Could you stop drinking if you wanted to?
The concept of 'Dry January' has shed a not-so-flattering light on the nation's drinking habits, and made many people ask themselves if they have issues with booze. Barbara McCarthy looks at the Irish drinker.
The annual dry January will soon be drawing to a close and those who are still booze-free can happily pat themselves on the back for displaying discipline and abstinence in the face of temptation.
Others may have had good intentions but fell off the wagon because of boredom, stress, a family event or in some cases, they just couldn't stick life without a drink.
As over half of adult Irish drinkers have harmful drinking patterns, it's difficult to distinguish between someone who just falls back into bad habits and someone who has serious issues around alcohol.
If you enjoy a 'well deserved' bottle of wine in front of the TV of an evening, a few civilised gins on a Saturday and a rake of pints on match days, you would be classified as a heavy drinker; but you would not necessarily be an alcoholic, despite your high-volume alcohol intake.
Meanwhile, your mate, who is currently kipping on your couch and arrives in your house with a four-pack of Polish beer of a Monday afternoon could be suffering from severe alcohol-related issues.
"The intake may be the same or less, but the outcome is completely different," says Gerry Hickey, a psychiatrist and counsellor for people with alcohol-related issues.
"The best way to tell if someone is an alcoholic is when their drinking interferes with their job, relationships, family and friendships. It's not about the quantity, but more about the effect it has on you."
"If you worry people's drinking could be affecting their lives, just ask the people who love them.
"They are the real victims of alcoholism because they have to deal with abuse, mental health and money issues and a host of other problems. In Ireland, 84pc of public order offences are alcohol-related, which is outrageous," he says.
"When I see a really drunk person, I don't think about how much they drank on the night or what they're saying or doing, I just think about the person they're going home to that night and what they may have to endure.
"Of the people who sit in front of me, 70pc have alcohol issues or are affected by people with alcohol issues. People who grow up in homes of alcoholics are more likely to be anxious and suffer from reactive depression and implications can be long standing."
One of the main problems with alcoholics is that their family are enabling them; even though they think they're not. They often dismiss their alcohol issues and brush them under the carpet.
"This happens among friends too," a male friend recently informed me. "A lot of men after the age of 40, to whom I count myself, who haven't been nailed down and don't have families, will find themselves becoming part of a tribe - consisting mostly of men with the same associations and wants.
"In many cases, these tribes drink a lot together and chances are they won't encourage each other to stop - in fact they'll do quite the opposite."
A lot of these tribesmen will drink a large quantity of booze four or five nights a week. But despite consuming 20 pints on Six Nations match days, most of these people won't be 'alcoholics' because they don't have dependency issues.
Neither does 'Jackie' who drinks an average of 45 to 60 units per week - consisting mostly of strong red wines and some vodkas and beers at the weekends. All in all, she drinks four times the suggested weekly limit for women, which stands at 14 units.
Frank Murray, professor at the Royal College of Physicians, says this amount of alcohol is way too much. "Drinking this amount regularly is highly lethal and can cause liver disease like cirrhosis down the line."
Despite the fact that she is a heavy drinker, neither she, nor most of the tribesmen are alcoholics, simply because they could stop if they really had to - "I will cut down this year. I'll start looking at labels and try to count my units. It's not done me any damage yet, but I just quit the fags so one thing at a time."
Murray says Jackie is one of the 1.3 million Irish people who are drinking dangerously, but doesn't seem to be aware of it. "Like many people who hold down jobs and families, buying a bottle of wine with the groceries is normal and it shouldn't be.
"Alcohol is not part of your five a day. We are drinking twice as much as we were 50 years ago."
The death rate among women from liver disease has doubled in recent years and the problem is that once the symptoms start to show, it's too late, he adds.
Despite her heavy drinking, Jackie has lots of other things going on in her life, whereas in many cases, someone with severe alcohol addiction issues doesn't.
Their lives more or less revolve around booze and they forego such things as travel, family, sports and work in favour of drinking.
A lot of them will have built up an impenetrable layer of denial, which allows them to exist in a state of blissful delusion.
From my experiences, the bigger problem they have with alcohol, the more they delude themselves.
They still talk about writing that book, starring in that movie or completing that work of art like it's imminent.
I call them the 'tomorrow people' - who happily spend their dole money on cheap beers today with the promise of taking on the world and doing all the things they want to do - tomorrow.
They seem to be oblivious that their health, looks, abilities and coherence are declining due to rampant alcohol abuse.
Many are now extremely dysfunctional and toxic to be around, which is extremely unhealthy for those closest to them.
