There is no doubt that alcohol has some good characteristics when enjoyed in moderation, such as its relaxing effects and the almost inextricable connection with family and social events.
However, as with most good things in life, one can sometimes have too much.
Long-term overconsumption of alcohol can lead to many harmful effects.
Alcohol has been called the "great mimic of disease" and can affect every part of your body, from your skin to your bone marrow, causing up to 60 different diseases.
It is estimated that alcohol is directly responsible for approximately one fifth of all hospital admissions - not just because of intoxication, but because of strokes, heart disease, liver disease, cancer, depression, suicide attempts and road traffic accidents.
World-renowned researcher Prof David Nutt and his colleagues concluded that alcohol was more harmful than so-called "hard" drugs such as heroin and methamphetamine.
When they considered the harms caused to the user and the harms caused to others, including family and community, alcohol was ranked the most harmful drug by a large margin.
How is it that this cheap, readily accessible and well-advertised beverage can do so much damage?The Community Alcohol and Drug Service (CADS) in Dunedin sees about 800 new referrals each year from around Otago.
However, this is only the tip of the iceberg and includes only the most severely alcohol or drug-affected individuals with what is described as problem substance use.
Most referrals to this specialist addiction service are for problems related to alcohol.
It's not just the consumption of alcohol that constitutes harm, but the consequences of heavy drinking for the drinker and for others.
For those who drink too heavily for too long, other problems become evident, including severe depression, major anxiety and almost invariably marked physical changes to the body.
Finances, work and relationships with family and friends are also adversely affected.
For some people, there is evidence of brain damage, including the development of a true dementia - just through drinking alcohol.
Alcohol can also cause or aggravate a large number of physical illnesses. The liver can be directly affected by inflammation, a build-up of fatty material, or the development of scar tissue which may ultimately result in liver failure.
Cancer is well known to be related to lifestyle factors and alcohol is one of these factors.
The risk of cancers of the mouth, throat, gullet and liver is increased even with moderate alcohol consumption - that's two standard drinks a day. Further down the digestive system moderate to high alcohol consumption increases the risk of bowel cancer.
Cancers of organs which are not part of the digestive system can also be related to alcohol. In particular, recent research has clearly shown that breast cancer risk is increased by alcohol.
Even small amounts of alcohol increase the risk of breast cancer slightly and higher consumption leads to a substantial increase in risk.
Problem drinking occurs when drinking takes priority over previously enjoyed activities, there is an inability to limit or control the drinking and when there is a negative impact on family or work life.
You may recognise that there are problems but continue to drink, often feeling compelled to do so.
These signs suggest a developing addiction to alcohol or to use the correct term becoming "alcohol dependent".
This condition affects about 5% of the population.
You don't need to have major withdrawal effects such as the shakes, vomiting, diarrhoea, hallucinations or seizures to be described as alcohol dependent.
The long-term effects of heavy alcohol consumption can be initially subtle, but given time health effects will emerge.
One Auckland study revealed that 16% of all people who attended their GP for a health consultation were drinking at a level that is likely to cause significant damage to their health.
The aggressive marketing and promotion of alcohol without highlighting the real consequences has led to an imbalance in terms of the truly destructive nature of the product.
Recently, Sir Geoffrey Palmer and the Law Commission outlined evidence-based recommendations to improve both the understanding of and attitude towards alcohol and its inherent dangers.
Introducing these would make a substantial difference to the extent of heavy alcohol consumption in New Zealand.
The increasing costs to people's lives and to the health service have long outweighed the apparent pleasures that overconsumption of alcohol can bring.
Wide-ranging changes to legislation regarding the sale and purchase of liquor are needed.
These include stronger drink-driving countermeasures and greater restrictions or even a complete ban on alcohol advertising and promotion.
Alcohol is a drug like any other, to be treated with respect and with a great deal of caution.
Addiction medicine specialists agree that alcohol is no ordinary commodity because of the burden of social and health-related harm.
This growing burden will require an increase in funding so that those with problems can receive help and treatment as quickly and efficiently as possible.
It would appear that regulation is the only way to curb the excessive commercialisation by the liquor industry and what is essentially a national emergency.
It is time for politicians and lawmakers to shoulder some of the responsibility and to think long and hard about the long-term consequences of our liquor and advertising laws.
The Law Commission's recommendations should be implemented as soon as possible.
- Dr Gavin Cape is medical director of the Community Alcohol and Drug Service, Dunedin, and Associate Prof David Perez works in the oncology department, Dunedin Hospital
Where to get help?
• See your family doctor.
• Alcohol Advisory Council www.alac.co.nz Salvation Army: 03 477-9852.
• Alcohol Helpline: 0800 787-797.
• Community Alcohol and Drug Service: 03 476-9760.
• Dunedin Homebase Detox Service: 03 477-9852.
• Alcoholics Anonymous: 0800 229-6757.
