Health Check: how do I know if I drink too much?

While alcohol is a legal and common way many societies stimulate social interaction, when consumed at high levels over long periods it can undermine physical health and cause cancers and other disease. Most people know excessive drinking isn’t good for our health, but how do we know when we’re drinking too much?

Alcohol consumption is associated with long- and short-term consequences. Long-term health consequences include: alcohol-related diseases such as cirrhosis of the liver; stroke; high blood pressure; heart disease; and more than 60 cancers, including of the mouth, lips, throat, oesophagus, stomach, pancreas, liver, bowel and breast.

Short-term health consequences include fatalities, physical injury or road accidents due to impaired cognitive performance and diminished reaction times.

Social consequences may include domestic violence, absenteeism, violence and crime.

How much is safe to drink?

It’s important to know the recommendations on drinking to ensure we’re not drinking too much for our own health and for the safety of others.

In 2009, the National Health and Medical Research Council updated the Australian drinking guidelines. The guidelines contain four recommendations to ensure our drinking is “low risk”. Low risk is defined as drinking at a level that reduces the chance an individual will suffer from short-term injury or long-term disease.

Healthy men and women are advised not to drink more than two standard drinks on any one day. If a person drinks less than that, the probability he or she will suffer from long-term alcohol-related disease (such as cancer) is approximately one in 100.

For both men and women, drinking no more than four standard drinks on a single occasion reduces the risk of alcohol-related injury to one in 100. Risk of injury includes physical injury, or road accidents due to impaired cognitive performance and diminished reaction times.

Short-term risky drinking is most often associated with intoxication. Intoxication in its mildest form produces slight changes in inhibition, reduced co-ordination and decreased alertness. More extreme forms may involve slurred speech, boisterous or aggressive behaviour, inappropriate sexual behaviour, swaying, rambling conversation and difficulty concentrating.

Who can drink?

Pregnant women are advised to avoid alcohol because of the possibility of alcohol passing through the placenta into the embryo. This may affect brain and other developments of the child.

Evidence shows the brains of children under the age of 18 are still developing. Thus it is recommended children under the age of 18 should avoid consuming alcohol. Consuming alcohol before the age of 18 also increases the risk of numerous poor developmental and social outcomes.

Settings and their associated customs and norms can influence how much alcohol we consume. People will often consume more alcohol in settings like bars, nightclubs and sports clubs, for example. This is usually because alcohol in these settings is sold, managed and marketed in ways that encourage easier or greater consumption.

People should be aware of this phenomoneon and try to consciously consume moderate amounts in these types of settings.

Symptoms of drinking too much

While all drinking has elements of long- and short-term risk, consistent drinking can lead to dependence and other alcohol-related problems. If you find it hard to stop drinking after you have started, you do things that are not normally expected of you because of your drinking, or you feel you sometimes need a drink in the morning, you may be showing signs of dependence and should consult your GP or a health practitioner.

Another sign of dependence is that, over time, greater amounts of alcohol are required to achieve intoxication. Persistent use and being preoccupied with your consumption, despite evidence of harm, is another sign your drinking might be unhealthily habitual.

If you feel guilty after drinking, have injured someone because of your drinking, or someone has suggested you reduce your drinking, you should also consider talking to someone about your alcohol consumption.

Steps to reduce alcohol consumption

While alcohol is part of our world, we can reduce the risk of short-term harm, disease and dependence. For adults, it is advised you have no more than two standard drinks a day. On any one day it is advised adults should not consume more than four standard drinks in a session.

A good way to cut down on your drinking is to start by ensuring you are having at least one to two alcohol-free days. On these days, you may want to substitute an alcoholic drink with something else, like sugar-free tonic water. This has a sophisticated taste but has no calories or alcohol.

Because of the long- and short-term risks, there should always be room to reduce your alcohol consumption. Perhaps in the long term you could try to avoid consumption during weekdays.

When going to functions where alcohol will be available, have a strategy rehearsed in your mind as to how and why you will not consume alcohol. You may say it is one of your alcohol-free days, you are not drinking today, or you are pacing yourself this week.

People are more health-conscious these days so tend to be more open about not drinking for health and well-being reasons. A non-alcoholic substitute drink will help you feel more socially integrated in these settings.

We should also ensure our children avoid alcohol before the age of 18. This is the safest way of maximising their health and human potential.