This information has been adapted from the pamphlet How Drugs Affect You: Alcohol, produced by the Australian Drug Foundation. For single copies of this pamphlet contact the DrugInfo Clearinghouse on telephone 1300 85 85 84 or email druginfo@adf.org.au (Victoria only). Multiple copies are available through the ADF Bookshop.
What is alcohol?
Alcohol is a liquid produced by fermentation, which is the action of yeast on liquids containing sugars and starches. Pure alcohol has no colour or taste. Alcoholic drinks vary in colour and taste because of other ingredients that are added to them.
Alcohol is a depressant drug—not a stimulant as many people think. Alcohol slows down activity in the central nervous system, which means it slows down the messages going between the brain and the body. Depressant drugs affect concentration and coordination, and slow the person's response time to unexpected situations.
In small quantities, depressants such as alcohol cause people to become relaxed and lower their inhibitions. They feel more confident and often act in a more extroverted manner. In larger quantities, depressants can cause unconsciousness and even death.
Effects of alcohol
How alcohol is absorbed into the body
Alcohol is absorbed directly into the bloodstream through the stomach and the small intestine. Food in the stomach slows down the rate at which alcohol is absorbed, but does not prevent intoxication or drunkenness. All alcohol consumed will reach the bloodstream, regardless of how much food is in the stomach. Alcohol is distributed throughout the water in the body, but not into fatty tissue.
How alcohol leaves the body
The liver breaks down about 91 per cent of alcohol, and a small amount leaves the body in urine, sweat and the breath. The liver can only work at a fixed rate, getting rid of about three-quarters of a standard drink an hour. Sobering up takes time, and cold showers, exercise, black coffee, fresh air or vomiting will not speed up the process. Someone who drinks a lot at night may still have a high concentration of alcohol in their bloodstream the following day.
Possible health benefits of alcohol
Research shows that moderate amounts of alcohol can reduce the risk of developing some types of cardiovascular disease in people aged 40–45 years and over. However, it is important to remember that the risk of cirrhosis, some cancers and other diseases becomes greater with increased alcohol consumption.
Immediate effects
After a few drinks the person may feel more relaxed, have reduced concentration and slower reflexes.
After a few more drinks, they may have fewer inhibitions, more confidence, reduced coordination, slurred speech and intense moods (for example, sad, happy, angry).
If the person continues to drink they may experience confusion, blurred vision and poor muscle control.
Continuing to drink may result in nausea, vomiting and sleep.
Consuming more alcohol could possibly result in coma or death.
"Binge" drinking
Binge drinking can be described as drinking heavily over a short period of time or drinking continuously over a number of days or weeks.
Binge drinking is harmful because it results in immediate and severe intoxication. As well as health risks, this can lead people to take risks and put themselves in dangerous situations.
Common effects of binge-drinking episodes are hangovers, headaches, nausea, shakiness and vomiting.
Long-term effects
Heavy consumption of alcohol over a long period of time can cause damage to many parts of the body. Impairment of brain and liver functions can be permanent. If the person’s diet is also poor, this can further affect their health. Emotional difficulties, such as depression and relationship problems, are also likely.
Other possible long-term effects include:
• cancer of the mouth, throat, oesophagus, lips, liver
• brain injury, loss of memory, confusion, hallucinations
• high blood pressure, irregular pulse, enlarged heart and changes in red blood cells
• weakness and loss of muscle tissue
• sweating, flushing and bruising of the skin
• inflamed stomach lining, bleeding and stomach ulcers
• increased risk of lung infections
• severe swelling of the liver, hepatitis and cirrhosis
• inflamed pancreas
• tingling and loss of sensation in hands and feet
• for men, impotence, shrinking of testicles and damaged and reduced sperm
• for women, greater risk of gynaecological problems.
Social problems
Excessive alcohol use can effect all areas of a person's life, including family, work and personal relationships.
• Family problems: Arguments over someone's drinking can cause family and relationship problems that may lead to break up.
• Work problems: Drinking alcohol at work and hangovers can lead to poor performance and accidents at work, while illness can result in absenteeism.
• Legal problems: Drink-driving may lead to fines, loss of license and even imprisonment.
