Curbing binge drinking when you’re over 40
The NIAAA defines a binge drinker as someone who consumes more than five standard drinks in one sitting. If every Australian was asked to put their hand up if they know someone who has had this many drinks on a weekend (or if they do themselves), it would probably look like a national Mexican wave.
When we think about binge drinking, often we imagine teenagers or young adults downing pints of beer or spirits, and getting into tricky situations, having to go to hospital, making regrettable decisions and generally being pretty messy. One thing that might surprise you is that, statistically, some groups of older adults are alongside their younger counterparts in being classified as ‘binge drinkers’.
Binge drinking is something that many older adults might be in the habit of doing, either at home with their partners, or while out with friends. Think about barbecues, dinner parties, long lunches … situations where there is lots of alcohol available, no real limits on time, and surrounded by others who are drinking similar quantities.
Drinking to celebrate or ‘cut loose’
Often in these situations it is expected that people will be drinking to get drunk, and drunken behaviour is either tolerated or celebrated – maybe it is part of a bonding experience or a way to relax. Often it is something that we don’t really think of as being unusual or problematic if it is all around us and everyone is doing the same thing. Sometimes it is only when we start to experience the harms of binge drinking, like health issues, mood issues the following day, or consequences from decisions made when drinking, that we might consider making changes.
Binge drinking amongst older adults has been in the spotlight lately, most notably for the fact that as we get older, our bodies respond differently to alcohol and so drinking to excess can have much more significant effects than when we were younger. In addition to this, there are all the other risks that arise when we are drinking to excess. Things like falling over, risky behaviour, drink driving or even getting involved in altercations. Adults who are binge drinking might describe feeling really ashamed about some of the situations they find themselves in, saying things like;
‘I should know better, I’m an adult!’, or ‘I can’t believe I got so bad, I’m really embarrassed’.
As adults we like to feel in control and often have lots of responsibilities and so it can be frightening to find ourselves in situations where we can’t remember what happened, or being told that we behaved in a certain way because of alcohol.
The health effects of binging
Doctors will often advise those over 50 to moderate their alcohol consumption, with an increased risk of all types of cancer, heart disease, diabetes, kidney and liver disease seen in high-risk drinkers over this age. For us, we see a lot of Daybreak members making the decision to step away from binge drinking around this age. This is due to a number of reasons, including health, mood, and also a desire to socialise in a more moderate and balanced way. Many people actually find that when they cut back on their drinking, social occasions are a lot more manageable (fewer hangovers and consequences) and they will be able to focus on interacting with friends and loved ones, rather than drinking to excess.
If you think you’re at risk of binge drinking, or you fit into the category of someone who is drinking in excess regularly, here are some ideas to start to make changes:
Monitor your drinking for a week – just keep track of how much you drink by taking note on your phone. Consider how much you’d like to be drinking and how much would be reasonable for you to aim for. Consider the situations in which you might be wanting to drink less and the situations where no change is needed.
Try implementing some replacement behaviours – like soda water or even low-alcohol beer or wine, to see if this will help to reduce the amount you are consuming in a session. Even a few glasses of soda water with lime is going to help your body to process alcohol if you are drinking. Often we tend to binge when those around us are drinking heavily, there are no limitations, and we are drinking on an empty stomach, so see if you can address these issues.
Take note of the ‘culture’ in your friendship group – is it around getting drunk together, and if so, what might you like to change about this? Sometimes this can be the biggest challenge – saying no to that extra drink and needing to explain that you are cutting back, and why. Try experimenting with this and some possible reasons you may have for cutting back, including health, or even saying ‘I’m taking a break for a while, to see what it’s like without alcohol’.
Talk to those around you about creating goals– for reducing the amount you are drinking. Discuss with them how much is ‘enough’ and what kind of relationship with alcohol you might like to form. Maybe your partner or friends are also noticing the cumulative effects of alcohol on their bodies and mood. Perhaps consciously changing the drinking culture in your home might help turn things around and give you a boost.
Consider situations where you generally don’t drink as much and look at what helps in that situation – is it knowing you have a limit (e.g. driving), or is it situations where you’ve eaten beforehand, or are with people you know aren’t big drinkers? See if you can use these existing situations to inform future plans. Similarly, consider the situations where you tend to drink heavily, what is happening there? Is there an expectation that you’ll drink, and a situation that supports this (e.g. staying overnight, unlimited alcohol).
Ensure that if you are going to a party or social event, that you have eaten – or are going to eat something to balance the effect of alcohol on your stomach. Many people will experience gastrointestinal issues as a result of drinking on an empty stomach, this means that the alcohol impacts us more quickly, as well as irritating the stomach lining and leading to further health issues.
