NHMRC's new alcohol guidelines – what do they really mean?


Professor Jon Currie

6 March 2009

How much alcohol can you drink before it starts posing a risk to your health? Should different people set different limits? And what is the sliding scale of risk if you do drink?

Professor Jon Currie is Chair of NHMRC's Expert Working Committee on Alcohol Guidelines. Here he explains to Marilyn Chalkley that the new guidelines are not so much trying to tell people what they can or can't do, as provide information so people can make their own choices about what they drink.

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Transcript of podcast

Voice-over: Welcome to this National Health and Medical Research Council podcast. Our podcasts aim to keep you in touch with major health and medical research issues and the people who shape them.

Introduction: Hello I'm Marilyn Chalkley. How much alcohol should you drink to reduce the risk to your health? The new Australian Alcohol Guidelines to reduce health risk from drinking have just been released and they recommend no more than two standard drinks a day for women and men.

Professor John Currie from St Vincent's Hospital in Melbourne and Melbourne University was the Chair of the NHandMRC Committee that has spent the last three years working on the guidelines.

Interviewer: Professor Currie thanks for talking to us today. What are the major changes that you see in these guidelines from previous guidelines?

Prof. Currie: The new guidelines which we're just releasing have several important changes in them. The first is that we have taken a new concept which is looking at what is the risk to you over your lifetime if you drink at a certain pattern, that is a certain number of drinks per day or a certain number of times per week, and we've tried to define what your risk of accident, injury or alcohol related disease is over your lifetime. We're not trying to tell you how much you can drink, but what we're trying to tell you is what is the risk so you can make an informed choice about how much you want to drink. And the guidelines reflect this. The first guideline says that for healthy men and women no more than two standard drinks on any one day reduces the risk of accident, injury or disease to under one in a hundred and we feel most people would accept that as a reasonable risk.
The second guideline looks at what happens on any single occasion if you drink and that is the risk of accident or injury related to drinking on that occasion and it is evident that if you drink more than four standard drinks on any one occasion your risk of accident or injury rises dramatically.

Interviewer: Now that's a guideline that people might find a little hard to understand at first because they might say well what do you mean by a single occasion, I mean how long is the amount of time that I can have my four drinks in. How would you define that?

Prof. Currie: Right, the single occasion is defined really as a period where you drink and your blood alcohol does not reach zero. So it could occur over a number of different settings, you could move from place to place, it could occur in your home when you're having dinner in the evening but the point is that if you drink more than four drinks and your blood alcohol does not reach zero between those drinks then above the four your risk increases dramatically for accident and injury and this is what we're trying to advise people about in terms of their safety and the safety of the people they're with.

Interviewer: So roughly how long does it take for your blood alcohol level to return to zero?

Prof. Currie: Well obviously it depends on how much you've drunk, what your situation is that you've been drinking in, relationship to food and the absorption of the alcohol, but reasonably over a period of six hours we would look at the period of six hours being one in which we would try and have the four drinks taken. So we're not talking about four drinks in an hour or four drinks in 15 minutes, we're talking about over a period of probably about six hours.

Interviewer: How do you think that people will find these guidelines, how realistic do you think it is for people to drink at these levels?

Prof. Currie: Well, a large number of Australians already believe that they probably are drinking too much and that these guidelines are ones that they are willing to listen to in relation to their health. Obviously some people drink much more and what we are hoping is that they will be able to make decisions based on evidence rather than just accepting what is popular culture, because in fact popular culture differs quite considerably from what people actually believe so surveys have shown that a majority of Australians believe that these levels of two drinks on a daily basis or four drinks on an occasion, are actually ones that they can recognize as sensible in relation to the risks to their health.

Interviewer: And one of the guidelines that is really a little different from previous cases is that you're recommending that people under 18, young people under 18, don't drink anything at all. Now some parents might find that hard to persuade their charges under 18 to carry out.

Prof. Currie: Again what we're looking at is presenting evidence so that people have factual bases on which to recommend things to their children or to in fact encourage them to recommend for their own drinking. And the evidence suggests very strongly that young people under the age of 18 are at the greatest risk of harm from drinking alcohol and in particular that young people will engage in risky activity and have much greater risk of accident or injury if they do engage in drinking. The other thing is that for young people the brain development is still progressing and for those who drink at an early age the risk later on of alcohol related illnesses, alcohol related mental health problems, increases quite significantly compared with not drinking.

Interviewer: And pregnant women… you're also recommending no drinking for women who are breast feeding or pregnant.

Prof. Currie: Yes, this comes back again to this question of risk. What we are trying to do is give advice on how to reduce risks so the question was asked: well, what is a safe level for pregnant women? And the answer is, we cannot define any level of drinking which can be guaranteed to be safe. In other words even low levels of drinking of several drinks a week may have some affect on the unborn child and so the safest option is actually to recommend not drinking during pregnancy and not drinking during breast feeding. Now this doesn't mean that if someone's had a few drinks and then find they're pregnant there is an obvious risk to the baby in fact there is probably a very low risk. But what we are saying is that if you are planning a pregnancy or wanting to become pregnant it is worth considering taking measures to actually stop drinking throughout the pregnancy.

Interview: And finally, how will the guidelines be used, Professor Currie?

Prof. Currie: The guidelines themselves, the Government, the NHandMRC are not telling you what you can or can't do in relation to drinking. The aim of the guidelines is to give you information so that you can make your own informed choice about how much risk you're willing to take in relation to your health when you drink. And what is very clear is that if you stick to no more than two standard drinks on any day it will keep your risk of harm from alcohol related diseases, alcohol related accident and injuries to under one in a hundred, and we believe this is a level which most people would accept as a reasonable health risk and one which they're prepared to work with.

Interviewer: Professor John Currie I really appreciate talking to you today about the alcohol guidelines to reduce health risks from drinking which have just been released by the NHandMRC.

Voice-over: This podcast was brought to you by the National Health and Medical Research Council working to build a healthy Australia. You'll find more information about this and other health and medical research issues on our website at www.nhmrc.gov.au.