Drinking Alcohol Safely in the Festive Season

The festive season in Australia is a time when people gather amongst family and friends and many enjoy a few alcoholic drinks around the barbeque or at the beach. However, at this time of year there are many social gatherings and it can be easy to over-indulge.

Social time is important and can have many health benefits, such as enjoyment and stress relief. However, people who consume too much alcohol can endanger their health both in the immediate and long term. It is therefore an important time for people to be informed about how to consume alcohol safely and be careful to avoid consuming alcohol in quantities that put their health at risk.

The National Health and Medical Research Council (NHMRC) recommends that men and women drink no more than two standard drinks on any given day in order to reduce the long term risks of alcohol consumption. These risks include an increased likelihood of developing cardiovascular problems, diabetes, cancer?and liver disorders.

There are also a number of immediate risks associated with alcohol consumption, which arise because alcohol reduces motor and sensory skills, and also inhibitions. In the immediate term, excessive alcohol consumption increases the risk of trauma and death (for example,?if someone is very drunk and passes out, they may stop breathing or choke). To reduce these immediate risks, it is recommended that individuals do not drink more than four standard drinks in any one sitting.

If a person is intending to drive a motor vehicle or operate other machinery, their blood alcohol level should not exceed 0.05 g ethanol per 100 mL of blood (0.05%). This is the equivalent of consuming one standard drink per hour.

There is evidence that alcohol consumption increases in the festive season. A study conducted in Spain reported increased alcohol and substance abuse at work Christmas parties compared to other times of the year. A study from Finland reported increased alcohol sales (and an increased incidence of fatal alcohol poisonings) on weekends and at times of celebration such as Christmas and May Day.

It is important for people who drink alcohol to be aware how much alcohol can be consumed safely, and to develop strategies to ensure that they don't drink too much. The following tips for safe alcohol consumption apply to any time of year, but may be particularly useful in the pre-Christmas period when people tend to drink alcohol more frequently and in larger quantities.

Remember the difference between a standard drink and a serving of alcohol

Remember that a standard drink is not always equivalent to a serving of alcohol. In Australia, a standard drink is one containing the equivalent of 10 g of ethanol. However, in many cases a single serving of alcohol (e.g. a glass of wine, a bottle of beer) is more than one standard drink or 10 g of ethanol.?A standard drink is the equivalent of:

100 mL of wine (9.5–13% alcohol);250 mL of full strength beer (4.9% alcohol);375 mL of mid-strength beer (3.5% alcohol);470 mL of light beer (2.7% alcohol);30 mL of spirits (37–40%).

Standard serving sizes often contain more than one standard drink. For example:

In restaurants, wine is often served in 150 mL glasses (1.4–1.6 standard drinks);Standard cans and bottles of beer contain 375 mL of alcohol (1.4 standard drinks);Cans of pre-mixed spirits can contain up to 2.1 standard drinks.Reference: Australian guidelines to reduce health risks from drinking alcohol [online]. Canberra, ACT: National Health and Medical Research Council; 2009 [cited 11 January 2011]. Available from: URL link

This information will be collected for educational purposes, however it will remain anonymous.

?

Keep track of how much you drink

It is often difficult to keep track of the amount of alcohol consumed, because the concentration of alcohol varies between alcoholic beverages, and because drinks are served in glasses that can hold more than one standard drink. When keeping track of alcohol consumption, it is important to consider both the serving size and concentration of alcohol. Monitoring alcohol consumption on a daily and weekly basis is also important. To make monitoring alcohol consumption easier:

Avoid refilling a half empty glass: It is much harder to keep track of how much is being consumed if a half empty glass?is refilled, compared to when the drinker waits and refills their glass only when it is empty;Keep track of the serving size of drinks: Convert them to standard drinks. Don't assume that a single serving is equivalent of a standard drink;Check how much alcohol the beverage contains: Read the label, which in Australia must state the?percentage of alcohol in the beverage. The more alcohol a drink contains, the lower the quantity that is equivalent to a standard drink.How much alcohol do you have in your system?

Most of us would have been?given a random breath test at least once but how does the reading this test gives actually relate to how many drinks you've had? Use this tool to estimate how much alcohol you have in your blood and how long it might take to sober up.

Click here to calculate your BAC

Set a limit and say no when you've had enough

Aim to limit alcohol consumption to the quantity recommended by the NHMRC for safe consumption. Stop drinking alcohol before or once you have reached the daily limit of four standard drinks. Some people may choose to drink in excess of these guidelines despite the health risks involved. However, these people should still set a limit at which they will stop drinking. It may be difficult to stop drinking sometimes (e.g. if everybody else is having another drink), so it is also important to be assertive and resist the peer pressure to continue drinking.

Space alcoholic drinks and drink in moderation

To avoid getting drunk, space alcoholic drinks throughout the day or evening, for example by:

Starting with a soft drink, fruit juice or glass of water;Drinking a glass of water after each alcoholic drink. This will help to rehydrate the body and also lengthen the period of time between alcoholic drinks;Use a small glass for alcoholic beverages;Drink slowly, taking sips not gulps;Avoid 'shouts' or 'rounds' of drinks or drinking competitions. These may encourage people to drink too quickly to keep up with the rounds;Only have one alcoholic drink at a time;Keep busy while drinking, for example by playing pool or talking with friends;When planning a party, ensure there are plenty of alcohol-free and low alcohol options available.

Choose low-alcohol options

The amount of alcohol contained in various alcoholic drinks varies considerably. For example, full strength beer contains approximately 5% alcohol (compared to 2.7% for light beer) while wine contains 9–13% alcohol and spirits 37–40% alcohol. Because there are many social gatherings in the pre-Christmas period, individuals are more likely to drink more often and may risk exceeding their recommended daily or weekly alcohol consumption. Choosing beverages containing no alcohol or lower concentrations of alcohol (e.g. light beer) or adding non-alcoholic mixers to spirits and wine to reduce the amount of alcohol consumed per glass can play an important role in reducing the total amount of alcohol consumed in the festive season.

Don't forget to eat

Having food in the stomach reduces the absorption of alcohol into the bloodstream and reduces the intoxicating effects of alcohol. It is very important to eat before or while consuming alcohol, and to eat enough food to fill the stomach. If you're planning a party, ensure there is plenty of food available for guests.

Don't drink and drive

Never drive a car if you've had more than one standard drink in an hour! When consumed, alcohol enters the bloodstream and affects the functioning of the drinker's brain, reducing their ability to think and coordinate their actions. Drinking alcohol therefore reduces an individual's ability to perform tasks such as driving a car. Driving under the influence of excessive amounts of alcohol is a major contributor to road accidents in Australia, particularly amongst young people and men. Over half of all alcohol-related road deaths and injuries in the country occur amongst young people aged 15–24 years, while 25% of all road accident deaths amongst men and 41% of all injuries are alcohol related (compared to 11% of deaths and 11% of injuries for women).

In Australia it is illegal to drive with a blood alcohol content of 0.05 g ethanol per 100 mL of blood (0.05%). This is the equivalent of drinking a single standard drink (10 g alcohol) in a one hour period, and is?the level at which an individual's sensory and motor skills remain adequate for performing complex tasks. It is therefore important to avoid driving a car after consuming more than one standard drink per hour. People planning to drink more than one standard drink in an hour should:

Go out with friends and designate a driver who will avoid alcohol, or organise a non-drinking friend to give them a lift;Use public transport (e.g. bus or?taxi) and ensure they have budgeted for the cost of getting home;At a house party, make sure there is extra bedding available for guests who are unable to drive home;Encourage friends who have been drinking not to drive.?
For more information on drinking alcohol, including drinking disorders and alcohol's effect on the body, as well as some useful tools, see Alcohol.?
For more information on health during the festive season, including sleep, diet, exercise and stress, see?Festive Health.Australian Drug Foundation. Ensure this Christmas isn't silly season [online]. 2009 [cited 14 December 2009]. Available from URL: http://www.adf.org.au Australian Drug Foundation. Safe partying for all ages [online]. 2008 [cited 13 December 2009]. Available from URL: http://www.druginfo.adf.org.auNational Health and Medical Research Centre. Australian guidelines to reduce health risks from drinking [online]. 6 March?2009 [cited 22 August 2009]. Available from URL: http://www.nhmrc.gov.au/ publications/ synopses/ ds10syn.htmState Government of Victoria. Tips for a safe night out drinking [online]. 2009 [cited 13 December 2009]. Available from URL: http://www.vic.gov.au/ news-detail/ alcohol-campaign-urges-responsible-drinking.htmlPublic Health Agency for Northern Ireland. Celebrating Christmas by drinking responsibly [online]. 27 November 2009. [cited 13 December 2009]. Available from URL: http://www.publichealth.hscni.net/ lnews/ 49 Press release - Celebrating Christmas by drinking sensibly - 27 November 2009.htmlVidal-Infer A, Tomas-Dols S, Aguilar-Moya R, Samper-Gras T, Zarza MJ, Aguilar-Serrano J. [Christmas work dinners. A pattern of recreational use of alcohol and other drugs?] [Article in Spanish]. Adicciones. 2009; 21(2): 133-42.Poikolainen K, Leppanen K, Vuori E. Alcohol sales and fatal alcohol poisonings:?A time-series analysis. Addiction. 2002. 97(8): 1037-40.

