High Sobriety (16 page)

I try to imagine a ten-year-old alcoholic. My niece is nearly seven. The idea that in just over three years she could be chugging back bottles of Scotch is impossible to imagine. I wonder if he's trying to scare me. Is it really possible that a child could be ruined by booze by their tenth birthday? Perhaps sensing my scepticism, he tells me a story that eliminates any doubt. ‘We just admitted someone the other day who was wheelchair-bound at 24 from brain damage. Couldn't walk because the balance centres in the brain had been hit by alcohol, like a massive stroke. That's not a day or two of alcohol, that's probably ten-plus years. You extrapolate back and ask yourself, how the hell could this happen at 24? Well, he must have been drinking at 15, 16? No. He was drinking at ten. These consequences: you'll start to see them not at 35 but at 25, and you'll get this slow shift to younger ages of what are really chronic diseases — liver disease, cancer, brain damage; it will start to happen earlier and earlier. Young people are drinking earlier, and the proportion that is drinking heavily is climbing. We're going to reap the harvest of that in a period of five or ten years.'

He refers to a Victorian survey released last year that showed 42 per cent of 16- to 24-year-olds had drunk more than 20 drinks — almost three bottles of wine — in one sitting at least once a year. That's a massive night, even by my standards. More than half of them experienced blackouts: they got so pissed that they couldn't remember what happened. It's the stuff of parents' nightmares. But not every binge drinker will end up with a brain so saturated with vodka that they're confined to a wheelchair. What is it that turns a weekend party-animal into an addict?

‘You must have had this situation where everyone goes out and has a good time, but for the rest of the week no-one does it — except one friend, who then finds the next party, and the next party, and the next party. They're the ones who end up really sick, and rapidly moving along that pathway,' he tells me. ‘That's the most susceptible group, and the most difficult to treat because we really have to keep them and alcohol separate; they just can't really be exposed. For that group, even after a year of not using it, they are still likely to go back and become re-addicted. Even a year later, the brain is likely to be primed to want to go back to it.'

I'm suspicious as to why he mentions a year. Does he think that my brain is primed, and raring to go back to booze? I ask him how easy it is to move along the addiction pathway; he tells me that it's easier than most people realise. It's a subtle creep. The number of drinks in each binge steadily rises, and the gap between sessions gets smaller. At this point, mornings-after are no longer hangovers but mini-withdrawals, as the body and mind begin to crave more booze. Thousands of young Australians are drinking in this way, he says, largely on Thursday-, Friday-, and Saturday-night heavy sessions. Come Monday and Tuesday, they find it hard to function.

‘Essentially, what you're looking at is brain toxicity two or three days past the episode. This is really quite frightening in terms of economic performance for the country because how many people are out there accident-prone or not working as well because they've got this problem on Monday or Tuesday? Part of it is sleep and part of it is withdrawal — brain-chemical changes that have happened with the heavy intake. Young people are much more tolerant of the physical effects of alcohol, so they can drink more without becoming as intoxicated, and they don't get the warning signs of four drinks, six drinks, eight drinks. But their brains are much more susceptible to damage because they're still developing. The risk is that young people who binge drink will have impairment of subtle cognitive function as they grow older. If you expose the brain early, there's also the risk of the increased incidence of mental-health issues, particularly anxiety and depression, and an increased risk of drug and alcohol dependence later in life.'

I think of my own struggles with anxiety and depression, and, for the first time, consider whether they were exacerbated or even caused by my early binge-drinking habits. At 14 and 15, my friends and I would pair up and share bottles of Martini Bianco undiluted (we thought it was supposed to be drunk like wine) before heading out with our fake IDs to drink vodka and Coke in pubs. We'd often vomit; occasionally, one of us would pass out. We've all grown up to be healthy, and to have successful jobs and relationships. We're not like the brain-damaged alcoholics whom I've written about in
The Age.
But what Jon's suggesting is that my brain may have been changing in ways that I didn't even realise.