Today I choose to not drink; with Osher Günsberg
We chat to Osher Günsberg, one of Australia’s most recognised TV hosts, about how he learned to change his relationship with alcohol by taking it one day at a time.
Osher shares that he lives a great life now and can choose how he spends each day. This wasn’t the case eight years ago.
“There was a time when I could tell you exactly how my day would end. I no longer had a choice. I look at the way I lived when I was still drinking and I guess now what I get to do is live a life in contrary action to that.”
“Making the choice to not drink everyday, allowed me to redefine who I was as a man.”
Osher started to realise how embedded alcohol was in our culture and how socially acceptable it was to use it as a way to self-medicate. For Osher, it was managing his nerves and anxiety.
“It’s in every piece of pop culture, ‘Oh I need a drink, I had a shit of a day’. Everyone’s fine with it and for some people that’s okay, but for me I had started to use it to be able to function. The amount that I needed to feel okay eventually become unmanageable and I needed it to stop.”
When Osher had this realisation he reached out to a sober friend to ask how he managed to quit drinking.
“He told me he went to meetings and I asked him if I could come to one of those meetings with him, and he said sure.
I always thought sobriety was sad people drinking bad coffee on plastic chairs under a church. I didn’t know that sobriety could look like this guy who was fit, healthy and talented.”
You have to make the decisionOsher wrote down in a Journal the day he decided to start his journey towards an alcohol-free life:
“I won’t have a drink until I can have a healthy relationship with alcohol.”
He admitted that it was too much at first to say ‘that’s it, I’m never drinking again’; he had to trick himself.
“I remember at one point, one of the people helping me through it said all you have to do is just get to 10 o’clock tonight when your head hits the pillow without having a drink and you’ll be fine. So I got to 10 o’clock that night and put my head on the pillow and went, ‘well, there you go, I did it. It was hard, but I did it.’ The next day was just a tiny bit easier and the next day a tiny bit easier than that.”
“Sometimes it got smaller and I made the decision not to drink that hour.”
You need support
Within six weeks or so the possibility was evident to Osher that perhaps he could never have a drink again. However, by then he was okay with that. Osher said it wasn’t until he started to explore the reasons why he was drinking that it became easier not to. He went to meetings, worked with a therapist doing CBT, and explored other things and new people to inspire him. As well as finding meaningful work to do.
“There’s a big difference between being sober and not drinking.
Not drinking is – ‘I’m gritting my teeth and carving my fingernails into the desk here just to get through this shitty day and wishing that I could have a drink.’ Being sober is – ‘I’m okay with living life the way it is and I’m okay with the ups and downs.’
There’s a big difference with learning the skills and management strategies from your own emotions to get through those difficult times without turning to alcohol.”
One day at a time
Osher says the most important thing when changing your behaviour is to break it down and just get through that time.
“Sometimes it might be like, ‘I’m not going to have a drink before lunch. Then you get to lunch and say, ‘I’m not going to have a drink before dinner and you grit your teeth after sunset and say, ‘you know what? I’m going to go to bed today without having a drink’. Sometimes you make that choice not once a day, but ten times a day.”
“If you’re no longer making choices in your life because of your drinking I would say to you – what are you doing to yourself? To your family? And to your own happiness?”
Feature image by Who Magazine
What Comes After Dry July?
Recent years have seen an increase in the number of people who are taking part in initiatives like Dry July, Ocsober, FebFast and others. You might say that an increased focus on public health by high profile organisations and sponsored by high profile public figures, is a universally positive thing.
This is because we are rethinking our patterns of consumption. These initiatives also give us the opportunity to break patterns of behaviour that we know to be harmful and occasionally destructive. In addition to this, we are given the opportunity to raise money at the same time – to support just those causes.
Opening up a conversation
Approaches like this are a world away from twenty years ago, when the thought of going for a month without alcohol was derided and mocked. The normalisation and visibility of these campaigns has opened up the conversation about why someone might choose to take a break from alcohol and made it possible for people to openly say that they are choosing to abstain.
There is only one potential issue with approaches like this. From a behavioural perspective, addressing an issue like alcohol consumption by going ‘cold turkey’ might not actually result in lasting changes. When we are considering our relationship with alcohol, we are acknowledging that it is a part of our lives, day-to-day. Stopping for a month may be a good way to get into shape and have a break, but we are not necessarily working on the way that we use alcohol itself.
For some people who do Dry July, their experience of having a month off alcohol will be so positive and profound that they may never drink again. For the majority of people, however, they will return to drinking and likely slip back into old habits and patterns of alcohol use. As a psychologist, I often have clients describing a positive experience doing Dry July. Things like improved mood, weight loss, more energy and money saved, are then undermined by what happens when alcohol is reintroduced.
From a behavioural perspective, it is nearly impossible to change the relationship with something when it is out of your life. You actually need to be coming into contact with it in order to understand how to best manage it!
