Alcohol abuse is widespread in Ireland. Half of the Irish people who drink do so excessively. Ireland has one of the highest consumption of alcohol in Europe.
Alcoholism is associated with significant physical, mental and social harms.
Alcohol dependency results in an increased risk of:
- Accidental overdose
- Heart problems
- Depression and anxiety
People who develop problems with alcohol don’t set out to develop drink badly. For many who do develop problems their drinking is unproblematic for a while until they become more reliant on the drug. Early intervention is crucial and ideally before their drinking gets out of control.
Problems with alcohol range from mild to hazardous to dependent drinking. Each stage will require different interventions, often a combination of pharmacotherapy and different forms of psychotherapy. The vast majority of cases of alcohol misuse can be safely managed as outpatients.
Alcohol plays a prominent role in Irish life. Probably as many as one in two people who drink do so in excess of safe weekly limits (14 units a week for a male and 7 units a week for a female).
Many people who drink to excess are unaware of this.
In Ireland, alcohol advertising keeps this drug in the nation’s consciousness while alcohol awareness campaigns largely fall on deaf ears. We seem to celebrate the most minor of occasions with alcohol and internationally Ireland has a reputation as heavy drinking nation. This is borne out by the statistics.
In 2003 alcohol consumption in Ireland was 13.4 litres per adult, ranking third highest behind Hungary and Luxembourg in a comparison of 26 countries in the expanded European Union.
What are the features of an alcohol problem?
This question is more difficult to answer for the person abusing alcohol. There is a short self-assessment or screening tool that might be helpful in eliciting a problem with alcohol and it is denoted by the acronym C.A.G.E.
C. Have you ever felt that you need to Cut down your drinking?
A. Have people ever Annoyed you by criticising your drinking?
G. Have you ever felt Guilty about your drinking?
E. Have you ever had to take a drink first thing in the morning to help you deal with a hangover (an Eye-opener)?
If you score two or more on these four items then this is suggestive of a problem which may require further investigation.
That are reasons why people drink to excess but this is not as simple as it is often made out.
key reasons why people drink
1. To deal with stress and anxiety
2. To deal with mood problems
3. To deal with issues of low self-esteem
4. To deal with boredom
5. To deal with loneliness
6. To deal with emotional and physical pain.
Whilst the above list increase the risk of drinking they are not necessarily the major risk factor for a drink problem. For example, most people will suffer from any or possibly all of the above yet only a minority will develop an alcohol problem.
The answer to this might be a combination of genetic predisposition, personality factors, circumstances and the ability for alcohol to induce dependence.
Alcohol addiction rehab is aimed at not only helping patients address their addiction but also the risk factors that lead to alcohol dependence.
Dr McGovern believes firmly in the adage “If you look after the risk factors the addiction will look after itself”.
Getting a handle on our drink problem, [Irish Medical Times, Dr Garrett McGovern]
Finding the right fix to treat addiction, [Irish Times, Dr Garrett McGovern]
Cannabis is not as harmful as alcohol, [Irish Examiner, Dr Garrett McGovern]
Alcohol related documentaries
This documentary was screened in 2001 as part of Channel 4’s Cutting Edge series. It tells the story of Brian Davis, a Cambridge graduated journalist who had a very successful career in advertising. By 2000 his health declined as he slipped into alcoholism and became homeless. It is a fascinating documentary and a reminder that alcohol dependence affects all people regardless of creed or class.
Watch Cutting Edge’s Brian’s Story Here
Case Study 1
A 55-year-old business woman self-referred herself to an outpatient alcohol rehabilitation programme Jane was drinking 8-12 units of alcohol per day. During the course of the assessment it emerged that this patient, who ran her own business, lived alone and was drinking one to two bottles of wine in the evening.
Her husband died many years ago and her adult children had long since left the family home. She says she drank to deal with the stress of her business and it “helped with the loneliness”. She never consumed alcohol during working hours. No other major issues emerged in the course of the assessment. This lady engaged in an outpatient alcohol rehab programme which consisted of treatment by a GP addiction specialist, counselling, cognitive behavioural therapy (CBT), family therapy and relaxation therapy. Following six weeks of alcohol rehab therapy she successfully gave up alcohol.
She was prescribed Acamprosate (a medication that helps deal with alcohol cravings) for a period of six months and found this medication very helpful in dealing with the urge to drink. The identification of middle-aged women at risk of drinking is important as this is a group where problematic drinking is often missed. It is estimated that only about 10% of problem drinkers will actively seek formal treatment.
The stigma of alcohol addiction is a significant barrier to looking for alcohol rehab treatment. Compared with people suffering from other, alcohol unrelated mental disorders, problem drinkers are less frequently regarded as mentally ill, are held much more responsible for their condition and provoke more social rejection.