View the original article here

Healthy Alcohol Consumption on New Years Eve

New Year's Eve is a night when a lot of people attend social gatherings, often large public events. People typically drink alcohol at New Year's Eve gatherings, and while many people drink responsibly, binge drinking (drinking until drunk or intoxicated) is also common amongst people of all ages. Binge drinking increases the risk of violence; drunk people are more likely to?experience injuries requiring hospitalisation than sober people.

In the long term, binge drinking is also associated with an increased risk of numerous health conditions, and therefore has significant health, economic and emotional costs. Preventing alcohol intoxication on New Year's Eve is therefore important for an individual's health and for the health of loved ones. So this New Year, find out how to consume alcohol safely and still have a good night!

Healthy alcohol consumption means drinking alcohol in moderate quantities –?that is, quantities that keep the long and short term health risks of alcohol consumption to an acceptable level. Safe levels of alcohol consumption in Australia are determined by the National Health and Medical Council (NHMRC), based on evidence about the risks of varying levels of alcohol consumption. The NHMRC recommends that both men and women drink no more than four standard drinks at a time to prevent the short term risks of alcohol consumption (e.g. trauma and accidents) and no more than two standard drinks on any given day to prevent the long term risks of alcohol consumption.

Reference: Australian guidelines to reduce health risks from drinking alcohol [online]. Canberra, ACT: National Health and Medical Research Council; 2009 [cited 11 January 2011]. Available from: URL link

This information will be collected for educational purposes, however it will remain anonymous.

?

No studies have been conducted about alcohol consumption on New Year's Eve, although it is widely perceived as a night of festivities, involving large public gatherings and often excessive alcohol consumption. However, there is evidence that alcohol consumption increases in the festive season. For example, a study conducted in Spain reported increased alcohol and substance abuse at work Christmas parties compared to other times of the year. A study from Finland reported increased alcohol sales (and an increased incidence of fatal alcohol poisonings) on weekends and at times of celebration such as Christmas and May Day.

Alcohol intoxication carries numerous short and long term health consequences. In the long term these include:

In the short term alcohol intoxication increases the risk of:

Road accident;Going to hospital because of an injury (e.g. from falls, poisoning and drowning);Experiencing alcohol-related violence, either as a perpetrator, witness or victim;Unhealthy sex, which risks pregnancy, sexually transmitted infection and psychological health issues;Personal conflict, for example within families;Social embarrassment; andA hangover the following day.Use AUDIT to assess your drinking patterns

In order to avoid consuming excessive amounts of alcohol this New Year's Eve, why not try:

Think about the acceptability, harm and cost of excessive alcohol consumption on New Year's Eve before you go out. For example, think about how much money you will spend, the potential risks of consuming too much alcohol, and how you will feel the following day;Aim to drink in accordance with the NHMRC guidelines for safe alcohol consumption, which allow no more than four standard drinks on any given day for both men and women;Assess your alcohol consumption and keep track of how much you drink throughout the night, remembering that a standard drink as defined by the NHMRC is often less than a standard serving of beer, wine or other alcoholic beverage;Eat before and while drinking alcohol. This may be easier (and healthier) if you take food from home to outdoor New Year's Eve spots, where food may not be available or you may have to stand in long queues to get food;Plan a night out at an alcohol-free venue with good entertainment;Avoid refilling a glass while it is half empty, as this makes it difficult to keep track of how much is consumed;Space alcoholic drinks by having a glass of water or a soft drink in between;Avoid buying drinks in "shouts" or "rounds" as this encourages everyone to keep up with the person who is drinking the fastest;Keep busy dancing, watching entertainment or chatting with friends while awaiting the New Year. This can reduce the amount of alcohol consumed;Don't drink and drive. Designate a driver or plan to catch public transport or use a taxi. Be aware that there are often long queues for public transport and taxis on New Year's Eve, and be prepared to wait.How much alcohol do you have in your system?

Most of us would have been?given a random breath test at least once but how does the reading this test gives actually relate to how many drinks you've had? Use this tool to estimate how much alcohol you have in your blood and how long it might take to sober up.

Click here to calculate your BAC

?For more information on drinking alcohol, including drinking disorders and alcohol's effect on the body, as well as some useful tools, see Alcohol.?For more information on staying healthy in the New Year, including tips on diet, partying, exercise and general health, see Health in the New Year.?Meller N. Measures to reduce violence at major public events: New Year's Eve. Paper presented at Second National Conference on Violence;?Canberra, 15-18 June 1993 [online]. Australian Institute of Criminology. 16 January 2004 [cited 14 December 2009]. Available from URL: http://www.aic.gov.au/ events/ aic upcoming events/ 1993/ ~/ media/ conferences/ ncv2/ mellor.ashx National Health and Medical Research Centre. Australian guidelines to reduce health risks from drinking [online]. 6 March?2009 [cited 22 August 2009]. Available from URL: http://www.nhmrc.gov.au/ publications/ synopses/ ds10syn.htmVidal-Infer A, Tomas-Dols S, Aguilar-Moya R, Samper-Gras T, Zarza MJ, Aguilar-Serrano J. [Christmas work dinners. A pattern of recreational use of alcohol and other drugs?] [Article in Spanish]. Adicciones. 2009; 21(2): 133-42.Poikolainen K, Leppanen K, Vuori E. Alcohol sales and fatal alcohol poisonings:?A time-series analysis. Addiction. 2002. 97(8): 1037-40.Australian Government Department of Health and Ageing. National binge drinking strategy: About the campaign [online]. 2009 [cited 14 December 2009]. Available from URL: http://www.health.gov.au/ internet/ drinkingnightmare/ publishing.nsf/ Content/ about-the-campaignWorld Health Organisation. Defining sexual health: A report of a technical consultation of sexual health [online]. 21 December 2006 [cited 15 December 2009]. Available from URL: http://www.who.int/ reproductivehealth/ topics/ gender_rights/ defining_sexual_health.pdf Australian Drug Foundation. Safe partying for all ages [online]. 2008 [cited 13 December 2009]. Available from URL: http://www.druginfo.adf.org.auState Government of Victoria. Tips for a safe night out drinking [online]. 2009 [cited 13 December 2009]. Available from URL: http://www.vic.gov.au/ news-detail/ alcohol-campaign-urges-responsible-drinking.html

View the original article here

How Tobacco, Alcohol and Drugs Affect Sperm

A healthy male produces millions of sperm?each day, althoughonly a few of these sperm will ever go on to fertilise an egg and create an embryo. Despite the vast quantity of sperm produced by a healthy man, the number of sperm which actually fulfil their fertilising potential is therefore extremely small. Even when a man is producing sperm at a healthy capacity and his partner is fertile, it is not uncommon for couples to take up to a year to conceive.

Some men produce sperm which is suboptimal, either in quantity or quality. These men will typically take longer to conceive and are more likely to require the assistance of artificial reproduction techniques to do so. Some men may experience suboptimal sperm production because of a genetic or birth trait (e.g. deletions on the Y chromosome or history of cryptorchidism). In many cases, sperm production declines over time as a result of exposure to a range of risk factors.

Drugs, tobacco and alcohol allhave a range of short and long term health effects, including effects detrimental tothe production of sperm. These effects include reduced concentrations of sperm in the semen and reduced concentrations of sperm which have a normal shape and are able to move or swim. Men who are trying unsuccessfully to conceive, and those who wish to protect the health of their sperm for the future, should therefore avoid a range of drugs, including alcohol and tobacco.

A number of studies have reported an association between tobacco smoking and male infertility and/or suboptimal sperm production.A review of observational studies on smoking and semen parameters found that 20 of the 25 studies reported an increased risk of lower sperm concentration in smokers compared to non-smokers. On average, sperm concentration was 13% lower in smokers compared tonon-smokers. Smoking men also had a lower average proportion of sperm that were motile (moving or swimming) and morphologically normal (sperm with a correct body shape), compared to non-smoking men.

For more information on smoking and its health effects, and some useful tools, videos and animations, see Smoking.

A number of performance enhancing and recreational drugs affect male fertility. Performance enhancing drugs (e.g.anabolic steroids) are associated with subfertility in men. They cause men to become subfertile by changing the concentrations of various hormones that influence the sperm production process.

The hormone-altering effect caused by consuming performance enhancing drugs is reversible.Normal hormone levels should return 612 months aftera man has stopped taking these drugs.

Recreational drugs(also called lifestyle drugs) include marijuana, alcohol, heroin and cocaine. These drugs can impair sperm production and/or quality.

Long term overconsumption of alcohol is associated with decreased semen parameters (decreases in one or more of the measures of semen quality) as determined by semen analysis testing, and detrimental changes in hormonal levels.

Use AUDIT to assess your drinking patterns

For more information on drinking alcohol, including drinking disorders and alcohol's effect on the body, as well as some useful tools, see Alcohol.

Drugs used in medical treatment can also affect male fertility. Those used in chemotherapy are particularly well known for their irreversible affect on sperm production. It is not uncommon for men who have undergone chemotherapy to be left sterile by the treatment.

Medications that change the body's hormonal environment (e.g. testosterone injection,anti-androgenic drugs) can also impair sperm production. This is because hormones regulate the sperm production process, and changes to hormone levels therefore affect sperm production.

Many of the drugs that affect sperm health are lifestyle drugs, that is, drugs taken for recreation rather than medical purposes. As such, there are a range of lifestyle modifications individuals can make in the interests of maintaining sperm health, including:

Stopping smoking;Minimising alcohol consumption;Avoiding anabolic steroids and other performance enhancing drugs; andAvoiding marijuana, cocaine and other recreational drugs.