Many of my clients express frustration about how well they did in Dry July and then the issues they have had with starting to drink again and feeling that nothing has really changed. The big challenge is finding a way to still have alcohol in their lives, while not necessarily using it every day, and in large quantities.
Consider you were going into relationship counselling with your partner. Yes, you would likely benefit from individual sessions. From these sessions you might get some insight into relational patterns and how you are being affected by the relationship problems. However, the real work would be done in the sessions with your partner. This is when your triggers are activated, when you have to struggle and experience in real life some of the issues that have led you to make changes.
It is the same with alcohol. Changing our relationship with alcohol is, essentially, a learning experience. We must re-learn how to use alcohol and how to manage its effect on us. Taking a break and then hoping we have ‘reset’ may not be enough. It is beneficial but is not really a longer term option, particularly if we intend on reintroducing alcohol into our lives again at some point.
So, if you are nearing the end of Dry July, what kinds of things might be helpful to keep up the momentum and observe some lasting changes? Here are some ideas:
– Consider what you might like your relationship with alcohol to look like. What kinds of things did you enjoy about Dry July? Was it the increased energy, better health or financial savings? How might you need to moderate your intake of alcohol to still see these benefits?
– If you are wanting to re-introduce alcohol into your week, consider what kinds of goals you might have. Whether it is four alcohol free days a week, or setting a limit on the amount you drink each day, think about what might be realistic for you.
– Reflect on how much you are currently drinking in a week (eg. 3 standard drinks each day, equalling 21 standard drinks per week), and see if you can set a new goal for yourself. Most of the risks that are associated with alcohol come from drinking daily and in high quantities, so reducing one of those variables is likely to be beneficial.
– Consider what is happening behind the scenes of your alcohol use. Is it being used to manage stress, deal with negative emotions, or temporarily lift your mood? Developing other strategies that can meet these needs may mean that alcohol feels less necessary. For example, having a shower and getting into comfortable clothes at the end of the day might be helpful in ‘closing a chapter’ on the day.
– Be curious about patterns and themes with your alcohol use. Perhaps there are some friends that you are likely to drink to excess around, or certain situations (after work, when alone, when nervous) that alcohol is being over-used. Similarly, perhaps there are some situations where you don’t feel like drinking at all, or at the very least do not struggle with the urge to have another drink.
– Set expectations with those around you. if you are wanting to make some longer-term changes with your alcohol usage, let those who are close to you know what your goals are, and what you might like from them. Even asking a partner not to buy wine on the way home, or organising coffee with friends rather than drinks, can be a useful way to set up situations that will support you to change. This way you’re not in a situation where drinking is expected.
So if you are nearing the end of Dry July – well done! It is a great first step in making a big change in your relationship with alcohol. At this stage you will likely be conscious of a lot of things that might trigger an urge to drink, as well as the strategies that are effective in doing things other than having a drink. Now is a great time to consider what you might like the rest of your year to look like and how you might be able to create lasting change.
Salt, sweat and tears – healing through water
They say the best way to get through a tough emotional time is by turning to salty water, sweat and tears. For some people the best way to calm themselves if they are feeling anxious is to go for a fast run and let the blood pump through the body and the sweat pour. For others feeling a bit blue, diving into the water is their way to refresh themselves and ‘wash off’ any negative feelings, and of course, for some a good cry is just as helpful.
Why is water healing?
Humans are made up of 60% water and many can report feeling peaceful next to a big body of water, whether that’s a lake, an ocean or a river. You often hear of people taking holidays by the sea side, or a long walk by the river. The water is medicine for many – surfers, divers, swimmers – a remedy for relieving stress and helping them feel healthy and full of vitality.
A study by The University of Exeter showed that people who live near the ocean report feeling less stress and have better health than those who don’t. The study suggests that the calming atmosphere gives people a more positive outlook.
Sweat, sweat, sweat
Exercise generally puts you in a better mood as sweating it out releases endorphins that can help change our mental state. Sweating can also flush the body of alcohol, cholesterol, and salt. The body releases toxins by using sweat as the conduit.
Have you ever put on some motivating music and channelled your anger or hurt through a run or a gym session? Put on a playlist that makes you want to move your body, and whether that’s going for a run, dancing by yourself in your room, lifting weights or searching for a youtube workout that suits, sweating out our shitty feelings always make us feel better and get us out of a negative or heavy headspace.
Tears are the river of life
A good cry always makes you feel better, because you’re allowing yourself to just let it out. It is the body’s way of releasing a build-up of emotional tension. Crying reduces stress by releasing toxins through our tears and has also been shown to cause the release of endorphins, our body’s natural pain killer, thus making us feel better.
Try out this experiment from our Daybreak mobile program to help you deal with challenging times in your day.
