Drinking alcohol is part of many New Zealanders’ lives. What many of us don’t realise is how harmful even ‘low-risk’ drinking can be. The following advice is designed to help you make informed choices about drinking and reduce your risk of alcohol-related harm.
Key points about harm called by alcohol
The level of alcohol consumption considered by many to be relatively safe a few years ago has now been shown to be associated with an increased risk of cancer, heart disease and many other life-threatening diseases.
Other harms from alcohol include injuries, alcohol poisoning, alcohol dependence, road trauma, assaults and negative impacts on children and families.
No level of drinking is completely without risk. The true number of people experiencing negative health outcomes due to drinking is likely to be higher than reported.
If you choose to drink, you can reduce your long-term health risks by drinking no more than 2 standard drinks a day for women or 3 standard drinks a day for men, with at least 2 alcohol-free days a week. See low-risk drinking.
If you are worried about your drinking, there is support available to help you to cut down or stop drinking.
What happens when I drink alcohol?
Alcohol is a chemical compound that is poisonous to the human body in large amounts, but generally tolerable in small amounts.
When you drink alcohol, it goes directly into your bloodstream where it is immediately sent all around your body.
As it reaches different parts of your body, alcohol slows down the work of your cells, especially in the brain. You can feel this happening.
When alcohol reaches the liver, it is broken down (metabolised) and cleared from your bloodstream. Your liver works hard but slowly, taking 1 to 2 hours to break down 1 standard drink.
If you drink faster than your liver can cope, the alcohol stays in your system for longer and its effects are increased.
Alcohol can cause short-term and long-term harm to you and others.
Short-term risks of alcohol include:
accidents and injuries including vehicle collisions, requiring hospital treatment
unprotected sex leading to unplanned pregnancy or sexually transmitted infections
vomiting, passing out, hangovers and other signs of alcohol poisoning
black-outs and memory loss
violent behaviour leading to abuse, offending or assault.
People who binge drink (drink heavily over a short period of time) are more likely to behave recklessly and are at greater risk of being in an accident.
Alcohol increases your risk of developing serious health conditions including:
heart disease, stroke, liver disease and pancreatitis
certain cancers including mouth, throat, oesophageal, breast and colorectal
dependent drinking (alcoholism).
As well as causing serious health problems, long-term alcohol misuse can lead to social problems for some people, such as:
Is my drinking ok?
The Health Promotion Agency’s Is Your Drinking Okay? test can help you find out more about your level of risk from your drinking. Just complete the questionnaire and it will automatically add up your score and tell you what it means. It's that easy!
When you drink too much it often causes a number of problems for your family, relationships and friends. The following advice is to help you ease up on your drinking so that you can drink in a way that doesn't cause harm to yourself or others.
Record your drinking: keep a diary of when, where and exactly how much you drink.
Identify trouble spots: look at the situations where you drank too much and try to identify if there was a pattern to them. Are there particular people, places or emotions that trigger you to drink too much?
Make a plan: Now you know when you are most likely to have a problem with your drinking, you can make a conscious effort to stop it happening. Answer these questions: How much do you plan to drink? How long do you intend to drink for? What can you do to help yourself stick to your plan? Who can help you stick to your plan?
I want to quit drinking – what support is available?
If you or someone you know needs support and treatment to reduce their alcohol intake, a good place to start is to call the Alcohol Drug Helpline on 0800 787 797, visit the website, or free text 8681 for confidential advice.
Trained counsellors will answer your call or text 24 hours a day, any day. You can choose to talk with a Māori or Pasifika counsellor by calling the service's:
Māori line – 0800 787 798
Pasifika line – 0800 787 999
Discuss your drinking with your doctor, especially if you are pregnant and find it difficult to stop drinking.
Just like smoking, alcohol can cause physical dependence or addiction and some people cannot cut down. There are lots of groups keen to help you with the resources, moral support and motivation to achieve this. Ask your family and friends to support you too.
What treatment is available to help quit drinking?
Treatment for alcohol problems includes a range of activities, such as 12 step support groups, counselling services that provide one-hour counselling appointments, or residential programmes where you stay for several weeks.
The following advice from the Health Promotion Agency (HPA) is to help decrease your risk of alcohol-related accidents, injuries, diseases and death.
Low-risk is not no-risk. Even when drinking within low-risk limits, a range of factors can affect your level of risk, including the rate of drinking, your body type or genetic makeup, your gender, existing health problems and if you are young or an older person.
Reduce your long-term health risks by drinking no more than:
2 standard drinks a day for women and no more than 10 standard drinks a week
3 standard drinks a day for men and no more than 15 standard drinks a week.
Which means at least 2 alcohol-free days every week.
Reduce your risk of injury on a single occasion of drinking by drinking no more than:
4 standard drinks for women on any single occasion
5 standard drinks for men on any single occasion.
The above advice is based on 'standard drinks'. A standard drink contains 10g of alcohol. A common serve or pour of an alcoholic beverage is often more than 1 standard drink. Find out more about standard drinks
If you choose to drink alcohol, there are things you can do to help you stay within low-risk levels. These include:
know what a standard drink is
keep track of how much you drink – daily and weekly
set limits for yourself and stick to them
start with non-alcoholic drinks and alternate with alcoholic drinks
try drinks with a lower alcohol content
eat before or while you are drinking
never drink and drive
be a responsible host – i.e. provide alcohol-free drinks and food and make sure everyone has a safe way to get home
talk to your kids about alcohol
limit your drinking to recommended safe levels
have at least 2 alcohol-free days each week
seek help if you feel your drinking is becoming a problem.
A useful way to remember the number of standard drinks to lower your risk of alcohol-related harm is this chart from the Health Promotion Agency:
When not to drink alcohol
There are times and circumstances when it is advisable not to drink alcohol.
Recent evidence (BPAC 2018) shows that levels of alcohol consumption that were previously thought to be relatively safe are associated with an increased risk of negative health outcomes.
Clinicians in primary care are recommended to assess all patients for alcohol misuse and, where appropriate, consider interventions that are matched to the patient’s level of risk and readiness to change.
The tools available to reduce alcohol consumption range from brief counselling and online resources to pharmacological interventions and referral to specialist services.
Key practice points:
Guidance for safe drinking levels in the general population are being questioned and some experts believe that they should be lower than current recommendations.
Ask every patient about their use of alcohol and document their response; the AUDIT-C tool is initially recommended in most situations.
Patients who drink alcohol should be stratified according to the level of risk associated with the quantity that they are drinking.
Brief interventions in primary care with a general practitioner or practice nurse can reduce the amount of alcohol people drink; interventions should be matched to the patient’s level of risk and their readiness to change.
In patients who are misusing alcohol, the level of consumption helps determine whether withdrawal can occur in the community with management in primary care or whether specialist services or an inpatient facility is required.
Pharmacological interventions to reduce alcohol consumption, as an adjunct to psychological approaches, include disulfiram (fully subsidised with no restrictions), topiramate (fully subsidised with no restrictions, unapproved indication) and naltrexone (subsidised with Special Authority approval).