https://www.smh.com.au-By Sophie Aubrey
A lot of us wake up every year on January 1 and, perhaps feeling rather dusty, decide it’s time to break up with alcohol. The pledge usually doesn’t last long.
While we hear success stories about people who manage to give up the grog for good, or know people who take part in the month-long campaigns that come around each year – like Dry July and Sober October – for many Australians, it can feel unachievable.
A dry month is good, but better yet is a lifetime of drinking in a way that is cut back. Credit:Illustration by Dionne Gain
But there is a strong argument to be made for the value of simply reducing your alcohol intake – particularly following a year in which a fifth of us felt we drank more heavily than usual.
“A dry month can have benefits, but it’s better health wise to reduce your overall level of consumption … over a longer period of time,” says Professor Kate Conigrave, a University of Sydney addiction medicine specialist. “If you’re making a new year’s resolution, particularly with something as powerful as alcohol is to our brains, it really needs to mean something to you.”
Professor Nicole Lee, of Curtin University’s National Drug Research Institute, agrees: “I’m not suggesting we should all go alcohol-free. I like a drink on the weekend as well. But you want to be in control of your drinking so that you have the effects you want, rather than the alcohol being in control of you.”
The key is to figure out a realistic goal for yourself. Quitting alcohol isn’t easy. As Conigrave explains, it’s a sedative drug, so it dampens our body’s systems and brain activity, lowering our inhibitions and feels good. It also works on the reward centre of our brains, including our opiate receptors.
Conigrave helped develop Australia’s new alcohol guidelines, released in December, which state that adults should have no more than 10 standard drinks a week and a maximum of four in one day. The advice also stipulates that “the less you drink, the lower your risk of harm”.
Most Australians drink within the guidelines. According to the 2019 National Drug Strategy Household Survey, one in four drinkers consumed more than four drinks in one sitting at least monthly, and just under a fifth had on average more than two drinks per day. Interestingly, the proportion of drinkers (52 per cent) making efforts to lower their alcohol intake has never been higher.
Conigrave says that reducing is not an option for people with an alcohol addiction – in that situation, it’s best to quit altogether and seek professional help if needed.
But for others, even moderate drinkers (within the guidelines), Conigrave encourages trying to cut back. She says the reduction tactic means you can still have the perks drinking might bring you, but research shows you’re also up for a medley of health benefits.
Ahead, what you can expect to happen to your body and mind when you rein in your drinking, starting with the most immediate shifts to the longer term changes. And, of course, the more you reduce, the greater the below effects will be.
One of the first things you’ll experience when you ease your alcohol intake is better shut-eye. Conigrave says it’s common for people to drink to destress or to sleep, without realising it can make matters worse. “If you’re drinking regularly, your body pushes back against [alcohol’s] sedating effect by increasing the volume of your natural uppers – the NMDA receptors in your brain,” Conigrave says. “It’s just your body reacting: ‘I have a sedative on board, I’d better fight back’.”
So while alcohol may make you sleepy to start with, when it leaves your system the uppers are still working to keep you awake, Conigrave says. The balance of your REM and deep sleep gets disrupted.
When you cut down, Conigrave says sleep quality and duration should start to improve right away for a moderate drinker, noticeably so for a couple of weeks. People who were heavier drinkers (above the guidelines) may find their sleep is worse the first week, but then it continues to improve for up to a year.
If you’re making a new year’s resolution, particularly with something as powerful as alcohol is to our brains, it really needs to mean something to you.
Professor Kate Conigrave
Drinking alcohol may make you feel sexier at first because it shrinks your inhibitions, but when it gets down to it, you’re less likely to have satisfying sex, Lee says. Alcohol interferes with the hormones and chemicals that regulate a number of bodily functions including physical arousal, for example testosterone in men.
“Men who are heavy drinkers are less likely to get an erection … For women, when heavy drinking, they can lose interest in sex … It also has effects on lubrication and blood volume. We know from studies that orgasm takes longer and is less intense,” Lee says. “So when you reduce your alcohol intake, sex can become more enjoyable.”
Illness and injury
We know we can become quite uncoordinated when on the beers. So winding back the amount of alcohol you drink means you’re less likely to injure yourself, Lee says. “Not just with getting into car accidents or fights, but people are really clumsy when they’re drinking. You’re less likely to have minor or major injuries the less you drink.”
And of course, the hangovers the next day shouldn’t be as nasty, meaning fewer sick days at work, or fewer occasions where you’re working but feeling tired, unwell and unproductive.
Then, over the next month, your immune system can improve, meaning you shouldn’t be getting ill as often. Conigrave says if you’re regularly drinking heavily, it can suppress the function of your T cells, a type of white blood cell that plays an important role in helping your body ward off infection.
At first, it’s not always pleasant to cut down on alcohol. “The more you drink the more withdrawal symptoms you’re likely to experience,” Lee says.
If you’ve been a regular heavy drinker, your body has to work to readjust. Lee says you might feel restless, anxious, nauseous, sweaty, and you may experience vomiting, headaches and bad sleep. In severe cases, you need to consult a health professional.
You want to be in control of your drinking so that you have the effects you want, rather than the alcohol being in control of you.
Professor Nicole Lee
“It’s usually over within seven days or so, so if you can manage to get through that period you’ll feel a lot better and you’ll start feeling the other [positive] effects,” Lee says.
Moderate drinkers are unlikely to experience severe withdrawal symptoms when they cut down, but that’s not to say they won’t battle cravings. It’s about retraining your brain.
