The majority of Australians drink alcohol - approximately 77% of Australians over the age of 14 have consumed alcohol within the past 12 months (AIHW 2022a).

Drinking is associated with a wide range of our social and cultural activities and is often actively encouraged. Alcohol generally plays a prominent role in occasions such as celebrations, sporting events, during meals, clubbing and at house parties. It can be viewed as ‘un-Australian’ to turn down a drink. Our heavy drinking culture dates back as far as colonisation - for a period, convicts were paid partially in rum (Moodie 2013).

When alcohol is absorbed into the bloodstream, short-term effects on the brain, such as a sense of relaxation and reduced inhibition, can be seen within about five minutes (This can vary from person to person, depending on their body mass and state of health) (Swift 2017). Consumed in excess, however, alcohol consumption can quickly lead to nausea, vomiting, loss of consciousness and even death (DoHAC 2022).

Alcohol Addiction

Alcohol addiction refers to a physical dependence on alcohol. This is a serious medical issue that can have permanent consequences, such as brain damage and an increased risk of cancer and cardiovascular disease (ReachOut n.d.).

To have an addiction is to have a dependence on a substance or activity. As opposed to someone who simply wants something, a person with an addiction will have physical cravings for the substance they’re addicted to (ReachOut n.d.).

Alcohol in Australia

In 37% of drug treatment episodes in 2020-21, alcohol was the primary drug of concern - making it the most commonly treated drug in Australia (AIHW 2022a).

Furthermore, in 2014-15, approximately one in six Australians were consuming alcohol at levels that placed them at lifetime risk of an alcohol-related injury (AIHW 2017).

Alcohol was also the only drug where the approval of regular use (by an adult) was higher than disapproval (46% approved; 22% disapproved) (AIHW 2019).

There were 1,559 alcohol-induced deaths recorded in 2021. This was the highest rate of alcohol-related deaths in 10 years (ABS 2022).

Alcohol Use Disorder as Defined by the DSM-5

In 2013, the DSM-5 made changes to the categorisation of alcohol use disorder. DSM-5 now integrates the two DSM-IV disorders, alcohol abuse and alcohol dependence, into a single disorder called alcohol use disorder (AUD) including mild, moderate, and severe sub-classifications (NIAAA 2021).

The 11 Symptoms of Alcohol Use Disorder as Listed in the DSM-V

1. Alcohol is consumed in large amounts or over a longer period than was initially intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control drinking.
3. A lot of time is spent drinking or recovering from the effects of alcohol.
4. A person wants a drink so badly they cannot think of anything else.
5. They find that drinking or being sick from drinking often interferes with taking care of home or family, or causes job or school problems.
6. They continue to drink even though it is causing trouble with family or friends.
7. They have given up on or cut-back activities that were important or interesting to them, or gave them pleasure, in order to drink.
8. More than once they have engaged in situations while or immediately after drinking that increased the chances of getting hurt (for example swimming, using machinery, or having unsafe sex).
9. They continued to drink even when it was making them feel depressed or anxious or added to another health problem, or after having a memory blackout.
10. Have to drink more than they previously did to get the intended effect, or found that the usual number of drinks had much less effect than before.
11. Experience withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure, or sensed things that were not there.

(NIAAA 2021)

The presence of at least two of these symptoms indicates an alcohol use disorder. The presence of two to three is considered mild. Four to five is moderate and six or more is severe (NIH 2021).

The Effects of Alcohol Consumption

Short-term

• Reduced inhibitions
• Loss of alertness or coordination and reduced reaction rates
• Impaired memory and judgement
• Double or blurred vision
• Disturbed sleep patterns
• Disturbed sexual function
• Nausea, shakiness and vomiting.

(Swift 2017)

Long-term

• Brain damage and dementia
• Liver cirrhosis
• Oral, throat and breast cancers
• Forms of heart disease and stroke.

(Swift 2017)

High Risk Groups

Based on recent statistics, the following groups are at greater risk of forming a dependence on alcohol:

• Aboriginal and Torres Strait Islander Peoples
• People with mental health conditions
• Older people
• Younger people.

(AIHW 2022b)

Which Types of Drinks Have the Highest Alcohol Content?

Some alcoholic drinks have a higher concentration of alcohol than others. In Australia:

• Beer contains 0.9% to 6% alcohol
• Wine contains 12% to 14%
• Fortified wines such as sherry and port contain 18% to 20%
• Spirits such as scotch, rum, vodka and bourbon contain 40% to 50%.

(Swift 2017)

This means that for the same volume of liquid, both wine and spirits will affect you faster than beer.

Withdrawal From Alcohol

Read: Drug and Alcohol Withdrawal: An Insight

Withdrawal from chronic alcohol use should be completed in line with medical advice and/or supervision due to the life-threatening nature of its effects.

The body goes through significant changes as prolonged and heavy alcohol use stops. This is known as alcohol withdrawal.

Symptoms of withdrawal from alcohol include:

• Trembling
• Sweating
• Nausea
• Headaches
• Insomnia
• Anxiety.

(Harvard Health Publishing 2019; SA Health 2022)

The effects of withdrawal are prominent when alcohol consumption ceases abruptly. Withdrawal syndrome is a hyper-excitable reaction of the central nervous system (CNS) as a result of the lack of the sedative effect of alcohol following long-term exposure to high quantities of alcohol (SA Health 2022).

Over time, the brain changes its own chemistry to balance the effects of the alcohol. It produces stimulating chemicals such as serotonin or norepinephrine (similar to adrenaline), in greater quantities (Harvard Health Publishing 2019).

Note that most hospitals and health services have their own policies and procedures relating to the management and treatment of alcohol withdrawal including the Alcohol Withdrawal Scale (AWS).

Tips for Cutting Down Alcohol Consumption

• Setting a drink limit and sticking to it
• Counting drinks, keeping in mind that drinks at a bar or restaurant might contain more than one standard drink
• Drinking water before drinking alcohol to quench thirst
• Drinking slowly
• Eating before and while drinking
• Finishing a drink before the next is started, and trying not to top up drinks as it is possible to lose track of how many drinks have been consumed
• Drinking a non-alcoholic drink between drinks
• These tips considered, it is vital not to cease the consumption in the event of previous heavy usage without medical advice or supervision.

(Healthdirect 2022)

If you’re in crisis and need support, call Lifeline on 13 11 14. Lifeline is open 24 hours a day, 7 days a week.