What does alcohol do?

Alcohol is the most widely used mind-altering drug in New Zealand. It is legal, it is readily available and it is generally socially acceptable.

Alcohol has stimulating, depressing and mood-altering functions that leave practically no circuit or system of the brain untouched. This range of effects is what sets alcohol apart from many other drugs.

It acts as a stimulant when it directly stimulates those brain cells, which lead to feelings of pleasure and euphoria. It is a depressant when it slows the brain down and reduces tensions and worries. It can affect our judgement and make us do things we would not usually do when sober. Alcohol acts as an anaesthetic when it slows down our reflexes and our coordination. It can put us to sleep, it can induce a coma and it can kill.

Alcohol's effects are dose related - the more alcohol you drink, the greater the effects that may occur. The effect alcohol has on you can also be related to your mood and your expectations. If we get the dose of alcohol right, it can be a pleasant and sometimes useful drug. If the dose is wrong, then alcohol can cause a wide range of harmful effects. Some of these are discussed below.

Defining alcohol problems

A number of different terms are used to describe alcohol problems. Sometimes the terms can be confusing.

• Hazardous drinking means drinking at levels or in situations that are likely to cause harmful consequences.
• Alcohol abuse refers to the idea that alcohol causes harmful consequences for a person, and the person continues to drink alcohol despite these consequences.
• Alcohol dependence is a more technical term indicating that either the body or the mind has become hooked or addicted to alcohol.
• Psychological dependence occurs when the mind seems to take over the control of a person's drinking. The person feels they have to drink to feel good or normal. Psychologically dependent people start to act in ways to ensure their addiction is satisfied - they think a lot about alcohol, they always ensure they have enough alcohol to drink and they plan their activities around alcohol.
• Physical dependence occurs when the body adapts to the high use of alcohol and requires this level of use to feel right or maintain its balance. There are two main signs of physical dependence.
  - Tolerance, which means a person has to progressively drink more alcohol to achieve the same effect that was previously achieved with smaller amounts.
  - Withdrawal, which is a state people can experience if they go without alcohol. Here the body reacts against the absence of alcohol by going through a period of shaking and sweating. If this progresses to a more severe stage, delirium tremens (DTs) may occur, with people becoming confused and experiencing hallucinations (seeing things or hearing things when there is nothing to be seen or heard).

Alcoholism or alcoholic are descriptions that mean different things to different people. Usually alcoholism relates to a state of alcohol dependence, but many people can have severe alcohol-related problems without having signs and symptoms of dependence.

Alcohol use is very common. Estimates are that over 90 per cent of New Zealanders drink alcohol. Studies suggest over 20 per cent of the population drinks excessively and that, at any one time, seven to 10 per cent of us have a problem with dependence on alcohol.

It is further estimated that about 30 per cent of people who are admitted to a general medical hospital have an alcohol-related health problem. Around 40 per cent of people in contact with the mental health services drink in a hazardous way.

Many people drink heavily for brief periods at different times and are then able to reduce or control their drinking. Severe drinking problems can become long-term ones if they are left unchecked or untreated. People who continually drink heavily can expect to have a disruptive life with more social problems than moderate and non-drinkers. They can expect more health problems and they can expect to die earlier.

Signs of an alcohol problem

How much a person drinks, or whether or not they are hooked on alcohol is perhaps less important than looking at the whole picture of a person's drinking and whether the way in which a person drinks causes problems both to themselves and to others. If this is the case, managing the drinking will need to be part of the solution.

In deciding whether or not drinking is a problem, it is useful to look at the level of drinking and the patterns of drinking (see below).

How much can be drunk safely?

The amount of alcohol we drink can be measured in a number of ways. The most commonly used method is to refer to a standard drink. There are about one-and-a-half standard drinks in the smaller size can of average strength beer; there is one standard drink in a small (100ml) glass of wine, and there is one standard drink in a hotel or bar size double nip of spirits.

There are no hard and fast rules as to what constitutes responsible drinking. Current advice is that up to 14 standard drinks a week for women and 21 standard drinks a week for men are at the upper limit of safer drinking.

This does not mean that if you drink below these levels you will never have any alcohol related problems, or that above these levels you will necessarily run into problems. People's ability to handle alcohol varies enormously. Evidence suggests, however, that as alcohol consumption rises above these recommended levels, the incidence of alcohol related problems rises proportionally.

Drinking patterns

Drinking two cans of beer a night might be within these limits. Drinking 14 cans of beer a night, once a week, would also be within these limits but the effects would be quite different. The advice is for men to keep to less than six standard drinks on any one occasion and for women to drink less than four standard drinks.

See also:
Alcohol - do you have a problem?
Alcohol - acknowledging problem drinking
Alcohol - overcoming problem drinking

Helpline

The Alcohol Drug Association of New Zealand (ADA) runs an alcohol and drug helpline - 0800 787 797 from 10am to 10pm, 7 days a week. You can also visit: www.adanz.org.nz

Original material provided by the Mental Health Foundation of New Zealand, 2002. Edited by everybody, June 2005.