According to Hickey, they have yet to hit rock bottom. People with severe alcohol issues often need to hit rock bottom before anything can happen for the better.
The only problem with that is that everyone has a different rock bottom. Some people's rock bottom is an embarrassing night at the local boozer involving a few too many vodkas or perhaps a drink-driving incident; while others lose fortunes, end up in the slammer, inflict untold damage on themselves and others and get up to go about their daily business without a care in the world.
I used to know a guy for whom getting arrested was a very regular occurrence. He even managed to get himself arrested at a friend's wedding only to wake up after the night in a drink tank and then go back to the wedding to be arrested again. I once saw him mixing vodka with sour milk in the morning time accidentally, and still drinking it.
It's sad to see such a level of abuse, especially because you know that family members have to suffer so much and there is little support available for the victims of alcoholics.
I also know someone who regularly falls asleep with a bottle in hand and wakes up with broken glass all around, still clenching onto the dangerous broken item. Oddly enough, when he wakes up on the floor, he just continues on his day.
It's sad to think that eventually he could end up on the streets, as some addicts do, simply because he is too difficult for family and friends to handle.
As an alcoholic, he is affecting between eight and 10 people directly. When you add up how many people that is in Ireland, you realise how much alcohol features in people's daily lives.
It's shocking when you look at websites about alcoholism in the US, you read such things as - "you could be an alcoholic if you set out to drink one glass of beer and end up having 10".
In Ireland, that's a normal night out. Only no one ever really plans to have just the one beer. That would be ridiculous.
Peer pressure is a huge part of our drinking patterns. When you look at the continent, people nurse their drinks. They have a much healthier relationship with drink.
In France, people enjoy one glass of wine for hours, while in Germany you can buy booze in bakeries and at the side of a road at 6am, yet it is perfectly acceptable to order a mineral water with apple juice in the pub without an inquisition from your mates.
It's not really our custom to get involved in people's lives. I have heard many a man say that his mate's alcoholism is none of his business, so let him have it.
In many cases, he will be a heavy drinker himself and would selfishly want to be around someone who drinks more in order to feel better about his own drinking.
Statistics from the World Health Organization show that alcohol is the world's leading risk factor for death among males aged 15 to 59. In Ireland, eight deaths every month are directly attributable to alcohol.
According to figures shown by Alcohol Action Ireland, more than half of 18 to 75-year-old drinkers are classified as harmful, which equates to 1.35 million people. The list goes on.
"We have drink issues here. Public drunkenness is acceptable, which is ridiculous" says Joe Barry, Professor of Population Health at Trinity College.
So, if you surmised that you may not be an alcoholic, it's probably best not to reach for the bottle of red on the supermarket shelf on a cold Monday night.
Heavy drinkers still cause themselves untold damage, even if they don't get arrested on a night out.
If you think you may need a break, buy one of those fancy Japanese teas instead. At the very least you'll thank yourself the next day.
Have you got a drink problem?
In a nation of drinkers, it's very difficult to distinguish when someone has a serious problem or just drinks too much. According to the World Health Organisation there are three types of drinkers:
- The hazardous drinker, who drinks above the recommended amount, but is not causing major problems.
- The harmful drinker whose drinking causes harm
- The dependent drinker, who is in denial about their drinking and will persist with a harmful pattern of abuse, despite health warnings.
Dr. William Flannery of the College of Psychiatry says the heavy drinker will often have interests outside of booze, but alcoholics often won't. "Of the 40pc of problem drinkers in Ireland only between 3 and 5pc have alcohol dependency syndrome, so there is a big difference," he says. "Serious alcoholism is 50pc genetic and 50pc what happens in your environment. Often events can trigger alcohol dependency issues. By binge-drinking over prolonged periods of time, we accelerate alcohol dependence," he adds. 75pc of alcohol consumed in 2013 was done so on a binge-drinking session. "Historically we drink too much. We drink the equivalent of a bottle of whiskey per week," he says. That's twice as much as what is considered healthy.
Psychiatrist Gerry Hickey says there are a number of defining factors which mean you are in trouble. "So you have to be honest with yourself and ask yourself or your friends and family members who have problems the following questions:"
1. What does your partner, sister, friend, mother make of your drinking? Ask them. You may not get the answer you want, but you will get the answer you need to make a change.
2. Could you stop if you wanted to? Be honest with yourself.
3. Have you caused harm or are you causing harm to people in your life?
4. Have you reached a point where you think it's time to change?
5. Have you hit rock bottom?
Health & Living