Heavy drinking and health module
Heavy drinking and health module
Preferred Name: Bryan
Bryan lives by himself in Sydney. His parents live close by and he sees them every other day. He describes his ethnic background as ‘Australian’. Both of his parents were born in Australia.
Bryan has been drinking heavily for the last six to eight years. Up until recently, he was drinking around a litre of vodka each day, but at the time of the interview he hadn’t had any alcohol for three weeks. Over the last few years he had accessed different kinds of treatment but found medication-assisted (Valium) home-based withdrawal most effective. Bryan recently found out he has the beginning of cirrhosis of the liver, and is taking a break from alcohol so that he can get his ‘liver well’ and ‘one day […] be a sensible drinker’.
Bryan started drinking on the weekends when he was fifteen. He says that from a young age he ‘was a drinker’ and ‘known as a drinker’. He likes alcohol, the ‘physical buzz’ he gets from drinking and getting ‘smashed’. When he was first made redundant 10 years ago, he partied a lot over the weekends with friends, drinking, and taking ecstasy, ketamine, speed and cocaine. Over the last six or seven years, however, he has drunk more at home by himself. Until his recent home-based withdrawal, Bryan was drinking up to a litre of vodka a day. While Bryan thinks that for ‘98% of [his] life’ he drank because he wanted to, lately he’s considered drinking a ‘crutch’. It has been harder to take care of himself and his parents, and get his daily chores done.
Over the last few years Bryan began experiencing issues with his stomach and liver. He started feeling sick a lot of the time and had intense bouts of vomiting, and thinks that he ‘drank so much, it made [him] ill’. He described one occasion where he presented to the Emergency Department at the hospital after vomiting ‘for about 12 hours’. After completing a week-long withdrawal program in the hospital, he was given a stomach medication that stopped him vomiting and made his stomach feel better. He subsequently completed several more hospital and home-based withdrawals but continued to drink heavily. Despite encouragement from the hospital and his local GP to enter a withdrawal unit again, Bryan prefers to withdraw at home because it’s less institutional. He’d prefer it if he didn’t have to ‘jump through hoops’ to access Valium to do home-based withdrawals. He thinks that when you ‘put your hand up’ for help, treatment services need to act quickly.
Bryan’s doctor recently told him he had the beginnings of cirrhosis of the liver. Bryan’s health has now become his ‘main motivator’ for not drinking. He recently did another home-based withdrawal and intends to avoid drinking for a while. Although he doesn’t plan on not drinking forever, he is currently enjoying eating and sleeping better, saving money and improving his liver health.
At the time of the interview, Bryan reflected that he ‘love[d] alcohol, but at the moment, it can bugger off’. As he put it, ‘I still love you, but I can’t live with you any more [laughs].
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.
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.
Bryan [late 40s, Australian, unemployed but previously worked in business, no drinking in last three weeks] describes the pleasurable change and ‘physical buzz’ drinking alcohol provides.
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.
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.
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’.
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.
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.
Bryan [late 40s, Australian, unemployed but previously worked in business, no drinking in last three weeks] explains how recently he has tried to stay busy. Mowing the lawns and cleaning the house gives him a sense of achievement which motivates him not to drink.
I love alcohol, but it is hurting me at the moment in numerous ways, so I’m motivated to stop that for a while, you know. Like I said, I haven’t even been counting the days of being off the grog. I’m happy to be off the grog. Like I said, now [in the interview] I feel a bit funny. But before that, yesterday for instance, I was actually saying … I was sitting in the kitchen having a cup of tea about half past three and a smoke, and I thought, ‘I’ve got such a[lot done] … this and this and this and this and this and this and this and this done today. If I was drinking last night for instance, none of that would’ve got done. So, this is good and I’m doing something.’ And I thought, ‘Yeah, good. I’m going to stay sober for a while.’ Maybe I was thinking about having a drink, I don’t know, but for now, I’m going to stay sober for a while. I’m not having any … this is all right. I’m getting shit done.
Bryan [late 40s, Australian, unemployed but previously worked in business, no drinking in last three weeks] went in for a cardiology problem and the doctor told him he had a fatty liver (from heavy drinking).
What happened was I have a family history of serious cardiology problems. Mum’s had a bypass and all that sort of stuff. So, I went to a cardiologist just to get it checked out and I had a … it was an angiogram, but an angiogram through the MRI, not through the traditional up the groin area. Then he told me I had a surprisingly good result. He told me, ‘I thought you were going to have a shit result […]’ and I said, ‘Just lucky, I guess, mate. I’m born to party!’ [laughs] you know. And he said, ‘Well, why don’t you use this opportunity of having a good heart result and just pull your head in a bit?’ He’s a bit of a lad [the cardiologist] […] And in the end, he said, ‘Right, now there’s something else that’s showing up.’ He goes, ‘We didn’t look at this, but they noticed it.’ He said, ‘Your liver, it’s showing that it’s got this and that, and there’s fatty tissue in that.’ He goes, ‘Basically, it’s saying you’re fat,’ and I said, ‘Well, thanks, doc’, you know. So, we sort of laughed and he said, ‘Why don’t you, you know, start pulling your head in a bit? You’ve had a good result. Try and use it as a positive’. So, he told me I had a liver problem and then I had a liver blood test, and I’ve been watching my blood test for my liver numbers to creep up over the last couple of years.
Bryan [late 40s, Australian, unemployed but previously worked in business, no drinking in last three weeks] explained that Valium helped him when withdrawing from alcohol and managing cravings, but felt his doctor’s perception of him would prevent further prescriptions.
I suspect [the doctor wouldn’t give me Valium because] from my local doctor’s point of view, it’s because I live in a high-risk area and I’ve told her that I’ve been a party animal for all my life. I’m 48 now and I’m still single and no kids. So, it gives you an idea of what kind of life I’ve led. I’ve always had good jobs, but I’ve always liked to party as well and, yeah […] She was worried about that, yeah. Because the other day [when] she said to me, ‘Now, how many have you got left?’ I said, ‘I’ve got one sleeve left.’ She said, because she only wants me to take it when I absolutely need it now, the few that I’ve got left over after the detox, which is fine. I understand that. I’ve been pretty good. I don’t know. I think they were worried that maybe I was going to go home and get on the piss and suck down some Valiums and get smashed, but I wanted to get well. It’s not a matter of access to drugs, it’s a matter of, ‘Bloody hell! I’m cooked.’