Alcohol abuse combined with social isolation can be lethal. It’s what killed my brother

Two of the most popularly underrated threats to the health of Australians are alcohol abuse and social isolation (with or without loneliness). Combine them and the synergy is devastating and lethal. It’s what killed my brother, Jason, the day after his 61st birthday.

Much is said and written about the effects of alcohol abuse on others – namely violence from or among abusers, dangerous driving, work accidents, alienating family. This is all valid, but the longer-term effects on health need greater consideration. These include gradual liver damage and the effects on the brain that may start with mild memory lapses but become much more significant later in life. Alcohol abuse also exacerbates or triggers long-term anxiety and depression by disrupting mood regulation and the balance of brain chemicals.

There are also the metabolic effects that promote fat accumulation, whole-body inflammation, insulin resistance and a higher risk of type 2 diabetes. The digestive system can become chronically inflamed, resulting in ulcers, pancreatitis and liver disease. My brother had debilitating diarrhoea in the last two to three years of his life, and he died with (but not because of) small bowel cancer.

Alcohol is also classed as a Group 1 carcinogen by the International Agency for Research (part of the World Health Organisation). Heavy alcohol use can increase the risk of contracting mouth, throat, oesophageal and laryngeal cancers by five times. Liver, colorectal and breast cancer risk also increases, as does pancreatic cancer when chronic pancreatitis has set in (as occurred with another dead brother, also a heavy drinker).

Often people split hairs on the defining points between a “heavy drinker” and an alcoholic. The term “functional alcoholic” is frequently bandied about, often jokingly. In my brother’s case, he was probably considered “functional” by doctors and colleagues only because he could hold on to a job (albeit often getting up 20 minutes before working from home). This was misleading, as absolutely nothing else was functional about his life – household management, health management, social connections or family and community interaction.

After living in the same area for 26 years, the names most often seen around his home were Dan Murphy, Jack Daniels and Charles Lindeman.

For the heavy drinker, the danger of social isolation is that there is no accountability. Heavy drinkers with plenty of social contacts either in or out of the home may tend to have at least some accountability to the times they drink, the amounts they drink, their behaviour, health, hygiene and day-to-day responsibilities – which may be for others, or even just themselves. These can all get lost for the heavy drinker in social isolation.

Perspective is lost – with time (“I’ll give up … soon”); with wellbeing (“I’m sick/not feeling well/I stumbled” as opposed to “I fell because I was drunk”); with limits to drinking, social behaviour and self-control. It is too easy to lie to other people about the scale and volume of the drinking, which in turn makes it easier for the drinker to lie to themselves.