Alcohol Use Disorder: When and how to get help

Drinking can be synonymous with socialising in Australia, but when it comes to alcohol, there’s no truly safe level.

“Alcohol is classed by the World Health Organisation as a class 1 carcinogen,” says Medical Director at Clean Slate Clinic, Dr Chris Davis. “The less you drink, the safer it is.”

The National Health and Medical Research Council suggests that healthy men and women should drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day.¹

“However, it’s not as simple as saying ‘if I drink less than 10 standard drinks a week, I don’t have a problem,” says Chris. “If alcohol is having a negative effect on your life, or you feel like it’s a problem for you, that probably means it is.”

“There's no medical definition for what an alcoholic is,” says Chris. “It’s not a term we tend to use because it comes with so much stigma.”

Alcohol Use Disorder (AUD) is a problematic pattern of alcohol use.

“Many regular drinkers fit the criteria for a mild alcohol use disorder,” says Chris. “Perhaps you look forward to Friday so you can have a drink, have tried Dry July but not been able to make it to the end of the month, or you miss out on weekend activities because you’re hungover. These are all signs that alcohol might be causing you problems.”

If you relate to 2 or more of the following criteria², then it’s worth seeking help with your alcohol intake:

• Alcohol is often taken in larger amounts or over a longer period than was intended.
• There's a persistent desire or unsuccessful efforts to cut down or control alcohol use.
• A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
• Craving, or a strong desire or urge to use alcohol.
• Recurrent alcohol use resulting in a failure to fulfil major role obligations at work, school, or home.
• Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
• Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
• Recurrent alcohol use in situations in which it's physically hazardous.
• Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
• Tolerance, as defined by either of the following:
  *A need for markedly increased amounts of alcohol to achieve intoxication or the desired effect.
  *A markedly diminished effect with continued use of the same amount of alcohol.
• Withdrawal, as manifested by either of the following:
  *The characteristic withdrawal syndrome for alcohol
  *Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.

“Many people will hide or minimise their alcohol use because of the guilt and shame they feel around it,” says Chris. “Having an honest conversation with someone about your drinking, and the effects it’s having on your life can motivate many people to get help. Your GP is always a good place to start. They will be able to give you resources and refer you to the right support networks.”

If you’re worried about a loved one, the key is “respectful curiosity,” says Chris.

“Ask how they’re doing, how their mood is, or how they’re sleeping,” he suggests. “Then you can suggest that any negative feelings might be linked to their alcohol intake. Being there in a supportive way and having an open discussion can be really helpful.”

The Alcohol and Drug Information Service is available 24/7. It's staffed by counsellors and nurses who will you give you helpful advice about any alcohol issues. You can call them on 1800 250 105.

“There is a huge amount of support there if you know how to access it,” says Chris.

“If someone has developed a problem with drinking, there’s no guarantee that if they stop drinking they will never run into problems with alcohol again,” says Chris.

“The key is having the right support and treatment. One of the AA mantras is that ‘you alone can do this,’ but when it comes to drinking less, I believe that you can’t do it alone.”

“Recovery is absolutely possible for everyone, even if you’ve been through detox and rehab a number of times. Every time someone lapses, you learn more about yourself and your relationship with alcohol, which gets you closer to where you want to be.”

“There are safe, effective anti-craving medications which reduce the urge to drink,” says Chris.

These are usually used as part of holistic treatment, alongside therapy or counselling. “People often drink for a reason, and those issues often can’t be dealt with when alcohol is blurring the picture,” he explains. “An important first step is to remove alcohol or minimise its effects so then any underlying mental health conditions or life circumstances can be identified and treated.”

If you’re in need of urgent support, there is help available:

Lifeline provides 24/7 suicide prevention and crisis support. Call 13 11 14

Suicide Call Back Service offers free 24/7 counselling support if you are at risk of or affected by suicide. Call 1300 659 467

Beyond Blue offers mental health support. Call 1300 22 4636

Clean Slate Clinic offers a range of treatments for dependence on alcohol, stimulants, cannabis and other drugs.

Alcoholics Anonymous offers free recovery programs around Australia.