Al­co­hol abuse eclips­ing heroin

Aware­ness that Aus­tralia has a drink­ing prob­lem has reached the high­est lev­els of gov­ern­ment, writes Bianca No­grady

The Weekend Australian - Travel - - Health -

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

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Pic­ture: Amos Aik­man

Jour­ney’s end: Andrew, who never thought he had a drink­ing prob­lem, with Odyssey House CEO James Pitts, right

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