Tolerance and dependence
People who drink heavily usually develop a tolerance to alcohol. This means that they need to drink more to experience the same effect. As a result, some people can drink large amounts of alcohol without appearing to be intoxicated. However, the amount of alcohol consumed can still damage their health.
People who regularly drink heavily may become dependent on alcohol. Dependence can be psychological or physical, or both. People who are psychologically dependent on alcohol find that drinking becomes far more important than other activities in their life. People who are physically dependent upon alcohol find that their body is used to functioning with alcohol present.
Withdrawal
If a person who is physically dependent on alcohol suddenly stops drinking they will experience withdrawal symptoms because their body has to readjust to functioning without alcohol.
Alcohol withdrawal symptoms include:
• loss of appetite
• nausea
• anxiety
• insomnia
• irritability
• confusion
• tremors
• sweating.
In severe cases, alcohol withdrawal may cause convulsions, cramps, vomiting, delusions, hallucinations and even death. A person considering withdrawing from alcohol should first consult a doctor or other health professional.
Treatment
There are a number of drug treatment options available in Australia . While abstinence may be a suitable treatment aim for some people, many programs recognise that for others this may not be possible or realistic. Most programs adopt strategies that have an overall aim of reducing the harms and risks related to the person’s alcohol use.
Some treatment options include counselling, withdrawal (detoxification) and medication (pharmacotherapy). Residential and "out-patient" programs are available.
Treatment is more effective if tailored to suit a person's circumstances, and usually involves a combination of methods.
For referral to a treatment service, contact the alcohol and drug information service in your state or territory.
Women and alcohol
Research has shown that alcohol affects women differently than men.
• Higher blood alcohol concentration (BAC): If a man and a woman drink exactly the same amount of alcohol, the woman will almost always have a higher BAC. One reason is that a woman’s body contains more fatty tissue and less water than a man’s body and women are often smaller than men.
• Health problems: Women may develop liver damage and other health problems at lower levels of alcohol consumption than men. Women who drink alcohol are at an increased risk of developing breast cancer and gynaecological problems than women who don’t drink.
• Hormonal differences: Some research suggests that a woman’s reaction to alcohol may vary at different stages of her menstrual cycle, due to differences in hormone levels. Women who take the contraceptive pill may take longer to get rid of alcohol in their bodies than women not on the pill.
For all these reasons, health authorities recommend that women should drink less alcohol than men.Pregnancy and breastfeeding
Alcohol consumed during pregnancy crosses the placenta to the baby. It can cause problems in pregnancy, such as bleeding, miscarriage, stillbirth and premature birth.
There is evidence to suggest that if a pregnant women drinks two or more standard drinks a day the baby can be affected and grow more slowly. Babies born of women who are heavily dependent on alcohol can suffer alcohol withdrawal symptoms after birth, have poor coordination and movement, and foetal alcohol syndrome (FAS). Babies with FAS may be born with facial defects and physical and intellectual disablility.
The World Health Organization suggests there is no safe level of drinking alcohol during pregnancy, and recommends that the safest approach for pregnant women is not to consume any alcohol at all.
There is evidence that that alcohol is excreted into breast milk and can reduce the milk supply. During the first 12 months of a baby's life alcohol can cause damage to the developing brain. For women who are breastfeeding it is better to avoid consumption of alcohol as much as possible.
See your doctor or other health professional if you are taking or planning to take any substances while pregnant or breastfeeding, including alcohol, and prescribed and over-the-counter medications.
Standard drinks
The use of standard drinks can help people to monitor their alcohol consumption and exercise control over the amount they drink.
A standard drink is defined as one that contains 10 grams of pure alcohol. Different types of alcoholic drinks contain different amounts of pure alcohol. For example, each of the drinks below are equal to approximately one standard drink:
• Two 285ml pots/middies/schooners/handles of light beer (2.7% Alc./Vol)
• One 375ml stubbie of mid strength beer (3.5% Alc./Vol)
• Three-quarters of a 375ml stubbie of full strength beer (4.9% Alc./Vol)
• One 285ml pot/middy/schooner/handle of full strength beer (4.9% Alc./Vol)
• 100ml of wine (12% Alc./Vol)
• Two-thirds of a 330ml bottle of alcoholic soda (5.5% Alc./Vol)
• 30ml of spirit or liqueur (40% Alc./Vol).
