The personal cost of alcohol abuse

The Dominion Post ~ 19 July 2005

Think you've got a problem with alcohol? The relief one woman found in seeking help for her spiralling abuse is a salutary lesson for others in the same boat, she tells Cushla Managh.

The three white lines on the road wavered as Joan* drove home from work, blind drunk. She bought a bottle on the way and when that was emptied, she hiffed it over a farmer's hedge. More bottles awaited, stashed inside gumboots and the backs of cupboards; all Joan had to do was get home without killing anyone.

At home, her husband Harry* waited. He'd been trying to keep track of Joan's drinking, searching for the hidden bottles and marking them, but he was sick of it. Joan knew her marriage would end soon if she didn't stop drinking.

Desperate not to lose the children and husband she "adored", Joan downed two or three stiff gins and phoned Alcoholics Anonymous. Help me, she asked, and they did – and 21 years later this articulate professional woman, now in her 70s, is still attending AA meetings and, more importantly, she's still sober.

Like thousands of other New Zealanders, Joan knows what it means to crave alcohol beyond reason. These days when she sees someone drunk in a gutter, she's saddened by the knowledge it could have been her.

"That could be me, a little old bag lady. I would be in a mental institution, or dead, if AA hadn't been there for me," she says with feeling.

As a nation, there's little doubt we like our tipple. According to the Alcohol Advisory Council (ALAC), people aged 15 and over drank a total of 28 million litres of alcohol last year, putting New Zealand 24th out of 50 countries for the amount of alcohol consumed per head of population. On average, each household spent about $20 a week on alcohol. ALAC's research found that most adult drinkers used alcohol to wind down and relax, and 45 per cent said they enjoyed the "buzz" they got when they drank.

But getting drunk comes with a big price tag. Economic research done for ALAC estimates that alcohol-related harm costs New Zealand between $1 billion and $4 billion each year. That money is used to dry out the nation's drunks, treat their physical ailments, tackle alcohol-related crime, and combat the devastating social effects of alcohol on individuals and families. It includes an estimated $1.17 billion lost in workplace productivity.

People who drank too much and who couldn't stop used to be called alcoholics but ALAC's chief executive, Mike MacAvoy, says they're known now as alcohol-dependent, which more accurately describes their condition. He thinks about five per cent of the population falls into that category and he says every alcohol-dependent person affects the lives of at least 10 other people.

Alcohol dependency is characterised by a craving for alcohol, withdrawal symptoms if it's not available, and an increasing tolerance of its effects. Other than that, drinking patterns vary. Some people go on benders, drinking all day and all night for a week or two, while others drink steadily and heavily every day for months or years on end.

Still others turn to a bottle for solace after a relative's death, but eventually manage to stop drinking.

Dr MacAvoy says teenagers often have drinking patterns that appear alcohol-dependent but, inexplicably, they grow out of it.

"It's often a very difficult time for young people to socialise, and they need the alcohol to support them mixing with the opposite sex, but a lot of that disappears when young people get jobs, form relationships, get married, take on a mortgage - and that's one of the real problems with defining alcohol disease. It doesn't fit any of the normal criteria of disease because you can change it by removing the drug or by introducing a mortgage."

Dr MacAvoy says alcohol-dependency is often accompanied by mental disorders such as depression or anxiety, and dependency on other substances like tobacco. Many drunks wind up in court on drink-driving charges, their relationships collapse and they find they're unable to hold down jobs.

Too much alcohol also affects their health. Their liver, stomach, heart, nerves and brain suffer damage, and their day-to-day working memory may also be affected. Dr MacAvoy says women's bodies often show signs of damage before men's.

"While it might take a man 10 years of heavy drinking to damage his liver, it may only take a woman three years."

Following diagnosis, the priority is to get the people to stop drinking so their body can heal. An eclectic mix of treatment regimes is then used - drugs, therapy, support groups - and Dr MacAvoy says they appear equally effective.

He's cautious, though, about defining what constitutes successful treatment.

"I've always avoided that question because for some people success may be total abstinence but they may be absolute bastards. A dry drunk is sometimes worse than when they're on the booze. There are some people (for whom) success is that they're at least holding their job but continuing drinking. Some are continuing to drink but at least they've stopped beating up their wives."

For Joan, however, success is measured by her continuing abstinence after 21 years.

She drank heavily as a university student in England but says it wasn't till her late 40s, when she was married with children, that she started drinking to cope. She was a perfectionist at home and work but says she was exhausted, and drinking helped her get through the days. Before long she was hiding alcohol around the house, lying, and becoming abusive and argumentative.

When she told her GP she was drinking too much, he told her not to be ridiculous and suggested a course of antidepressants. Joan says it was a particularly hard time for her teenage daughter, who was very distressed by her drinking.

"The guilt, the dishonesty, the remorse and the shame...I really wanted to stop - and I found I couldn't."

Her husband Harry, now 88, says he initially denied his wife had a problem, attributing her changed behaviour to work pressures. When he realised the seriousness of the situation, he became depressed and felt he was to blame.

"I felt that if I was offering a good married life this wouldn't have happened. I also got very depressed because it seemed to me that the personality of my wife was deteriorating. She did not have the same regard for truth that she used to have, and all sorts of deceits were taking place."

Contacting AA proved a turning point for Joan. As she listened to others talk about the horrible things they had done to obtain alcohol so they could drink themselves into oblivion, Joan was overwhelmed with relief.

"Relief that I wasn't weak-willed and pathetic and a bad person. All these people had done all the sort of dreadful things I had done, and some of them worse. They'd been to prison and I said 'oh, I haven't been to prison yet' and they said 'yet' ... and they're absolutely right."

She urges people dependent on alcohol to seek help.

"It was pride and denial that kept me so sick for so long. I just didn't want to believe that I had more than a bit of a problem. Help is there, and there's a lot of compassion and a lot of love."

Today, Joan counts herself fortunate to have good health - and, against the odds, to still be with Harry.