Some of the drugs that affect male fertility are used for medical purposes, and in some cases for life-saving medical treatment, so avoidance may not always be possible. In these cases, individuals should investigate the possibility of cryopreserving spermbefore undertakingfertility-threatening treatments such as chemotherapy. Cryopreserved sperm can then be used in assisted reproductive technologies such as in vitro fertilisation (IVF).

Formore information on sperm health and male fertility, see Sperm Health

Royal College of Obstetricians and Gynaecologists. Clinical Guideline: Fertility: Assessment and treatment for people with fertility problems [online]. Royal College of Obstetricians and Gynaecologists. 23 February 2004 [cited 30 October 2008]. Available from URL: http://www.rcog.org.uk/ files/ rcog-corp/ uploaded-files/ NEBFertilityFull.pdf Hirsh A. Male subfertility. BMJ. 2003; 327: 669-72.McLachlan R. Fact sheet: Male infertility [online]. Andrology Australia. 31 August 2007 [cited 15 April 2009]. Available from URL: http://www.andrologyaustralia.org/ pageContent.asp? pageCode= MaleInfertility Mathusami KR, Chinnaswamy P. Effects of chronic alcoholism on male fertility hormones and semen quality. Fertil Steril. 2005; 84(4): 919-24.Vine MF. Smoking and male reproduction: A review. Int J Androl. 1996; 19(6): 323-37.Balen AH, Rutherford AJ. Management of infertility. BMJ. 2007; 335: 608-11.McLachlan, R.I. de Krester, D.M. Male Infertility: The Case for Continued Research. MJA, 2001;174:116-7.

View the original article here

Alcohol and Pain

Pain is an unpleasant sensation arising from injured or damaged body tissues.

Pain signals are then carried along nerves to the spinal cord, transmitted upwards and perceived by various parts of the brain. This is called nociceptive pain. In chronic pain sufferers, there is also a type of pain known as neuropathic pain.

Neuropathic pain is experienced when the nervous system is damaged or not working properly. Treatment of pain has been an important issue in all medical systems. For many years, analgesic (pain relieving) substances have been intensively studied and sought out. Alcohol was among the earliest substances found to be effective. Over 80% of the population drink alcohol.??

In everyday life, many people continue to deal with pain by self-medicating with alcohol. Due to its ability to depress the central nervous system (CNS), it slows down the brain and nervous system, and delivers a certain amount of pain relief. It also has muscle relaxant and sedating properties.

Unfortunately, there is a tendency for alcohol to be abused (alcohol abuse and alcoholism), and the use of alcohol for pain relief can easily cause problems. It is not uncommon for the amount of alcohol used to become excessive. If combined with the wrong medications, alcohol can have an additional lowering (depressant) effect on the nervous system, leading to disastrous consequences.

With prolonged use and excess consumption, the body begins to build up a tolerance to the effects of alcohol. It takes more alcohol to produce the same results. Increased amounts of alcohol over time can cause many health problems, affecting all organ systems in the body. This includes problems such as impaired brain function and memory, to peptic ulcers and liver cirrhosis. In addition, because alcohol is a major depressant, it will exacerbate any underlying depression and is also dangerously habit-forming (addictive). Alcohol may provide temporary relief of pain, but may worsen the problems that pain sufferers may face.

It has been suggested that doctors should:

Ask patients with pain about alcohol use; Ask patients with drinking problems about pain; Educate patients about the risks of using alcohol as a pain reliever; Promote other more safer, more effective methods of pain relief.

In our older population, many people suffer from pain and a large number of people drink alcohol excessively. There have been some studies performed, to examine the relationship between pain and alcohol problems amongst older adults. 401 adults living within the community were studied over a three year period.

At the beginning of the study, more of the problem drinkers (people who drank too much alcohol) than non-problem drinkers reported having moderate to very severe pain (43% versus 30%). A greater proportion of problem drinkers used alcohol to treat their pain (38% versus 14%).

Results from the study show that the level use of alcohol to manage pain predicted:

an increase amount of chronic health problems and injuries in men more drinking problems in women after three years.

In conclusion, whilst alcohol is used to self medicate and manage pain, there are many problems with it's use. Large doses may seem to help temporarily, but more effective, safe and long term pain killers should be used to provide relief from pain.

The image below is that of activity levels in an alcoholic's brain compared to a healthy person's brain.

?For more information on drinking alcohol, including drinking disorders and alcohol's effect on the body, as well as some useful tools, see Alcohol.

Brennan PL, Schutte KK, Moos RH. Pain and use of alcohol to manage pain: prevalence and 3-year outcomes among older problem and non-problem drinkers. Addiction. 2005;100(6):777-86. [Abstract]Hanson RW. Biophysical aspects of pain [online]. 2003 [cited 2 April 2006]. Available from: URL link??
Rang HP, Dale MM, Ritter JM. Pharmacology. China: Churchill Livingstone; 2000. [Publisher]Sadock B, Sadock V. Pocket Handbook of Clinical Psychiatry. USA: Lippincott Williams & Wilkins; 2001. [Publisher]

View the original article here

Alcohol Hangovers

An alcohol hangover refers to the mental, emotional and physical symptoms which an individual experiences after they have consumed alcohol. A hangover occurs when the person has recovered from the intoxicating effects of alcohol – that is, when the body has metabolised or processed the alcohol consumed and is sober. People usually suffer from a hangover the morning after they consumed alcohol. Sometimes,?however, the person will still be intoxicated when they wake up and will not experience a hangover until they are sober again.

Anyone who has experienced a hangover would probably describe it as an unpleasant experience. It can last anywhere between 8 and 24 hours, and disrupt daily tasks and responsibilities such as going to work, looking after kids or enjoying time with friends and family.?

A hangover is also a good sign that you drank too much – that is, you've consumed so much alcohol that it might present health risks, including damaging your brain. It's not surprising that people who report a greater number of hangovers show damage to brain structures.

How much alcohol do you have in your system?

Most of us would have been?given a random breath test at least once but how does the reading this test gives actually relate to how many drinks you've had? Use this tool to estimate how much alcohol you have in your blood and how long it might take to sober up.

Click here to calculate your BAC

Hangovers produce a range of unpleasant physical, mental and emotional symptoms that combine to create an overall feeling of poor wellbeing. Each person will experience a hangover differently, but there are some common symptoms.

Physical symptoms

The physical symptoms of a hangover can include:

Mental symptoms

The mental symptoms of a hangover can include:

Dizziness; Vertigo; Irritability; Changes to visual perception;Poor performance on identification tasks;Difficulty paying attention, staying alert, reacting and processing information;Reduced coordination, including hand–eye and limb coordination;? Poor memory and recall; andPoor performance with task-driven activities.

Emotional symptoms

Some people will experience depression, anxiety and/or irritability when they have a hangover, and the more you consume, the more likely you are to experience these emotional symptoms.

However, emotional changes may be indirect effects of a hangover, caused not by the effects of alcohol itself, but by the physical and emotional symptoms of the hangover. For example, a study showed that a person's mood deteriorates throughout the morning when they have a hangover, making them more prone to be depressed, anxious or irritable as the day wears on. As these disturbed moods only occur as the day progresses, not immediately?when the person becomes sober, scientists believe that hangover symptoms such as headaches and difficulty remembering and processing information cause anxiety and depression, rather than the alcohol itself.

Hangovers are a common side effect of drinking to intoxication. People who drink heavily more often are more likely to experience hangovers. The more intoxicated one becomes, the more severe a hangover is likely to be. For example, one study reported that the greater the concentration of alcohol in a person's body, the more severe their hangover. Peak alcohol concentration refers to the highest concentration alcohol reaches in your body body when you are intoxicated. It is believed to be a better predictor of hangover than the overall amount of alcohol consumed, adjusted to take into consideration your body weight. Hangovers also become more likely the longer the duration of alcohol consumption.

As such, the prevalence of hangovers is expected to be higher in populations that drink more heavily, including:

Stressed people: The more stressed a person, the more likely they are to drink larger quantities of alcohol;Men: Men are more likely than women to consume intoxicating quantities of alcohol; andYouth: Young people tend to binge drink more than their older counterparts.

However, not all people experience a hangover after moderate levels of alcohol consumption, and peak alcohol concentration does not reliably predict whether someone will experience a hangover. For example, one study reported that 76% of participants experienced a hangover the morning after moderate drinking (defined as a quantity of alcohol which caused their alcohol concentration to rise to 0.115 g%, much higher than the .05 level acceptable for driving). Other studies have reported 25–50% of participants did not experience a hangover after intoxication. Interestingly, a study on a group of people with alcohol dependence (alcoholism) determined that 50% of the participants had not experienced a hangover in the previous year.

Studies indicate that factors other than the quantity of alcohol consumed also influence whether a hangover is experienced. However, the causes of hangovers remain poorly understood. It is not clear whether a hangover is a direct effect of alcohol, the aftereffects of alcohol, or a combination of the two. Non-alcohol factors such as changes in sleep and eating patterns associated with alcohol intoxication may also play a role.

Researchers have identified a number of factors which potentially play a role in hangovers and may make some people more susceptible to hangovers, including:

Beverage congener content

Congeners are a common ingredient in dark alcoholic beverages, including dark spirits and red wine. Alcoholic beverages with a high congener content appear to cause more severe hangovers than those with a low congener content. One study reported that individuals who became intoxicated drinking bourbon reported more severe hangovers the following day than individuals who became intoxicated drinking vodka. However, there were no differences between a bourbon and vodka drinker on mental tests performed the following day.

