Dying for a drink

Graeme Alford took his first IQ test while attending the distinguished Trinity Grammar school in Melbourne in the 1960s. His second intelligence test taken two decades later gave the game away.

Alford was 35 at the time but had already lived too many lifetimes. From private schoolboy to carousing law student, criminal barrister for Melbourne's notorious underworld, husband to college sweetheart, father to two boys, problem gambler, embezzler, and finally bank robber.

There was one constant, however: alcohol. His dad, a big drinker, died when Alford was six. His mother buried her husband then bought a pub. He lived upstairs in hotels in Collingwood until the age of 12.

"Everything about my upbringing centred on alcohol. You associated it with good times and bad times. It was an integral ingredient to living," Alford says. "I had my first real drink at 13. At 16 on a school footy camp I drank a whole bottle of Rio Vista sweet sherry. I vomited all night and the coach dropped me. But still I was only a social drinker, parties or dances."

The blackouts started at Melbourne University. A counter lunch with law school mates would result in him being the last back to the library, if at all. Bar jobs inevitably ended with beers after a shift. He played footy on weekends with Trinity Old Boys where they "really got stuck into it" after the game.

Alford did articles at a law firm with a drinker for a senior partner, and found companions in other lawyers who drank during and after lunch. They were in their 50s, he in his 20s. "It escalates without you noticing," he says. "You just find people who drink like you do and you don't feel abnormal."

Alford's downward spiral quickened. As a criminal barrister he drank with clients: painters and dockers and underworld figures. He gambled: two-up and the horses. The $100,000 in his trust account proved too tempting.

"I was drinking 30 beers a day six days a week. Gambling is easier, the light changes from red to green when you're full of juice."

Caught and sentenced to five years' jail for plundering the trust fund, he was out in 16 months, heading straight to the nearest hotel for a drink.

But it was the botched armed bank job in Chapel Street, Prahran, in 1982 while drunk that finally led to his redemption. Ever cunning, he sought to use his drinking as a mitigating factor in his sentencing. Renowned criminal psychologist Ian Joblin tested his IQ and compared it to the test done at Trinity Grammar.

"I'd lost more than 40 points off my IQ in the areas of memory and concentration," Alford says. "I'd gone from 133, in the top two per cent, to below 90, the bottom 10 per cent. That was the jolt I needed."

Alford knows he has alcohol-related brain injury, and continues to deal with it, 25 years after taking his last drink.

In his recognition of the problem he is lucky. Alcohol-related brain injury treatment service ARBIAS suggests that more than 200,000 Australians suffer undiagnosed alcohol-related brain damage, and two million others are at risk due to the volume of alcohol they consume.

The number of those who drink too much is on the rise, according to National Health Survey figures. In 1995, 8.2 per cent of Australian adults were drinking at risky levels (six or more standard drinks a day for males, three or more for females), increasing to 13.4 per cent in 2004-05.

A standard drink is less than you think, 100ml of wine which is around half the average serve, or 285ml of beer, less than a can (375ml). Risky drinking is consuming 300ml of wine or just under half a bottle a day for women and 600ml of wine or 4 1/2 cans of beer for men.

That grim news is exacerbated by Australia's lack of recognition of the problem, with a new Roy Morgan survey released today showing that 70 per cent of men and 60 per cent of women have no clue about how much alcohol puts them at risk of brain damage.

The survey shows that 20 per cent of women believe they can drink four standard drinks (400ml of wine or just over half a bottle) a day over a period of eight to 10 years and not put themselves at risk of brain damage. It does. One in five young men think it takes more than 20 standard drinks a day before they are at risk. It's six.

The lack of public awareness, and the apparent lack of political impetus to address the issue has ARBIAS chief executive Sonia Berton worried "a whole generation of brain damaged Australians will emerge". "It's absolutely horrific and it's time people were told. Where are the ads and messages warning people? Why aren't we being told?" she says. "Alcohol-related brain injury affects as many as one in eight Australians. It's slow, progressive, and ultimately this damage affects a person's thinking, emotions, communication and ability to care for themselves.

"Many people are unaware they are living with alcohol-related brain impairment until the damage is severe. Because Australia has moved to becoming a binge-drinking culture, something has to be done. In the next 10 years treatment providers will be swamped with alcohol-related issues," Berton says.

Australian National Council on Drugs chairman John Herron agrees. "Alcohol-related brain damage is a very under-reported issue for this country," Herron says.

"It is unfortunately true that too many people drink to excess and that translates into many problems for the community and massive health costs. We as a community must start to confront the simple reality that alcohol-related brain damage is a real risk for many people and a growing problem for our nation."