HALT stands for Hungry, Angry, Lonely and Tired. These are the types of feelings anyone reducing their alcohol intake may experience. It is important to learn how to cope with these feelings and be aware of them to reduce the risk of having a slip up.
When you experience an urge, begin by looking for an underlying feeling you may be experiencing.
Try this experiment to help you find what to look for.
1. HALT for the next 30 seconds. Stop and pay attention to what your body is telling you. Take a moment to scan your body and notice any particular sensations.
2. Hungry. Are you hungry? If so, go and eat. Prepare something yummy or try something new.
3. Angry. Are you angry? If you are, tell someone about it, vent to a friend, exercise to release the excess energy, or squeeze or punch a pillow.
4. Lonely. Are you lonely? If you are, surround yourself with friends or loved ones. If all of your friends drink and you are finding that difficult, start to make new friends by exploring new groups you could join or new activities you can try out or write a post on the community feed in Daybreak.
5. Tired. Are you tired? If you are, you simply need to rest. Take a nap or chill out by watching TV or listening to some music.
People often forget to take care of themselves, as they don’t monitor these particular feelings. Learning to do so is an important skill; just as important as learning new strategies and skills for drinking in moderation or taking a break from drinking altogether. Spend the next week paying attention to these four feelings and notice which ones you tend to experience when you feel an urge to drink. Maybe a good cry, a swim or a sweaty exercise session will do you wonders!
Life with alcohol dependence
‘Rachierach’, a member of Hello Sunday Morning’s Daybreak program, shares her story about how she struggled for years to change her relationship with alcohol, until a big wake up call.
I started binge drinking at 14 years old. I was sneaking out and drinking every night, spending my nights at the skate park or a friend’s house.
My drinking didn’t continue steadily from there. I really only drank heavily for a year and then would only drink on social occasions and weekends, but always drank A LOT when I did drink. Back then I thought drinking competitions were so much fun; silly, looking back!
My first son was born when I had not long turned 18, and my second son was born 22 months later. I didn’t drink through pregnancy except for a couple of occasions; even then, it was only a couple of glasses. Life was pretty cruisy. I lost contact with my entire family when my first son was born. It was a drama-free life for myself and my young family when we moved from country Victoria to Queensland.
When I look back, I was drinking every night from when my second-born was a baby. The boys’ dad worked nights and I was home alone often. But I didn’t look at myself then as having an alcohol dependence.
I was dealing with many emotions from my childhood, like the lack of contact and interest from my own family. It wasn’t until 2006 when my marriage went down the tube that I really amped up the drinking. My boys were nine and 11 and I felt like I had failed them. I never wanted them to go through the things I had to. My Dad left when I was six and I didn’t see him again until I was 16. We don’t talk now; the relationship was never a good one.
So in the year of 2006, thanks to the stresses of a pending divorce and the feeling of failing my boys, I had a full-blown mental breakdown. It lasted 12 months. I was drinking more than a bottle of vodka a day and was also on anti-depressants as well as anti-anxiety and sleeping pills. I was suicidal and an outright mess.
There were so many events that year I have zero memory of. I was blackout drunk every single day. I was lucky to have an extremely understanding boss that allowed me a lot of time off. So from there, with a new partner that enjoyed drinking, I just kept on going, not blacking out every night but drinking every night.
It was about five years ago that I knew I had a problem. I was desperate to get home from work each day so I could drink, and often stopped at the pub on my way. Sometimes, I even stopped in for the odd beer during my lunch break just to take the edge off. I tried giving up but found it all too hard. With my now-husband working nights, my drinking increased again, to a point where I would black out regularly.
My life turned around
In October of 2015, I had some routine blood tests done because I was lacking energy. My liver results were not good, but I chose to ignore it for more than a year. I kept telling myself that I was only 39, I was too young to have liver issues. And there was no way I was giving up before my 40th party; the one I had waited my whole life for.
As it happens, it was at that very party in November 2016 that I knew the time had come for me to quit. I had repeated my liver test from the year before and my results were actually 10 times worse than just 12 months earlier. Eventually, I was barely getting through each waking day without needing to take a rest to stop fainting, which I soon learned was my liver saying ‘no more’.
I started my journey on my own, without telling a soul except for my husband. It was the hardest thing I have ever done in my life. My initial goal was to have a dry spell and then drink moderately on social occasions. I went 47 days and then had the odd glass here and there on five occasions. Australia Day was fast approaching and I was dreading going through that without drinking but knew that it had to be all or nothing for me.
That’s when I joined Daybreak, when I was most desperate for some support. My husband was far from supportive; he wasn’t ready to lose his drinking buddy.
