You’d struggle to find a social scenario in Australia where drinking alcohol isn’t strongly encouraged or at the very least an available option. From pubs to footy games, kids’ birthday parties to cinemas — drinking is run of the mill.
Excess drinking might conjure images of bad behaviour and heavy hangovers but it’s not hard to exceed the drinking guidelines — one full-strength beer or a restaurant pour of wine is around 1.5 standard drinks. Around 1 in 4 men aged 18 and over (24%) average more than two standard drinks per day, exceeding the lifetime risk guideline. More than 1 in 2 men (54%) consume more than four standard drinks on any one occasion, exceeding the single occasion risk guideline. It’s not just individual willpower at play when it comes to risky drinking — structural and environmental factors have a significant influence.
“Alcohol's available on every corner, it's marketed heavily, and it's relatively cheap,” says Caterina Giorgi, CEO of the Foundation for Alcohol Research and Education. “Those sorts of things send a message that it's okay to drink and it's okay to drink to excess, and those sorts of things contribute to people's perceptions of alcohol as a product, rather than as a potentially harmful drug.”
Booze has also been built into our daily routines, celebrations and milestones.
“Someone might mark the end of a week with a drink or a celebration with a drink, because we've been constantly told through marketing from alcohol companies that alcohol's the way that you celebrate, it's the way that you commiserate,” Giorgi says.
Particularly troubling is marketing that associates alcohol use with manliness.
“There's an expectation for everyone, but particularly for men, that they are drinking and there are lots of questions when they're not,” Giorgi says. “In social environments and also in the sorts of roles and employment areas that men are usually in, there's an expectation of risky drinking.”
The impact on your health
Risky drinking habits are doing your health serious harm, in the short term and the long term. While consuming alcohol you’re at greater risk of falls, accidents, conflict, lowered inhibitions and risky behaviours. Many people use alcohol to help with poor sleep, anxiety, stress or low mood when it actually worsens these issues.
“We know that alcohol use contributes to more disrupted sleep, alcohol use contributes to worsening mental health and anxiety,” Giorgi says. “It also affects your mood, and the energy levels that you have.”
Long-term alcohol consumption contributes to more than 200 different types of diseases and injury including cardiovascular disease, diabetes, cancer, liver disease, anxiety and depression. Critically for men — who make up 75% of suicides in Australia — alcohol is one of the most significant risk factors for self-harm.
The COVID-19 pandemic has a varied impact on alcohol consumption amongst Australians, with equal numbers of people increasing their drinking during the lockdown as those drinking less than usual.
“What we found is that people who were more likely to be drinking in a social environment, say at a pub, club, at a bar, they may have reduced their drinking, but people who are more likely to be drinking in a home environment, the environment is such that they might've increased their drinking,” Giorgi says. “Men were more likely to drink as a result of psychological distress, anxiety, and concerns about things like employment or job loss, or reduction in work hours.”
Risky alcohol use during the pandemic has also been driven by boredom and the habit becoming part of a new routine.
“Some are saying that they're starting earlier in the day, or more likely to drink on more days, and they're the sorts of habits that are really hard to undo as time goes on, and we're now entering year three of the pandemic, and those sorts of things that contribute to alcohol use disorder.”
Recognising a problem
There is a spectrum of alcohol use and unhealthy use ranging from non-drinkers to low risk, to hazardous, to harmful to dependence. Hazardous alcohol use is when excessive drinking is yet to cause harm but is putting you at risk, harmful drinking has caused physical or mental harm (and often social consequences) and alcohol dependence is you cannot control your use of alcohol despite adverse consequences.
Alcohol use disorder (colloquially referred to as alcoholism) is a problematic pattern of alcohol use that results in significant impairment or distress. It affects anywhere from 800,000 to more than a million Australians.
Recognising problematic drinking habits can be challenging and it’s not always as clear cut as hitting ‘rock bottom’. Start by comparing your consumption to the guidelines to reduce the risk of alcohol-related harm over a lifetime and consider how your booze habits impact your day to day.
“If it's starting to impact on your everyday life and your ability to do the sorts of things that we all do and need to do, then it's a sign that alcohol is a problem,” Giorgi says. “If you're finding that you're setting a goal or setting a limit for the drinks that you're going to have, and you're finding it hard to stick to that limit, if you're finding that people in your family or your friends are mentioning that they're concerned about your drinking, if you're finding that it's hard for you to get through a day without drinking, all of these things are signs.”
Other signs your drinking habits need a closer look include:
- Needing to drink more to feel the same effects
- Drinking is affecting your physical or mental health
- Not feeling in control of your drinking
- Struggling with work, education or relationships for no obvious reason
- Feeling the need to lie about about how much you drink or hide your alcohol consumption
- Craving alcohol and feel anxious about when you will be able to drink
- Forgetting what you said or did while you were drinking
- Experiencing nausea, sweating, shakiness and anxiety if you stop after a period of heavy drinking
Simon Ives, 40, stopped drinking alcohol two years ago after realising his habits were getting a bit out of hand.
“I’d moved to a mining town called Mount Isa in North West Queensland and this place has a massive drinking culture — there is nothing that happens without alcohol,” Ives says. “Over time, I noticed I was drinking a lot more, more frequently and greater amounts.”
He was prompted to reflect on his alcohol consumption during a family holiday to Fiji.
“Drinking alcohol is not as much part of the culture over there so I was drinking less and then I was thinking, this isn't good, I've put on a fair bit of weight, and just made the decision to stop drinking.”
What to do next
It’s a good idea to chat to your doctor if you want to stop or reduce your drinking. If you’re a regular or heavy drinker, it’s essential to see your GP as it can be dangerous to reduce or quit alcohol on your own. They will create a withdrawal plan for you to follow, connect you with support services and help you keep track of your progress with regular checkups. Medication and counselling can help.
When reducing or quitting alcohol consumption it’s important to do a bit of planning. Think about:
- Your goals — why do you want to reduce or quit alcohol?
- Your triggers — why and when do you drink?
- Your strategies — how will you reduce or quit alcohol?
- Your support network — who will you turn to for help?
Ives says a realistic plan helped him.
“I'd know which events I'd be going to or whatnot so I could plan ahead,” he says. “What I did do was look at other things that I could drink that would be satisfying but were non-alcoholic.”
Instead of coming home from work and having a drink to wind down, Ives got stuck back into a hobby he’d let slip.
“I used to build guitars when I was younger, so I started doing that again, which is a very time consuming and detail oriented task, so I'd be heavily focused on that.”
Having the support of his family really helped as well.
“My wife, she has not decided to give up drinking completely, but she's fully supportive of me doing it, so I have that encouragement and support and someone I can talk to if there's any challenges, has been a great help,” he says.
Online networks such as Hello Sunday Morning and their program Daybreak or Sober in the Country can connect you with a like-minded community and it’s a good way to chat through strategies and seek support.
Ives originally set a goal of quitting drinking for the six months leading to his birthday, but he felt so much better he decided to continue.
“I could sleep so much better, I could fall asleep a lot better, and I wasn't waking up in the night, and I've lost weight, in the last two years I've lost 10 kilos.”
Although some people in his life were a bit sensitive in response to his decision, most people were positive.
“All my work colleagues were like, ‘Oh, this is fantastic, good for you’,” Ives says. “But to be honest most places I go, if I'm sitting there having a glass of diet Coke in a glass, people would just assume I'm having a Coke with some sort of alcohol in it.”
 McDonough et al., 2021. Understanding and managing comorbidities for people with alcohol problems: polydrug use and dependence, co-occurring mental disorders, and physical comorbidities. Med J Aust