Alcohol-related brain injuries, in the early stages, are difficult to diagnose. Usually sufferers go to their GP with other health problems, and by this time it will almost inevitably have gone beyond the mild stage. The most common brain disorder associated with alcohol consumption is frontal lobe damage. This can result in changes to thinking and emotions. The ability to plan, organise, control behaviour and adapt to change is affected. Some people lose the ability to learn or acquire new information.

Recovery is difficult and limited to those under 40 years old who give up drinking completely and adopt a healthy lifestyle. Mostly people are forced to do what they can to manage a permanent injury.

"I'll give you a profile of the ARBI sufferer," says Berton. "Twenty-five per cent have been through the criminal justice system. Fifty-five per cent are also diagnosed with a psychiatric condition such as schizophrenia or depression, although we are still not sure whether it's the alcohol dependence or the mental illness that comes first. Seventy per cent are still drinking or taking drugs. One hundred per cent are unemployed. Virtually none have any support from friends or family, who have long ago given up on them."

Berton says despite the focus on alcohol problems faced by indigenous communities, the issue is widespread throughout the community. Her organisation is swamped with people referred by GPs. The waiting list to obtain help is years long.

"The whole stereotype of the homeless person with the brown paper bag couldn't be further from the truth. It cuts across age, gender, colour. We see solicitors, we see pilots, we see people who had very promising and well-earning careers before they came to us. Alcohol-related brain damage doesn't discriminate."

Former draftsman Kevin Clarke's upbringing wasn't centred on alcohol. Now 49, Clarke and his brothers grew up in a strict, teetotal, Catholic household in Melbourne. He first drank with his brothers. Later, as a draftsman, he would drink with the builders after work.

"By 28 I had a wife, four children, a house, a business, my life was made," Clarke says, his slurring voice and slow delivery a product of his brain damage. "I was social, at the kids' netball, Auskick. I gravitated to those who drank. I found the drinkers and it made me feel more normal. But I thought of myself as a social drinker, sometimes heavy but always social. In my 20s I'd go camping with my boys, but there'd always be (a cooler) of beer in the car, and a pub to pull into."

At his worst, he would drink litres of port every night, along with vodka and beer. He became angry with his family. His business disintegrated, as did his marriage.

For anyone else, a life-threatening motorcycle accident while riding under the influence might have a wake-up call. But that's a sober man's logic. Clarke drank harder.

"When I was assessed they said I had a traumatic brain injury from the accident, exacerbated by alcohol abuse. They said it was likely I had a brain injury even before the accident," Clarke says.

When Clarke's son killed himself in 2002, he saw it as another reason to drink. It wasn't until a year later, in hospital poisoned with a blood alcohol level of 0.35, that he went to his first Alcoholics Anonymous meeting. Diagnosed with an alcohol-related brain injury, he hasn't drunk for four years. He cries easily, and knows he doesn't have the capacity to go back to his drafting job. Instead, he gives his time telling his own cautionary tale to others.

Berton says the timelag between the drinking and the brain injury can be eight years. "This is a massive invisible issue. Alcohol-related brain injury is very difficult to diagnose and some people with the injury function adequately for quite a while not realising that short-term memory loss is a clue there is a problem," she says.

"People may suffer anxiety, paranoia, depression, anger and confusion. The impact on the family can be devastating."

She wants the federal Government to fund a $20 million education campaign, with some of the revenue raised from alcohol-related taxes spent on prevention. She also wants the alcohol industry to "accept the hand it has played in one of Australia's most significant health problems".

Health Minister Tony Abbott's spokeswoman says the Government "does not provide direct funding in relation to ARBI, however the current suite of initiatives assists in informing and educating the public on the issues of harmful alcohol consumption".

"These were complemented in the most recent federal budget, which provided an additional $79.5 million to be invested in expanding the non-government organisations treatment grants program to ensure more treatment places and services are provided for people with alcohol and other drug problems," the spokeswoman says.

Alford is one of the lucky ones. He caught the damage at 35 before it became irreparable. While he was serving more than three years for the armed robbery, he worked his brain.

"I did what I called mental toughness exercises, crosswords, played cards. I read biographies of successful people. When I first started reading I'd manage two lines, but then couldn't remember what I'd read. I'd read it again and again. I was lucky because I was in jail and couldn't drink. I don't want to blow my own trumpet, but I don't know anyone who has worked as hard as I did to get their brain back functioning."

Alford has gone on to a variety of careers, including teaming with Bob Ansett to bring promotional speakers such as Mikhail Gorbachev, Norman Schwarzkopf and Nelson Mandela to Australia. He still does his mental toughness exercises every day. "I don't sit down and think I'm managing a brain injury, but that's exactly what I'm doing. I won't stop because I'm frightened as hell about what would happen if I did."

The Australian