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Heavy drinking and health module

Further Perspectives on Alcohol

Perspectives on heavy drinking

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 we interviewed for this module describe many different experiences of and perspectives on drinking and its relationship to health and social life. Some participants use the terms dependence, addiction or alcoholism to describe their regular drinking. According to most participants, heavy drinking was dangerous and antithetical to good health. However, most agree that alcohol is difficult to avoid in daily life due to its availability and central role in Australian culture. For most of the men in this study, regular heavy drinking is normal, and, for some, pleasurable. A few participants also describe heavy drinking as a strategy to relieve emotional or physical pain. Their stories capture the ambivalence and complexity of their perspectives on alcohol and drinking. While regular heavy drinking was typically regarded as a problem that needs to be addressed in order to be healthy and live well, the social and pleasurable effects associated with drinking make finding this balance challenging (See Strategies to manage drinking).

Read on to find out more about how the men in this study perceive heavy drinking. We begin with the most commonly expressed perspectives, highlighting the key ideas and terms men use to describe their heavy drinking.

Addiction, dependence and alcoholism

Most men who took part in this study describe regular heavy drinking using the language of addiction, dependence or alcoholism. This is unsurprising given the participants had experienced health problems related to drinking, and had been in contact with alcohol or other drug treatment services. Definitions of addiction, dependence and alcoholism varied but typically they were related to ideas of repetition, craving, obsession, compulsion and loss of control. For example, Bryan [late 40s, Australian, unemployed but previously worked in business, no drinking in three weeks] explained that he experienced what he called ‘alcohol dependence’ because he needed alcohol every day and encountered physical symptoms (see Looking after health) when he didn’t drink. Here it is important to note that despite the inflexibility that typically characterises notions of addiction, all our participants described changing patterns of drinking over their lifetimes.

Arjun [late 30s, Indo-Fijian, unemployed but previously worked as a chef, no drinking in last six months] describes gradually drinking more each day and becoming ‘addicted’ to deriving ‘pleasure and comfort’ from his drinking. (Read his personal story)

And [my drinking] became gradually [heavier], meaning one or two glasses of […] wine or beer. It became more extensive than that [… up to three litres of wine and beer per day], having more and more of it, which then obviously you become addicted to that and I became addicted to that situation. So, I thought, you know, like, I couldn’t rectify it because I found the pleasure and comfort in [drinking], which was obviously detrimental to my health.

Anthony [late 50s, Australian, works in hospitality, no drinking in last three months], describes himself as an ‘alcoholic’ because he drank daily and experienced mental and physical cravings. (Read his personal story)

When [my alcohol use] became a problem, I was actually working in a [sports] club […] just up the road. So yeah you know, I would drink in the morning before I went to work and then I would drink during the day and I would drink when I went home you know […] Because I thought I had to, you know, because I was an ‘alcoholic’ […] I just needed [it] you know … not just like the physical craving, but the mental craving as well. If I didn’t have a drink, I would just be thinking about it all the time, until I actually had a drink.

Jakub [mid 70s, Polish, retired, drinking less], explains that although he had managed to moderate his daily drinking he was still concerned about the potential to lose ‘control’ and start drinking heavily again. (Read his personal story)

I think I will have a problem with alcohol even if I [do not] drink and, like now, it’s not affecting my life, but I still have to be aware about this [issue] because of what I was told [about my health condition]. I believe addiction is when you start to drink and after that, it is very easy to drink again and more often, more often, more often, and I know if I don’t drink, it’s okay, but if I will be in a situation where other people want to drink heavily, for sure, if I start to drink one beer, maybe I will drink two beers. After that, losing control.

Heavy drinking not consistent with good health

Another common theme in participants’ accounts of drinking was that regular and heavy drinking was inconsistent with good health (such as eating and sleeping well), and positive habits and routines (such as going to work and seeing friends and families) (For more information about how the men in this study do manage their alcohol-related health issues see Looking after health).

Steve [early 60s, Indigenous, unemployed but previously worked in nursing, drinking less] explains that, for him, heavy drinking had been associated with health issues such as coughing and vomiting, and took a toll on his personal relationships too. (Read his personal story)

I’m doing positive stuff now, whereas before [… when I drank more heavily] I selected [jobs] where I could drink. So I chose the job where I knew I could be sneaky, and that’s what alcohol does to you. It’s written in all the [Alcoholics Anonymous] literature. Cunning, baffling and powerful, and drugs are the same […] But the thing is, when you are using or drinking, you’ve got to top up. It’s like your car, you’ve got to put a bit of petrol in it every now and then and, you know, you wake up in the morning with the death rattles and you’re vomiting and what not, you’re cleaning your teeth and then you get the first beer down, ‘Aaaahhh that’s better’ and then you get the second one down, and now I’m laughing, now I can start work, and during the day, you sneak out and have another one and another one. It did bad stuff for me, it cost me two marriages. It didn’t cost me my children, but it cost me two marriages, and I was extremely lucky too, because the way we balanced our books up and, you know, the house, I could not hock [sell] the house.

According to Bryan [late 40s, Australian, unemployed but previously worked in business, no drinking in three weeks] heavy regular drinking was connected to chronic illness and financial stress. (Read his personal story)

Basically, I drank so much, it made me ill. My liver is playing up, my stomach is playing up. I’m sick of being sick, or sick of being drunk … not necessarily sick of being drunk, but sick of being sick, and I’d spent all my, what would you call it, my allotted money for playing, because there’s a certain amount that I will never go under because I worked hard for that money and I’m not blowing it. So, money was one thing. I racked up a $1000 credit card bill. I’ve never had a credit card bill in my life, and it was … half of it was drunken Uber orders and silly things like that. So anyway, I pulled some money out of my share fund and I paid my bill off. I got around it, you know. So, money was a big thing. The shakes were just horrendous, and one litre [of vodka] per day is just not sustainable.

