DRINKING MORE? AND WHAT CAN WE DO ABOUT IT? Dr SALLY HUNT RESEARCH - - PowerPoint PPT Presentation

WHY ARE (SOME) AUSTRALIAN WOMEN DRINKING MORE?

AND WHAT CAN WE DO ABOUT IT?

Dr SALLY HUNT

Prof Frances Kay-Lambkin1! Prof Maree Teesson2! Prof Tim Slade2! A/Prof Cath Chapman2! Dr Matthew Sunderland2!

1 The University of Newcastle! 2 The University of Sydney!

University of Newcastle Priority Research Centre for Brain and Mental Health!

RESEARCH COLLABORATORS FUNDING SOURCES

WHAT THIS TALK ISN’T

• ! Judgement laden (I hope)!
• ! A call to curb women’s rights and

freedoms!

• ! Implying that hazardous alcohol use by

men is any less important!

WHAT THIS TALK IS

• Providing information so that women can make an

informed choice about what they put in their bodies

• Acknowledgement that women have busy, stressful lives

and alcohol is part of that

• The reasons for use, physical impact and long term

consequences of alcohol differ between men and women so it is worth considering them separately

WHAT DOES HAZARDOUS DRINKING LOOK LIKE?

WHA WHAT IS A T IS A ST STAND ANDARD ARD DRINK? DRINK?

A D C B

AL ALCOHOL COHOL HEAL HEALTH TH GUIDELINES GUIDELINES

ARE AUSTRALIAN WOMEN DRINKING MORE?

• Historically harmful use of alcohol by men almost double that
• f women (3.8%:2.1%; ABS, 2007)

HIST HISTORICAL P ORICAL PATTERNS TTERNS OF OF AL ALCOHOL COHOL USE USE

Illustration by Claudine Ryan & Humyara Mahbub

CLOSING THE GAP

CLOSING THE GAP

• Men are drinking less

– Successful health messages – Lock out laws – Responsible service of alcohol

• Women are drinking more

– Change in traditional gender roles (Seedat et al., 2009) – Change in gender specific attitudes towards drinking (Kuntsche et al., 2011) – Change in drinking contexts & environments (Holmila et al., 2005)

REASONS FOR THE REASONS FOR THE CL CLOSING OSING GAP GAP

• Delayed motherhood
• Change in the mother role

WHY ARE WHY ARE WOMEN OMEN DRINKING MORE? DRINKING MORE?

• Work
• The myth of

balance

WHY ARE WHY ARE WOMEN OMEN DRINKING MORE? DRINKING MORE?

• ! Equality!

WHY ARE WOMEN DRINKING MORE?

!

• ! Social Media!
• ! Abundant permissive attitudes!

WHY ARE WOMEN DRINKING MORE?

• How much are women drinking?
• What motivates them to drink?
• How can we use this information to develop more effective

interventions and public health messages?

WHY W WHY WOMEN DRINK OMEN DRINK RESEAR RESEARCH CH QUESTIONS QUESTIONS

REASONS FOR REASONS FOR USE USE

To relax, to feel like a different person when I step out of the mum role when the kids are in bed I drink to release stress & feel better about my life

Socialising after work - I'm not that interested in drinking but people usually single you out and ask why not drinking (and often assume pregnancy as the reason), so I drink a small amount to avoid questions! To wind down in the evening. Have only been drinking since having a baby before that only socially

To relax and take my mind

• ff the

pressures of life

WHY IS INCREASED DRINKING A PROBLEM?

SHORT TERM CONSEQUENCES OF HAZARDOUS DRINKING

LONG TERM CONSEQUENCES OF HAZARDOUS DRINKING

WHY IS IT A CONCERN FOR NURSES?

PROFESSIONALLY

• Front line health care provision

WHERE DO WHERE DO NURSES NURSES FIT? FIT?

1 in 6

(17%) people consume alcohol at levels placing them at lifetime risk of an alcohol-related disease or injury

1 in 7

(15%) people have consumed 11 or more standard drinks at least in the previous 12 months

1 in 5

(22%) Australians aged 14 and over reported being a victim of an alcohol-related incident in 2016

1 in 4

(26%) people have consumed alcohol at levels placing them at risk

• f harm on a single occasion, at

least monthly

Australian Institute of Health & Welfare (2017)

• Front line health care provision

WHERE DO WHERE DO NURSES NURSES FIT? FIT?

In a sample of rural Australians only 11% of people with Alcohol Use Disorder (AUD) sought help for their AUD

Kay-Lambkin et al. (2014)

Delay to seeking treatment for AUD was 14 years

Kay-Lambkin et al. (2014)

This means that nurses in general health settings will see these patients long before drug and alcohol services do!

WHAT CAN YOU DO WHEN AOD ISN’T YOUR CORE BUSINESS?