“Even people who have a couple of drinks a couple of times a week can find it difficult to change [the habit],” Lee says.
Even a little bit of alcohol can irritate your digestive system directly and cause acid reflux. At the top of our stomachs is a sphincter that Conigrave says acts like a “drawstring purse”. “Alcohol can relax that muscle and let the acid come up and burn the oesophagus,” she says.
If you cut down your drinking, your symptoms of reflux can immediately recover, but it might take inflammation about a week to settle down, Conigrave says.
The process of breaking down alcohol in the liver can damage the organ. That’s because, Conigrave says, one of the key breakdown products of booze, called acetaldehyde, can cause oxidative stress and trigger the body to attack its own cells in the liver. “But here we’re talking about six or more standard drinks a day or people who have a holiday binge,” Conigrave says. “Someone drinking within the guidelines shouldn’t have issues with this.”
The good news is that if the damage isn’t severe, the liver is usually quick to heal. “If there’s not permanent damage or scarring, even over two weeks your liver enzymes can come halfway back to normal.”
Alcoholic drinks contain more energy than many realise. It varies, but a serving of beer or wine can contain 400-500 kilojoules. It’s not insignificant when you consider the average adult should have 8700 total kilojoules in a day.
“So if you reduce [your drinking] … most people find they lose a little bit of weight,” Lee says, adding this can be noticeable within a month.
The influence on weight is not just thought to be the energy in booze itself, but also the behavioural effects of alcohol: it can make you more impulsive and more tempted by junk food.
“For some people, even one or two drinks, that bit of disinhibition can cause them to take on behaviours that affect their health, from unhealthy food to illicit drugs to cigarettes. So [curbing your alcohol] also helps you live the way you want to live,” Conigrave says.
Not to mention, when you drink less you’re more likely to engage in healthier behaviours. Saturday morning HIIT classes become less of a problem.
After about a month of lightened drinking, your mood will be improved, Lee says, as should symptoms of anxiety and depression. She explains that part of that is to do with getting more sleep and generally feeling healthier, and part of it is that alcohol reduces your ability to recognise and regulate your feelings because it hampers chemical messaging in the brain.
Every time the brain releases the feel-good neurochemicals, dopamine and serotonin, it takes time to rebuild those stores. But because alcohol releases a lot more dopamine and serotonin than usual, your stores are more quickly emptied and you can be left feeling flat or depressed, Lee says.
So while some people drink to relax or quieten unpleasant feelings, it can trigger a vicious cycle of exacerbated depression or anxiety and self-medicating with alcohol.
“[When people reduce their alcohol,] most find their thinking is much clearer, they can manage stress better, they feel less anxious and things are less likely to get them down,” Lee says.
Conigrave adds that the change in her patients can be “quite striking”.
Alcohol can lower your blood pressure at the time of drinking, then raise it 12 hours later. There are several factors thought to explain why, from alcohol’s effects on the kidneys, the nervous system, cortisol levels and body weight. If you regularly drink heavily, it can lead to sustained high blood pressure, or hypertension, which is linked to heart attack and stroke. Thankfully, Conigrave says, this is very reversible and can improve within about a month of decreasing the booze.
Other aspects of your cardiovascular system can also improve, including heart palpitations, heart rate and, in severe cases, heart muscle function.
We often consider drinking to be a social activity, but because it’s so disinhibiting, there’s a risk you’ll say or do something you might regret. By scaling back your alcohol, your social skills improve and your bonds can strengthen.
“Your social interactions are going to be much more in control and more deliberate,” Lee says.
Conigrave says it might at first feel strange to be catching up with a group of mates without a beer in hand, but you need to look past any simmering worry that you won’t be interesting or articulate enough.
“You’ll usually find you just ease into it and you are actually capable of more than you realise and you don’t need alcohol,” Conigrave says.
You’ll usually find you just ease into it and you are actually capable of more than you realise and you don’t need alcohol.
Professor Kate Conigrave
Plus, Lee says, if you’re drinking less, you’re less tired and stressed, and therefore more tolerant of loved ones.
Conigrave says heavier drinkers who cut down often notice major changes to their relationships. “[Patients] say things to me like they’re much more present for their kids, more patient, clearer thinking at work,” she says. “It all just comes down to becoming more successful, happier humans.”
Some of the most important health benefits from easing your alcohol intake are long-term. Your risk of getting cancer, in particular of the bowel and breast, rises with each standard drink you consume per day, Conigrave says, meaning it isn’t just heavy drinkers who are at risk.
“It’s quite dramatic,” she says. “That’s the chief reason for the guidelines.”
Other cancers frequently linked to alcohol are liver, stomach and pancreas, as well as oesophagus, mouth and throat, which are six times more common in drinkers than non-drinkers.
Changing and maintaining a new behaviour is really difficult, Lee says. It’s normal to have little slip-ups and not meet your drinks goal each week. Lee’s advice is to keep reminding yourself of the benefits.
“After you get some of the benefits and it becomes the new normal, you can forget how much weight you had on or how sluggish you felt,” she says.
Conigrave says peer pressure is often the biggest factor, and she recommends talking to the people around you so they don’t inadvertently work against you. And don’t be afraid to look to resources from SMART Recovery or Hello Sunday Morning for support. Your efforts will be well worth it.
If you need help, you can call the National Alcohol and Other Drug Hotline on 1800 250 015.