Addiction  |  Anxiety and Depression  |  World Mental Health Day 2020

Bottoms Up! How Much is Too Much?

BY DR ANDREW PEH LAI HUAT

13 October 2020  |   5 min read

During the circuit breaker, it was reported that the sales of bottled alcohol, such as wine, increased significantly. To avoid health complications from excessive alcohol consumption, it is helpful to be able to distinguish between sensible and hazardous drinking.

A Singapore Mental Health Study (2016) found that the lifetime prevalence of alcohol abuse and alcohol dependence is at 3.1% and 0.5% respectively.

With a prevalence rate of 10%, binge drinking is common and equally prevalent in both genders. It is especially common in young adults, ranging from 18-29 years old.

Effects of alcohol

Alcohol has effects on the central nervous system, circulatory system, and gastrointestinal system. It also affects the kidneys, temperature regulation, and interacts with other drugs.

Alcohol can temporarily alleviate feelings of anxiety and depression. It is often used by individuals as a form of ‘self-medication’: an attempt to cheer themselves up or help with sleep. But it can, instead, make existing mental health problems worse.

Individuals who consume high amounts of alcohol have shown an increased risk of developing mental health problems. It can also disrupt sleep patterns, leading to reduced energy levels.

Regular consumption of alcohol also decreases the brain’s level of serotonin — an important chemical that regulates mood. This leads to one feeling even more depressed.

Individuals who consume high amounts of alcohol have shown an increased risk of developing mental health problems. It can also disrupt sleep patterns, leading to reduced energy levels.

Alcohol use

One standard drink (10 g alcohol) is equivalent to:

  • 425 ml of light beer
  • 285 ml of regular beer
  • 120 ml glass of table wine
  • 60 ml glass of fortified wine
  • 30 ml of spirits

Generally, individuals should limit themselves to not more than 2 standard drinks a day, with at least 2 alcohol-free days a week. Women have a lower threshold for safe drinking.

Binge drinking refers to the consumption of 5 or more drinks for men, and 4 or more drinks for women, on a single occasion. This is generally within a period of 2 to 3 hours.

Most people picture problem drinking as having to drink daily and not being able to function without a drink. However, binge drinking and routinely excessive alcohol use can also have long-term consequences.

The CAGE Questionnaire can be used to screen for alcohol use disorder (AUD):

  1. Have you ever felt that you should Cut down on your drinking?
  2. Have people Annoyed you by criticizing your drinking?
  3. Have you ever felt bad or Guilty about your drinking?
  4. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (Eye-opener)?”

The screen is positive if there are 2 or more “yes” responses to the CAGE questionnaire (for the elderly, 1 “yes” response)

Signs and symptoms of AUD

The symptoms of alcohol use disorder span a wide variety of problems and impairments arising from alcohol use:

  1. Taking the substance in larger amounts or for longer than intended
  2. Failing to cut down or stop using the substance despite wanting to
  3. Spending a lot of time getting, using, or recovering from the use of the substance
  4. Cravings and urges to use the substance
  5. Not managing to do what you should at work, home, or school, because of substance use
  6. Continuing to use, even when it is causing problems in relationships
  7. Giving up important social, occupational, or recreational activities because of substance use
  8. Continuing to use the substance despite it putting you in danger
  9. Continuing to use despite the knowledge of a physical or psychological problem that could be caused or made worse by the substance
  10. Needing more of the substance to achieve the intended effect (increased tolerance)
  11. Development of withdrawal symptoms, which is relieved by further use

Complications from excessive alcohol use

These include:

  1. Medical – hypertension, cancer, liver cirrhosis, brain damage, birth defects, malnutrition
  2. Psychological – disturbed sleep patterns, sexual dysfunction, anxiety, depression, poor memory, withdrawal symptoms
  3. Social – family conflicts, troubled relationships
  4. Occupational/academic – absenteeism, decreased productivity, workplace accidents, a decline in school grades
  5. Financial – loss of income
  6. Legal – drink driving

Where to seek help & types of treatments

See your family doctor for an assessment, support, and advice.

Other avenues of help for alcohol use disorders include:

  1. Alcoholics Anonymous (AA) – Tel: 8112 8089
  2. WECARE Community Service – Tel: 6547 5459
  3. National Addiction Medicine Services (NAMS) – Tel: 6389 2200
  4. CGH Addiction Medicine Clinic – Tel: 6850 3333

Learn more about Addictions this World Mental Health Day!

The workshops on Managing Addictive Behaviours is designed for family members whose loved ones are actively in addiction. Understand the addictive behaviours in adult and youths and develop coping strategies to adjust support for your addicted loved ones. 

The contributor is a Senior Consultant of Psychological Medicine at Changi General Hospital and CGH ASCAT.

Header image by Canva.