Heavy drinking and health module
Heavy drinking and health module
Quotes are presented word for word apart from minor editing for readability and clarity. Identifying details have been removed. Square brackets show text that has been added or, where ellipses (three dots) appear, removed. For example, ‘as soon as I have that first sip, a change comes over me and that’s all that matters […] I just feel the physical buzz when I have the first drink.’
The men in this study all describe heavy drinking while also encountering significant alcohol-related health issues. Most describe heavy drinking as a routine activity or a ‘way of living’, despite having chronic health conditions that make them feel unhealthy. Most were socially isolated. Many lived alone and were unemployed, and only a couple were in relationships at the time of interview. These stories suggest the difficulties associated with boredom or lack of social engagement or purpose. Drinking provides routine, comfort and passes time in contexts characterised by little contact with friends and family, and limited meaningful social relationships or responsibilities.
When asked why they drank in the patterns they do or did, a few participants explain that it is because they were lonely or bored. Jakub [mid 70s, Polish, retired, drinking less], for example, explains that ‘loneliness is a big part of drinking in my case. Loneliness, bored[om], and like I said, after a long time of drinking, you lose interest. I lost interest to do some things. It was a disaster, very, very bad.’ For others, such as Arjun [late 30s, Indo-Fijian, unemployed but previously worked as a chef, no drinking in last 6 months], drinking helped to manage stress and pain. Some mentioned that although drinking could contribute to socialising and the maintenance of important friendships and other relationships, it also had unintended and unwanted consequences for relationships with partners, friends and children.
Despite periods of heavy drinking, all participants describe changing their patterns of drinking over time too. For some, heavy alcohol consumption became associated with mental health issues, injuries and accidents, and chronic and painful health conditions (See Looking after health). Below we discuss these themes in more detail.
What is heavy drinking? The men interviewed for this module have different perspectives on what counts as heavy drinking. As described above, some speak about drinking large quantities of alcohol regularly throughout the day and evening. Some describe regular heavy drinking as leading to addiction, dependence or alcoholism, and say drinking heavily makes looking after themselves challenging (See Perspectives on heavy drinking). Most men also describe gradually developing alcohol-related health problems and difficulties such as liver scarring, cirrhosis, ascites, oesophageal cuts, bleeding and vomiting.
Anthony [late 50s, Australian, works in hospitality, no drinking in last three months] explains that he continued to drink heavily despite being told he had the beginnings of cirrhosis of the liver. (Read his personal story)
I normally end up with an injury [laughs]. I always find something wrong with me. Look […] when it was mentioned to me […] that I had just the beginnings of cirrhosis of the liver, I didn’t have any scar tissue. I was actually first made aware that I could […] end up with scar tissue, [and that] it’s a problem, and it’s susceptible to cancer […] I just drank myself under the table and the next time I actually had liver function tests, that’s when I was told – I had another MRI, one of the numerous things they did to me – then I found out that I actually had scarring of the liver […] And like it got really bad where I just drank and I didn’t eat and I just, you know, I’d think I was all right and, you know, I think I looked all right, but I was yellow and, you know, I was almost dying and, you know, I’d just have another drink and go to sleep and wake up and do it all again.
Some describe being involved in repeated injuries and accidents.
Arjun [late 30s, Indo-Fijian, unemployed but previously worked as a chef, no drinking in last six months] describes blacking out on the street in front of the postman, who ran to alert his family. (Read his personal story)
Within that period when I was drinking heavily, I came to [in] situations where I just blacked out. Maybe walking down the street coming back home, I would just drop. Then I noticed every time I used to cough, you know, really coughing, blood was coming out. There were symptoms there which, again, I was stupid not to pay attention to […] The biggest sign is when you black out. I’ve blacked out where the postman drove past and, he knew me, and he’s gone straight to my house, [to get] whoever […] and my mum had to come and get me. I was a dead weight, so that was another issue. I’ve blacked out a few times and that was during my heavy drinking days but, again, I never, never pursued it thinking, ‘Oh, it’ll be all right, it’s probably just a one-off thing.’
NOTE: Arjun uses the term ‘black out’ here to mean losing consciousness.
