Party on: Our growing love affair with alcohol

It’s party season and all too easy to let one drink lead to two and more. Keep an eye on your units and your body will thank you for it, says Áilín Quinlan.

‘TIS the season of good cheer and time to be merry — old pals arrive home from abroad, scattered families regroup, and having a drink is all part of the fun of catching up.

But what happens when one tipple becomes two — or three or more?

“We know that we have a ‘seasonal relationship’ with alcohol — we drink more at holiday times, particularly Christmas,” says Suzanne Costello, chief executive of Alcohol Action Ireland.

The root of the problem lies partly in our increasing culture of casual drinking, explains Dr Mark Rowe, a GP, lifestyle medicine expert, and author who believes that the Irish habit of casual tippling increases our tolerance for alcohol and paves the way for heavier drinking at peak social occasions such as Christmas.

Even the traditional offer of a neighbourly cup of tea during a social visit is increasingly being replaced by the pop of a wine cork, he says.

“People are now drinking at home. This is the new norm. The pot of tea has been replaced by the bottle of wine and there is a lot of recreational drinking which goes unacknowledged.

“A lot of people are not taking stock of how much they are drinking,” he warns.

“Wine has become the new tea and those few glasses of wine can add up to half a bottle a day which can be three bottles a week.”

Dr Rowe says alcohol consumption results in the release of endorphins and dopamine, both of which are pleasure-boosting, producing feelings of happiness or even euphoria, which, of course, is why we like drinking.

While alcohol intoxication can initially make us feel good, it can also make us feel depressed, argumentative, angry, and irrational.

Alcohol intoxication involves a small molecule called ethanol which disrupts the neurons in our brains, affecting their functioning, says neuroscientist and author Dean Burnett.

“Adding alcohol, even in small amounts, can be like pouring sand into delicate clockwork — you don’t need much before it starts becoming a pain.”

Alcohol powers down a lot of neurons. “The main ones it powers down are those in the prefrontal cortex — where the higher functions are handled, like impulse control, anticipation, risk assessment, analysis — which leads to reduced ability to worry or recognise problems/issues.

“It affects cerebellum neurons, which control movement and co-ordination. It hits temporal lobe neurons, where memory is processed effectively.

“To put it simply, because of the way it works, alcohol turns down the neurons responsible for our ability to worry, to make rational decisions, to walk normally, and to remember things.”

Alcohol also interferes with the beta-endorphin system. “Endorphins are the most powerful ‘pleasure’ chemical in the brain, causing the greatest amount of activity in the reward pathway. The presence of alcohol stimulates the release of these chemicals, which result in a chemical reaction leading to feelings of euphoria by stimulating the reward pathway, that part of our brains which produces pleasure, of all sort.”

Alcohol also seems to increase the concentration of dopamine in key areas involved with the reward system, says Burnett, which increases the feelgood effects further.

However, alcohol also has something called a “biphasic” effect which means the positive effects of intoxication diminish after you reach a blood alcohol level of 0.05%-0.06%, after which drinkers can experience a darkening of mood and a lack of energy.

As Rowe points out, the more regularly we drink, the greater our tolerance for alcohol, and therefore, the more alcohol we require on big sociable occasions to experience that same pleasurable kick. And so when Christmas arrives we tend to drink more to get the same pleasurable feeling.

But along with the feelgood sensations induced by alcohol, there are other reasons why we go from one drink to three or more — Christmas is also a time when we get together, connect, and renew friendships. And socialising in Irish culture is closely entwined with alcohol.

At times like Christmas, people may not necessarily be consciously looking for an excuse to drink, explains Marion Rackard, addiction counsellor, psychotherapist, and, as HSE project manager for the HSE alcohol programme, one of the drivers of the high-profile Ask About Alcohol campaign and website

They may be simply relaxing, having a good time, or connecting with old friends, but culturally, all of these, she observes, are closely associated with alcohol consumption.

“Christmas can be seen as an opportunity to have a really good time and party,” says Rackard, pointing to the drinking tradition of the 12 pubs of Christmas, which, she warns, encourages excessive consumption and has introduced a social norm around it. “It’s very hard to break this when people are in the loop.”

Our often harmful drinking culture seems entirely normal to us. “Alcohol has been around as almost part of the staple diet and we have tolerated harmful drinking in this country for generations.

“Alcohol consumption is increasing and the more people drink, the more harm done in society. We have tended to accept and tolerate that harm.”

Ireland is one of the heaviest drinking nations in the world. The amount we drink has more than doubled since 1960 and, according to studies undertaken by the Health Research Board, we significantly underestimate how much we drink, with many of us mistakenly perceiving ourselves to be ‘light’ or ‘moderate’ drinkers.

Some 75% of our alcohol is consumed as part of binge-drinking sessions, defined as drinking six or more standard drinks in one session.

We also, according to Ask About Alcohol, binge-drink more than most other countries — because this type of drinking is so commonplace in Ireland, we tend not to see it as a problem.

