- 80% of New Zealand adults take alcohol, but 10% of these drink 60% of the alcohol.
- 10 - 20% of drinkers have problems with alcohol sometime in their lives.
- Concomitant major illness can be an important stimulus to behaviour change.
Some pointers to harmful drinking:
- Gastrointestinal problems.
- Symptoms of alcohol withdrawal.
- Anxiety.
- Epileptic seizures.
- Recurrent accidents.
- Memory failing.
- Blackouts.
It is often a good idea to ask about alcohol use at the same time you ask about diet, exercise and smoking, so that it forms part of a general health screen.
- Males: Over 15 standard drinks per week.
- Females: Over 10 standard drinks per week.
- Male: Over 5 standard drinks per occasion.
- Female: Over 4 standard drinks per occasion.
For routine use it is easier to express intake in units of alcohol, where one unit roughly equates to the standard New Zealand drink. A unit contains about 10 grams of alcohol. In making calculations, due account needs to be taken with unusually high and low concentration drinks e.g., low alcohol beers, wine coolers and departures from standard volumes per drink.
- Standard NZ drink = one unit = 10 g alcohol
= 330 mL (12 oz) beer, or
= 110 mL (4 oz) wine (small glass), or
= 30 mL (1 oz) spirit (1 pub nip)
- 1 jug of beer = 3 standard drinks
- 750 mL bottle of wine = 8 standard drinks
- 1125 mL bottle of spirits = 40 standard drinks
- Alcohol is often taken in larger amounts or over a longer period than intended.
- Persistent desire or unsuccessful attempts to cut down or control alcohol use.
- A great deal of time spent in alcohol-related activities.
- Important social, occupational or recreational activities given up or reduced because of alcohol use.
- Continued use despite knowledge of significant medical or psychological consequences.
- Acquired tolerance.
- Withdrawal symptoms or relief use.
- Do you drink alcohol at all?
- On average how many days a week do you drink?
- How many standard drinks would you consume on those days?
- Have you ever been admitted to hospital because of accidents?
- Have you any blood relatives who are heavy drinkers?
- Does anyone annoy you by telling you to cut down on your drinking?
- How often during the last year have you failed to do what was normally expected from you because of your drinking?
- Most people have days when they drink more than usual; how many times in the last year have you drunk more than 6 standard drinks?
If the answers indicate that an alcohol problem is present, tell the patient what was found in the way of blood tests or physical examination and then provide them with some frank advice. It can be effective if done in a caring and concerned manner, e.g., "firstly, I have to tell you that the amount you have been drinking, although it doesn't seem much to you, has caused some damage to your liver".
The next step is to offer support and/or intervention.
The treatment options range from outpatient support groups to inpatient rehabilitation programmes. Referral to the Social Work Services is recommended (
80420). They provide a social worker comprehensive assessment and intervention plan which can include referral to the Alcohol and Other Drug Central Coordination Service.