Well, as I said, I fell over three times last week. It was Friday night [and then] Saturday night and that was the week before last […] and I think then Tuesday night I fell over and cut my scalp and bled everywhere. I’ve got a fair bit of blood sitting on the walls to remind me of my bad health, so I haven’t wiped it all off. I tend to have a bit of blood on most entrance ways in my house. I fell over three times right in front of the toilet. Not in the bathroom but right outside the door to the bathroom, which I found really strange. But it’s because when I get up out of bed on any occasion, I’ve got to rest for about 10 minutes. I get really dizzy, which is something new … quite new, I get really dizzy and I’m putting it down to the change of antidepressants, which we changed last year. Yeah […] because I’m walking very heavily and have sore hips, I tend to be very aware of my illness, I guess.
Drinking was, or had been, a daily habit for all the men we interviewed in this study. Most speak about drinking large amounts of wine, beer and spirits regularly throughout the day and evening. For example, John [60 years of age, Australia, retired, drinking less] explains that, for him, drinking heavily is a ‘way of living’. These accounts indicate how drinking is embedded in ordinary activities and daily life.
In the couple of years before I finally stopped, yeah, I [drank] quite heavily. You know, I would drink bottles of vodka and casks of wine and you know, made sure that I had wine left for the next day so I could go to the bottle shop after and get some more vodka or whatever. You know, it was just like a revolving door, yeah just drinking […] I’d have a meal and I’d think ‘Wow that’s good, I’ve had a meal, I must be doing all right’.
When Arjun [late 30s, Indo-Fijian, unemployed but previously worked as a chef, no drinking in last six months] drank heavily he still experienced feelings of ‘euphoria’, as well as social benefits. (Read his personal story)
You get the euphoria, which might last for a couple of hours, but the euphoria is what you chase. [Your] sleeping pattern obviously gets disturbed, so you have alcohol to sleep better, and the other aspect of it was the social thing as well [… I would drink] with friends, you know. You know a certain company you have that you can go towards [and say], ‘Okay, time for a drink.’ So, you chase that aspect of it. A lot of it is social-based and a lot of it is just secluded on your own, and there I found a point where I can go either social or I’ll just do it on my own.
While some participants comment on the pleasures and benefits of alcohol, others describe how heavy drinking can disrupt parts of their everyday life. Most of the men we interviewed say heavy drinking impacts on their relationships with family and friends. Some also explain that improving relationships with family and friends also motivates them to access treatment (see Experiences of treatment)
Bryan [late 40s, Australian, unemployed but previously worked in business, no drinking in last three weeks] explains that heavy drinking meant he woke later in the day and this interfered with his daily tasks and ability to care for his ageing parents. (Read his personal story)
I live by myself, but my parents live in a house next door […] Yeah, it is good. They’re getting old now, mum’s an invalid, so I do a lot of sort of carer work I suppose, you call it. You know, make beds, cook dinner, go shopping, do all that crap for them […] Drinking got in the way of everything because I wouldn’t wake up until 12 or 2. By 3:30-4, I’d be back on the grog. So, nothing gets done […] No extras got done, you know what I mean? Like lawns and yards ended up going to the pack because I look after 900 square metres of land with two houses. So, you know, it’s a bit of work […] I was just hanging on, yeah, and I’ll tell you honestly, my lawns had weeds like that [high]. I had people, someone come over who hadn’t been over for a couple of years and said, ‘What’s wrong, [Bryan]? Your place is a mess,’ because normally it was shmick you know, my lawns and that. I said, ‘I’m drinking mate’.
For others, drinking resulted in losing touch with family. According to Steve [early 60s, Indigenous, previously worked in nursing, drinking less] heavy drinking had negative effects on his family life and commitments. After losing his license he was unable to help his wife pick up his kids or drive himself to work.
John [60 years of age, Australian, retired, drinking less] explains that for many years he did not see his children regularly because of their attitudes towards his drinking. (Read his personal story)
I was on the outer perimeter of the family for a long time, except I didn’t care. Then as I got a bit older, I thought, ‘Why don’t I see my kids?’ Especially when I was living by myself and I lived by myself for like the last 10 years. I wanted to see my kids. I wanted to see my family. And it’s just recently, about the last 12 months, I’ve been starting to see my children, even though they are adults now. They knew I was sick and they thought I was going to die and they went, ‘Uh oh.’ They didn’t approve of me drinking [but] now I’ve got full support [from] them because they thought, ‘Dad’s dying,’ and it made them realise that they’ve got a father. Because [for] many, many years I was just around, ‘Oh, yeah, Dad. He’s a drunk.’