The latest statistics from the Healthy Ireland studies show that 39%-40% of drinkers binge-drink, and, on any occasion, will have six or more standard units of alcohol. The figures also show that more than half of drinkers, or 54%, drink at least once a week.

A typical binge-drinker seen by Dr Rowe is “a guy [who] says he only drinks at the weekend. He will go out on Friday night and have up to eight pints and on Saturday he goes out to watch the match and can start drinking at 1pm and not come home until 1am the following morning.”

Research shows that, along with all the other cultural factors at play, clever marketing can also play a big part in how much we drink. “There is no doubt that marketing has an impact on how we drink and what we drink and buy. There would not be so much money spent on marketing if it didn’t have an impact,” says Pat Kenny, senior lecturer at the DIT School of Marketing.

He says tens of millions of euro are poured into the advertising of alcohol every year. Research has shown marketing can convince people to switch from one brand to another, get them to drink or buy more of a product, and it encourages people who do not consume alcohol to start consuming, he says.

Kenny points to a 2009 study by researchers at Oxford Brookes University which found that data suggested an association between exposure to alcohol advertising or promotional activity and subsequent alcohol consumption in young people.

“There are a lot of longitudinal studies that track cause and effect over time, which show that people who have been exposed to more marketing of alcohol drink at a younger age and drink more — these studies would have been carried out in Europe, the UK, and US over the past 10 years to 15 years.”

While pointing out that there is no research specifically into the impact of marketing on drinking habits at different times of year, Kenny believes marketing can ‘nudge’ people to drink more at particular times a year. “The media also plays a role, so a combination of marketing and the media can encourage consumption at Christmas.”

In this context, he strongly welcomes the Public Health Alcohol Bill, which passed through the Dáil last October, and will pave the way for a variety of measures to be introduced, such as minimum unit pricing, cancer warnings, and segregation of alcohol sales in shops. The bill also restricts advertising of alcohol in places such as schools, playgrounds, sporting events, and in the cinema.

“We like to boast about how much we drink. Marketing plays a role in all of that and the new bill is a positive step forward,” says Kenny.

However, while Sheena Horgan, chief executive of Drinkaware, another organisation which campaigns against harmful drinking, says the organisation welcomes the bill, she emphasises that realistically, marketing is only one of several elements required to get the message about harmful drinking across to the public.

Drinkaware, which is funded by the drinks industry but which, says Horgan, is a not-for-profit, independently managed organisation, believes in taking a number of different approaches to the problem. “Our research shows that 95% of the population don’t even know what the guidelines are in terms of 11 standard units for women and 17 for men, or that a typical glass of wine is more than one standard unit.”

The Drinkaware website, which boasts more than 30,000 visits a month, says Horgan, offers a number of free tools to help people become aware of their alcohol consumption and cut down on harmful drinking.

These include free plastic measure-cups available from its website — 700 people ordered these last year. Drinkaware’s online drinks calculator was used by 25,000 people in November and December last year, says Horgan, adding that Drinkaware also offers information about alcohol consumption in the shape of a wheel which depicts how many units, grams of alcohol, calories, and sugar are contained in a measure of alcohol. The information about how many calories are contained in a pint of beer or a glass of wine can be a “great motivator”, she says.

“There is an awareness and a willingness to change, but it’s about converting awareness into action,” she adds bluntly.

“You have to give people the tools and the reason to do it. Our tools have been tested and checked against best practice.”

Converting awareness into action is how we can make that drink or two, and only that drink or two, an enjoyable part of the festive cheer.

How to tackle that hangover

ALCOHOL can disrupt the hormones that regulate our biological clock, which may be why a hangover can feel like jet lag, and vice versa. Alcohol can also trigger migraines, so some people may think they’re hungover when it’s really an alcohol-induced migraine they’re suffering.

However, according to Healthbeat, the newsletter of Harvard Health Publishing, there are some things we can do to help alleviate the pain of a hangover.

  • Drink fluids. Alcohol promotes urination because it inhibits the release of vasopressin, a hormone that decreases the volume of urine made by the kidneys which can lead to dehydration. And, if your hangover includes diarrhoea, sweating, or vomiting, you may be even more dehydrated. So although nausea can make it difficult to get anything down, even just a few sips of water might help.
  • Try some carbs. Drinking alcohol can lower blood sugar levels, so it’s possible that the fatigue and headaches of a hangover may result from a brain working without enough of its main fuel. Many people also forget to eat when they drink, something which can further reduce their blood sugar levels. So eating carbohydrates like some toast, with a glass of juice, is a way of getting blood sugar levels back to normal.
  • Try taking some aspirin, ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs). These may help with the headache and the overall achy feelings.
  • Drink tea or coffee. Although caffeine may not have any special anti-hangover powers, it is a stimulant and so can help with the grogginess. However, remember that coffee is a diuretic so don’t over-do it as it may exacerbate dehydration.

- Dean Burnett is author of The Idiot Brain and The Happy Brain

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