Be knowledgeable about alcohol and its effects



Heavy drinkers tend to hang out with other heavy drinkers and thus justify their consumption as normal.  They are often unaware that

 

  • Even though it is legal - alcohol is a powerful and harmful drug with  no health benefits. World Health Organisation  2022. “No safe level” 
    Ref:  who.int..2023-no-level-of-alcohol-consumption-is-safe-for-our-health

  • The recommended healthy drinking standards are based upon over fifty years of a huge volume of rigorous scientific studies.

    Australian Government Recommendations: “To reduce the risk of harm from alcohol-related disease or injury, healthy men and women should drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day. The less you choose to drink, the lower your risk of harm from alcohol. For some people, not drinking at all is the safest option”. 
    Ref: health.gov.au/…how-much-alcohol-is-safe-to-drink

  • Many heavy drinkers/ alcoholics will think you must be joking !

    Knowing and accepting the recommended healthy drinking standards empowers you to discuss this issue in more depth and educate your client.

  • There is a higher risk for a range of cancers, for example. with increased alcohol consumption.
    Ref: cancer.gov…causes-prevention/risk..alcohol-fact-sheet

    Having this sort of information can validate your concern for your client's health, rather than your being seen as being critical or judgemental for no specific reason.

  • Factors such as gender, body size, fat to muscle ratios etc. can affect the blood alcohol level when drinking drink for drink with others.
    Ref: adf.org.au/reducing-risk/alcohol/bac/

    For example, a 55 kilo 13 year old teenage boy’s BAL would be twice of a 110-kilo male if drinking drink for drink.

  • Alcohol is not processed proportionally in the same way as other drugs.

    For example the half life of nicotine is 8 minutes, which means that the BNL (Blood Nicotine Level) drops to one half in 8 minutes, to one quarter in 16 minutes, to one eight in 24 minutes, to one sixteenth in 32 minutes - no wonder nicotine addicts need a top up after half an hour to one hour.

    Alcohol is only processed at about 1 standard drink (10 grams alcohol) per hour.

    • 30ml of spirits (40% alc/vol)

    • 60ml of fortified wine (18% alc/vol)

    • 100ml of champagne (12% alc/vol)

    • 100ml of wine (12% alc/vol)

    • 150ml of light wine (8% alc/vol)

    • 280ml of standard strength beer (4.9% alc/vol)

    •  375ml of low-alcohol beer (2.8% alc/vol)

      Each standard drink raises the BAL/BAC approximately 0.01g/% to 0.03g% points
      Ref: sahealth.sa.gov.au/wps/wcm/connect/../BACMOD…D

  • The drinking rate of regular drinkers in bars/ group settings is roughly 3-4 drinks per hour.

    So someone who has been drinking for four hours (12 to 16 drinks) starting from zero BAL/BAC could have a BAL/ BAC of 12-4 = 8 to 16-4 =12 drinks.

    Using the .01g% liver processing rate this is a BAL/BAC of 0.08g% to 1.2g% - over the driving limit.
    Using the .02g% liver processing rate this is a BAL/BAC of .04g% to 0.6g% - on the edge.

    People with some liver impairment are more likely to processing alcohol more slowly and so have at a higher BAL/BAC

    Note: Using the one drink per hour rate, means someone who is over the limit on the way to work in the morning, is most likely to have been drinking heavily the night / day or days before.

  • TIP - Always ask about a person’s alcohol use - but Refrain from asking people how many drinks they have per day or per week.


    Whilst the drinking patterns of Australians are changing to the better, 17% are not drinking moderately.

    Ref: alcoholbeveragesaustralia.org.au/drinking-in-moderation-is-the-new-norm/
    (Note: An observation is that the introduction of Random Breath Testing in the early 1980s had an important broader impact on our Australian drinking culture. Before then, there was not a socially acceptable reason to refrain from drinking.)





    If you note signs that you may be dealing with a problem drinker, it is very likely you are. So in trying to draw out information about their level of drinking, assume the worst as if it were normal:

    And allow the person to correct you - probably coming under the amount you suggest - but still more likely to give you a better picture that just asking a single question.

  • For example, for a person in certain types of employment - you might say: I suppose you have a few drinks with the boys/ girls at the bar over lunch (1 hour) - say 3 or 4 drinks?

    And after work, you’d go to the pub or bar - I suppose that means you go home around 9 or 10 - sometimes later?
    What time then?

