Have you been accused of not having an off switch when it comes to alcohol? Do you drink more than you planned? Do your friends or family joke about your drinking habits? Or maybe you accuse others of being boring when they don’t drink. These behaviours, though normalised in social settings, might indicate something deeper — alcohol-use disorder (AUD).
As the festive season arrives, these questions may resonate. AUD is a medical condition that makes it hard to control drinking, even when it impacts relationships or health. It's not alcoholism but exists in a "grey area" of problematic drinking. As one friend puts it: “When you’re nursing a hangover on the sidelines of your 10-year-old son’s football match, hoping no one notices.”
What is Alcohol-Use Disorder?
According to the British Medical Journal (BMJ), AUD is a “problematic pattern of alcohol use leading to significant impairment or distress.” Unlike alcoholism, which involves a compulsion to drink, AUD can range from mild to severe.
“Alcohol-use disorder sits on a spectrum," explains Sir Ian Gilmore, a professor of hepatology. "People with AUD don’t necessarily drink daily — they can go weeks without a drink. It’s the number of symptoms that defines its severity."
Genetics often play a role. Gilmore notes, “It’s common to see AUD run in families, even among twins raised apart.” Cultural attitudes toward drinking also contribute. Celebrations often centre on alcohol, while non-drinkers are seen as "killjoys." Messages like "wine o’clock" normalise heavy drinking, especially among women juggling work and parenting.
Drinking Habits in New Zealand
While New Zealanders drink less than many other OECD countries, binge drinking remains an issue. A Health Survey reports that 84% of adults drink responsibly — a 3% improvement over the previous year. However, midlife binge drinking persists, often disguised as "social fun."
One friend, a 46-year-old solicitor, shares, “I can go weeks without drinking, but when I do, I binge. It’s been my pattern since my twenties.” Another parent confesses, “Friday playdates often become wine-fueled. The next day, I feel hungover, anxious, and guilty about my parenting.”
Data shows the highest alcohol consumption occurs among those aged 45-64. Middle-class, midlife drinkers often fall into the "at-risk" category without realising it.
When Does Drinking Become “At-Risk”?
“Ask yourself: Is your drinking causing physical, mental, or social harm?” says Gilmore. Warning signs include:
Underperforming at work
Missing events due to hangovers
Accidents caused by alcohol
Persisting in harmful habits despite negative consequences
The risks of AUD extend beyond hangovers. Short-term effects include anxiety and sleep issues, while long-term risks include high blood pressure, heart disease, cancer, and poor mental health.
Steps to Cut Back
If you’re ready to reassess your relationship with alcohol:
Try no-alcohol or low-alcohol alternatives.
Swap alcoholic drinks for water during social events.
Set boundaries with drinking companions.
Identify and manage your triggers, whether it’s stress or social pressure.
Do You Have Alcohol-Use Disorder?
The American Psychiatric Association identifies the following criteria. Agreeing to 2-3 suggests mild AUD, 4-5 moderate, and 6 or more severe:
Drinking more than intended.
Persistent attempts to cut back.
Spending excessive time on drinking-related activities.
Craving alcohol.
Neglecting obligations due to drinking.
Continuing despite social or personal harm.
Reducing activities to accommodate drinking.
Drinking in hazardous situations.
Continuing despite physical or psychological harm.
Developing a tolerance.
Experiencing withdrawal symptoms.
If these signs resonate, it’s time for a change. This season, pause and reflect—your health and happiness depend on it.