Alcohol abuse eclipsing heroin
Awareness that Australia has a drinking problem has reached the highest levels of government, writes Bianca Nogrady
ANDREW didn’t think his friends had a drinking problem. That is, until a few drink-driving offences landed him in the Odyssey House drug and alcohol rehabilitation program. Now Andrew sees alcohol a little differently.
‘‘ I was drinking pretty much half a bottle to a bottle of bourbon a night, and a six pack of beers,’’ he says. ‘‘ I sort of thought I had a drinking problem, but I thought I had youth on my side — I thought it wasn’t something I had to address right now. (I thought) it wasn’t causing much of a problem for me — but it was causing a problem for my health.’’
That’s putting it mildly. When he came off alcohol he had ‘‘ the DTs’’, or delirium tremens — the confusion, disorientation and agitation sometimes experienced by longterm heavy drinkers who suddenly cut their habit. He had a heart murmur, and his doctors told him he had a high chance of having a stroke. That was just over a year ago. Andrew is 24.
He’s now teetotal, and doesn’t hang out with his former drinking friends, who he says ‘‘ don’t understand’’ the risks alcohol poses. ‘‘ When you’re drinking, time is never really on your side,’’ he says. ‘‘ Alcohol is advertised every night on TV, and at sporting events. It fuels (complacency about alcohol) in some people.’’ Andrew, who asked that his surname not be used, says his former friends have problems of their own with alcohol, even though they don’t realise it.
As Prime Minister Kevin Rudd this week noted, a lot of people are getting into trouble with alcohol. For the first time in 30 years, alcohol has topped the list of reasons for people entering treatment programs at the Sydney-based Odyssey House.
Four years ago, 60 to 70 per cent of people entering the treatment program would have nominated heroin as their problem says Odyssey House CEO James Pitts. But now only about 8 per cent cite it as their primary reason for entering treatment.
While alcohol — legal, available everywhere and cheap — is the common number one drug of concern for most other treatment centres around the country, this shift is significant for Odyssey House, which has primarily treated illicit drug users.
Rudd this week said he was examining ways to tackle what he described as a worsening ‘‘ epidemic’’ of binge drinking, and discussions with police nationwide had convinced him the problem was growing. I am concerned about what I describe as an epidemic of binge drinking across the country,’’ he said on radio. ‘‘ I think it’s not good. I’ve already begun to have some discussions with the federal Health Minister Nicola Roxon about what we might do on this front.’’
As Weekend Health reported on January 19-20, Family First leader Steve Fielding is lobbying hard for government support for his bill proposing tough new rules on alcohol promotion, including a ban on TV and radio advertising before 9pm, and proper enforcement of existing rules supposed to prevent advertisers suggesting alcoholic drinks will grant consumers success — either in bed or anywhere else. Advertisements would have to be pre-approved by a government-appointed body, rather than under the existing selfregulatory system.
Australia has something of a blind spot when it comes to alcohol, says DrinkWise Australia CEO and doctor Mike MacAvoy. ‘‘ Alcohol is such an integrated part of our culture, to suggest that Australia has an alcohol problem is almost un-Australian, but it’s not un-Australian to say heroin is a scourge.’’
However, this hides a significant change in the way Australians drink. ‘‘ If we look at the way people drink we find that the pattern of drinking that we have developed and refined in this country is that of excessive consumption on single occasions of drinking, most commonly that occurs among young people,’’ MacAvoy says. That translates to a relatively teetotal working week, followed by one or more binge sessions on the weekend when, as MacAvoy puts it, ‘‘ all hell breaks loose’’.
That ‘‘ hell’’ means work for staff at hospital emergency departments around the country, who patch up the victims, and perpetrators, of drunken assaults, alcoholrelated car accidents, alcohol poisoning, sexual assaults and a host of other incidents caused by excessive alcohol consumption.
Professor Paul Haber, medical director of Drug Health Services for Sydney South West Area Health Service, says alcohol consumption ‘‘ is one of the most common reasons to be presenting to the emergency department of a hospital, and has been that certainly throughout my career.’’
Professor Steve Allsop, director of the National Drug Research Institute, says it’s common to think of problem alcohol consumption as the ‘‘ bottle in the bottom drawer’’ scenario, but intoxication is now the issue.
‘‘ When you talk about alcohol problems, people think of dependence,’’ Allsop says. ‘‘ People think, ‘ I’m not dependent, I’m not alcoholic, so I’m OK’.’’
But dependence — what Allsop calls ‘‘ the regular drip, drip, drip of alcohol into your system’’ — is just one part of the picture.
‘‘ If you look at some of the major problems for young males in particular, but increasingly young females, it is about that heavy episodic drinking that results in them harming themselves and more importantly, harming other people.’’
Historically, people have focused on alcohol-related harms such as cirrhosis, but cirrhosis is just one part of a bigger and more worrying picture.
Directly or indirectly, alcohol causes a huge range of health damage. In addition to physical injury, there are the physiological effects of alcohol on the body. The most wellknown is the impact of alcohol on a developing foetus, but there is also alcoholrelated brain injury, cancer, neurological damage and gastroenterological damage.
While most of the neurological effects such as impaired speech and blackouts are shortterm, sustained and excessive alcohol con- sumption can lead to serious and persistent changes, including brain shrinkage and atrophy of nerve cells.
Chronic alcohol abuse also interferes with the availability of thiamine, also known as vitamin B1, an essential nutrient for brain function. This can lead to WernickeKorsakoff syndrome, a combination of mental confusion, vision problems, poor muscle coordination and persistent learning and memory problems.
Alcohol is also a known risk
Journey’s end: Andrew, who never thought he had a drinking problem, with Odyssey House CEO James Pitts, right