HOW MANY GLASSES MAKE YOU A HEAVY DRINKER?

10? 15? Ac­tu­ally, it’s eight. Here’s why it might be time to find your booze bal­ance

Marie Claire (South Africa) - - FRONT PAGE - Words GLY­NIS HORN­ING

IT’S A SOBER­ING THOUGHT

in the sea­son of good cheer, but for all the pub­lic­ity around other drugs, al­co­hol is the most abused sub­stance in South Africa and glob­ally.

‘Re­search over the past 20 years in­di­cates that women are drink­ing more, drink­ing younger, and in­dulging in more bingedrink­ing,’ says Claire Sav­age, se­nior train­ing of­fi­cer at the South African Na­tional Coun­cil on Al­co­holism & Drug De­pen­dence (Sanca) Dur­ban Al­co­hol and Drug Cen­tres.

About 130 peo­ple die in South Africa each day of al­co­hol-re­lated causes, says prof Charles Parry, di­rec­tor of the Al­co­hol and Drug Abuse Re­search Unit at the SA Med­i­cal Re­search Coun­cil. And ac­cord­ing to our Min­is­ter of So­cial De­vel­op­ment, Batha­bile Olive Dlamini, we have one of the high­est av­er­age in­di­vid­ual con­sump­tion rates of al­co­hol and rank high­est for binge-drink­ing in the world.

Mea­sur­ing the prob­lem

But how much is too much? You’re a ‘heavy drinker’ if you have eight or more drinks a week (men can have 14), ac­cord­ing to the US Cen­ters for Dis­ease Con­trol and Preven­tion. And South African women top the list of heavy-drink­ing women in Africa, ac­cord­ing to a World Health Or­gan­i­sa­tion (WHO) re­port last year – we tie with Zam­bia. It’s small con­so­la­tion that Africa ranked be­low Europe and the US,es­ti­mated to have a per capita al­co­hol con­sump­tion of 12.18 litres and 8.67 litres re­spec­tively, com­pared with our 6.15 litres a week. We ranked 55th out of 189 coun­tries in the heav­i­est­drink­ing stakes.

Of spe­cial con­cern is our bingedrink­ing. The WHO re­ported that 41.2% of South African women were binge drinkers, mean­ing they drink in a way that brings their blood al­co­hol con­cen­tra­tion lev­els to 0.08g/dl – which typ­i­cally oc­curs af­ter four stan­dard drinks in two hours for women ( ve drinks for men). A stan­dard drink is 360ml of beer (5% al­co­hol con­tent); 150ml of wine (12%), a typ­i­cal wine glass; or 45ml of 80-proof (40%) dis­tilled spir­its like gin, vodka, whiskey, rum, a tot or shot.

What’s driv­ing us to drink?

Women drink for a cock­tail of rea­sons, says Claire – from at­tempt­ing to es­cape from the dis­tress of poverty or heartache, to mask­ing in­se­cu­ri­ties, shed­ding in­hi­bi­tions and just ‘feel­ing good’. And though it’s not a prob­lem in mod­er­a­tion, it can eas­ily tip into abuse. This has be­come much eas­ier in re­cent years be­cause the so­cial stigma that tra­di­tion­ally gave women a greater sense of shame about drink­ing and get­ting drunker than men has faded, she says – and ad­ver­tis­ing and celebrity drinkers have given al­co­hol ac­cept­abil­ity, even allure.

Women are also in­creas­ingly driven by de­mand­ing ca­reers and their mul­ti­ple roles as part­ners and par­ents. On top of this, there’s the pres­sure of be­ing con­stantly on call, and the new wor­ries so­cial me­dia brings, from fear of miss­ing out to feel­ing we must com­pete with oth­ers’ care­fully edited posts and air­brushed images.

Count­ing the costs

The temp­ta­tion to es­cape with a drink can be high, but the cost of over­do­ing it is higher. ‘Heavy drink­ing causes im­pair­ment of the cen­tral ner­vous sys­tem, par­tic­u­larly your brain,’ Claire says. It dulls senses, slows re­ac­tions, im­pairs sex­ual per­for­mance and mem­ory, dis­torts judge­ment, af­fects con­cen­tra­tion and co­or­di­na­tion and brings mood swings and de­pres­sion. It also raises your risk of every­thing from breast can­cer to hy­per­ten­sion, ul­cers, liver dam­age, os­teo­poro­sis and re­pro­duc­tive prob­lems, in­clud­ing in­fer­til­ity; and if you’re preg­nant you put the foe­tus at se­ri­ous risk.

As for the ar­gu­ment that al­co­hol, es­pe­cially red wine, can be bene cial, ‘some re­search in­di­cates that mod­er­ate al­co­hol con­sump­tion (a glass a day) may el­e­vate good choles­terol, but the fact is that pro­longed drink­ing has been as­so­ci­ated with strokes and heart fail­ure,’ Claire says. Charles agrees, say­ing that even one drink a day can in­crease your chances of breast can­cer by about 20%.

Spot­ting the signs

When it comes to slip­ping from so­cial drinker to prob­lem drinker, trau­matic or dis­rup­tive early life ex­pe­ri­ences such as di­vorce, aban­don­ment or abuse make you es­pe­cially vul­ner­a­ble, as does al­co­holism or psy­chi­atric ill­ness in your fam­ily, says Charles. Ge­net­ics have a role, but are re­spon­si­ble for only half your risk for al­co­holism. En­vi­ron­men­tal fac­tors ac­count for the rest – peers, fam­ily and al­co­hol avail­abil­ity.

Early warn­ing signs to watch out for are drink­ing to re­lieve stress, and a high tol­er­ance for al­co­hol. ‘Peo­ple who can “hold their drinks” are not strong, but po­ten­tially al­co­holics,’ Claire says. Other signs in­clude, gulp­ing drinks at par­ties, need­ing a drink for your ‘nerves’, min­imis­ing or ly­ing about your drink­ing, feel­ing guilty and get­ting de­fen­sive about it, and miss­ing work be­cause of it.

Cut­ting back

‘Not ev­ery­body who drinks al­co­hol abuses it,’ says Dr Os­born Ma­han­jana, chief ex­ec­u­tive of the Industry As­so­ci­a­tion for Re­spon­si­ble Al­co­hol Use. He be­lieves the ‘re­spon­si­ble drink­ing’ mes­sage is reach­ing peo­ple, and quotes WHO statis­tics which sug­gest 40% of South Africans drink al­co­hol, ‘but only 10% abuse it’. ‘We sim­ply need to get peo­ple to drink less; to binge less fre­quently,’ he says.

The key is to as­sess your drink­ing. ‘Be hon­est about how much you’re con­sum­ing,’ Claire says. ‘If you’re hav­ing more than two drinks a day, make a com­mit­ment to cut down, if not to stop drink­ing al­to­gether.’ Iden­tify your trig­gers, change your rou­tines and plan how you’re go­ing to so­cialise and deal with dif­fer­ent pres­sure sit­u­a­tions. If you can’t do this, get pro­fes­sional help.

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