FROM LOW RISK TO HIGH RISK – THE STAGES OF PROBLEM DRINKING

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For many years, professionals working in the field of alcohol and drug addiction treatment have used data to determine if there is an amount of alcohol that can be consumed without any harmful effects.

Dr Stephen Jurd, director of the Sydney Retreat and leading authority on alcohol and drug addiction treatment in Australia says that according to the latest research, there is no longer such a thing as no-risk drinking, only low-risk drinking.

Dr Jurd says the definition of low-risk drinking will come as a surprise to many:

“Low risk drinking probably stops at about two drinks per day (standard sized drinks) and never more than four drinks on one occasion. Those are the sorts of numbers that infer a risk but a low risk, and probably one that’s acceptable in our society,” says Dr Jurd.

The latest research contradicts the belief that there are some benefits to moderate drinking. People in their 60’s and older have often been told by their GP to enjoy the benefits of a small whisky or brandy before dinner. That advice was consistent with the view that alcohol in moderation may reduce the incidents of heart disease. Now, those benefits are attributed to not smoking; drinking minimal amounts of alcohol regardless of how old you are; a balanced, healthy diet and regular exercise.

“In recent times, the notion that alcohol is helpful to people has been significantly undermined,” said Dr Jurd. “Most of the cutting edge thinking says there is no safe amount to drink.”

In fact, instead of being good for the heart Dr Jurd says that once you start having more than a couple of drinks per day then you are significantly increasing the likelihood of heart disease, stroke and cancer.

“It’s been well known that beyond about four drinks a day alcohol is bad for the heart. It certainly increases the risk of stroke past three or four drinks a day; and more than two drinks a day you increase the risk of a number of cancers including breast and bowel cancer,” says Dr Jurd.

But when discussing the social impact and health outcomes associated with drinking, older Australians having a small whiskey or brandy before dinner is not the demographic that we should be concerned with. For many, a small, measured indulgence may be just as life-affirming as having a healthy heart.

On the other hand, the one group that all professionals agree are most at risk are young drinkers. Because the brain continues to develop into your early and mid-twenties, the risk of brain damage from alcohol in young people is greatly increased. This is the group where any alcohol consumption is potentially dangerous. There is also evidence to suggest that drinking habits formed in young adults lead to bigger drinking problems and potentially alcoholism later in life.

As a culture, we have a tradition of casual, everyday drinking combined with celebratory drinking on significant days and events. The Social Impact Research Centre in the United Kingdom says cultures with these types of drinking patterns are associated with higher levels of alcohol-related problems. Simply put, their research identifies beliefs and norms inherent in our culture that support drinking and drunkenness.

As a society, we’ve resisted putting restraints and limitations on how much we drink. In fact, before random breath testing was introduced into NSW in 1968, the right to drink and operate a motor vehicle was considered an important liberty that should not be surrendered. And it wasn’t until 2007 that we placed enforceable limitations on serving alcohol to people who were already intoxicated with a legislative framework for the responsible service of alcohol (RSA).

Having a few drinks is so enjoyable to many and so much a part of the Australian lifestyle that drinkers tend to ignore the problems that their drinking may be causing.

Many drinkers think that they can consume large amounts of alcohol with impunity.

For some the damage is slow and the harm incremental. It’s been said that a drinking problem can appear like a thief in stocking feet.  Alcoholics in recovery all have similarities and differences in their personal stories. Generally, the first signs are relationship, family and professional problems.

According to Dr Jurd, the main damage that alcohol and other drugs cause is to relationships.

“The more you drink and the more you take drugs, the more your relationships are distorted,” he says. “The person on the other side of your relationship has to adapt to your sometime intoxication; your sometime hangover; to your sometime inappropriate behaviour.”

Problem drinkers can fall into a number of categories. For some drinkers, the realisation that there are problems is enough for them to take stock and moderate. Not all people who find themselves drinking over the suggested limits are alcoholic. Many people identify a problem or potential problem, seek a drug and alcohol rehab or another form of rehabilitation service and successfully stop or control their drinking, as the case may be. But for others, alcohol can either be problematic from the first drink or the habit has formed in them so completely that despite their best intentions they will be incapable of stopping or moderating for any significant amount of time.

Dr Jurd says that a drinker who can’t moderate or stop drinking when there are good reasons to suggest that they should, may need help. He also believes that the alcoholic stereotype keeps many people drinking much longer than they should. They believe that because they still have their home or a relationship or a job then they can’t be alcoholic.

“If you drink and have problems you should alter your drinking pattern. But if you can’t then clearly you have a problem and you might need help with that problem.”

In many instances it is just a matter of time until the delusion of a manageable life is shattered. The behaviour continues to escalate to the extent that it may include crime, violence, social disobedience and disorder, accidents and even partner abuse. Later, they will start to experience a deterioration in their health and wellbeing.

They become the person who is incapable of exercising any control over how much they drink and even get drunk at the most inappropriate times. Interventions seem pointless. Often their drinking escalates to such an extent that their lives are literally disintegrating. No matter what occurs or how much they lose, their decline continues and they seem incapable of offering any resistance. Sobriety seems an impossibility.

In time drug abuse and addiction may become a part of their makeup if it wasn’t to begin with. You may find that their disposition seems so hell-bent on self-destruction that you finally have to detach from them because to witness their decline becomes too difficult.

Alcoholics and addicts in recovery will tell you that alcoholism and addiction are progressive diseases. Some people are predisposed. Many alcoholics and addicts came from what they described as an alcoholic family, although most people could probably identify somebody in their family who they recognised as having a problem with alcohol. As the saying goes: If you shake the family tree an alcoholic is sure to come tumbling out.

Whatever the reasons and no matter how far down the scale you have gone, help is available. You may recognise some of the warning signs and find that you are able to drink in moderation or stop for the sake of your relationship or your profession. Some people may require some type of intervention, others won’t.

But if you can’t stop drinking on your own, then according to Dr Jurd the first thing that a drinker needs to do is admit that they are in trouble.

“To look at your life and say that this part of my life isn’t working and to then ask yourself if you are living the life that you want to live? Then to talk to somebody about it and get help through the process. This kind of appraisal is a daunting prospect,” he says.

Providing this kind of support for the 50 or 60% of problem drinkers for whom other methods of stopping had failed was the catalyst for the Sydney Retreat.

“The Retreat is a peer led recovery approach that benefits from the lived experience of people in recovery. It introduces residents to the recovery community and most importantly, it provides the education and support for people so that they know that they are not alone.”

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