn child.
   
• Don't drink if you are operating machinery, you put your fellow workers as well as yourself at risk.
   
• If you are a regular drinker, have at least two alcohol-free days each week.
   
• Don't drink to cope with stress. Exercise, relaxation, meditation or talking to friends are safer ways of coping.
   

Treatment
Many individuals with drinking problems and their families despair because they think the situation is impossible, the problem is incurable and there is nowhere to get help. Any behaviour change is difficult, whether it is changing diet, stopping smoking, modifying drinking habits or taking more exercise. Often many attempts are needed to succeed. The actor W.C. Fields once said "Giving up smoking is easy, I have done it hundreds of times".

However, there is now good evidence that treatment of problem drinking at an early stage, before severe health problems develop, can be very effective.

Treatment is often straightforward. The first step is the recognition that drinking could be causing harm. You should speak to your general practitioner or contact a drug and alcohol counsellor it you think you need help.

For those with a more established drinking problem, treatment needs to be more intense. Both the affected individuals and their families need to be aware that this may take time. Many individuals will benefit from face-to-face counselling. Others will want to supplement this with assistance from self-help groups such as Alcoholics Anonymous and Women For Sobriety. Al-Anon is a support group which can be of great benefit to the family.

Application Statement

This document has been prepared by the Digestive Health Foundation, of the Gastroenterological Society of Australia and every care has been taken in its compilation. The booklet is intended to be used as a guide only and not as an authoritative statement of every conceivable step or circumstance which may or could relate to the management of diseases related to Alcohol.