This sheet provides general information about the health effects of alcohol, alcohol use disorder, and available treatments. It is intended for patients, carers, and anyone concerned about their drinking. It does not replace a conversation with your doctor.
How much alcohol is safe?
The Australian Alcohol Guidelines (NHMRC, updated 2020) state that to minimise the risk of harm:
- Adults should consume no more than 10 standard drinks per week
- No more than 4 standard drinks on any single day
- Certain people should avoid alcohol altogether — including pregnant women, those under 18, and people on many medications
What is one standard drink in Australia?
One standard drink contains
10 grams of alcohol. Examples:
- Regular beer (4.9%): 285 mL (a middy or pot)
- Full-strength beer (4.9%): 425 mL (a schooner) = 1.6 standard drinks
- Wine (13%): 100 mL (a small glass)
- Spirits (40%): 30 mL (a pub measure)
- Premixed RTD can (5%, 375 mL): approximately 1.5 standard drinks
The new evidence is clear: There is no "safe" level of alcohol when it comes to overall cancer risk. Even low-to-moderate drinking is associated with increased risk of several cancers, including breast, bowel, liver, and mouth cancers.
Effects of alcohol on the body and mind
Mental health
- Worsens depression and anxiety
- Disrupts sleep architecture (lighter, less restorative sleep)
- Increases impulsivity and risk-taking
- Can trigger or worsen psychosis (alcoholic hallucinosis)
- Associated with suicidal thoughts and self-harm
- Contributes to memory impairment over time
Liver
- Fatty liver (reversible with abstinence)
- Alcoholic hepatitis (serious, sometimes fatal)
- Cirrhosis — permanent liver scarring
- Increased risk of liver cancer
Cardiovascular system
- Raises blood pressure
- Increases risk of atrial fibrillation ("holiday heart")
- Dilated cardiomyopathy (weakened heart muscle)
- Stroke (ischaemic and haemorrhagic)
Nervous system
- Peripheral neuropathy (tingling, numbness in hands/feet)
- Wernicke–Korsakoff syndrome (severe thiamine deficiency)
- Cerebellar damage (balance and coordination problems)
- Seizures during withdrawal
Gastrointestinal system
- Gastritis and peptic ulcers
- Pancreatitis (acute and chronic)
- Oesophageal varices (in cirrhosis)
- Increased bowel cancer risk
Other effects
- Malnutrition (including vitamin B1/thiamine deficiency)
- Increased cancer risk (breast, oral, pharyngeal, oesophageal)
- Immune suppression — more infections
- Sexual dysfunction and fertility effects
- Skin — rosacea, spider naevi
What is alcohol use disorder?
Alcohol use disorder (AUD) is a medical condition characterised by a pattern of drinking that causes significant distress or impairment. It exists on a spectrum from mild to severe, and it is more common than most people realise — affecting approximately 1 in 5 Australian adults at some point in their lives.
Indicators that may suggest AUD include:
- Difficulty cutting down or controlling alcohol intake
- Strong cravings or urge to drink
- Needing more alcohol to get the same effect (tolerance)
- Experiencing withdrawal symptoms when drinking stops (sweating, shakiness, anxiety, nausea)
- Alcohol use causing problems at work, home, or in relationships — but continuing anyway
- Giving up activities you used to enjoy in favour of drinking
Alcohol withdrawal — why it matters
Unlike withdrawal from most other drugs, alcohol withdrawal can be medically dangerous — even life-threatening. In people with moderate to severe alcohol dependence, sudden stopping can cause:
- Severe anxiety and agitation
- Seizures (usually within 24–48 hours of last drink)
- Delirium tremens (DTs) — a serious state of confusion, fever, and hallucinations (usually 48–72 hours)
- Dangerous fluctuations in blood pressure and heart rate
Do not attempt to stop heavy daily drinking suddenly without medical supervision. Please discuss with your doctor before making any changes. If you experience seizures, severe confusion, or hallucinations, call 000 immediately.
Treatments for alcohol use disorder
Medically supervised withdrawal
For people who are physically dependent, the first step is usually a structured withdrawal (detoxification), either in a hospital, residential facility, or — in some cases — at home with close medical supervision. Medications (typically diazepam) are used to manage withdrawal symptoms and prevent seizures.
Medications to support recovery (pharmacotherapy)
- Naltrexone — reduces the pleasurable effects of alcohol and decreases craving. Available as oral daily tablets.
- Acamprosate — helps reduce cravings, particularly in people who have achieved abstinence. Taken three times daily.
- Disulfiram (Antabuse) — causes an unpleasant reaction if alcohol is consumed. Occasionally used under close supervision in motivated patients.
- Baclofen — used in some patients, particularly those with liver disease where other medications are difficult to use. Use is monitored carefully.
Other medications — further discussion required: Several additional agents are used in certain clinical contexts and may be considered depending on your individual circumstances. These include:
- Topiramate — an anticonvulsant with emerging evidence for reducing heavy drinking days and craving. Not TGA-approved for AUD in Australia but used off-label; requires careful monitoring for cognitive side effects and is not suitable for everyone.
- Gabapentin — sometimes used to manage alcohol withdrawal symptoms and post-withdrawal sleep disturbance, and has some evidence for reducing relapse. Requires careful monitoring given its own potential for dependence.
- GLP-1 receptor agonists (e.g. semaglutide) — emerging research suggests these agents, primarily used for diabetes and weight management, may reduce alcohol cravings and consumption. Evidence is still developing and use for AUD is not yet standard practice.
- Varenicline (Champix) — primarily a smoking cessation agent, it has shown benefit in reducing alcohol consumption in some studies, particularly in people who also smoke.
If you are interested in any of these options, please discuss with Dr Kenchaiah at your appointment. Suitability depends on your medical history, other medications, and treatment goals.
Psychological therapies
- Motivational interviewing — helps you explore your own reasons for change
- Cognitive Behavioural Therapy (CBT) — addresses patterns of thinking that drive drinking
- SMART Recovery groups — secular, science-based peer support
- Alcoholics Anonymous (AA) — 12-step peer support for those who find it helpful
Thiamine (Vitamin B1) supplementation
People who drink heavily are commonly deficient in thiamine (Vitamin B1), which is essential for brain function. Supplementation is routinely recommended — ask your doctor about this if you have not already discussed it.
What about reducing rather than stopping?
For some people, a goal of reducing alcohol intake to within safer limits may be more achievable than complete abstinence — at least initially. This is a valid approach and can still significantly reduce health risks. Your doctor can help you set goals that are realistic for your situation.
For people with severe alcohol dependence or serious health complications, complete abstinence is typically recommended.
Support services
- National Alcohol and Other Drug Hotline: 1800 250 015 (24 hours, free)
- SMART Recovery Australia: smartrecoveryaustralia.com.au
- Hello Sunday Morning (Daybreak app): Online community and app for people wanting to change their relationship with alcohol
- Turning Point: turningpoint.org.au
Questions?
Please bring your questions and concerns to your next appointment. You can also contact the rooms on 03 9834 3600. There is no judgement here — seeking help is the most important step.
Clinical content informed by: the National Health and Medical Research Council (NHMRC) Australian Alcohol Guidelines (2020) for standard drink definitions and recommended limits; and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, American Psychiatric Association) for diagnostic criteria. NHMRC guidelines available at nhmrc.gov.au.