Joining Daybreak was my saving grace. I will be forever grateful for the wonderful community that has supported me through some really tough times and cheered me on through some victories. It has been more than nine months and I am still on Daybreak almost every single day because I get great joy in encouraging others to live a better life. Some of the friends I have made through Daybreak are friends I will have for life. They get it like no-one else can.
I can truthfully say that there are ups and downs on this road and the first few months were an unbelievable roller coaster of emotions including shame, guilt, sadness; you name it.
But all those things don’t last forever. Once you get past them and accept that the past is the past, and that’s not the person you are anymore, there is an overwhelming feeling of freedom.
So even though I have a really tough personal event to get through coming up, I’m feeling confident that this day will be a whole lot different to what it has been my entire life. I have confidence in myself that I have never had before and life feels good. Damn good!
To find out more and to download Daybreak, a program by Hello Sunday Morning, visit hellosundaymorning.org/daybreak.
How childhood temperament can predict heavy drinking
An edited excerpt from Woman of Substances: A Journey into Addiction and Treatment by Hello Sunday Morning supporter, Jenny Valentish.
1982. The UK. The Falklands War erupted. The lowest temperature on record was captured by a lonely weather station in east Scotland, at -27.2°C. Unemployment exceeded three million, the highest since the 1930s. The IRA bombed Hyde Park and Regents Park, killing eight and wounding forty-seven. Thatcher’s Tories were top of the opinion polls. In every kid’s Christmas stocking there was a copy of When the Wind Blows, depicting a nuclear attack on the UK by the Soviet Union. I was seven.
I don’t want to lose your sense of intrigue straight off the bat, but I was a sickly child, matted with eczema and, later, permanently trailing a hankie. The umbilical cord had noosed around my neck upon my grand entrance, rendering me mute. I brought with me a special delivery of postnatal depression and was soon registered as ‘failure to thrive’.
Around our house they called me the Grizzler. My super-powers included a sixth sense for the acutely unfair, and internal combustions at perceived slights. My parents also bandied around ‘sulking’, or ‘sulking again’, but those words didn’t do it justice. When wronged, their youngest child was a kamikaze pilot in a nosedive, unwilling or unable to pull up. Empires should collapse.
‘It’s not the end of the world!’ Mum would exclaim, in an ascending tone. Dad’s favoured description of Mum was ‘wittering’. Mum’s nickname for Dad was ‘Eeyore’. We all did the Myer Briggs personality test one time and came out as introverts with tempers rising. Our default setting was: ‘Expect nothing and be pleasantly surprised.’ Addendum: ‘Any pleasant surprise will be a massive fluke and should be dismissed as such.’
What I’m describing here is temperament. Temperament is observable from birth, and it’s the foundation upon which personality is built. The dim light in which I view 1982 gives some insight into mine.
There’s an episode of the 2012 ABC documentary Life at Seven called ‘Tackling Temperament’. The Australian children it follows have been the subjects of a longitudinal study since birth, and now it’s time to test their response to frustration with ‘The Painting Experiment’.
In groups of three, the children in the documentary are given the task of painting a picture of flowers. Midway through they’re distracted by a researcher, who calls them over to inspect the real floral arrangement more closely. While their backs are turned, one girl – who’s in on the trick – scribbles on their artwork, then slips back to her own easel.
Initially, each child is dismayed to discover their ruined painting – and they’re suspicious, of course.
Child 1 is subdued. She says she knows the other girl did it, but she keeps going with her painting regardless. By the time she skips out of the room, the insult is forgotten.
Child 2 finds another blank page beneath the first and, pleased with his own ingenuity, starts over from scratch.
Child 3 wants to get to the bottom of it, but eventually her desire to continue wins out. ‘I know,’ she decides, ‘I could colour the background in.’
Child 4 is angry. She stamps her foot. ‘That just can’t happen,’ she says. The researcher leans in: so what should Child 4 do? ‘I don’t know,’ she whimpers. Does she have an idea? ‘No.’ She rejects the suggestion of turning over the paper to the clean side, claiming that won’t work.
‘How did it happen?’ Child 4 repeats, aghast. Eventually she’s persuaded to start over, but the sense of injustice lingers.
Perhaps Child 4 adopted a permanent explanation for this ruined-painting scenario. This is a mindset described by psychologist Martin Seligman in his book The Optimistic Child. A positive thinker will regard a setback as being temporary: ‘This picture has been ruined but at least I had only just started.’ A pessimistic child will tell themselves a story with finality to it: ‘This is hopeless. Just my luck. This happens every time. People always have it in for me.’
This type will also have what’s called an external locus of control: the belief that they are a passive victim of their circumstances, rather than the architect of their own destiny. Every time a reasonable solution is offered, they’ll play the ‘yes, but’ game, preferring to nurse that sense of unfairness like Gollum and his ring.