Another study found a lower prevalence of hangover in participants drinking low congener alcohols (white wine, gin, vodka, pure ethanol) compared to participants who drank high congener alcohols (e.g. brandy, whiskey and red wine).

Biological differences

Biological differences (e.g. physical and mental differences) which affect an individual's response to alcohol might also?affect the incidence and severity of hangover. These include:

Personality and temperament: Some aspects of personality or temperament have been reported to affect the likelihood of hangover, including personality traits such as neuroticism, anger and defensiveness; Family history of alcoholism and other risk factors for alcohol dependence: Has been found to increase the likelihood and severity of hangover. The reasons for this are not well understood, although some researchers believe it is because individuals at greater risk of alcohol dependence may experience more acute hangover symptoms and drink further alcohol to treat such symptoms, and in doing so increase their chances of developing alcohol dependence; and Metabolism.

Metabolism of methanol

The rate at which an individual metabolises methanol (a congener commonly found in alcoholic drinks which produces formic acid and formaldehyde when it is broken down in the body) is thought to influence the experience of hangover. People who metabolise methanol more quickly are thought to experience more severe hangover symptoms. While no studies have examined methanol metabolism, evidence regarding the effects of methanol and the way in which it is broken down by the body support this hypothesis.

Drinks with a higher methanol content are associated with a greater likelihood of hangover, and hangover occurs at the same time the body begins metabolising methanol. In addition, administering ethanol (alcohol), which stops methanol being broken down to formic acid and formaldehyde, reduces the symptoms of a hangover (note that this should not be used as a treatment).

Metabolism of ethanol

The production of toxic by-products occurs in ethanol metabolism. Acetaldehyde is one such metabolite which has toxic effects on the body in high concentrations. For most people, the acetaldehyde is quickly metabolised and has little time to cause toxic symptoms. However, slow metabolisers can retain acetaldehyde for longer and, because of this, may experience symptoms typical of a hangover such as:

Rapid pulse;Sweating;Skin flushing;Nausea; andVomiting.

Psychological factors

Psychological factors influence a person's experience of hangover. Individuals with psychological problems report experiencing more severe hangovers after drinking to intoxication. These factors include:

Guilt about alcohol consumption; Having a neurotic personality; Being angry or defensive; Becoming angry or depressed whilst intoxicated; Having experienced a negative life event; andPersonality traits associated with a high risk for alcoholism.

These factors have been found in some studies to be more important determinants of hangover symptoms than the amount of alcohol consumed. As only 50–75% of people who drink alcohol to intoxication experience hangovers and many studies have shown no relationship between peak blood alcohol concentrations, these findings are plausible.

Gastrointestinal disturbances

Alcohol causes gastrointestinal disturbances such as:

Irritation of stomach and intestines;Gastritis (inflammation of stomach lining);Increased production of gastric acid; andIncreased production of intestinal secretions.

The gastrointestinal disturbances can cause abdominal pain, nausea and vomiting.

Diuretic effect of alcohol

Alcohol is a diuretic, which means it causes the body to expel more urine than usual. Consumption of four alcoholic drinks causes the elimination of 600-1,000 mL of urine. Alcohol affects the body's hormone production system and reduces the effect of the anti-diuretic hormone which prevents the expulsion of urine by triggering the kidneys to reabsorb water. When the kidneys do not reabsorb water, the water is expelled and the person urinates more often.

Low blood sugar

A decrease in blood sugar levels is an effect of alcohol consumption. The by-products of alcohol can inhibit glucose production, especially after binge drinking.

Excessive alcohol consumption, particularly when it is coupled with poor nutritional intake, can lead to hypoglycaemia (low blood glucose levels). The resulting hangover effects include weakness, fatigue and mood disturbances.

Alcohol withdrawal

Hangovers are thought to affect the brain in a similar way to alcohol withdrawal, which is the experience an alcoholic has if they do not consume alcohol. The symptoms of both hangovers and alcohol withdrawal are alleviated if the person is given more alcohol.

Scientists believe that the body compensates for alcohol's sedative effect by changing the way the brain responds, making it more responsive to excitatory stimuli and less responsive to stimuli which usually have an inhibitory effect. Effectively, the brain copes with alcohol by becoming hyper-excited. Once alcohol has been eliminated from the system, the brain remains in a hyper-excited state which induces tremor, sweating and rapid heartbeat.

Sleep deprivation

Sleep deprivation is a major contributing factor to a hangover and as such correlates significantly with emotional, mental and physical symptoms.

Hormones that control the wake/sleep cycle (e.g. serotonin and glutamate) are affected by alcohol consumption. As the blood alcohol level (BAL) rises, an individual is more likely to stay awake. When the BAL decreases, it?causes a sedative or sleepy effect.

Alcohol decreases the time it takes to fall asleep, but disturbs the natural sleep cycle. In the first half of sleep when the alcohol is being processed or metabolised:

The time spent in rapid eye movement?(REM) or light sleep is greatly diminished; andThe time spent in slow wave or deep sleep is increased.

In the second half of sleep when the alcohol has been processed or metabolised:

The time spent in REM sleep is increased and sleep is lighter than usual;The individual will experience increased wakefulness or difficulty sleeping.

The specific effects of sleep deprivation are complex and will depend on the amount of alcohol consumed and the time between consumption and sleep onset. In general, it can be said that alcohol consumption is associated with lighter, less efficient and more disturbed sleep. This will usually have a negative effect on the individual's mood and thinking the next day.

Other drugs

Using other drugs such as cocaine and tobacco while drinking may increase the severity of hangover, and some drugs may produce their own hangover effect. The associations between combining alcohol and drug use, and the presence or severity of a hangover, are poorly understood.

Ethanol is alcohol, or the ingredient in alcoholic beverages that causes intoxication. However, it is not known whether alcohol plays a direct role in causing a hangover, or whether other ingredients or side effects of drinking alcohol cause the hangover. There are other chemicals contained in alcoholic drinks that are believed to play a role in the development of a hangover, in particular congeners.

There have been studies conducted to investigate whether different types of alcohol are more or less likely to cause a hangover or affect the severity of a hangover. Many scientists believe that the greater the congener content in the alcohol, the worse the hangover will be. While drinks with more congener content may increase the perceived intensity of a hangover, there is no evidence to suggest that they worsen next-day performance, sleep or thinking ability. These results suggest that a glass of champagne, or a glass of red wine with the same alcohol content, are equally likely to cause a hangover. However, you may feel worse after drinking red wine.

Headaches are more commonly experienced after red wine than white wine. The former is thought to increase serotonin and histamine levels more than the latter; the reason for this is unknown.

The best way of preventing a hangover is by avoiding intoxication – in other words, abstaining from alcohol. Hangovers can also be avoided by reducing the amount of alcohol that is consumed and drinking in moderation.

In order to prevent a hangover, intoxication must be avoided. The National Health and Medical Research Council of Australia (NHMRC) recommends that in order to reduce the lifetime risk of harm (and injury) from drinking, healthy men and women should drink no more than two standard drinks on any day.

Reference: Australian guidelines to reduce health risks from drinking alcohol [online]. Canberra, ACT: National Health and Medical Research Council; 2009 [cited 11 January 2011]. Available from: URL link

This information will be collected for educational purposes, however it will remain anonymous.

?

People who accidentally drink to intoxication may prevent a hangover or reduce the severity of their hangover by rehydrating and taking anti-inflammatory painkillers before sleeping. Avoiding alcoholic beverages with a lot of?congeners (e.g. brandy, red wine and whiskey) may also reduce the perceived severity of experiencing a hangover.

Ethical considerations

Testing the effectiveness of various 'hangover cures' has received little attention in the health profession. Some health professionals argue that finding a treatment is undesirable because?hangovers act as a deterrent to intoxication. However, there is no evidence to suggest that the experience of a hangover deters a person from consuming alcohol, or that an effective hangover cure would lead to increased consumption.

Research into hangover cures

A limited number of high quality scientific studies have been conducted to assess the effectiveness of various preparations in relieving hangover symptoms, some with positive results:??

In one study, taking γ linolenic acid from Borago officinalis (borage) the morning after intoxication reduced the overall hangover severity and the severity of headache, tiredness and laziness; A yeast preparation (250 mg dried yeast, 0.5 mg thiamine nitrate, 0.5 mg pyridoxine hydrochloride, and 0.5 mg riboflavin) was found to reduce symptoms of restlessness, impatience and discomfort in another study; and Tolfenamic acid, a prostaglandin inhibitor, has also been shown to reduce overall hangover symptoms and individual symptoms, including headache, nausea, vomiting, thirst, dry mouth, nervousness and tremor, compared to placebo.

However, these hangover remedies are not commercially available and further studies are needed to confirm that they are, in fact, effective.

Simple hangover cures

There are many measures which are commonly thought to reduce the intensity of hangover symptoms, but which?have not been assessed in scientific studies. These include:

Consuming fruit, fruit juice and other fructose- or glucose-containing foods (to date, the few studies which have examined the role of fructose have not shown any benefit in reducing hangover symptoms); Consuming complex carbohydrates to counteract low blood sugar levels;Antacids for gastrointestinal symptoms;Sleep to ease the fatigue;Consumption of non-alcoholic beverages for rehydration; andCaffeine to counteract fatigue and malaise.

If you have a headache or muscles aches, taking aspirin or another NSAID may help. However, be careful using these medicines if you are nauseous.

Hair of the dog

It's important not to drink more alcohol. While drinking more alcohol (a 'hair of the dog' drink) will temporarily relieve symptoms, it will increase toxicity in the long run and your symptoms may be worse when you sober-up again. Drinking to relieve the symptoms of a hangover can also lead to alcohol dependence.

