Alcohol: drinking problems

The majority of people who drink alcohol do so at levels that are unlikely to cause problems. However, in Australia, an estimated one in 7 men and one in 9 women drink amounts of alcohol that could be damaging their long-term health.

Although most people use alcohol in a responsible way, it is important to remember that it is a drug. Its main effect is to depress the central nervous system.

Alcohol produces its effects by entering our bloodstream. Small amounts are absorbed through the wall of the mouth and the stomach lining, but most of the alcohol enters the bloodstream through the wall of the small intestine. Alcohol is then carried to all parts of the body. This happens more quickly if you:

  • drink strong drinks (for example spirits);
  • drink carbonated (sparkling) drinks such as cider or Champagne;
  • drink quickly; or
  • drink on an empty stomach.

The body gets rid of alcohol in a variety of ways. Most (about 90 per cent) is broken down in the liver. This takes about an hour for one standard drink. Small amounts of alcohol are also lost in the air we breathe out, in perspiration and in our urine.

There is no way of speeding up the body's ability to get rid of alcohol. Drinking coffee, having a cold shower and vomiting make no difference.

Alcohol affects different people in different ways. This will depend on the person (age, sex, general health, body size, personality and mood at the time), the drink (strength, how quickly consumed, other food or drugs present) and the circumstances (being alone, at a party, driving a car or operating machinery).

Harmful effects of alcohol

The effects of alcohol can be divided into immediate and long-term effects.

Immediate effects

Immediate (acute) effects of alcohol happen when the person is intoxicated. These include:

  • slowing down of mental activity (change in inhibitions, judgement and self-control, which can lead to getting into fights and arguments, having motor vehicle accidents, damage to reputation and risk-taking behaviours),
  • problems with the digestive system (stomach pains and vomiting) and
  • physical changes such as impotence and loss of balance.

Long-term effects

Long-term (chronic or over a long period of time) consequences of alcohol abuse include:

  • social problems, such as family disruption, loss of employment, financial difficulties;
  • emotional or psychological problems, such as anxiety and depression; and
  • physical problems, such as liver disease (including hepatitis and cirrhosis), high blood pressure, heart disease, certain types of cancer, erectile dysfunction, reduced fertility, memory problems and brain damage; ulcers in the stomach and damage to the pancreas that may produce pain, malnutrition and diabetic complications.

Because of the differences in body structure and chemistry between the sexes, women absorb more alcohol and take longer to metabolise it than men. As a result, women are more susceptible than men to the long-term health consequences of excessive alcohol use, including liver disease, memory loss and heart disease. The risks tend to be higher for women even if they drink at lower levels or have been drinking excessively for shorter periods.

For all these reasons it is important to be careful to use alcohol in moderation.

People with drinking problems can develop alcohol tolerance and dependence.

Alcohol tolerance

As with most drug addictions, people with alcohol problems usually find they have to consume ever-increasing amounts to get the same effect.

Alcohol dependence and withdrawal

Some people lose control of the way they use alcohol and become dependent on it. If this happens, the person may have physical withdrawal symptoms when alcohol is not available.

Withdrawal symptoms can include:

  • anxiety;
  • agitation;
  • insomnia;
  • nausea;
  • sweating; and
  • shakes or tremors.

In severe cases, there may be:

  • vomiting;
  • hallucinations; and
  • seizures.

Medically this is called delirium tremens (‘DTs’). Death can result from severe alcohol withdrawal.

    Treatment of alcohol misuse

    Much can be done to help those with alcohol problems, provided they are willing to seek assistance. Sadly the problem is often only revealed by some crisis, such as a motor accident, bankruptcy, marital breakdown, or other traumatic event.

    If you are concerned that you or someone close to you might have a drinking problem, discuss it with your doctor. Some early action can prevent serious problems later on.

    References

    1. National Health and Medical Research Council (NHMRC). Alcohol and health in Australia (updated 19 May 2014). https://www.nhmrc.gov.au/your-health/alcohol-guidelines/alcohol-and-health-australia (accessed Aug 2014).
    2. MayoClinic.com. Alcoholism (updated 9 Aug 2012). http://www.mayoclinic.org/diseases-conditions/alcoholism/basics/definition/con-20020866 (accessed Aug 2014).
    3. National Health and Medical Research Council (NHMRC). Australian guidelines to reduce health risks from alcohol; 2009. http://www.nhmrc.gov.au/guidelines/publications/ds10 (accessed Aug 2014).
    4. Australian Drug Foundation (ADF). Alcohol facts (updated 2 Jan 2014). http://www.druginfo.adf.org.au/drug-facts/alcohol (accessed Aug 2014).
    5. Centers for Disease Control and Prevention (CDC). Excessive alcohol use and risks to women's health (updated 16 Jan 2014). http://www.cdc.gov/alcohol/fact-sheets/womens-health.htm (accessed Sep 2014).
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