Something might go really well yet by the end of the day it’s catastrophised, remembered as an unmitigated disaster. They might similarly revise their entire childhood, levelling out all experiences to the baseline of the worst. In my memory, for instance, my childhood is like Nordic noir: everyone’s withdrawn and secretive, the sky is overcast, and people drift about wearing thick woollen jumpers (Dad never turned on the central heating). At any moment someone’s liable to walk out into a snowdrift and never return.
That’s the past. As for the future – which in Child 4’s case is the option of turning over a sheet of paper and starting anew – they’re harbingers of doom.
In defence of Child 4, certainly not all pessimistic or reactive children will grow up wanting to funnel the world up one nostril. There are plenty of coping techniques that, with a bit of encouragement, an individual can employ to regulate their moods.
The ruined paintings of the Life at Seven kids were a minor setback. In the case of experiencing childhood trauma, having low resilience – like Child 4 – can be a huge risk factor for adult anxiety, depression and problematic substance use.
One of the most thorough studies of childhood personality began in Melbourne in 1983 and is ongoing. The psychologists and paediatricians behind the Australian Temperament Project have been following the children of 2443 Victorian families. They’ve found that the features of temperament most likely to have long-term influence are persistence, flexibility and reactivity/emotionality, with the biggest predictor of adult behaviour being self-regulation.
Someone with poor self-regulation has little capacity to control their reactions, which include physiological responses, such as a churning stomach when something is upsetting, but also their interpersonal attitudes. Take me. I was one of those kids who, if a friend came over to play and a row started, would rather endure an hour of anvil-heavy, atom-buzzing silence until their mother arrived to take them away, than try to rectify the situation. Not much has changed. Fast-forward thirty years and there I am necking two beta-blockers before resigning from a job, in order to firmly get my points across without hurling a stapler or letting loose a spittled string of expletives.
So why do some people fail at self-regulation?
In part it’s hereditary, but it’s also down to the home environment. When a child’s stress-response systems are activated – which means an increased heart rate, rise in blood pressure and release of stress hormones – some calm intervention by a caregiver can bring these responses back down to baseline. If these skills are not observed and learned, the habit of self-regulation will not be routed into the neural pathways. Failure to learn might be through parental neglect or through watching parents catastrophise minor issues.
Conversely, pandering to a child’s every whim can mean they’ll never experience disappointment and how to adapt to it. Increasingly, drug and alcohol counsellors are seeing clients in their thirties and forties who are living back at home with enabling parents who never learned to tell them ‘no’.
The danger in both cases is that defeat can become comforting. There’s a familiar cycle of disappointment and then – if you grow up to coddle yourself with drugs and alcohol – self-soothing. In time, defeat becomes a self-fulfilling prophecy. Things are not for the likes of you. Something simply cannot be done. There is no point.
In summary, what we know to be high-risk factors for problematic substance use include low resilience, poor self-regulation, low self-efficacy and reactivity.
This is why it’s vital for any adult addressing their alcohol or drug use to specifically address their resilience and self-regulation, perhaps through counselling methods, such as CBT. Turn it into a game, if necessary: how quickly can I laugh off that slight? How many good things happened to me today before that wrong turn into shit-town? What advantage can I milk from this unexpected situation? What have I learned? Our temperament may be acquired through our genes, but our attributes are gained through our own free will.
The top six questions about drinking and health answered
From alcohol’s effect on fertility, to how long your liver takes to recover
Gastroenterologist Professor Weltman, helps us answer specific health questions asked by our community on Daybreak.
1. How long does it take for your liver to start to recover once you stop or cut down drinking?
Professor Weltman, Head of the Gastroenterology and Hepatology department at Nepean Hospital, NSW, says the recovery is variable as it depends on the individual.
“Alcohol does not work the same on everyone, so to start off with, it is best to give it 6–12 months before you’re able to see what kind of reversibility is there.”
Consensus in clinical research suggests that the liver is the only organ in the body that is able to regenerate by replacing damaged tissue with new cells, but it depends on the length of time the individual has been drinking and each individual is entirely different. Complications can develop after 5–10 years, though it more commonly takes 20–30 years.
Complications of liver disease occur when regeneration is either incomplete or prevented by progressive development of scar tissue within the liver. This happens when a damaging agent like alcohol continues to attack the liver and prevents complete regeneration. Once scar tissue has developed it is very difficult to reverse that process.
2. What impact does alcohol have on fertility for males?
It’s an inconvenient truth that heavy alcohol use reduces men’s fertility; it can cause impotence, reduce libido and affect sperm quality.
A recent study of couples undergoing assisted reproductive treatment looked at male and female alcohol consumption in the year prior to treatment, as well as during treatment. It found both male and female alcohol consumption decreased the chance of a healthy baby and increased the risk of miscarriage.
