28 November, 2017

How can you tell if your drinking is harmful?

Total levels of alcohol consumption have risen for the last two years and are some of the highest levels in Europe. There are many forms of excessive alcohol consumption that can cause substantial risk or harm to anyone of us.

Some people drink large amounts of alcohol each day.  Others have repeated episodes of drinking until they are drunk, so-called binge drinkers.  Others keep drinking despite the fact that their alcohol use is causing them physical harm or harm to their mental health and lastly, some people drink in a way which is dependant or addicted to alcohol and so they find it very difficult to stop

Excessive alcohol drinking causes illness and distress to the drinker but also to his or her family and friends.  It is a major cause of breakdown and relationships, of trauma, of hospitalisation, of prolonged disability and of early death.  Alcohol related problems represent an immense economic loss to many communities around the world.

Today, we are going to look at The World Health Organisation’s Alcohol Use Disorders Identification Test”, published by Thomas F. Barbor et al. The aim is to try and find out whether our drinking is modest and within safe limits or whether it’s hazardous and risks causing harm to our physical or mental health or whether our drinking is already likely to be harmful and is already damaging us or lastly, whether our drinking is actually dependant and likely to be difficult to stop.

According to The World health organisation “alcohol is implicated in a wide variety of diseases, disorders and injuries as well as many social and legal problems.  It is a major cause of cancer or the mouth, of cancer of the oesophagus and cancer of the larynx as well as cancer of the breast.  It is associated with damage to organs such as liver psoriasis and pancreatitis especially after long term excessive consumption.  Alcohol causes harm to the developing baby in the womb and may lead to growth retardation or learning disability or so-called foetal alcohol syndrome.  Alcohol exacerbates many common medical conditions such as hypertension or gastritis or diabetes and some forms of stroke.  These may be aggravated by even occasional or short term alcohol consumption as are many mental health disorders such as depression.  Alcohol use is associated with road traffic accidents and pedestrian injuries with falls and injuries at work.  The risk related to alcohol is linked to the amount of the consumption and to the pattern of drinking.

Obviously these risks are most prominent in people who are dependent on alcohol.  This is simply because there are people who drink more than other people.  However the bulk of harm associated with alcohol occurs amongst people who are not dependent if only because there are so many of them.  The identification of drinkers with various types and degrees of at-risk alcohol consumption has a far greater potential to reduce all types of alcohol related harm and ill-health.  No one develops alcohol dependence without first having engaged for some time in hazardous alcohol use.  Screening for alcohol misuse and dependence is worthwhile but it is most useful in those people who are not dependent but who may be well advised to reduce or stop their alcohol use because of the hazardous or harmful consequences that it is already having.  Many of us are ignorant or unaware of the safe limits of alcohol use and there are many social and cultural pressures on us to drink heavily.  Heavy alcohol consumption is part of our custom and this can be a very big pressure on us.  Many of us indeed may simply be in denial about our alcohol use.  So that using a screen such as the audit tool is helpful because it allows us to take the preventative measures which are proven to reduce alcohol related risks.

The Alcohol Use Disorders Identification Test was developed for health professionals, general practitioners and community nurses but it can also be taken as a self-report measure.  All we are doing now is to try and facilitate a guide and allow people consider their own alcohol use.  By giving you the tool that your doctor is likely to use, you can understand where the assessment is coming from and perhaps benefit from it all the more.

This test should help reveal whether we are modest drinkers, who need to be advised about safe drinking, or hazardous drinkers who need to recognise the danger alcohol consumption is putting us in, or whether we are harmful drinkers who are already damaging our physical or mental health or whether we are in fact dependent drinkers who need to seek professional help and should do so as soon as possible.  Each of these groups can benefit from education. 

If your alcohol use is in the hazardous region then you need to consider this evidence and consider reducing your alcohol use or even abstaining.  You need to get the best possible support for this, ideally speak to your doctor and seek advice and encouragement.  If your alcohol use is already causing you harm, you need to consider stopping drinking and you may need some brief form of counselling or continued monitoring to help you do this.  Those of you who are already in the dependent region and are addicted to alcohol should seek specialist support for further evaluation and treatment.

Calculating your Alcohol Use Disorders Identification Test Scores

An AUDIT score of less than 7 suggests that your drinking is modest and that you should be educated about it and try and drink safely. If however your score is above 8, between 8 and 15, you are now in the hazardous drinking zone and you need advice about this. If your score is between 16 and 19, you need advice and possibly some counselling because your alcohol use is causing actual harm to your mind or body. If your alcohol AUDIT score is greater than 20, it’s likely that you have an alcohol dependent problem and should seek greater help and advice, ideally through your general practitioner and possibly through a specialist.

Alcohol is described as our favourite drug.  The more we understand about the amounts of alcohol we are using and the dangerous patterns we have in our alcohol consumption, the more we can openly and honestly address the serious consequences for ourselves, our families and our society of alcohol abuse.  Our use of a simple screen like the AUDIT measure is an interesting way of addressing these questions and honestly answering them.  Taken in sincerity and in sobriety, the answers are remarkably helpful and have proven to be predictive and accurate.

Prof Jim Lucey | Medical Director

Support & Information Service

If you or someone you know has a problem with alcohol abuse and you want to know more about how to address it, you can contact our support and information service at 01 2493333 or info@stpatsmail.com

The Support & Information Service is a telephone and email service staffed by experienced mental health nurses 9-5 Monday to Friday with an answering and call-back facility outside hours. You can contact the Support & Information service by calling 01 249 3333, or if you would like to email your query to info@stpatsmail.com we will endeavour to get back to you within these hours.

Download The Alcohol Use Disorders Identification Test: Self-Report Version

Download The Alcohol Use Disorders Identification Test: Self-Report Version