Are you an oenophile? Or a functioning alcoholic? The difference isn’t always clear.

You have a stressful job, but you’re a success at what you do. You manage to juggle the demands of your career along with helping with your kids’ homework and keeping your partner happy.

You deserve that drink you always have as soon as you get home. It helps you unwind. As does the glass or two of wine you have with dinner each night. And the occasional nightcap to help you get off to sleep.

After all, wine is healthy for you. And it doesn’t affect your work, does it? Sure, there was that one time you made a bit of an arse of yourself at the office Christmas party, but other people were letting their hair down and you were able to joke about it afterwards, and, hey, let’s face it, the recommended safe drinking levels are ridiculously low.

“It’s very easy to exceed these limits,” admits Australasian Chapter of Addiction Medicine president Matthew Frei.

The National Health and Medical Research Council guidelines on safe drinking limits recommend you should not drink more than two standard drinks per day or four standard drinks on any one occasion. However the 2016 National Drug Strategy Household Survey revealed that nearly a quarter of Australian men and 10 per cent of women regularly break these guidelines.   

“A couple might open a bottle of wine with a meal and the female drinks half a glass and the male thinks, ‘Well, no point not finishing the bottle’,” said Frei. “Given that a bottle of wine is usually about seven standard drinks, this puts him well over the safe drinking level.”

Another challenge is the inconsistent strength of premixed drinks. “A can of spirits and Coke from one manufacturer may be one and a half standard drinks, but over two from another,” said Frei. “A can of beer is around one and a half standard drinks, meaning it is difficult to stay under the four standard drinks for the occasional drinker, because two cans is under, but three is over. The concern is that people may see the guidelines about risk too difficult to adhere to and therefore just give up.”

Photo credit: Rudy and Peter Skitterians

A 2014 report released by the VicHealth and Foundation for Alcohol Research and Education shows that alcohol is linked to more than 15 deaths and over 430 hospitalisations every day in Australia.

The rate of at-risk drinking peaks in middle age – reaching 29 per cent for men in their 40s and 13 per cent for women in their 50s. Many of these problem drinkers drink far in excess of the recommended safe drinking levels without it being obvious to others – the so-called “functioning alcoholic”.

Surfers Health Practice Principal Dr Mark Jeffery sees a number of high-functioning patients with alcohol-related problems in his practice. These patients often go on big binges and then come into his surgery to get weaned off their withdrawal with the help of medication.

“They are genuinely very highly successful people with families but have unfortunately developed alcohol dependence,” Jeffery said. “I think the drinking is a coping mechanism that they develop.”

Mental health counsellor and author of the book Understanding the High-Functioning Alcoholic Sarah Allen Benton defines a high-functioning alcoholic as someone who can manage their life, “such as a job, home, family, and friendships, all while drinking alcoholically”.

According to Benton this means their drinking patterns mimic those of the “traditional” alcoholic – that is, they are unable to stop at one drink, will “obsess about the next drinking opportunity”, undergo “personality changes” when intoxicated and “repeat unwanted drinking patterns and behaviours” – but, because they are successful in the outside world, they are in denial about the extent of their dependence.

One of the justifications high-functioning alcoholics often give for drinking is the possible health benefits of alcohol. As recently as August last year the British Medical Journal published research that found significantly lower dementia rates in those who drank 1–14 standard drinks a week versus teetotallers. And in February last year, the University of California Irvine’s Institute for Memory Impairment and Neurological Disorders study found that people who drank in moderation lived longer than those who abstained.

Australian and New Zealand Association of Neurologists president Matthew Kiernan admits there may be some benefits to drinking at safe levels.

“There were studies that went back a long time ago showing that red wine did have some antioxidant properties, and also it was a vasodilator, so it would basically slightly increase blood flow so you get a better perfusion of the heart and vessels elsewhere,” he said. “But if you go higher and higher levels, eventually you start to get into things like metabolic issues, vitamin deficiencies, folic acid problems, thiamine and so on, and that’s why I think that as you turn it up, eventually you’re going to start getting a higher incidence of dementia.”

Photo credit: congerdesign

However not all studies are supportive of the idea that drinking small amounts of alcohol is beneficial. A paper published in The Lancet in August last year, which analysed worldwide alcohol use and health outcomes between 1990 and 2016, found that any benefits from moderate drinking, such as reduced ischaemic heart disease and diabetes, were outweighed by increases in other alcohol-related morbidity and mortality such as cancer. The study’s conclusion was that the level of alcohol consumption that minimised health loss was zero.

Retired company director Steve Harrison⃰  will never forget the moment he had his first drink. “It was like turning on the lights on the Christmas tree,” he told me. “Whoosh! Everything was fantastic!”

However Harrison’s drinking became problematic. “Eventually the good times stopped,” said Harrison. “You just don’t get the same buzz any more. And you’re just left in this misery. And the only thing that slightly reduces the pain is more alcohol.”    

Harrison, 70, who has been sober for 38 years with the help of AA, describes the years of his drinking as filled with constant anxiety, misery and guilt. “I used to get all the alcohol in the house and pour it out and think, ‘Thank Christ, it’s all over, that’s it, that’s finished! And the next morning I’d be walking back up to the pub.”

It took Harrison over 200 AA meetings before he was finally able to give up alcohol for good and he continues to attend meetings to this day. “Some people can manage their alcohol but not alcoholics,” he said.

His advice for people who may be heading towards a dangerous point with their drinking is to stick to the recommended two drinks a day and see how they go. 

“If you can handle that, fine,” he said. “But you may find that it’s nothing or everything for you.”

⃰Name has been changed at interviewee’s request.

The National Health and Medical Research Council have released new Australian draft guidelines for safe drinking. The draft guidelines, which were released on December 16, are even stricter and recommend you should not drink more than 10 standard drinks per week or four standard drinks on any one occasion.

TIPS TO MAINTAINING SELF-CONTROL BY ADDICTION SPECIALIST DR MATTHEW FREI

  • Mix it up: intersperse low-alcohol beverages with non-alcohol beverages. For example, drink at least one glass of water for every glass of alcohol.
  • Drink slowly: sip rather than gulp, and space drinks apart.
  • Avoid shouts: buying rounds of drinks in turns is a recipe for over drinking.
  • Monitor drinks: keep in mind that the amount you are served is often more than a standard drink. For example, about 100 ml of wine is a standard drink, but bars and restaurants will often pour around 150 ml.   
  • Where there is repeated loss of control: the best strategy may be to avoid drinking altogether. 

Recovery Elevator founder Paul Churchill shares his courageous battle with alcohol addiction in this inspirational TEDx talk:

Suvi Mahonen is a Surfers Paradise-based journalist. Her work appears in The Australian, HuffPost, Mamamia and other health and lifestyle publications. Follow her on Facebook and online art-selling platform Redbubble.

Feature photo credit: Michal Jarmoluk

6 Replies to “Are you an oenophile? Or a functioning alcoholic? The difference isn’t always clear.”

  1. “Having read this I thought it was very enlightening. I appreciate you taking the time and effort to put this article together. I once again find myself personally spending way too much time both reading and commenting. But so what, it was still worth it!”

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