Although the scientific evidence about how low to moderate drinking affects a man’s fertility isn’t clear, the National Health and Medical Research Council recommends that men abide by the safe drinking guidelines and women don’t drink at all during this period.
3. What impact does alcohol have on fertility for females?
For women, heavy drinking also affects fertility, increasing the length of time it takes to get pregnant and reducing the chances of having a healthy baby.
The National Health and Medical Research Council guidelines also say that:
- For healthy women, drinking no more than two standard drinks on any day reduces the lifetime risk of harm from alcohol-related disease or injury.
- Heavy drinking before pregnancy is also known to affect women’s health. Women who consume large amounts of alcohol (seven or more drinks a week or more than three drinks on one occasion) are more likely to have heavy or irregular periods and take longer to get pregnant.
- For women who are pregnant or planning a pregnancy, not drinking is the safest option. For women who are breastfeeding, not drinking is the safest option.
4. What are the effects of alcohol on the brain?
The National Institute of Alcohol Abuse and Alcoholism says the short term effects of drinking alcohol can include: difficulty walking, blurred vision, slurred speech, slowed reaction times and impaired memory. Some of these impairments are detectable after only one or two drinks and quickly resolve when drinking stops. On the other hand, a person who drinks heavily over a long period of time may have brain deficits that persist well after he or she stops consuming alcohol.
“We do know that heavy drinking may have extensive and far–reaching effects on the brain, ranging from simple ‘slips’ in memory to permanent and debilitating conditions.”
A number of factors influence how and to what extent alcohol affects the brain, including:
- How much and how often a person drinks;
- The age at which he or she first began drinking, and how long he or she has been drinking;
- The person’s age, level of education, gender, genetic background, and family history;
- Whether he or she is at risk as a result of prenatal alcohol exposure; and
- His or her general health status.
5. What does alcohol do to your body after the age of 40?
Professor Weltman says alcohol does not really affect people differently at any age other than babies. It is more the fact that if people have been drinking heavily since they were young, they therefore are more likely to develop the consequences.
“Drinking heavily for a long period of time can cause people to have liver damage, fibrosis scarring, pancreas damage and damage to the brain, like an early cognitive disfunction that is similar to dementia.
“Your coordination can become unsteady and the heart’s rhythm can have disturbances as well as weakening of the heart muscle. Men specifically can develop testicular atrophy, enlarged breasts and reduced sexual function.
“Women can develop osteoporosis, bone loss and muscle loss. It is common for women to see nerve ending problems and damage where they loose sensation in hands and feet.”
6. What are the side effects of medications like Antabuse/Disulfiram, Campral/Acamprosate?
Professor Weltman says Disulfiram only has side effects when mixed with alcohol.
“The concept of the drug stems back from the 1960s: you either don’t take the drug or don’t drink, because when mixed, the reaction with alcohol causes people to become very unwell.
“Campral doesn’t have any side effects and works as a stimulater for the nerve transmitters in the brain to instead reduce the desire to drink.”
According to NPS MedicineWise, these medications are suitable as a long-term treatment for patients with alcohol dependance and should only be used in conjunction with a comprehensive treatment plan.
Pharmacotherapy is generally used for people with more severe behaviours. In Australia, there are three drugs currently approved − oral Naltrexone, Acamprosate and Disulfiram. NSP Medicine Wise have a different view on the side affects of the drugs, outlined below:
Naltrexone is recommended for patients aiming to cut down their alcohol intake who do not have severe liver disease or an ongoing need for opioids.
EFFECTS: Headache, nausea, lethargy and dysphoria.
Acamprosate is recommended for those who have achieved and wish to maintain abstinence.
EFFECTS: The most common adverse event is transient diarrhoea.
Disulfiram is no longer considered first-line treatment due to difficulties with compliance and toxicity.
EFFECTS: Drinking alcohol within two weeks of taking disulfiram results in the accumulation of acetaldehyde in the blood. This causes unpleasant effects such as sweating, headache, dyspnoea, flushing, sympathetic overactivity, palpitations, nausea and vomiting.
* To find the right treatment for you, speak to your GP and head to the site for more information on medication-assisted treatment for alcohol dependence.
Being an alcoholic made me a better mother
I think Tenley was maybe two or three when I decided I would start drinking. I drank Moscato , the sweetest kind you could find. I never felt odd, or buzzed and in hindsight that should have been an indication of tolerance, but if you are surrounded by drinkers, active drinkers , everyone’s truth is a little distorted.
The last three years have been a whirlwind. I hit the lowest of lows. Imagine seeing a grown woman clinging to her pillow in a nightgown, with fuzzy socks on and a missing tooth. That is who I was, walking through the doors as an inpatient. Luckily I have been able to have a pretty kick-ass, stellar recovery process that has been tiresome but so worthy.
