The sobering facts about alcohol
UQ Mythbusters
One in 4 Australian adults drink at unsafe levels, and many of us have wondered whether our drinking could be doing us harm.
From hangover cures to limiting liver disease, there’s no shortage of received wisdom when it comes to mitigating the impact of alcohol on our health. But how much of it is misleading? And is there really such a thing as ‘healthy drinking’?
In the latest instalment of UQ Mythbusters, Contact asked experts from UQ’s National Centre for Youth Substance Use Research (NCYSUR) – Professor Jason Connor, Professor John Saunders, Professor Paul Clark and Dr Daniel Stjepanovic – to set the record straight.
Key points:
- Data shows giving your child their first drink at home does not guarantee a healthier relationship with alcohol – the opposite may be true.
- You don’t have to drink heavily to be at risk of liver damage – even moderate drinking can lead to this.
- Studies that once pointed to low alcohol consumption being ‘healthier’ than abstinence have been largely debunked.
- People who have a mental health disorder should be particularly vigilant about their alcohol consumption.
Q: Many parents give their kids their first drink at home, believing a controlled approach will foster healthy drinking habits. But does the data validate this approach?
A: Despite parents wanting to do the ‘right’ thing by introducing alcohol in a perceived safer environment, there is limited evidence that this approach reduces the risk of future hazardous alcohol use.
We do know from the research that the earlier in life a young person starts drinking, the higher the risk of future alcohol abuse and mental health problems, regardless of who supplies or supervises drinking.
This is why national and international alcohol consumption guidelines recommend either no use or delaying alcohol initiation as long as possible for young people.
– Professor Jason Connor
Q: Are zero-alcohol products (containing < 0.5% alcohol by volume) a good alternative for young people to encourage healthy drinking behaviours?
A: Due to the recent introduction in Australia, there are limited studies examining attitudes and behaviours of young people using, or planning to use, zero-alcohol products.
Zero-alcohol products taste, smell and look like alcohol products. Many have almost identical branding to alcohol products. Some public health researchers have criticised this marketing approach, as it may ‘normalise’ underage consumption and provide a gateway to earlier alcohol initiation.
New data shows that zero-alcohol beverages do increase the desire to consume alcoholic drinks for people who already drink heavily. Ongoing UQ research (as yet unpublished) also shows that, among university students, there is limited interest in zero-alcohol drinks, with most students involved in the studies having never tried zero-alcohol drinks. Those who have report showing little interest in continuing to drink them.
– Dr Daniel Stjepanovic
Q: Liver disease is a major health risk of alcohol consumption, but that only happens to very heavy drinkers, right?
A: No – liver injury can occur from moderate alcohol consumption. Various medical, genetic and physiological factors influence how much alcohol damages your liver.
Liver damage is definitely correlated to intake, but intake does not always have to be ‘heavy’ to suffer liver damage.
– Professor Paul Clark
Q: Is there a ‘right amount’ of alcohol to drink? What’s your advice for drinking in a ‘healthy’ way when we choose to?
A: Alcohol can cause damage to your liver, brain, nervous system, heart and gut – among other things. While young people do die from liver disease, younger people commonly suffer alcohol-related harms from poor decision making, due to disinhibition and impaired risk judgement.
The most accurate answer to how much alcohol is the ‘right amount’ is no alcohol, as this is the healthiest option. How much is too much is guided by the NHMRC Guidelines, which suggest no more than 10 standard drinks a week and no more than 4 a day.
Determining the ‘right amount’ for an individual is more complex, and it may be less than indicated by the Guidelines – particularly if there are other risks to be considered, such as a history of alcohol and drug dependence or other mental health and medical problems.
– Professor Paul Clark
Q: Is it true that, when consumed in small amounts, some alcohol can actually be good for you?
A: We did believe this about 20 to 30 years ago, as some studies showed those who consumed moderate amounts of alcohol had a lower risk of several disorders – such as coronary heart disease – than alcohol abstainers. But these studies were found to be flawed. The problem was that the abstainers studied often had serious existing diseases and had stopped drinking alcohol because of this.
We now know there may be a small benefit of reduced ‘heart attack’ with moderate alcohol use (one to 2 drinks a day), but this potential benefit is completely offset by negative causal effects of alcohol on more than 60 other diseases including injuries, cancers and mental health.
The notion that alcohol is protective against a range of diseases is fanciful.
– Professor John Saunders
Q: Can you cure a hangover?
A: Hangovers can be easily prevented by not drinking, or not drinking too much! Studies show that hangovers cost the Australian economy about $3.8 billion a year. They impair concentration, recall and reaction-time and psychomotor performance, and these are observed even after moderate alcohol intake the evening before.
Impaired activity on measurement of electrical brain activity (EEG) can persist up to 16 hours after normalising blood alcohol levels. Alcohol also disrupts sleep quality, leading to fatigue.
Alcohol suppresses anti-diuretic hormone, increasing urination and worsening dehydration and hangover symptoms – so try to keep hydrated. Eating before or while drinking alcohol can also help to reduce alcohol-concentration levels.
Drinking enough to regularly cause hangovers may be a sign you are developing an unhealthy relationship with alcohol.
– Professor Paul Clark
Q: What do we know about alcohol's impact on our mental health, and how should we take this into account when making choices about how much and when to drink?
A: Research shows that regular consumption can result in an alcohol use disorder and, in these cases, the brain’s reward system is profoundly disturbed. The rewarding effects of normally enjoyable activities are no longer experienced, and the person descends into a low mood and loses motivation.
This can develop into an alcohol-induced mental health problem such as an anxiety or mood disorder. Alcohol has particularly deleterious effects in people who have an existing mental health disorder. Typically, the symptoms are worsened. When an alcohol use disorder develops, treatment of the pre-existing mental health disorder becomes less and less effective and the person may move into a ‘vicious circle’ of increasing mood disturbance and anxiety that is resistant to treatment.
People who have a mental health disorder should be particularly vigilant about their alcohol consumption.
– Professor John Saunders
Q: What are some of the other early warning signs, or questions to ask, if we think we (or a loved one) might be developing an unhealthy relationship with alcohol?
A: Alcohol affects people in different ways. Signs that someone is developing an alcohol use disorder range from simple to more subtle. The number of empty bottles or cans accumulated over a week, finding containers secreted away in the home, the frequency of purchase and amount spent in alcohol retailers can point to consumption increasing to unhealthy levels.
People may also find their (or a loved one’s) drinking is taking precedence over other activities and responsibilities. They may continue to increase levels of consumption to keep getting the effect they want.
Some early signs of more severe alcohol problems are mild tremors, irritability and anxiety when ceasing drinking. A simple way of assessing drinking is to do an online self-check, which provides a score and advice on seeking health professional support, if required.
– Professor John Saunders
If this article has raised any questions about alcohol use, there are confidential and free services available. A listing of services can be accessed via the Australian Government Drug Help webpage, or you can call the National Alcohol and Other Drug Hotline (1800 250 015).
Reduce your alcohol intake
Would you like to take part in a 12-week treatment program to reduce your alcohol consumption? UQ’s National Centre for Youth Substance Use Research is recruiting participants to take part in a research initiative to help improve treatments for people who want to reduce their alcohol intake. To express your interest and find out more, email nac-audstudyqld@uq.edu.au or phone 07 3176 5191.
All enquiries are confidential. This research is being undertaken by The University of Queensland. This study has been approved by the Ethics Review Committee (RPAH Zone) of the Sydney Local Health District (Protocol X21-0342) and The University of Queensland.
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