Key Points
- According to ABS data published in March 2022, one in four people aged 18 years or older exceeded the alcohol guideline in 2020-21
- Alcoholism is the inability to control drinking due to physical and emotional alcohol dependence
- People who have migrated to Australia are less likely to drink alcohol excessively
- It can be difficult for family members to have a loved one with a drinking disorder, but help is available
Alcoholism is a chronic disease that affects many people across Australia, regardless of ethnicity, age group, social status, or where they live.
shows one in four people in Australia aged 18 years and over (25.8 per cent or 5 million people) exceeded the alcohol guideline (10 standard drinks in a week) in 2020-21.
(AIHW), people from culturally and linguistically diverse backgrounds (CALD) are more likely to abstain from alcohol than those who speak mostly English.
Over half (53 per cent) of people who mainly spoke a language other than English were abstainers or ex-drinkers, compared with 19.2 per cent of primary English speakers.
This correlates with the ABS data, which indicates "people born in Australia were almost twice as likely as those born overseas to exceed the guideline (30.0 per cent compared to 17.3 per cent)".
Australia ranked above the OECD average for litres of alcohol consumed per capita by people aged 15 or older, at 9.5 compared with 8.7 litres per capita in 2020 (OECD 2021). Credit: Rafael Ben-Ari/Getty Images
How to tell if a loved one is on a path to alcoholism
Helen Gillies is the CEO at an organisation that supports families and friends of alcoholics.
She says people who are on a path to alcoholism usually show behavioural changes.
"They can become very angry or upset. They can become very elusive and secretive. They can become very argumentative, or they can become quite distant and removed," Ms Gillies explains.
She says it can be difficult for family and friends to identify the symptoms.
There are many people who can drink alcoholically and appear quite normal.Helen Gillies, Al-Anon Family Groups Australia CEO
"We know that there are a lot of very professional people who are conducting their work and appearing to be quite functional, who can have a very severe disability in terms of their addiction to alcohol," she adds.
"They can be perfect at work and then come home and not be very pleasant to deal with. It's that kind of change that tends to indicate that something is not quite right."
Having a parent that suffers from alcohol abuse issues may deeply impact a child's development and overall life. Credit: Richard Hutchings/Getty Images
Eleanor Costello is the Evidence Manager at the , a government-funded organisation that aims to minimise the harm caused by alcohol and other drugs.
She says another visible sign that a loved one is on a path to dependence may be a change in their level of engagement in activities that were important to them previously.
You might notice their energy levels are different and they don't engage the same way.Eleanor Costello, Alcohol and Drug Foundation (ADF) Evidence Manager
Stages of alcoholism and physical signs
Alcoholism isn’t developed overnight. It progresses from long-term alcohol abuse.
- Occasional abuse and binge drinking
- Increased drinking
- Problematic drinking
- Alcohol dependence
- Addiction
Alcohol dependence means the attachment to alcohol is such, that it taken over a person's regular routine. Despite being aware of the adverse effects of drinking, an alcoholic can no longer control their intake.
Other indicators of alcohol dependence include tolerance to drinking and withdrawal.
Addiction is the final stage of alcoholism. At this stage, drinking is not just for pleasure, and responds to a physical and psychological need to drink.
When alcoholics sober up, they may feel undesirable symptoms:
- nausea that is unrelated to a hangover
- body tremors
- sweating
- severe irritability
- a racing heart
- trouble sleeping
Alcohol and mental health
The link between alcohol and mental health is very close and complex, Ms Costello says. Many individuals with mental health issues turn to alcohol as an escape method or self-medication.
There's an intersect between alcohol and drug misuse and mental health issues.
Mental health conditions can make it more difficult for individuals to stop drinking, and increase the likelihood of dependence and risky behaviours, like binge drinking.
Also, alcohol use exacerbates the development, frequency and symptoms of many mental health conditions, and may extend their duration.
How to have the difficult conversation
If you believe your loved one has a drinking problem, the first step is talking to them about it.
But this may not be an easy task, as it’s likely that they will be in denial.
Alcoholism is "almost a psychological disease, where the person is completely captivated by alcohol", so they will do anything to avoid withdrawal, Ms Gillies explains.
"They will lie, they will cheat, they will manipulate, they will do anything they can ... because their body craves it", she adds.
Before having the conversation, it’s important for friends and family obtain professional guidance.
Ms Costello says the ADF website has available in to help people plan their approach, understand which questions to ask, and how to navigate their own emotions.
Make them feel like they are cared for, that they can trust the people around them, so they’re more likely to open up.
"Make sure they know how much you care about them ... that you're there to talk about anything that might be going on in their lives," she adds.
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Excessive drinking, anger and domestic violence
According to the World Health Organisation, alcohol abuse is more closely associated with aggressive behaviour than any other type of psychotropic substance.
Ms Costello says if any family member is at risk, it’s important to ensure safety first.
"[If] there's a potential for domestic violence or any other sort of aggression ... remove yourself from the situation, if you can. If you're in immediate danger, always call triple zero," Ms Costello says.
It's not acceptable to have somebody in your life who's aggressive or violent.
Ms Costello says if the person is in denial and doesn't want to accept that they have a problem, they will attempt to deflect, " to keep the focus away from themselves."
"Often they'll point the finger and say, ‘it's because the house isn't clean enough', ‘it's because you spend too much money’,‘it's because you are X,Y,Z’. None of that is really relevant".
Alcohol use disorder can be mild, moderate, or severe. Lasting changes in the brain caused by alcohol misuse perpetuate alcohol use disorder and make individuals vulnerable to relapse. Source: Moment RF / Nuria Camps Curtiada/Getty Images
A progressive disease
Alcoholism is a progressive disorder, so people deteriorate with time.
"Every time an alcoholic picks up a drink, it gets worse", Ms Gilles warns.
"They'll start having blackouts, they'll start having behavioural changes, they'll start having trouble at work, they’ll start having trouble with money, they’ll start having trouble with their relationships".
Drinking excessively for a prolonged period can alter the brain chemistry, affect neuro-pathways and hamper brain development in young people.
"The more you use (alcohol), it can make you feel sort of sad, because it is a depressant ... It also puts a lot of strain on your body, it actually raises your heart rate," Ms Costello says.
Seeking support during the early stages of problem drinking could help the outcome. However, it's dangerous for alcoholics to stop drinking without medical assistance.
"Professional help is the best thing for them. And there is professional help available," Ms Costello says.
"It also has a lot of self-help information because they may not be ready to talk to someone, but they might be ready to have a look at some of the things they might be able to do to start with — those initial stepping stones to getting some help and support," Ms Costello adds.
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Help for families
Seeing a loved one change due to excessive alcohol consumption can be painful and confusing.
"You can go years trying to support them. It can actually really impact the family’s well-being as well," Ms Costello says.
"It's really important to recognise that, and to be very kind on yourself and your family, who might also be going through a lot of pain," she adds.
Ms Gillies says once family members seek professional help, this may encourage the loved one to treat their addiction.
However, she emphasises that all the parties involved must make their own decisions, however difficult they may be.
"You can't change that person from making the choices that they're going to make, but the families can make choices and it can be really hard."
"I think one of the hardest things we ever have to do is see people we care about being in pain, but we have to look after ourselves and we have to make decisions about what's right for ourselves and hope that the other person gets recovery."
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