I like a wine with a meal and an occasional beer…

… but I am well aware that alcohol is by any reasonable definition a drug: “A drug, broadly speaking, is any chemical substance that, when absorbed into the body of a living organism, alters normal bodily function.”  So too are nicotine and caffeine. Whether a drug is legal or illegal is another matter entirely.

The evidence is, I think, quite clear that alcohol and nicotine are the most costly drugs Australia has in terms of health and harm to society. It can be argued, more controversially perhaps, that the greatest problems created by all the other drugs are caused as much by, or even more by, their illegality than they are by any properties or effects those drugs may have — not that I am arguing their harmlessness of course. Our embrace of substances like ice, cocaine, heroin, or even marijuana which itself while not harmless is no more harmful than alcohol or nicotine, is a sad commentary on our society. Certainly most other drugs are made worse in their effects by the co-presence of alcohol, and few would doubt the implication of alcohol in much violence, road death, domestic unhappiness, and criminal behaviour.

Culturally we are used to alcohol, and it is true that for many people alcohol can be a fairly benign drug. I am a drug user myself. I usually don’t abuse alcohol, but I certainly have in the past. I also have to admit that the drinking habits revealed on the recent Four Corners on the subject are quite disturbing, and we all know of the devastating effects — because they are so obvious — that booze has had on the Indigenous population. What is not so often acknowledged in that regard is that proportionally the non-Indigenous part of the Northern Territory population abuse alcohol more than does the Indigenous part**. What is also not recognised is that the devastating effects of alcohol on all sectors — except for those like practising Muslims who don’t use it — are just as real, though less noticed because they occur in circumstances that are less public and/or more affluent.

So we now have a new definition of binge drinking.

DRINKERS who quench their thirst with four or more middies of beer will be defined as binge drinkers under new national guidelines released next month.

The new top limit for safe drinking follows a review by the National Health and Medical Research Council and will apply equally to men and women.

In what one health professional has slammed as a message that “makes no sense at all”, the guidelines will say that more than four standard drinks per day constitutes a binge. A middie of beer is about 1.1 standard drinks and an average glass of wine is 1.5 standard drinks.

“That means that, if a man is sharing a bottle with his wife and takes a slightly larger share, that he’s had a binge,” said Paul Haber, the medical director of Drug Health Services, Addiction Medicine, at Sydney’s Royal Prince Alfred Hospital.

Former federal health minister Tony Abbott accused the Rudd Government of creating hysteria over alcohol and suggested the Government was moving away from the war on illicit drugs.

He said the debate focused on creating prison-like health camps headed by a nanny state.

“There is a moral panic, which is taking over the land,” Mr Abbott said. “There is no doubt that binge drinking is a problem, but it is no worse than in the past.

“I am in favour of people improving society but you have to be reasonable about it.

“Usually these debates are more about establishing the virtue of the people leading the way.

“In the end what an individual does is his or her responsibility particularly with something that is legal. While we can’t ignore the problem; we need to know the real enemy, and that is illicit drugs.

“Illicit drugs is a much worse problem and getting no attention.”

It will be clear from my preface that I have little patience with Tony Abbott’s position, especially given that the war on illicit drugs  itself smacks of moral panic. I may give chapter and verse on that at a later time, but suffice it to say that what we have here is a review of how much alcohol consumption is objectively harmful physiologically, not a call to governments of any persuasion to do anything unreasonable or undesirable about the way Australia’s most popular drug is policed and regulated. I think drinkers need to take note of the new definition.

standard drinks — Australian guidelines

Compare Dr Norman Swan on Catalyst last week.

Dr Chikritzhs: If you’re drinking two drinks a day, then your risk of dying from alcohol-related cancer or liver cirrhosis or those kind of conditions, is about one in a hundred. Any more than that, and your risk of dying from one of those conditions increases very rapidly.

Creina Stockley: I don’t think anyone should take up drinking for the sake of drinking, or in particular for their health, I think you should only drink wine if you actually enjoy drinking wine.

Huon Hooke: It just relaxes people, it makes them feel much more at, at ease with the, with the day’s troubles, and, and to say nothing of the way wine and food go together, because wine is made to go with food at the table, and the two enhance each other.

Norman: So what’s the bottom line here? Well the evidence is certainly not strong enough that if you’re a non-drinker you should turn into a drinker for the health benefits. You’re not necessarily going to get them. And if you’re drinking already you should be sticking to two standard drinks, standard drinks a day or less. And don’t delude yourself that they’re going to do you any good, because they may not be. Just enjoy the drinking for what it is.