Although drinking interfered with some participants’ ability to maintain regular employment, some of the men we interviewed speak about how the routines and obligations of work helped them manage their drinking.
Well it depends on how bored I get as to when I drink, but I have a drink most days. I try not to drink too early in the day because that wastes a whole day. Sometimes you just get so lost. So I tend to drink after 5 o’clock when I come home from work. I don’t work at the moment […] When I was working, I used to stop at 9 o’clock at night too. I wouldn’t keep drinking all night long, but it caught up with me anyway. That was one of the reasons they gave me […] for getting rid of me. [My boss] said, ‘Sometimes you smell of alcohol’. ‘Well if it’s in my blood, it doesn’t mean I’m drinking.’ I said, ‘I stop drinking in the night time. I stop drinking at 9 o’clock’ and he knew that I was on antidepressants, we had spoken about it at length. We spoke about a few things. Being made redundant wasn’t the smartest move, and I found that really hard, really hard. It actually triggered me to become drunk for about three months non-stop.
Weekends, they were easy. We’d be on the doorstep of the […] hotel at 8 o’clock in the morning and we wouldn’t leave until 10, 11 o’clock at night. We’d sit in the club, basically shout each other, it worked out better because we also gambled. If we won, which was quite a lot of the time, we could have a really good time, other times it was sort of spread out, so you wouldn’t drink as much. Work times, well I used to go to work, I’d have one hell of a hangover [laughs].
A key concern for most participants was finding ways to manage or change their heavy drinking patterns. Although regular heavy drinking was often described as routine and repetitive by many of the men we interviewed, most say that their drinking patterns have changed over the years. Some have gone through periods without drinking followed by regular drinking, while others have continued to drink but shifted between heavier and lighter drinking. Others describe specific events or occasions that can prompt them to drink more, or particular people who they drink more with. Some describe changing their beverage of choice to moderate their drinking. While changing drinking patterns were common, change was also described as hard to achieve by several participants.
[I started drinking] with school friends, just outside of school and parties and things like that […] Just a social thing [when] it started. [My drinking] has gotten worse and sometimes got better over time […] As I got to 18 and all that, I got a bit worse, but as I got into my 20’s, it got a bit better but then I went through a little stage where it went bad again, but then better again […] Like I was drinking more. I would have stages where I would drink a lot and then not drink at all, then drink a lot and then not drink at all, yeah […] Partying and stuff like that, yeah, but then sometimes I would just drink alone […] Maybe sometimes, like if I was depressed or something or going through something, I would drink, yeah […] Nowadays if I drink, it’s just to … if it’s a social gathering or something like that, yeah.
Anthony [late 50s, Australian, works in hospitality, no drinking in last three months] explains that he had previously tried to stop drinking but began to drink again when he was on holiday. (Read his personal story)
One time I stopped drinking for about four years […] Yeah, yeah, I did actually and then I fell for the oldest trick in the book, you know. I was going over to Vietnam with my lady friend and you know, I thought to myself and I knew anyway, I knew for sure, but I thought to myself ‘Oh I’ll have a couple of drinks on the plane and then when I get to Vietnam I’ll have some there […] and then when I get back to Australia, I’ll stop drinking’, but then I got back to Australia and I went straight to the bar you know and that was the end of that four years.
Dylan [late 40s, Australia, unemployed but previously worked in construction, continuing to drink as usual and was also on a methadone program] describes how he started drinking heavily to avoid testing positive to drugs while he was involved in a drug court. (Read his personal story)
Probably about eight years ago, yeah, I started [drinking] heavily […] I think I was [in the] drug court. You can’t use drugs because they test you all the time, so alcohol. It’s a substitute more or less […] I don’t know. It’s just a boredom thing to me really. I don’t get drunk, yeah, it’s just the vicious cycle […] Like health issues … it causes you health issues, [it’s] expensive and it’s a hard habit to kick. It’s the hardest habit that I’ve had other than heroin and all that, yeah.
