Alcohol: Still the Main Drug of Addiction
Published: 17 February 2020
Published: 17 February 2020
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) (NSW Ministry of Health 2017). Consumed in excess, however, alcohol consumption can quickly lead to nausea, vomiting. The long-term adverse effects are much more serious, even deadly.
Alcohol use disorder (AUD) is the medical diagnosis for prolonged and severe drinking that is causing problems in a person’s life. Alcoholism is the colloquial term for this disorder. It is extremely prevalent and a serious medical issue that can have fatal consequences.
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.).
In 35% of drug treatment episodes in 2017-18, alcohol was the primary drug of concern - making it the most commonly treated drug in Australia (AIHW 2016).
A recent study found that 1 in 6 Australians consumed alcohol at levels that placed them at lifetime risk of an alcohol-related injury (AIHW 2016).
Alcohol was the only drug where the approval of regular use (by an adult) was higher than disapproval (46% approved; 22% disapproved) (AIH 2017).
There were 1,366 alcohol-induced deaths recorded in 2017. There were an additional 2,820 (alcohol-related) deaths where alcohol was listed as a contributing factor to mortality (ABS 2018).
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 (NIH 2016).
(NIH 2016)
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 2016).
(NSW Ministry of Health 2017)
(NSW Ministry of Health 2017)
Based on recent statistics, the following groups are at greater risk of forming a dependence on alcohol:
(AIHW 2020)
Some alcoholic drinks have a higher concentration of alcohol than others. In Australia:
(NSW Ministry of Health 2017)
This means that for the same volume of liquid, both wine and spirits will affect you faster than beer.
Withdrawal from chronic alcohol use should be completed inline 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:
(Harvard Health Publishing 2019; SA Health n.d.)
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 n.d.).
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).
(Healthdirect 2017)
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.
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Question 1 of 3
True or false? Fortified wines such as sherry and port contain 18% to 20% of alcohol.
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