Take note

It's important to be aware that you may not be fit to drive a car or operate machinery while you have a hangover, as you are likely to be drowsy or have difficulty concentrating.

If you have a bad hangover, you may wish to visit your doctor for advice about treating the symptoms and preventing future hangovers. This is particularly important if you have problems with your heart or arteries, as a hangover could make them worse. It's also important if you often experience hangovers, as you may have alcohol dependence and need support from health professionals to reduce the amount you drink.

To find out more about whether your patterns of drinking put you at risk of alcohol dependence, complete the AUDIT questionnaire.

Use AUDIT to assess your drinking patterns

In addition to the unpleasant physical, mental and emotional symptoms, hangovers are associated with diminished workplace performance and poorer grades. In particular, the effects of a hangover have been found to impair the workplace performance of pilots, drivers, skiers and managers.

Regardless of occupation, people who have a hangover are more likely to:

Be late;Have an accident at work: This is especially dangerous for people who deal with machinery and other safety-sensitive operations; Be absent from work;Have lower morale while at work; Perform their work poorly; and Have disputes with peers and/or colleagues.

Not only does this affect the individual and their colleagues, but it also affects the business and the country's economy as a whole. A survey conducted in 2008 indicated that 8% of Australian workers are negatively affected by a colleague's drinking habit, and 3.5% of people need to work extra to compensate for the poor performance of these workmates. Using this data, researchers were able to estimate that the total cost to the Australian economy, as a result of absenteeism and poor work performance due to alcohol, was $453 billion per year.

For more information on drinking alcohol, including drinking disorders and alcohol's effect on the body, as well as some useful tools, see Alcohol and Drinking. Stephens R, Ling J, Heffernan TM, et al. A review of the literature on the cognitive effects of alcohol hangover. Alcohol Alcoholism. 2008;43(2):163-70. [Abstract | Full text]McKinney A, Coyle K. Alcohol hangover effects on measures of affect the morning after a normal night's drinking. Alcohol Alcoholism. 2006;41(1):54-60. [Abstract | Full text]McQueeny T, Schweinsburg BC, Schweinsburg AD, et al. Altered white matter integrity in adolescent binge drinkers. Alcohol Clin Exp Res. 2009;33(7):1278-85. [Abstract | Full text]Howland J, Rohsenow DJ, Allensworth-Davies D, et al. The incidence and severity of hangover the morning after moderate alcohol intoxication. Addiction. 2008;103(5):758-65. [Abstract]? Rohsenow DJ, Howland J, Arnedt JT,?et al. Intoxication with bourbon versus vodka: Effects on hangover, sleep, and next-day neurocognitive performance in young adults. Alcohol Clin Exp Res. 2010;34(3):509-18. [Abstract] Finnigan F, Schulze D, Smallwood J, Helander A. The effects of self-administered alcohol-induced 'hangover' in a naturalistic setting on psychomotor and cognitive performance and subjective state. Addiction. 2005;100(11):1680-9. [Abstract | Full text] Calder I. Hangovers: Not the ethanol, perhaps the methanol.?BMJ. 1997;314(7073):2-3. [Abstract | Full text]Ames GM, Grube JW, Moore RS. The relationship of drinking and hangovers to workplace problems: An empirical study.?J Stud Alcohol. 1997;58(1):37-47. [Abstract]Dale CE, Livingston MJ. The burden of alcohol drinking on co-workers in the Australian workplace. Med J Aust. 2010;193(3):138-40. [Abstract]Swift R, Davidson D. Alcohol hangover: Mechanisms and mediators. Alcohol Health Res World. 1998;22(1):54-60. [Abstract | Full text] Pittler MH, Verster JC, Ernst E. Interventions for preventing or treating alcohol hangover: Systematic review of randomised controlled trials.?BMJ. 2005;331(7531):1515-8. [Abstract | Full text] Wiese JG, Shlipak MG, Browner WS. The alcohol hangover. Ann Intern Med. 2000;132(11):897-902. [Abstract | Full text]Australian guidelines to reduce health risks from drinking alcohol [online]. Canberra, ACT: National Health and Medical Research Council; 2009 [cited 2 October 2010]. Available from: URL link Klatsky AL, Armstrong MA, Kipp H. Correlates of alcoholic beverage preference: traits of persons who choose wine, liquor or beer. Br J Addict. 1990;85(10):1279-89. [Abstract] Alcohol: Australian facts and figures [online]. Canberra, ACT: National Alcohol Strategy; June 2003 [cited 12 January 2011]. Available from: URL link

View the original article here

Alcohol: Responsible Drinking

Alcohol is commonly consumed for fun during social occasions in Australia and most Australians have tried alcoholic beverages at some stage. Alcohol can cause several long and short term negative health consequences. Drinking even small amounts of alcohol can present health risks, particularly if the individual has consumed alcohol regularly throughout their lifetime. As few as two standards drinks can cause cognitive impairment which increases an individual’s risk of injury. Overall, the lifetime risk of hospitalisation for an alcohol related injury is 1 in 10 for men and 1 in 12 for women who drink more than four drinks per occasion, once a week.?

The National Drug Strategy Household Survey showed that a large percentage of Australian adults are not aware of the amount of alcohol they can consume before putting their health at risk. 44% of men and 65% of women believed that consuming two standard drinks per day would not have any negative effects on their health in the long term. In the short-term, 30.6% of men believed that five to six standard drinks on one occasion would not put their health at risk and 40.1% of women thought that three to four drinks on one occasion was acceptable. The National Health and Medical Council (NHMRC) have introduced guidelines for safe and responsible drinking. These guidelines include recommendations for maximum average weekly alcohol consumption and also for safe daily alcohol limits. It is recommended that men and women drink in moderation and avoid drinking to intoxication.

The guidelines for safe drinking were developed because the immediate effects of intoxication can cause a considerable increased risk of harm and even death. These immediate risks occur because intoxication impairs an individual’s cognition, motor skills and other abilities which usually protect the individual from accidents including falls and motor vehicle crashes.

While general guidelines have been developed, it is important to remember that there is no safe limit of alcohol consumption that can be applied to every person as it will affect everyone differently.

The general guidelines for safe drinking are:

For healthy men and women, drinking no more than two?standard drinks on any day reduces the lifetime risk of harm from alcohol-related disease or injury;Drinking more than two standard drinks per day increases the lifetime risk of disease and injury;At low levels of drinking the risk for men and women is similar, but as levels increase the risk of harm from alcohol increases more significantly for women;For healthy men and women, drinking no more than four standard drinks on any single occasion reduces the risk of alcohol-related injury arising from that occasion. For example, more than four standard drinks increases risky behaviour and doubles the risk of injury within the 6 hours after drinking;Children under 15 years are at the greatest risk of harm from drinking and should not drink alcohol. 15 - 17 year olds should also abstain from alcohol; andFor pregnant or breastfeeding women, not drinking is the safest option. This also applies to women planning a pregnancy.Use AUDIT to assess your drinking patterns

The recommendation of the Australian Cancer Council (ACC) is that individuals should limit or avoid drinking alcohol. Current evidence suggests that no amount of alcohol protects against cancer.

A significant proportion of Australians consume quantities of alcohol in excess of those recommended as safe by guidelines. 90% of Australians reported that they do not exceed the overall amount of alcohol recommended for average weekly consumption (no more than 2 standard drinks per day), however it is common for Australians to drink more than the recommended levels of alcohol in a single sitting (more than four standards drinks on a single occasion). In the 2007 National Drug Strategy Household Survey, around one third of respondents drank above the guideline levels on at least one occasion in the year before the survey. This causes alcohol intoxication and cognitive impairment and increases the risk of death or injury.

It is important that people who intend to drink understand exactly how much alcohol they are consuming and what effects this will have in the short-term and the long-term. For many, especially younger drinkers, it is an easy mistake to assume that 1 pint of beer is equivalent to one standard drink but this is not the case.

Numbers of Australian standard drinks in common containers of various alcoholic beverages

Mid strength beer? (3.5% alcohol)

Full strength beer? (4.9% alcohol)

Pre-mixed spirits

(5 – 7% alcohol)

Reference: Australian guidelines to reduce health risks from drinking alcohol [online]. Canberra, ACT: National Health and Medical Research Council; 2009 [cited 11 January 2011]. Available from: URL link

This information will be collected for educational purposes, however it will remain anonymous.

Blood alcohol concentration is a measurement of the amount of alcohol in the body. BAC is measured in grams of alcohol per 100 milliliters of blood. So a BAC of 0.1 means there is 100 mg of alcohol in 100 ml of blood.

The BAC will depend on how much alcohol is consumed and over what time period. However, there are also a number of characteristics of the individual consuming the alcohol which will influence BAC and symptoms of intoxication including:

Weight;Fitness level;Liver health;Alcohol tolerance;Mood of the drinker at the time of consumption;The type of drink – carbonated or “fizzy” alcoholic drinks (champagne or spirits mixed with soda) tend to raise BAC quicker than non-carbonated drinks;Age - younger people are often less experienced in drinking alcohol and its effects and therefore are less tolerant to alcohol;Mental health - people who have a mental illness or are prone to mental instability may experience heightened affects of alcohol;Menstrual cycle – a woman may respond differently to alcohol depending on the timing of her menstrual cycle;Concomitant medications - Many medications can affect, or be affected by, alcohol. Ask your doctor if alcohol interacts with any medication you are taking. A woman’s reaction to alcohol may be affected by her contraceptive or hormone replacement therapy medications.

