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Alcohol use disorders

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Types of alcohol problems

When people get into problems with their drinking it’s usually because they’re drinking too much in one sitting (binge drinking), and/or drinking too much on a regular basis.

Risky alcohol use

Risky alcohol use usually means a session of heavy drinking, and might mean you:

  • Lose coordination or skills like problem solving
  • Pass out or get sick
  • Take risks, like drink driving
  • Get hurt, either in an accident (like a fall or being hit by a car), or an assault.

Dependent alcohol use

If you drink a lot on a regular basis you can become ‘dependent’ on alcohol, meaning that you might:

  • Need to drink more to get the same level of drunkenness
  • Crave alcohol, and find that alcohol is controlling your life
  • Suffer withdrawal symptoms if you haven’t had a drink for a few hours. Withdrawal symptoms can range from being unpleasant (e.g., getting the shakes, or feeling sweaty or anxious) to quite dangerous (e.g., seizures).

Problems associated with alcohol use disorders

Regular and heavy drinking can lead to serious health conditions such as heart disease, cancer, liver disease, and dementia. Alcohol use disorders are also associated with several other mental health conditions, because people often drink to try and manage the symptoms of PTSD, depression, or anxiety. This might seem like a good idea, but in the long term it makes those conditions worse and can make treatment for them less effective. Drinking can also create problems in your important relationships. If that’s the case for you, some relationship help might be in order too.

You’re not alone

If you’re worried about the effect that alcohol is having on your life, you’re not alone. Each year in Australia, more people are hospitalised or die from alcohol than any other drug (apart from cigarettes). Alcohol use disorders are also common in serving members and veterans. For example, just over a third of serving members have suffered from one of these disorders at some point in their lives . [1] It’s possible that alcohol problems are even more common in ex-serving members, with a large national survey of Vietnam veterans [2] finding that more than 40% had a problem with alcohol at some point in their lives. The demanding nature of military work and life might mean many serving members don’t develop serious problems until after separation.

I had no photo training or anything. I just went to see the Commanding Offi cer and I said, ‘Boss, can I be the unit photographer?’ And he went, ‘Can you take a photo?’ And I said, ‘Well, I’ve got a new camera!’. I’d seen some photographers in uniform getting around East Timor and the photos that were coming out were so powerful – images of these soldiers walking the streets with little, tiny kids in their hands. Read Bell's full story here (PDF, 1.88MB) .

 

Issues for family

Drinking problems don’t just affect the person who’s drinking; they affect partners, children, and other family members as well. It can be helpful to think about how you can support your loved one as they try and cut down on their drinking, and remember that wanting to help doesn’t mean that helping is easy. Sometimes you’ll need some support as well. Find out more about resources and referral options for families. It’s hard to force people to change when they don’t want to. There’s no ‘perfect’ way to talk to a loved one about their drinking, but here are a few tips that might help you:

  • Try not to argue with your loved about their drinking – it may make them more determined not to change.
  • Instead of criticising behaviour that’s unhelpful or unhealthy, try and support or encourage behaviours that are helpful or healthy.
  • Feel free to express your opinion, but be prepared to listen when others express theirs.

Alcohol issues and older vets

Alcohol use disorders are the most common mental health problem for Vietnam veterans. Around 43 percent will be affected by risky or dependent drinking at one point or another. Alcohol is a leading cause of death and hospitalisation for older Australians. Every year, almost 600 people aged between 65 and 74 die from alcohol related causes, and another 6500 are hospitalised. The longer you drink, the more problems it’s likely to cause, and the effects of alcohol on the brain and body tend to get more severe with age as well. As we age, our bodies are less able to repair the damage that alcohol causes, and alcohol can speed up some of the normal changes that come with age, like memory problems. The damage that alcohol causes is permanent, but it’s possible to get back some thinking skills if you decide to stop drinking, or keep your drinking within the levels recommended by the Australian guidelines. But the older we get, the harder it is to change our habits, so putting off making changes to your drinking might make it harder to change when you eventually decide you want to. Don’t put it off any more. Alcohol problems can be treated, even if you’ve had them for a very long time. Find out more about where to go for help.

What treatments can help?

Talking to your GP is a good place to start if you’re thinking about making changes to your drinking. They can manage any relevant medical issues, make referrals for specialists, and prescribe medication to help you change your drinking habits if necessary. Changing your drinking habits can be really hard, but effective treatments for are available. These include both psychological treatment and medication. It is generally best to start with psychological treatment rather than use medication as the first and only solution to the problem.

Counselling

There are certain types of counselling that are more effective in helping you to change your drinking habits, including:

  • Motivational interviewing – helps you get organised, make decisions, and set goals
  • Cognitive behavioural therapy – teaches you skills to help survive when you’re really craving a drink, recognise situations where you’re more likely to drink, and strategies to avoid drinking
  • Relapse prevention – provides skills and strategies to avoid falling back into old habits.

Counselling for problem drinking can happen individually, in groups, or for couples.

Some people need medication to safely reduce their drinking

If you’ve been drinking heavily and are thinking about cutting back or stopping, it’s important to see a doctor who can check to see if you’re alcohol dependent. People who are alcohol dependent can experience a range of symptoms if they just stop drinking, including some that can be dangerous (e.g., seizures). Your GP can prescribe medications to help you manage these symptoms, and to help manage intense cravings for alcohol that you might get once you’ve cut down. If you need extra support, your GP will talk to you about services that provide home visits from a nurse, or hospital facilities that specialise in alcohol withdrawal. It’s important to remember that even though medication can help your body adjust to not having its usual supply of alcohol, most people still require counselling to make lasting changes to their drinking.

Where do I get help?

  • A GP is always a good place to start when trying to overcome a drinking problem, as he or she can manage any relevant medical issues, make referrals for specialists, and support your efforts with medications if necessary.
  • This website has information on a range of professional care that is available to current and former serving members.

For more help in reaching your goals:

  • A useful veteran specific resource is The Right Mix website (or call 1800 1808 68) – it includes materials such as local support contacts, and tips for changing drinking behaviour.
  • The Department of Health and Ageing provides more information on drinking guidelines and self-management strategies.
I left the ADF 12 months ago and have found it tough going. Ever since I got back from Afghanistan I’ve found it really hard to relax. I feel like I’m constantly on edge and hyped up. I was like that most of the time I was over there, but it made sense then – we had to watch our backs and look out for our mates all the time. Read Mark's full story here.

 

[1] McFarlane, A. C., Hodson, S. E., Van Hooff, M., & Davies, C. (2011). Mental health in the Australian Defence Force: 2010 ADF Mental Health and Wellbeing Study: Full report. Canberra: Department of Defence.

[2] O'Toole, B. I., Marshall, R. P., Grayson, D. A., Schureck, R. J., Dobson, M., French, M., . . . Vennard, J. (1996). The Australian Vietnam veterans health study: III. Psychological health of Australian Vietnam veterans and its relationship to combat. International Journal of Epidemiology, 25, 331-339.

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  • Getting treatment does'nt mean just 'lying on a couch' like in the movies, its a chance to learn new skills and play an active role in your recovery.

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