    And when you get home, like many people, you have a few more to top up and maybe a night-cap?

    And I suppose that if your feeling a bit under the weather like many drinkers, you have one or two “heart-starters” most days. etc.

  • Or in other situations where the person maybe hiding their drinking - it may be best to start with _ I suppose like most people when you get home from work you have a few drinks to unwind?

    And a few drinks with dinner? What do you do after dinner? like most people I suppose you have a couple of drinks and a night cap?

    Do you take alcohol to work or have some at work for those particularly stressful days etc.



  • Factors such as tolerance can disguise person’s actual Blood Alcohol Level (BAL/BAC)

    People with drinking problems develop tolerance, which means that they can appear reasonably functional with higher blood alcohol levels than a person who rarely drinks.  
    Ref: duke.edu/…bio-factors-influence-alcohol-intoxication/

    That is, if a person appears reasonably functional at mid-range BALs, or able to tolerate high-range BALs that would be life-threatening to occasional drinkers, then you are dealing with someone with alcoholism/ alcohol use disorder/ alcohol dependence - whatever you like to call it.

    People with high tolerance may also have high tolerance to other drugs (called cross-tolerance). Something for medical staff, and especially Anaesthetists, to consider in their treatment plans. 


  • Higher “natural” tolerance may be a factor for those from families who have alcoholism in previous generations, in developing alcoholism.
    Ref: scienceofbiogenetics.com/…the-role-of-genetic-tolerance…alcohol-sensitivity-and-dependence


  • Alcohol is a diuretic impacting various body systems – most importantly the brain.
    Ref: healthline.com/health/alcohol-dehydrate..body

    For daily drinkers, especially at high dose levels, this can lead to these people trying to function in a “fog”, somewhat like a temporary dementia, where the person’s personality and abilities can decline over time.

    Unlike age-related dementia, this dehydration is reversible by stopping drinking.

    For some high dose drinkers, it can take  several months for the brain to be fully hydrated.


  • Alcohol affects memory.  Most known are the long-term effects of drinking which can lead to permanent short-term memory loss.
    Ref: wikipedia.org/wiki..effects..alcohol_on_memory

    Less commonly known is minimal brain-damage which can occur at drinking lower doses of alcohol and impair organisational skills.

    In turn, this can affect employment (The Peter Principle?) but also a person’s ability to gain insight into their own behaviour. AA’s stories help give insight by drawing aspects of alcoholism together.


  • Drinkers can be in a state called a “blackout”  that are not purposeful forgetting - although a person can do that too.
    Ref: niaaa.nih.gov/pub…interrupted-memories-alcohol-induced-blackouts

    Blackouts are not flaking out. Blackouts are periods where the person can be walking, talking, driving and appearing relatively normal to others, but not be recording the memory of what they were doing.

    This can be a disturbing and stressful as the person tries to piece together what they have been doing the following day.

    Blackouts are considered one of the indicators that the person maybe be an alcoholic.


  • Confabulation and paranoia. Whilst not widely investigated, it can be that alcoholics in seeking to make sense of their world, with blackouts, poor short term memory problems and minimal brain damage, can create explanations for things that baffled them and then believe these creations to be true. This can also contribute to paranoid delusions.

    Here, like the aged person with dementia, the person is not deliberately lying or trying to deceive.



  • One or two drinks may make one’s good intentions “dissolve”:

    Alcohol as a depressant drug slows down the nerve impulses affecting the frontal lobe - the centre of decision making and control of inhibitions. Not having the first drink avoids the risk changing those decisions.
    Ref: health.clevelandclinic.org/..alcohol-affect-the-brain



  • Withdrawal: Alcohol as a depressant drug means that as the person withdraws the nervous system speeds up, bringing on anxiety-  making an anxious person worse.

    Hangovers are a withdrawal effect.

    But for those in more serious withdrawal, this agitation can result in seizures, hallucinations (visual, auditory and tactile) and delirium. Severe withdrawal is a medical emergency as the person can die without treatment. Also, something for those managing people post-operative to be aware of.  
    Ref: adf.org.au/insights/safely-withdrawing-alcohol/



  • For Information on Understanding Addiction
    The Sydney Retreat - Twelve Step Facilitated recovery (TSF) Director Dr Stephen Jurd, specialist addiction psychiatrist.
    See www.thesydneyretreat.org.au/about-drug-alcohol-addiction/



The above information is provided to assist professionals to be able  help educate their clients and  deal with these difficulties with more objectivity.

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