Women will generally have a higher BAC than men after consuming the same amount of alcohol. This is because alcohol is absorbed into the body's water and men have a higher proportion of body water than women.

A drinker's BAC will be at its peak 30 to 60 minutes after alcohol consumption has stopped. Sometimes peak concentration will reach its peak two hours after drinking if alcohol is consumed with a substantial meal.

Alcohol is eliminated from the liver at a rate of between 4 and 12 grams per hour. There is no way to reduce the BAC other than wait for the alcohol to be eliminated.This means that drinking coffee, vomiting, taking cold showers, exercising and chewing gum will not have any effect on the rate of decline of alcohol from the blood.

Calculating BAC
It is possible to roughly calculate your BAC. Please note that this calculation will only provide a rough estimate and should not be used to determine whether you will be under the limit to drive. The only way to make sure that you remain under the limit is not to drink any alcohol.

How much alcohol do you have in your system?

Most of us would have been?given a random breath test at least once but how does the reading this test gives actually relate to how many drinks you've had? Use this tool to estimate how much alcohol you have in your blood and how long it might take to sober up.

Click here to calculate your BAC

Drink driving is a major cause of road accidents in Australia. In NSW drink driving is involved in 18% of fatal road accidents. In Victoria in 2001 24% of drivers killed on the road had a BAC over 0.05 and drink driving was responsible for a huge 32% of Western Australian road fatalities in 2009.33% of drivers who died on South Australian roads in 2010 had a BAC over 0.05.

70% of fatal drink driving crashes happen in country areas. 90% of drink drivers in fatal road accidents are male and a third of drink drivers in fatal crashes are between the ages of 17 - 24.

What most people do not realise is that the consumption of any alcohol at all affects driving ability - this is why in Australia provisional drivers cannot have any alcohol in their system at all if they are driving. The legal BAC limit for non-provisional drivers is 0.05. Even at this level, there is double the risk of being involved in a car crash compared to having a BAC of zero. This risk increases exponentially as the BAC rises. At 0.01 the risk of having a car accident is seven times greater and 25 times greater at 0.15.

Alcohol affects driving by:

Reducing reaction time;Reducing ability to concentrate;Increasing driver confidence which can lead to risk taking;Disturbing vision;Disturbing hearing; andInducing a sedative affect.

A general rule of thumb is that women should have no more than one standard drink per hour if they want to remain under a BAC of 0.05. Men should have no more than 2 drinks in the first hour and one each hour following. It is important to remember that this will not apply to everyone. Some people may need to take extra precautions to make sure they remain under the limit.

Below are some steps you can take to make sure you drink responsibly.

Tips for drinkers

Forward thinking is an important part of responsible drinking. Drinking too much can be avoided by estimating the amount of time that you will spend out and planning how many drinks you will consume in this time. If possible, you should bring these drinks with you and only consume what is on hand.If you intend to consume alcohol then driving should not be an option. You should organise a lift home or make sure that you can stay the night or catch a taxi home. Importantly, depending how much alcohol you consume, you can still be over the limit the next day.Drink “top ups” should be avoided. Each drink should be finished before another is poured. This makes keeping track of the amount of alcohol consumed a lot easier.Alcohol will only be eliminated from the body with time. No matter how much food, water or coffee you consume or if you vomit, it will not lower their BAC even if it makes you feel sober.Drink slowly and consume non-alcoholic drinks between alcoholic drinks.Eating before drinking will help to fill the stomach and therefore less alcohol will be consumed.Avoid eating salty “snack” foods while you are drinking as this will make you thirstier and more alcohol may be consumed.Drinking light beer or low alcohol wine is an option to reduce alcohol content.Mixed drinks like cocktails should be avoided as it is hard to keep track of how many standard drinks are being consumed. Bottled drinks with a clear indication of the alcoholic volume is a good way to keep track of the number of drinks.

The only way to ensure you remain under a BAC of 0.05 is not to drink.

Tips for hosts
Responsible drinking can also be optimised when the hosts of parties do their part to ensure their guests are well looked after. Tips for party hosts include:

Make sure there is a range of foods available for guests. Salty foods should be avoided as they will make guests thirsty.Make sure there is water and other non-alcoholic drinks available.Do not top up guest’s glasses. Hosts should wait for their guests to finish their drinks before refilling so they can keep track of how much alcohol they have consumed.It is important that hosts keep an eye on the intoxication level of guests and ensure that those that have had too much to drink do not drive home. It may be possible to organise a designated non-drinker that can offer people lifts home or offer guests a place to stay for the night.Providing entertainment – this will give people less time to drink and therefore reduce the level of intoxication at the party.

Tips for parents
Parents should be encouraged to set a good example for their children and teenagers in order to positively influence their drinking behaviour. Parents can positively affect their teenager’s drinking habits by:

Making sure their teenagers are aware of drink driving laws and the consequences of breaking these laws;Talking to their children about how to cope with peer pressure and the dangers of binge drinking; andRewarding positive behaviours about alcohol.Australian Guidelines to Reduce Health Risks From Drinking Alcohol [online]. National Health and Medical Research Council; 2009. [cited 2 Oct 2010]. Available from: URL LinkReport of the DGAC on the Dietary Guidelines for Americans, 2010: Chapter D7- Alcohol [online]. Dietary Guidelines Advisory Committee; 2010 [cited 28 Sep 2010]. Available from: URL LinkAustralian Government - Department of Health and Ageing: Alcohol [online]. Department of Health and Ageing, 2010 [cited 2 Feb 2011]. Available from: URL linkCancer Council of Australia. Position statement: Alcohol and cancer [online]. 2008 [cited 2 Feb 2011]. Available from: URL linkQueensland Government - Transport and Main Roads: Drinking responsibly [online]. Department of Transport and Main Roads, 2010 [cited 2 Feb 2011]. Available from: URL linkQueensland Government - Transport and Main Roads: Anti-drink driving [online]. Department of Transport and Main Roads, 2010 [cited 2 Feb 2011]. Available from: URL linkAustralian Transport Safety Bureau: Do you know when to stop? [online] ATSB, 2011 [cited 2 Feb 2011]. Available from: URL linkNSW Government - Transport, Roads & Traffic Authority: Accident statistics [online]. RTA, 2008 [cited 2 Feb 2011]. Available from: URL linkTransport Accident Comission: Drink Driving Statistics [online]. TAC, 2001 [cited 2 Feb 2011]. Available from: URL linkGovernment of Western Australia: Office Road Safety: Drink driving fact sheet [online]. ORS, 2010 [cited 2 Feb 2011]. Available from: URL linkSouth Australia Police: Road safety [online]. South Australia Police, 2011 [cited 2 Feb 2011]. Available from: URL linkAustralian Government - Department of Health and Ageing: Alcohol and your kids: a guide for parents and carers [online]. Department of Health and Ageing, 2009 [cited 20 Mar 2011]. Available from: URL link

View the original article here

Binge Drinking (Alcohol Intoxication Disorder)

Alcohol consumption is embedded in our culture. Over 62% of Australians drink at least once a week. There is, however, a big difference between having a beer or glass of wine, and binge drinking. While the responsible consumption of alcohol may be beneficial, binge drinking is a very serious matter that has important health, personal and community consequences.?

Alcohol intoxication disorder, more commonly known as binge drinking, has several different definitions, and the definition keeps changing. The Australian Bureau of Statistics defines binge drinking as more than 7 drinks a night for men, and more than 5 for women.?A newer definition of binge drinking, supported by the NHMRC Australian Alcohol Guidelines, is more than 4 standard drinks per night.

It is?important to realise that all of these numbers are standard drinks and not 'drinks'. A single can of full strength beer is actually 1.5 standard drinks, while an average restaurant serve of wine is up to 1.8 standard drinks. This means that it is very easy to underestimate how much we are actually drinking.

Reference: Australian guidelines to reduce health risks from drinking alcohol [online]. Canberra, ACT: National Health and Medical Research Council; 2009 [cited 11 January 2011]. Available from: URL link

This information will be collected for educational purposes, however it will remain anonymous.

?

In middle aged and older?people, beer accounts for 46% of total alcohol consumed, wine for 31% and spirits for 20%.

Young Australians have very different preferences.?Of youths who drink only a small amount?of alcohol, 58% had beer, 26% pre-mixed drinks, 16% spirits and 8% wine. However, of young binge drinkers, 59% drank beer, 51% drank pre-mixed drinks, 46% had spirits, and only 2% consumed wine.

There has been a steady change in alcohol preferences among binge drinkers?over the last decade. Beer and wine drinking?has decreased, while the percentage of binge drinkers who consume?pre-mixed drinks has soared from?18% to over 50%.

Australia

In 2004 in Australia, about 48% of adult males and 32% of adult females participated in binge drinking at least once a year. About 12% of males and 4% of females were binge drinking at least once a week.

The rates of binge drinking have?increased significantly since that time. It now seems that about 18% of Australians aged 20-29 are binge drinking at least once a week. Females under 19 have overtaken males under 19 in binge drinking. 28.3% of females aged under 19 binge drink, while only 24% of under 19 males binge drink.

Binge drinking was once considered to be predominantly youthful behaviour. It is now becoming more and more clear that not?only young people?are binge drinking.?In fact, the rates of binge drinking are similar in all age groups up to?55 years old.

Global

In the US, around 24% of adults binge drink. More young people under the age of 29 drink in the US compared to other age groups.