• You would think that having a heart attack would be enough to

stop eating junk and become more active

• You would think that knowing about lung cancer would stop

people smoking

• You would think that losing your licence or custody of children

would stop people drinking

• If simply knowing something was harmful was all it took to stop

doing it then I’d be out of a job

• 1. CHANGE IS
• 1. CHANGE IS HARD

HARD

• People are usually ambivalent about

change – they want to stop and they don’t want to stop

• Harnessing this ambivalence is how we

encourage change

2.

• 2. AMBIV

AMBIVALENCE ALENCE

• The trick is to lead the person to their own good reasons for

change rather than tell them why you think they should change

• 3. PEOPLE ARE MORE
• 3. PEOPLE ARE MORE

PERSU PERSUADED BY WHA ADED BY WHAT T THEY THEY HEAR HEAR THEMSEL THEMSELVES SA VES SAY Y

• Therapeutic definition: “MI is a collaborative, goal-oriented style
• f communication with particular attention to the language of
• change. It is designed to strengthen personal motivation for and

commitment to a specific goal by eliciting and exploring the person’s own reasons for change within an atmosphere of acceptance and compassion” Miller & Rollnick (2012)

WHA WHAT IS T IS MO MOTIV TIVATION TIONAL AL INTER INTERVIEWING VIEWING? ?

“Helpers want to help, to set things right, to get people on the road to health and wellness. Seeing people head down a wrong path stimulates a natural desire to get out in front of them and say, Stop! Go back! Don’t you see? There is a better way over there! and it is done with the best of intentions, with one’s heart in the right place. We call this the RIGHTING REFLEX – the desire to fix what seems wrong with people and to set them promptly on a better course …”

Miller & Rollnick (2012)

THE THE RIGHTING RIGHTING REFLEX REFLEX

THE CLIENT’S THE CLIENT’S COMMUNICA COMMUNICATION TION TELLS US WHERE TELLS US WHERE THEY ARE IN THE THEY ARE IN THE CHANGE CHANGE PR PROCESS OCESS LOOK FOR OOK FOR CHANGE CHANGE TALK ALK & SUST SUSTAIN T AIN TALK ALK

CHANGE CHANGE TALK ALK SUST SUSTAIN AIN TALK ALK

OPEN QUESTIONS AFFIRMATION REFLECTION SUMMARY

CORE CORE MI SKILLS MI SKILLS

Engaging Focusing Evoking Planning

Settle in to a helpful conversation Find a useful direction Draw out people’s own good reasons to change

FOUR FOUR PR PROCESSES OCESSES OF OF MI MI

If they want to, support them to plan changes

WHY IS IT A CONCERN FOR NURSES?

PERSONALLY

• Look online for the Alcohol Use Disorders Test (AUDIT)
• Measure your alcohol use for a week
• Pay attention to particular times/situations when you drink
• Is it when coping with stress or negative emotions?

SELF SELF ASSESSMENT ASSESSMENT

• Has alcohol become the priority in your life?
• Has alcohol has taken control of your life?
• Have you found it difficult to stop using alcohol once you have

started drinking?

• Are you feeling guilty or concerned about your alcohol use?
• Are you requiring more alcohol to achieve the desired effect?
• Are others in your life expressing concern regarding your alcohol

use?

SELF SELF ASSESSMENT ASSESSMENT

• Is your participation in social and recreational activities reduced
• r stopped?
• Is alcohol your preferred activity or focus?
• Have you failed to follow up, or find it more difficult to co-
• rdinate your normal roles and responsibilities?
• Are there signs of alcohol withdrawal symptoms when you are

not able to consume alcohol? Withdrawal signs may include unexplained tremors, increased sweating, headaches, anxiety, diarrhoea or vomiting, and issues sleeping.

• Has your mood and motivation changed?

SELF SELF ASSESSMENT ASSESSMENT

• Try swapping alcohol for another stress reliever
• Do a “holiday from alcohol” experiment

– What changed? – What was alcohol doing for you? – What was alcohol doing to you?

• Sources of support to make a change

– GP – Drug and Alcohol Services – Online support e.g. www.eclipse.org.au (mention Sally Hunt in the contact us email and you’ll be sent a log in)

IF THIS RESON IF THIS RESONATES TES PERSON PERSONALL ALLY Y

WHA WHAT DOES THIS T DOES THIS ALL ALL MEAN MEAN AND AND HO HOW CAN WE W CAN WE ST STOP THE OP THE CL CLOSING GENDER OSING GENDER GAP GAP? ?

• Drinking isn’t seen as a problem by many
• Healthy lifestyles rather than an intervention targeting drinking
• Support well being and coping

strategies

• Improved public awareness of

health risks

WHA WHAT W T WOULD A GENDER OULD A GENDER SPECIFIC INTER SPECIFIC INTERVENTION VENTION LOOK OOK LIKE? LIKE?

WHAT’S NEXT? A GENDER SPECIFIC INTERVENTION

WELCOME TO THE CIRCUS

sally.hunt@newcastle.edu.au @sally_hunt