Keep in mind:
• The "standard" size of drinks served in some hotels may be bigger than the standard drinks you are used to. Large wine glasses can hold two standard drinks or even more.
• Drinks served at home often contain more alcohol than a standard drink.
• Cocktails can contain as many as five or six standard drinks, depending on the recipe.
Blood alcohol concentration
Blood alcohol concentration (BAC) is the amount of alcohol in the bloodstream. A BAC of 0.05 means the person has 0.05 grams of alcohol in every 100ml of their blood.
Since the liver metabolises alcohol at a rate of about three-quarters of a standard drink an hour, the BAC level drops over time, unless more alcohol is consumed.
BAC is measured with a breathalyser, or by analysing a sample of blood.
Factors affecting your BAC
The more a person drinks, the higher their BAC. However, two people who drink the same amount might register quite different BACs. This is due to a range of factors, including:
• Body size: A smaller person will have a higher BAC than a larger person, because the alcohol is concentrated in a smaller body mass.
• Empty stomach: Someone with an empty stomach will reach a higher BAC sooner than someone who has just eaten a meal. Food in the stomach slows down the rate at which alcohol passes into the bloodstream.
• Body fat: People with a lot of body fat tend to have higher BAC. Alcohol is not absorbed into fatty tissue, so the alcohol is concentrated in a smaller body mass.
• Sex: After consuming the same amount of alcohol, a female will almost always have a higher BAC than a male.
Because of all these variable factors, counting the number of standard drinks you consume can only give a rough guide to your BAC.
Reducing the risks
Low-risk drinking guidelines
The National Health and Medical Research Centre Council of Australia has created a set of guidelines for males and females for low-risk drinking for both long-term harm and short-term harm.
For the general population, the guidelines for low-risk drinking for long-term harm are:
For males:
• An average of up to four standard drinks a day.
• No more than 28 standard drinks over a week.
• One to two alcohol-free days per week.
For females:
• An average of up to two standard drinks a day.
• No more than 14 standard drinks over a week.
• One to two alcohol-free days per week.
For the general population, the guidelines for low-risk drinking for short-term harm are:
For males:
• No more than six standard drinks on any one day, no more than three days a week.
For females:
• No more than four standard drinks on any one day, no more than three days a week.
These guidelines assume:
• The drinks are consumed at a moderate rate. For example, males should not consume more than two standard drinks in the first hour, and no more than one standard drink per hour thereafter and females should not consume more than one standard drink per hour.
• The person drinking alcohol is not on medication; is not pregnant; will not be driving, operating machinery or performing an activity that involves risk or requires a degree of skill; and is over 18 years of age.
• The person is of average or larger size.
How to drink less
• Start with a soft drink: You will drink much faster if you are thirsty, so have a non-alcoholic drink to quench your thirst before you start drinking alcohol.
• Use standard drinks: Monitor how much alcohol you drink. By converting what you drink into standard drinks, it is easier to keep track.
• Drink slowly: Take sips and not gulps. Put your glass down between sips.
• Eat before or while you are drinking: Eating slows your drinking pace and fills you up. If you have a full stomach, alcohol will be absorbed more slowly.
• Avoid salty snacks: Salty food like chips or nuts make you thirsty, so you drink more.
• Avoid "shouts": Don’t get involved in shouts, or rounds. Drink at your own pace—not someone else’s. If you do get stuck in a shout, buy a non-alcoholic drink for yourself when it’s your turn.
• One drink at a time: Don’t let people top up your drinks. It is hard to keep track of how much alcohol you have drunk.
• Pace yourself: Try having a "spacer", a non-alcoholic drink every second or third drink.
• Stay busy: If you have something to do, you tend to drink less. Play pool or dance—don’t just sit and drink.
• Try the low-alcohol alternative: A wide range of light beers are available. Low-alcohol or non-alcoholic wines are also becoming more available. Most places that serve cocktails also serve non-alcoholic versions.
• Have alcohol-free days: Have at least two days a week when you don’t drink at all.
• Keep a diary: Write down how much you drink each day. This can make you more aware of exactly how much you drink.
• Be assertive: Don’t be pressured into drinking more than you want or intend to. Tell your friends "thanks, but no thanks".
Alcohol can be an enjoyable part of life. However, alcohol can cause problems when consumption is not controlled.