In Europe, the rates of binge drinking vary considerably, with up to 40% of people in Poland binge drinking at least monthly. However, these people drink around 8 standard drinks during a binge. This is in contrast to the UK and Ireland, where only?35% of people binge drink on a monthly basis, but the average consumption is 14-16 standard drinks. The lowest rates of binge drinking are in Romania (8% of the population), Portugal (9%) and Greece (10%). In the rest of Europe, the rates of people binge drinking on a monthly basis are 10-20%, with varying amounts of alcohol consumed.

The reasons why people?binge drink?are complex. There have been?many explanations?of binge drinking as a way?of escaping problems or?forgetting crumbling relationships. When asked, people say that they binge drink for fun,?to loosen inhibitions and do silly things, because?their friends are also drinking, to relax or relieve stress,?to enhance confidence, to celebrate?and, most significantly,?to socialise.

Certainly a lot of?these reasons will be true for some people who binge drink. However, there is one very important and quite simple explanation?why the rates of binge drinking are so high.?That explanation is society's culture of alcohol.

Research is now showing that how a community views alcohol determines how much people drink in that community.?Communities that have a culture of drinking have much higher rates of binge drinking, while communities where drinking is frowned upon have much lower rates of binge drinking. It is now thought that a community's views on alcohol are more important than individual or family views on alcohol. The reason for binge drinking is?much more complicated than one single factor,?but it is important to realise that how a community perceives alcohol?does influence?binge drinking rates.

Most people know the short term effects of excessive alcohol, such as:

However, these are just the tip of the iceberg. There are other, much more serious, complications of binge drinking. These?include:

Falling over Assaults Sexual disinhibition (resulting in an unplanned pregnancy?or STI) Car accidents (both while drinking or as a pedestrian involved in an accident) Drowning Losing friends because of inappropriate actions Death

Every year in Australia, hospitals must look after more than 60,000 patients?as a result of drinking too much alcohol.

The short term consequences of binge dinking are potentially serious. However, they are?small compared to the far more dangerous long term consequences. In the long term, the main consequences of binge drinking include:

Mental illness, including:? Increased risk of cancer, including:? Increased risk of neurological disorders, including:? Heart disease, including: Liver problems, including: AnaemiaPoor immune system?Long term alcohol abuse (60% increased risk)?Illicit drug abuse (70% increased risk)?Increased risk of smoking?120% greater chance of having a criminal conviction?Homelessness?Becoming socially isolated

The above list is not?complete, but does provide an overview of the main long term consequences of alcohol abuse. It is impossible to tell exactly how much a person has to drink to develop these specific consequences, but it is well known that drinking more than 2 standard drinks per day is harmful.

The only way to avoid binge drinking is to know how much you are actually drinking, and then limit your total alchol consumption. This sounds much easier than it actually is. Firstly, a single 'drink' is often much more than a standard drink. A standard drink is exactly 10 grams of pure alcohol. This translates into:

1 can (375ml) of light beer1 pot (285ml) of full strength beer? can of regular beer1 shot (30ml) of spirits1?small glass (only 100ml) of wine

It is very hard to assess how much?you are being served, and it is even harder to?know?how many standard drinks are contained in pre-mixed drinks and cocktails. Sweet pre-mixed drinks (alcopops) mask the taste of alcohol, but?have a high alcohol content.

Also know your limits and know how alcohol affects you. The amount you can drink depends on your size (bigger people can drink more than smaller people), your metabolism, and how fast you?drink.?Set yourself a limit?of how much you are going to drink, and then stick to that limit.

How much alcohol do you have in your system?

Most of us would have been?given a random breath test at least once but how does the reading this test gives actually relate to how many drinks you've had? Use this tool to estimate how much alcohol you have in your blood and how long it might take to sober up.

Click here to calculate your BAC

Always remember to have a designated non-drinker if you are going out. This is both for driving you home, and to generally look out for the drinkers in the group and make sure they don't do anything dangerous.

Some other tips to avoid binge drinking include:

Start with a non-alcoholic drinkDrink slowly (take sips and not gulps)Try low alcoholic beverages (e.g. light beer)Eat a meal before drinking alcoholHave 1 drink at a time and avoid?topping upAvoid rounds or 'shouts'Avoid drinking gamesPace yourself and drink non-alcoholic beverages between the alcoholic onesBe assertive - don't let yourself be pressured into drinking more than you canStay busy, do not just sit and drink

If you think that you have a problem with alcohol,?speak to?your health care professional.

?For more information on drinking alcohol, including drinking disorders and alcohol's effect on the body, as well as some useful tools, see Alcohol.Alcohol consumption in Australia: A snapshot, 2004-05 [online]. Australian Bureau of Statistics. 25 August?2006 [cited 1 July 2008]. No. 4832.0.55.001. Available from URL: http://www.abs.gov.au/ ausstats/ abs@.nsf/ mf/ 4832.0.55.001/ Australian Alcohol Guidelines: Health risks and benefits [online]. National Health and Medical Research Council. 2001 [cited 1 July 2008].?Available from URL: http://www.nhmrc.gov.au/ publications/ synopses/ ds9syn.htmKing E, Taylor J, Carroll T. Alcohol consumption patterns among Australian 15-17 year olds from 2000 to 2004.?Australian Government Department of Health and Ageing. 2005.2007 National Drug Strategy Household Survey: First results [online].?Australian Institute of Health and Welfare. 27 April?2008 [cited 1 July 2008]. Available from URL: http://www.aihw.gov.au/ publications/ index.cfm/ title/ 10579Banta J, Haviland M, Przekop P. Mapping estimated county-level income and binge drinking among California men. Psychiatric Services. 2008; 59(2): 138.Read J, Merrill J, Kahler C, Strong D. Predicting functional outcomes among college drinkers: Reliability and predictive validity of the Young Adult Alcohol Consequences Questionnaire. Addictive Behaviors. 2007; 32(11): 2597-610.Kuntsche E, Rehm J, Gmel G. Characteristics of binge drinkers in Europe. Social Sci Med. 2004; 59(1): 113-27.Guise JMF, Gill JS. 'Binge drinking? It's good, it's harmless fun': A discourse analysis of accounts of female undergraduate drinking in Scotland. Health Edu Res. 2007; 22(6): 895-906.Ahern J, Galea S, Hubbard A, Midanik L, Syme S. "Culture of drinking" and individual problems with alcohol use. Am J Epidemiol. 2008; 167(9): 1041-50.Drug Info Clearinghouse. Fact Sheet: The facts?about binge drinking [online]. Australian Drug Foundation. 2002 [cited 1 July 2008]. Available from URL: http://www.druginfo.adf.org.au/ druginfo/ fact_sheets/Deas D, Brown S. Adolescent substance abuse and psychiatric comorbidities. J Clin Psychiatry. 2006; 67(7): e02.Viner R, Taylor B. Adult outcomes of binge drinking in adolescence: Findings from a UK national birth cohort. J Epidemiol Community Health. 2007; 61(10): 902-7.Standridge J, Zylstra R, Adams S. Alcohol consumption: An overview of benefits and risks. Southern Med J. 2004; 97(7): 664-72.Talley N, O'Conner S. Clinical Examination. 5th Ed. New York: Churchill Livingstone, 2006.Sheehan M, Ridge D. 'You become really close... you talk about the silly things you did, and we laugh': The role of binge drinking in female secondary lives. Subst Use Misuse. 2001; 36(3): 347-72.

View the original article here

Alcohol Consumption: Short-Term Health Consequences

Alcohol is a legal drug in Australia and is commonly consumed by Australians for pleasure and sociability. When consumed in moderation the effects of alcohol are positive, after one standard drink individuals will feel relaxed, confident and talkative. One standard drink consumed in 1 hour will raise the Blood Alcohol Concentration (BAC) of an individual with average build by approximately 0.01 to 0.03%. As the amount of alcohol consumed in a single sitting is increased, the BAC increases proportionately.

Once the BAC has surpassed 0.05%, inhibitions are reduced and judgement and movement are impaired. An individual with a BAC from 0.08–0.15% may exhibit slurred speech, impaired coordination and loss of balance, impaired vision, emotional instability, nausea and vomiting. With a BAC over 0.15% individuals are classified as being in a high-risk state of intoxication. They may become sleepy, have trouble walking without help, lose bladder control and experience loss of memory and loss of consciousness.

A BAC in excess of 0.3% can lead to coma and death.

How much alcohol do you have in your system?

Most of us would have been?given a random breath test at least once but how does the reading this test gives actually relate to how many drinks you've had? Use this tool to estimate how much alcohol you have in your blood and how long it might take to sober up.

Click here to calculate your BAC

The most immediate effect of alcohol is on an individual’s cognition (thinking). Drinking alcohol stimulates the release of endorphins and results in feelings of relaxation, increased well-being and reduced inhibitions. Consequently, alcohol consumption can increase an individual’s tendency to engage in risky behaviours. These effects are more prominent in younger individuals who have not developed cognitive processes such as rational thinking and problem solving at a mature level. Individuals under 15 years take greater risks and engage in more anti-social behaviour when consuming alcohol.

Cognition progressively deteriorates with increasing alcohol consumption. Large quantities of alcohol can produce a blackout effect, resulting in the individual being unable to remember what they were doing for a period of time whilst intoxicated.

An individual’s cognitive and verbal ability to deal with conflict also deteriorates with increasing alcohol consumption and the risk of violent conflict increases.