Dylan later describes how he was worried about alcohol withdrawal when he entered the prison system last year:
When I went to jail I was drinking a lot and I was worried about when I was getting locked up, because of the withdrawals. I was surprised yeah, that I didn’t get the shakes. I didn’t withdraw at all […] But I didn’t tell them I was a bad alcoholic when I went into jail, because if you do, they lock you in a safe room, you know what I mean […] Take everything off you […] Because it’s just … it takes your dignity away from you. They take all your clothes off you and leave you in a cell with just your undies.
Jakub [early 70s, Polish, retired, drinking less] has had periods without drinking followed by periods of regular drinking. Now he has decided to try a different approach: to reduce the amount he drinks rather than stop altogether. (Read his personal story)
Yes, [I’ve drunk] more, but also [there have been] periods when I didn’t drink at all, you know […] But in that time, I think I built up some thinking inside me, you know, to stop drinking. First I was thinking I will stop completely, but let’s say four years back, I sat with my counsellor [and said], ‘No, it’s too hard for me because when I stop drinking and after I relapse, I experience, you know, depression. I would think, ‘No, I can’t do anything.’ Sometimes I felt hopeless, you know. So, we organised [to do it] like this. She said, ‘Just try to reduce how much you drink.’
Bryan [late 40s, Australian, unemployed but previously worked in business, no drinking in last three weeks] describes his plan to stop drinking now so he can become healthier and resume drinking in the future. (Read his personal story)
I’m only giving up drinking now so I can drink later […] That means I don’t want to have to go without alcohol for the rest of my life, but if I continue the way I have been lately, I’m going to be told at some point, ‘You cannot take a drink because you’ve wrecked your liver.’ I want to get well, so one day I can be a sensible drinker. Not in the short term, because I recognise that I need to be off the grog for quite a while, and I want to get my liver well if I can and things like that, but one day I would like to be able to have a few drinks.
Steve [early 60s, Indigenous, unemployed but previously worked in nursing, drinking less] explains that as he has gotten older he has cut back his beer consumption, and no longer drinks scotch [strong language]. (Read his personal story)
Now [my health is] a priority, because I’ve got to the age now where [it’s important]. I don’t get drunk any more. [Drinking] doesn’t take away all the stuff that [it used to] before. You get a couple of drinks, get happy and party and go home and you wake up and you’ve still got the same stuff, living rent free in your head, you know. You get to a time in your life where it doesn’t work. Now if I have a drink, it’s only to be social. I go to the pub on a Thursday night, because they have the badge draw. I know how much I drink too, you know. In a pub, I’m not knocking down 10 schooners in half an hour. I’ll sit on one for ages, you know. Like, you know, the … what’s the friggin’ point, you know? It’s a waste of time. I just go to the pub and have a chat to a couple of friends, put my bets on and then go home. I don’t drink in my house. I won’t [allow] alcohol in my house whatsoever […] I spent […] months in here, from an alcohol induced knock out. Three months I spent in here, it was terrible, blown [up] like a balloon, I couldn’t walk, I was yellow. They came and got my family to come over and they said ‘[… that I wouldn’t] make it’, but I did.
Although the men we interviewed describe the ways their drinking patterns have changed over time, change was still described as challenging and hard.
I’m sick and tired of the word abstinent. You’ve got to be abstinent. No, it’s a load of crap. There’s a lot more to being abstinent than just the word. The personal hell an alcoholic has to go through when he stops. It’s support and help, and I do find, the medical help that I’m getting has been successful for me. The support I’m getting from the hospital, I can’t fault it. And I’ve had a lot of experience trying to be abstinent. I hate the bloody word. I know it means to stop drinking. To stop drinking. How, mate? How do I stop drinking? You know, there’s a lot of questions to be asked and an alcoholic like myself is often intelligent and can hide it well as long as he doesn’t get smelled [laughs…] I’m not being nasty to people who are trying to help me, please, please, I’m not, I’m not that type of guy, but words like counselling, like the rehabs which I mentioned, I’ve spent quite a lot of time in rehabs. It’s really done nothing to me, but when you look at death in the eye and you know it, and there’s people out there keeping you alive and they want you to be healthy and they want you to do this, that’s positive.