Anthony [late 50s, Australian, works in hospitality, no drinking in last three months] also says regular heavy drinking meant he struggled to complete routine tasks such as cooking dinner. (Read his personal story)

No [I couldn’t have looked after my health when I was drinking], because I probably would [have] set fire to the place or something. I don’t know, I’d fall asleep or leave something in the microwave for too long and whoosh, the microwave [would overheat]. I would be too drunk to do stuff like that, you know. I would attempt it, but it wouldn’t normally […] end up very nice or something, or I’d put the wrong thing in.

The social aspects of drinking

The social aspects of drinking are another common theme in this study. Alcohol was typically described as ubiquitous to most social settings. It was readily available and cheap and hard to avoid. Daily drinking routines were also prompted by, and embedded in, everyday activities, such as work (or its absence), seeing friends and family, completing chores and relaxing. For our participants, the social nature of alcohol and drinking makes changing, renegotiating and managing drinking patterns more challenging and difficult.

Dylan [late 40s, Australian, unemployed but previously worked in construction, continuing to drink as usual and is on a methadone program], describes the ready availability and low price of some alcohol products affecting the frequency of his drinking. (Read his personal story)

Just because it’s everywhere … bottle shops, you know what I mean […] And you can get a cheap box of wine [for] $9. Yeah, when I was drinking bad, I was drinking wine. I don’t drink wine now, but yeah.

Arjun [late 30s, Indo-Fijian, unemployed but previously worked as a chef, no drinking in last six months] observes that heavy drinking was a regular and normalised part of his work culture. (Read his personal story)

The other thing about [being] a chef, is so when you clock off, [drinking is] kind of part of the package. You sit there and drink. So, hence, it really didn’t [… give me a break]. During work time and everything, I was sober, but I knew, ‘Okay, we’ll clock off, we’ll all get together, we’ll have a sit down and have a drink.’ So, that also didn’t help, but in the back of my head, I thought, ‘Hey, at the end of the day, I’m still going to have a drink.’ So, it really … that aspect of it didn’t help.

Like other men in this study, Wayne [late 50s, Australian, unemployed, continuing to drink as usual] finds it difficult to moderate his drinking because it is entwined with his daily routines, habits, chores and relationships. (Read his personal story)

No, I haven’t stopped drinking, but I’ve cut back, which is just has hard […] It’s like you crave a cigarette and you go outside and have a cigarette and you don’t think about it. I go home and have a glass of wine and don’t think about it. It’s just like part of your routine, part of what you normally. Do the dishes, clean up, have a sip of wine, cook dinner if I get round to it. Cooking for myself is kind of boring, but sometimes my [… ex-wife] is beside me, we live beside each other, so she’ll come over and see how I’m going and cook food for two of us, because she knows that I won’t do it for myself.

Steve [early 60s, Indigenous, unemployed but previously worked in nursing, drinking less] describes drinking as historically embedded in Australian social life. He explains how colonisation established drinking as a cultural norm, and points out that the ongoing harm of colonisation has negatively impacted on the health of Indigenous Australians. (Read his personal story)

Alcohol is the worst, because it’s the most accessible and […] it’s really sad because out of all the population in this country, the [Indigenous] people who own the land are the ones who are most affected by alcohol […] Like people who came from Europe […] they come out and they give them this and they get drunk and then they take advantage of them. You know, you see it so much.

Enjoyment and pleasure

Although participants describe serious health concerns and difficulties associated with drinking, they also speak of the enjoyment and pleasure they derive from it. Many of the men we interviewed were not employed in fulltime work and were managing serious health issues and related treatment. In this sense, while drinking was said to generally feel good and produce a ‘buzz’, the pleasures of drinking could sometimes provide relief from the very concerns around health participants experience related to drinking. These stories also tell us that pleasure and feeling good remain central to why men drink, even when heavy drinking can be considered ‘addictive’, unhealthy, dangerous, and for some, life-threatening.

Bryan [late 40s, Australian, unemployed but previously worked in business, no drinking in last three weeks], for example, describes the pleasurable change and ‘physical buzz’ drinking alcohol provides. (Read his personal story)

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 […] Like even my old man said, when I was a kid, he said, ‘You have one drink and you want to drink the world dry.’ I said, ‘Bloody oath!’ you know. And that’s just the way I am, like I’m a bit of an all or nothing sort of person. I would have a couple of beers or I’d rather have none. Give me 12, no problem […] I’ve always liked it. Like I’ve just loved to get smashed, you know. Am I hiding from something or do I have issues? Well, everyone has got issues, you know what I mean? So, I think 98% of my life, I’ve done it because I wanted to, you know what I mean, but I think in the last couple of years, I’ve been just … it’s just been a crutch. ‘Oh, good, it’s 4 o’clock, time to switch off. Everyone can go and stick it. I’m having my drink,’ do you know what I mean. Dinner can wait.

John [60 years of age, Australian, retired, drinking less] explains that he used to relax by drinking at home, listening to music and enjoying himself. (Read his personal story)

I escape. I escape reality […] Even recently, I would drink at home and I’d listen to music, and I would pretend I was the star singing, and alcohol fuelled that, and I quite enjoyed it. And I was telling everybody I enjoyed my own company because I had a drink, it relaxed me. It made me a little bit drunk, and I went into my fantasy land, you know. It was my form of escape. It always has been, always has been.