You’re probably asking how being an alcoholic made me a better mother. There are few key reasons that all sort of tie in with the theory of ‘desirable disadvantages’.
I was a very loving and kind mother. Most women naturally fill that role. But then I began to fill my nights with drinking and the nights turned into days which turned into months and, before I knew it, everything was unraveling.
Tenley has always been a child of bright curiosity and she radiates joy wherever she flutters. I was tired, irritable, half-assing my way through a job I loved but couldn’t find any additional strength for. I was disengaged, always planning my next stop for alcohol and/or planning to have care on the weekends I did have her, because ‘it’s normal to drink with friends’. Her joyful mother became sad, tired and uninterested.
That is one of the hardest truths I will ever have to swallow. To admit that when it came down to Tenley or alcohol, I would have chosen alcohol. It took me years to figure out why and what that meant and I accept that it isn’t a choice. Once you are at that point, you are a passenger on the train.
The last year and a half of sobriety have been the hardest moments in my life. I was broken, poor, unhealthy, starting my career over again. But I got creative. I saved everything I could, learned to budget correctly, attended night classes and rode the bus two hours every morning (a consequence of an OWI/DUI).
The first year of my change, I white-knuckled it all — I was happy to be alive, but did not yet appreciate what that entailed. I found myself jealous of my old life prior to sobriety but when I really put forth the effort that this deserved , my whole life shifted.
I believe the statement above with every fibre in my being. One of the hardest things for any parent to do is admit they failed their children.
And I did it. I failed Tenley. I wasn’t the mother she deserved or needed or asked for. I scared and worried my daughter and the shame kept me spiralling out of control. I didn’t want to accept that I had done this to her as I love Tenley more than anything. When I am drinking I am not choosing to not be the best mother, I cannot choose. I see so many excellent parents weighted with defeat. I see the stress, the sagging shoulders and bloodshot eyes.
YOU CAN GET BETTER. YOU CAN BE BETTER. YOUR CHILD WILL RESPECT YOUR FIGHT, AND LOVE YOU FIERCELY FOR IT.
Tenley and I are closer than ever, we talk openly about my past and my choices. She isn’t walking forward with a mum that hides or shames horrible behaviour or consequences or alcoholism, she is walking forward with my recovery, hand in hand with me. She is learning to overcome the worst case scenario and be the best version of herself she can.
Your children are your biggest fans, they love unconditionally and will forgive you in a heartbeat (but do not take advantage of a soft heart, they become adults who remember). They want you to be YOU and if that means taking time to go to rehab, DO IT, if that means changing jobs, DO IT, if that means getting medication to help curb chemical imbalances, DO IT. Your children are watching you fall, but more importantly, watching you stand back up and dust your knees and shoulders off, before grabbing them too, brushing the dirt from their knees, walking forward together because you are worth it and it is never too late. Ever.
I now have better relationships. It took me a long time to understand the ‘needs’ versus ‘wants’ concept. I need someone who loves me as is and can share that love with a smaller version of me. Tenley is watching me in a relationship with a recovering drinker who put sobriety first. Thankfully, my partner emits so many qualities that I would want for her to experience. She sees love practiced and given without condition, she sees a disagreement become a solution and finally she sees me valuing myself first and knowing that I can’t be a partner or mother if I am drinking.
I am financially stable. Drinking took a LOT of money from me, but also taught me how to plan a budget when my one source of debt was rejected. She watches me budget, and I now think about where my money is going.
I have a supportive job. I was able to be candid about my drinking past, and that makes me better prepared if I begin to feel stressed or anxious. In the past, drinking on the job became very easy and it usually does for most addicts. It’s not purposeful, it’s to survive at that point. When you stop drinking you shake, you crave, your body does everything it can to get you temporary relief. I shared my past openly with my boss in the first interview, because for me, it’s life or death. I don’t suggest that you share intimate details of your life if they aren’t necessary but for this position I needed to be candid and was respected for it.
Here is the takeaway. I am a better mother now because I have fought hard to be one again. My moments with Tenley are an adventure that strayed off track for a few years. I am a better mother because I value the little moments, even the bad moments, because when you are accepting of death, you become very much alive if you are given a second chance. Joy is more joyful, silence is more warming, love is bigger and louder.
This isn’t to say I live without pain. Fifty percent of my time is spent without my little radiant pixie and it’s in those times that I find myself sinking into that dark hole of loneliness and hurt, wondering how I made it through the past few years. It’s simple, I made it because I wasn’t feeling anything: my goal was to not feel. But my god, does the joy feel joyful.
Parents , if anything sticks with you , please let it be this: continue to fight for what is good and true. You are giving your children an incredible gift and that is showing them when you fail, there is a chance to do it right.
If you find yourself in a similar situation and are feeling alone, you are not. Tenley and I are rooting for you, hand in hand.