‘We're not talking about people dragging their knuckles and dribbling into their Wheaties. We're talking about subtle impairments, which means that you're at 95 when you could have been at 100 per cent,' he says. ‘Given how much effort so many mums put into ensuring what's best for their babies, it's just extraordinary that they'll have the kids drinking when all this work's gone into getting tutors and doing everything they can to optimise their chances at VCE or HSC. It's this misguided business of it being better to introduce them to alcohol in the family environment — there's not a lot of evidence that that works, and there's a reasonable amount of evidence that in fact it can be quite dangerous.'

But if heavy drinking as a teenager could set you up for problems later in life, what damage are you doing if you're still drinking that way at 35? ‘The issues of adolescence are about development, but at 35 it's about function. If you already have a predisposition to depression and anxiety, that can be significantly exacerbated by drinking. Conversely, if you do lots of drinking, you can precipitate depression even if you're not particularly that way inclined. In terms of waking up the next morning, it seems fairly clear that older people do not tolerate heavy drinking sessions as well.'

In the last couple of years, my hangovers had become increasingly mind-numbing; I'd often find myself at work on Monday or Tuesday morning with a brain that felt like half a kilogram of mince. On some level, I guess I knew that mince-brain wasn't a sign of optimal health, but there's something about hearing the words ‘brain toxicity' that leaves me cold. What has 20 years of drinking done to my wiring? I have joked about my head being a brain-cell graveyard, but I didn't seriously believe that I was inflicting lasting damage. In fact, as galactically stupid as it sounds, particularly for a health reporter, I've never really thought of alcohol as a drug. I'm reminded of my teetotaller friend Nick, who describes getting pissed as a delicate balancing act between drinking just enough poison to give you a buzz, but not enough to kill you. ‘For all the wine-tasting and brandy snifters and expensive cellars, it's essentially no different from sniffing petrol or chroming. It's just dressed up,' he said. ‘Can you imagine businessmen with plastic bags spraying paint and saying, “Why, yes, it's a 1954 Dulux. Yes, that was a good year. Is that the enamel? Ah, lovely.”'

As I mull over the potentially changed chemistry of my brain, Jon begins to ask questions about my habits. He wants to know if I've found myself drinking more in each ‘episode', as the years have passed. My ability to hold my liquor and be the last one standing has always been a source of pride; I thought it made me hardcore. I am Scottish, after all. He shakes his head and tells me it means that my tolerance has become so high through years of heavy drinking that I need to consume more to get the same effect of being drunk. I don't like where this is going. I came here to talk about the patients who visit his addiction clinic, not to discuss my nights out. But it seems that through his eyes, in some ways, he can't separate us. It dawns on me: he's taking a clinical history.

‘Have you ever blacked out through drinking?' he asks. I think back to Melbourne Cup Day last year — a barbecue at a friend's place that started at lunchtime and ended around 10.00 p.m. It was a laugh. Hats were compulsory: there was a chicken hat, a pig hat, a couple of trilbies, a straw boater, and one Saddam Hussein mask. I chose a See You Jimmy tartan bonnet with Viking horns. I drank champers, which is not my usual tipple, and by mid-afternoon I was hammered. The champagne is surely the only explanation for why I have very few memories of events after about 5.00 p.m., including of how I got home. Honestly, it wasn't the first time — I had a couple of those nights last year.

‘We know that multiple episodes of blackout is a significant risk of brain impairment, not to mention the risk of what happens when you're blacked out,' Jon tells me, with a look to suggest that only dumb luck has saved me from more serious consequences. ‘That sort of effect on the brain becomes worrying in a 35-year-old. One of the most interesting things about drinkers in the 30-to-40 age group is what has happened to their cognitive function: they often have the cognitive processes of a 60-year-old when they're only 40. They're tired in the afternoon, they don't have the memory they used to have, and they can't multi-process.'

The tips of my fingers are tingling. My mouth is suddenly dry. I have often felt like a geriatric when I'm struggling to string sentences together on a Monday morning. My short-term memory is woeful. When I ask him if he was shocked when he read about my binge-drinking double life, he doesn't sugar-coat his answer. ‘I'm not surprised that a health reporter would drink that much because the definition of addiction is the compulsive seeking out and using of the drug even knowing the negative health consequences. There's a total cognitive dissonance between what I do and what I know. You can know it all, but it doesn't stop you wanting it.'