See Australian Alcohol Guidelines — the guidelines operative at the moment.

** Or so I recall reading. However, this study concludes “In the NT, per capita consumption among Aboriginal people is approximately 1.97 times, and among non-Aboriginal people about 1.43 times, the national average. It is concluded that alcohol consumption in the NT is greater than in Australia as a whole and there is significant regional variation. The problem is not simply an Aboriginal problem, and a broad range of strategies including a component to address regional variation – is required to reduce it.”  On the other hand:

Aboriginal people drink less than white people

Many Australian health surveys have shown that Aboriginal and Torres Strait Islander people are less likely than non-Indigenous Australians to consume alcohol:

 

Alcohol consumption in percent by age group for Indigenous and non-Indigenous people in Australia.

Across all age groups less Aboriginal people consume alcohol in the low risk group. Only in three age groups is the number of Aboriginal people significantly higher. Source: Australian Bureau of Statistics, National Aboriginal and Torres Strait Islander Health Survey 2004-05.

The diagram above shows that across all age groups in the low risk group fewer Aboriginal people drink alcohol than do non-Indigenous people. On average, 55% of the non-Indigenous people drink at low risk while only 36% Aboriginal people do.

In the risky group more under-24-year-old Aboriginal youth drink than non-Indigenous young people. In other age groups statistically the same number of people drink alcohol. This is also true for the high risk group, except for people over 35 years of age. Here, almost twice as many Indigenous people drink alcohol as non-Indigenous people do. The decline in the over-55-year-olds could be attributed to the lower life expectancy of Aboriginal people who on average die before they reach 60 years of age.

According to surveys in 1993 and 1994, the percentage of Indigenous (84%) and non-Indigenous people (82%) who had tried alcohol at some stage in their life was about the same. But 72% of the non-Indigenous population actually drank alcohol, while only 62% of the Indigenous population consumed alcohol.

One common stereotype of Indigenous Australians is that they all drink alcohol to excess. But the reality is that a smaller percentage of Aborigines drink alcohol than do other Australians. Mick Dodson & Toni Bauman, Aboriginal Australia & the Torres Strait Islands,
Lonely Planet, 2001, p.124

In 2004-05, around half of all Indigenous adults (49%) reported having consumed alcohol in the week prior to another survey, of whom one-third (16%) reported drinking at risky/high risk levels in the long term. After adjusting for age-differences, the proportion of Indigenous adults who reported drinking at risky or high risk levels is similar to that for non-Indigenous adults. — SOURCE.*

Have to wrap this post up now, as I have to go and meet Sirdan at the Bat and Ball Hotel…

Back from the pub

This meal with a glass or red, plus another glass of red at Bar Cleveland, where we sat out of the rain in considerable comfort. Two standard drinks… 😉

I have hardened my view — see the comments below — that the words “binge drinking” are being used inadvisably in the recent report to describe risky drinking. This admission does not reduce my belief that alcohol remains one of our major drug and health problems, in real terms — such as the numbers affected and the seriousness of those effects — a bigger problem than most of the illicit drugs. I guess that means I have moved closer to Tony Abbott’s position…

UPDATE

* No wonder I thought I had read such things before! 😉

There are more young people in the Northern Territory, as evidenced by the median age of 28 compared to the national median of 32 years. As young people drink more often and have a greater likelihood of engaging in irresponsible practices such as binge drinking, this skewness in the population suggests that drinkers are more prevalent in the Territory. This might be exacerbated by the fact that 56% of individuals in the NT are single, compared to 45% nationally.

A greater proportion of the Territory workforce is employed in industries known to have more high risk drinkers. For example, the percentage of people employed in the mining industry is three times higher in the Territory than it is nationally and the percentage in the Defence Forces is probably more than double the national level. Similarly, Aboriginal people and Torres Strait Islanders comprise 22% of the Northern Territory population, compared to 1.4% nationally. Although nearly 60% of Aboriginal people (or more than twice the proportion of the urban population of the Territory) do not drink, excessive consumption is common among the small number of those who do drink. Further, the number of interstate and overseas visitors to the Territory each year is approximately four times the resident population and tourism is associated with higher levels of alcohol consumption. — Living with alcohol in the Northern Territory

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