As the quantity of alcohol consumed increases, positive feelings such as increased well-being are overtaken by negative physical effects including:

Drowsiness;Loss of balance and difficulty walking;Depressed cardio-respiratory systems;Deterioration of coordination;Slurred speech;Blurred vision; Slowed reaction times;Fine motor skills such as those required for driving are affected to an extent that the risk of injury increases after a single standard drink of alcohol. One standard drink increases the blood alcohol content of a person with average build by approximately 0.01–0.03% (0.01–0.03 g of alcohol per 100 ml of blood), which is just below the legal maximum limit for driving in Australia;Impaired endocrine?functions are also affected as alcohol consumption suppresses the secretion of pituitary anti-diuretic hormones. These hormones signal the kidneys [link to renal anatomy] to reabsorb water, and the suppressed?secretion which occurs with alcohol consumption promotes dehydration; andNausea, vomiting and coma. When these co-occur they can be fatal as a comatose individual who vomits may choke.?

Age-dependent physical effects of alcohol
It is important to note that there are age differences in the effects of alcohol. Young people tend to maintain their motor function better than their older counterparts who have consumed the same amount of alcohol. Young people also appear less affected by the sedative effects of alcohol. They may therefore stay awake for longer than their older counterparts when consuming alcohol. They may also be more likely to rely on motor skills while intoxicated, unaware of their impairment. For example, a young person might be more likely to think they are capable of driving a car when they are intoxicated.

The key hazard associated with alcohol intoxication is an increased risk of injury.

Injuries and accidents that have been associated with alcohol intoxication include:

Transport injuries including road traffic accidents and boating accidents;Intentional or unintentional poisoning- In Australia, 56% of emergency department presentations for poisoning are alcohol related.Fire injury;Falls;Drowning;Exposure to mechanical forces (including machinery accidents);Self-inflicted injuries; and Interpersonal violence.

As a result of this increased accident rate intoxicated individuals have a higher risk of injury to the head,?spinal cord and soft tissues. Alcohol intoxication is also associated with higher all-cause mortality from associated injuries and death from suicide.

Drinking no more than two standard drinks on any given day reduces the lifetime risk of alcohol-related injury to less than 1% (the level of risk designated acceptable by the National Health and Medical Research Council or NHMRC) in healthy men and women. Drinking less reduces the risk further.

Drinking more than two drinks per day increases the risk of alcohol related injury to greater than 1%. Drinking more than four standard alcoholic beverages in a single sitting more than doubles the risk of injury in the following 6 hours. The risk increases further if more drinks are consumed. Young?people have a higher risk of alcohol related injury and greater than 50% of serious alcohol related injuries in Australia occur in individuals
aged 15–24 years.

The rate of alcohol related death rose in the UK from 6.9 deaths per 100,000 people in 1991 to 12.9 deaths per 100,000 in 2005. In the United States, some 90,000 deaths each year are attributed to alcohol abuse. Alcohol-related death is also a significant public health issue in Australia. The lifetime risk of death from alcohol-related injury increases from less than 1% amongst those who drink once a month or less, to over 5% and 10% amongst female and male daily drinkers, respectively. The risk of death remains less than 1% amongst men and women who never consume more than two drinks in a single sitting.

Gender differences
There are significant gender differences associated with alcohol related death. In men, the risk of death from alcohol-related injury is greater than risk of death from chronic alcohol-related disease. For example a man who consumes eight standard drinks per day has a 15 in 100 chance of dying from any alcohol related cause in his lifetime. This includes a 5% chance of mortality associated with chronic alcohol-related health conditions and a 10% chance of mortality due to alcohol-related injury. Women, on the other hand, are more likely to experience morbidity from chronic alcohol related conditions than sudden injury. A woman drinking eight standard drinks daily has a 14% chance of alcohol-related death; she has an 8.5% risk of dying from a chronic health condition and a 5.5% chance of death from an alcohol related injury.

Cultural differences
Deaths from alcohol related causes occur twice as frequently amongst the Aboriginal and Torres Strait Islander population compared to the non-Indigenous population, despite a lower proportion of the Aboriginal and Torres Strait Islander population consuming alcoholic beverages. Suicide (discussed further below) is a particularly prominent cause of alcohol-related death in this group.

Differences in age
Alcohol-related death is a particularly acute problem amongst young people. In Australians aged 14–17 years, 13% of deaths can be linked to alcohol consumption. Each week a 14–17 year old Australian dies from an alcohol-related cause and a further 60 are hospitalised.

Alcohol consumption also increases the degree to which individuals take sexual risks. Young people who use alcohol on average:

Initiate sex earlier in life;Are less likely to use a condom during their first sexual encounter; andAre more likely to contract a sexually transmitted disease.

Young women who consume alcohol are more likely to experience pregnancy as a teenager. The association between teenage pregnancy and alcohol consumption may arise because individuals who consume alcohol are predisposed to other risky behaviours, including unprotected sex.

There is also evidence that men become more sexually aggressive when drunk and women who are drunk are more likely to condone male sexual aggression. The risk of sexual coercion for females increases with intoxication and alcohol is particularly likely to be involved in instances of acquaintance rape. Over half of all rape cases on university campuses in the United States (most of which are acquaintance rapes) occur after the victim, perpetrator or both have consumed alcohol.

Alcohol consumption and excessive daily alcohol consumption are associated with an increased risk of mental health conditions. In addition those who binge drink are more likely to attempt or complete suicide.

There is also evidence that individuals with existing mental health conditions are more likely to consume excessive quantities of alcohol, sometimes as a form of self-treatment. While the associations between mental health conditions and excessive alcohol consumption are often long-term, they result in an immediate increased risk of suicide, particularly amongst young people. Adolescent males and females are 17 and three times more likely to attempt suicide whilst intoxicated respectively. In these instances, depression and intoxication appear to work synergistically to greatly increase a young person’s risk of suicide.

The short-term effects of drinking not only affect the individual who is consuming the alcohol but can also affect the community. Over 70% of the prisoners in Australia had a positive BAC before they committed the crimes that led to their imprisonment. 40% of domestic violence cases and 16% of child abuse cases involve alcohol.

Drinking can also lead to a hangover the day after the alcohol is consumed. Hangovers can contribute to loss of productivity in the workplace as well as in the classroom.

If an individual has drunk to the extent that they have developed alcohol poisoning, immediate medical attention is required. Symptoms of alcohol poisoning include:

Slow breathing (less than eight breaths per minute);

These symptoms can occur before the individual has passed out. This is common during binge drinking. It is also important to remember that alcohol is a depressant and can inhibit breathing and the gag reflex, which increases the risk of coma and choking.

Everyone who consumes alcohol, and particularly those who consume alcohol in excess of recommended levels, is at risk from the intoxicating effects of alcohol. This is regardless of age, sex, race or income. However some individuals have higher levels of risk than others. These include:

Young people have been well documented to take greater risks and exhibit more anti-social behaviour when under the influence of alcohol. A significant proportion of Australian youth drink alcohol on a regular basis (70% of 17 year olds drink at least once a month), thus the majority of Australian adolescents are at risk of alcohol related injury; Individuals taking medications which may interact with alcohol;Individuals with mental illness, who may display more intense symptoms of alcohol intoxication. Individuals with mental disorders including?depression, attention deficit hyperactivity disorder and bipolar disorder?are more likely to abuse drugs, including alcohol;Individuals working in hospitality, manufacturing, construction, retail and agriculture, as these occupational groups are more likely to drink at levels associated with?increased risk of injury;Individuals with personality traits including impulsiveness, extraversion, inhibition and dominance are more likely to drink large quantities of alcohol more frequently than individuals who do not display these personality traits;Individuals residing in regional and remote areas, as these individuals are more likely to drink at levels which increase the risk of alcohol-related injury. Heavy drinking is also more common in socially deprived areas; andIndividuals who are Aboriginal or Torres Strait Islanders, as this group is more likely to drink at levels which increase the risk of alcohol-related injury.South Australia Drug and Alcohol Services: Alcohol and its effects [online]. SA Health, 2010 [cited Feb 2011]. Available from: [URL link] Newbury-Birch D, Walker J, Avery L, et al. Impact of alcohol consumption on young people- A systematic review of published reviews [online]. Newcastle University; 2009 [cited 2 October 2010]. Available from: [URL link]Australian Guidelines to Reduce Health Risks From Drinking Alcohol [online]. National Health and Medical Research Council; 2009. [cited 2 October 2010]. Available from: [URL Link]Alcohol Alert: Alcohol’s damaging effects on the brain. 2004; 63 [online]. Oickville, MD: National Institute on Alcohol Abuse and Alcoholism; 2004 [cited 2 October 2010]. [URL Link] Rehm J, Baliunas D, Borges GLG, et al. The relation between different dimensions of alcohol consumption and burden of disease: an overview. Addiction. 2010; 105: 817–843.? [Abstract]Report of the DGAC on the Dietary Guidelines for Americans, 2010: Chapter D7- Alcohol [online]. Dietary Guidelines Advisory Committee; 2010 [cited? 28 September 2010]. Available from: [URL Link]Stephens R, Ling J, Heffernan TM, et al. A review of the literature on the ognitive effects of alcohol hangover. Alcohol Alcoholism. 2008; 43(2): 163-70. [Full Text]Abbey A. Alcohol-related sexual assault- a common problem amongst college students. J Stud Alcohol. 2002; Supp14: 118-28. [Abstract | Full Text]National Institute on Alcohol Abuse and Alcoholism: Parents help your teens party right at graduation [online]. NIAAA, 2005 [cited Feb, 2011]. Available from: [URL link]

View the original article here