Hold up. The definition of what?

‘Those levels [of drinking] and those effects you were experiencing, that's representative of subtle or mild pathology. You don't need to be Sherlock Holmes to see that it must have been taking a chunk out of your brain performance, and that's a worry because you want that performance at 60 or 80 — and if there's already impairment at the age of 35, what's going to happen in another ten years? That has a suggestion of incipient dependence. It's slightly pre-malignant addiction. Like pre-malignant cancer; it's cells that are not quite healthy. This isn't, “Oh gosh, she's an alcoholic,” but, “Gee, there are aspects there which are more than we would expect with somebody who hasn't got any issue at all with it.”'

There are certain phrases in life that you hope never to hear but will be forever seared into your memory, such as ‘Collingwood premiership' or ‘geriatric sex aid' or ‘pre-malignant addiction'. In that moment, my year without alcohol becomes more than just an interesting social experiment. What I have considered normal for years has a medical term. Like pre-cancerous cells that may grow to create tissue-destroying disease, my nights on the piss could be the precursors to alcoholism. If I already show signs of ‘incipient dependence', how many more beers will it take to reach my tipping point? Perhaps my editor was right: maybe I should never drink.

But I can't help wondering, is this doctor simply out of touch? A lot of my friends drink like this. I'm not even the biggest drinker in the group. Nobody can be expected to have no more than two standard drinks a day — that would be a very short night in the pub. The way I drink is normal.

‘There's a difference between normal and healthy,' Jon says, in a statement so profound that it seems to echo back at me in surround sound. ‘We have to ask ourselves if we are going to get, over time, a gradual increase in this being acceptable, and are we risking pickling the brains of future generations because we are setting them up with an environment where this kind of excessive drinking is more and more normal?'

I feel as if I've just been told the world is flat. I knew that I was drinking more than was healthy; I don't have to be chugging wine for breakfast to know that alcohol has a hold on me. When I tell him about my heroin-like chocolate habit, he says that this might also be indicative of an addictive predisposition. Suddenly, my treatment on
Kerri-Anne
seems a little less outrageous than I thought.

I don't want him to see how freaked out I am. Adopting an air of casual curiosity — slightly betrayed by the shrillness of my voice — I ask him what he thinks will happen if I go back to drinking at the end of the year. He describes the situation as being like an elastic band stretched out to its maximum point of tension. Eventually, it will prove too much, and the band will snap back. He suggests that I might want to try something called ‘controlled drinking', which he uses with patients who are not full-blown alcoholics but have dependency problems and need help to improve their drinking habits. Prior to going out, you nominate how much you plan to drink — preferably no more than four standard drinks, in accordance with the national guidelines — and stick to that. This is the template you always use. If, over a period of time, you find you're failing to stick to it, then it might be time to consider not drinking at all.

But if it were that easy, we'd all be sticking to the national guidelines. How many times have I heard friends say, ‘I'm not having a big night,' only to find that a couple of beers has turned into a 3.00 a.m. bender? Controlled drinking has one fundamental flaw — every beer chips away at the powers of reasoning and self-control you need to help you make good decisions. I find that once I have a taste for it, alcohol only gets more appealing as the night goes on. Perhaps abstinence is an easier choice.

Jon offers to conduct some tests: brain scans and neuro-psychological tests that may reveal whether two decades of binge drinking have damaged my brain's structure and function. He tells me that researchers now know the brain doesn't stop developing until well into our twenties, not in the late teens, as previously thought. Binge drinking from a young age may have had an impact on my neurocognitive development — particularly on the brain structures that transport the chemical serotonin, which regulates mood and memory. I'm curious about his offer, but also scared. I've sensed for some time that my brain is not working to its full potential, especially during those protracted hangovers. My memory is really bad, and my moods have been erratic from an early age, but I'd always presumed that was just my personality. Maybe some truths are best left unspoken.