Understanding Liver Disease and Alcohol Consumption

Please watch the video Understanding Liver Disease and Alcohol Consumption (4:04). After watching the video, please spend some time answering the questions in the following sections.

Calculation of Daily/Weekly Standard Drinks

Explained in the video, is that liver disease related to alcohol is largely diagnosed based on the amount of alcohol consumed. These amounts are listed below: 

Women: more than 1.5 standard drinks per day or 10 standard drinks per week

Men: more than 2 standard drinks per day or 15 standard drinks per week

In Canada, a standard drink is the following:  

Beer, cooler, wine glass, prepared spirits
Beer
341 ml (12 oz) of beer
5% alcohol
Cooler, cider, ready-to-drink
341 ml (12 oz) of drinks
5% alcohol
Wine
142 ml (5 oz) of wine
12% alcohol
Spirits
(whiskey, vodka, gin, etc.)
43 ml (1.5 oz) of spirits
40% alcohol

Use the chart below to determine whether your consumption of standard drinks falls within the criteria for ALD. There is an online calculator that can you can use to assist with the calculation of standard drinks. Find it by following this link: Standard Drink Calculator.
 

 

# of drinks per day/week

(explain the type and size and/or amount of the drink you would consume)

# of standard drinks per day/week

(change the number of drinks consumed per day/week to a number of standard drinks)

Does this amount meet criteria for ALD? Yes or No?

 

Example:

3-2oz shots (6 oz) of 40% whiskey per day

= 42 oz per week

4 standard drinks per day

= 28 standard drinks per week

Yes

Alcohol Use Disorder (AUD) Self-Assessment

The video mentions that the word “alcoholic” is no longer used, but that it is possible that some people with Alcohol-related Liver Disease (ALD) have an Alcohol Use Disorder (AUD). AUDs are diagnosed by medical professionals according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V) and are sub-classified as mild, moderate or severe. Below are questions that you can ask yourself to gauge whether or not you have (or had) an alcohol use disorder, and how severe it is (or was). Attempt to answer the questions without judgment or blame. The self-assessment is simply a means to develop greater awareness of yourself and your behaviours as they relate to alcohol consumption. Know that not everyone who has a diagnosis of ALD has an AUD (and not everyone with an AUD has ALD). (Note that the self-assessment is written for those who are still consuming alcohol [present tense]. If you have stopped consuming alcohol, you will answer the questions as per your past consumption of alcohol [changing the self-assessment into past tense].)

Do you … 

  1. Continue to consume alcohol even though it causes relationship problems?

Yes / Maybe / No

  1. Want to cut down on alcohol, but have difficulties doing so?

Yes / Maybe / No

  1. Have cravings or urges for alcohol?

Yes / Maybe / No

  1. Consume more alcohol or for longer periods of time than you intend?

Yes / Maybe / No

  1. Spend a lot of time getting alcohol, consuming alcohol or recovering from alcohol?

Yes / Maybe / No

  1. Find it difficult to manage your responsibilities at home, work or school because of your alcohol consumption?

Yes / Maybe / No

  1. Give up important social, work or leisure activities because of alcohol consumption?

Yes / Maybe / No

  1. Consume alcohol again and again even though it puts you in danger?

Yes / Maybe / No

  1. Continue to consume alcohol even though your physical or emotional health is worse from it?

Yes / Maybe / No

  1. Need to consume more alcohol to get the desired effects from it?

Yes / Maybe / No

  1. Have withdrawal symptoms (nervousness, irritation, headaches, depression, sweating, heart racing or tension) when you don’t consume alcohol for a while, and then these go away when you return to it?

Yes / Maybe / No

My total number of “yes” or “maybe” responses: _____

If you responded “yes” or “maybe” to just two or three of the questions, you may have a mild AUD. An AUD is moderate with four or five “yes” or “maybe” responses, and is severe with six or more “yes” or “maybe” responses. 

Underlying Reasons for Alcohol Consumption

Shared in the video, is that there are all kinds of reasons for alcohol consumption regardless of the amounts you consumed, or how problematic your alcohol consumption may have been. Many underlying reasons for alcohol consumption including, stress, anxiety, worry, depression, anger, guilt, shame, grief and boredom are well known. It is also well known that childhood experiences of trauma, such as emotional, physical, and sexual abuse can predispose a person to consume alcohol later in life as a means of coping. Consider the underlying reasons for your consumption of alcohol from the list below.

  • Anxious 
  • Stressed
  • Worried
  • Nervous
  • Inauthentic
  • Overwhelmed
  • Afraid 
  • Avoiding
  • Paranoid
  • Sad
  • Depressed
  • Angry
  • Frustrated 
  • Irritated
  • Rebellious
  • Misunderstood
  • Embarrassed
  • Humiliated
  • Criticized 
  • Pressured
  • Inadequate
  • Insecure 
  • Deprived
  • Neglected 
  • Envious
  • Jealous 
  • Resentful
  • Revengeful 
  • Guilty
  • Shameful
  • Punished
  • Grieving 
  • Bored 
  • Lonely
  • Disconnected
  • Detached
  • Uncomfortable
  • Happy
  • Confident
  • Excited
  • Passionate 
  • Aroused
  • Hungry
  • Tired
  • Other:_______

How Behaviour Changes 

The video highlights that changing your alcohol consumption is possible regardless of the reason for consuming or amounts consumed. It says that in order to do so it’s helpful to think about the biological (what you do with your body), psychological (how you think), sociological (who you spend time with) and spiritual ways that people make change. In the chart below, consider the changes you can make in each one of these areas. 

Biological
Do I need to change my diet?

Is exercise a part of my regular routine?

Should I consider anti-craving medications for my alcohol consumption?

Psychological
Do I know my indicators for stress?

How does anxiety show up for me?

What do I do to manage worry?

Do I tend to use unhelpful thinking styles, for example: catastrophizing, mindreading, disqualifying the positive?

Am I aware of my automatic thoughts related to my alcohol consumption, for example: “I’m going to test myself to see if I can have just one,” “I need something to take the edge off and help me relax,” “I can’t have fun or excitement if I don’t drink”?

Sociological
Do I have healthy and supportive relationships in my life?

What can I do to improve my relationships?

Do I need to create boundaries in some of my relationships?

How do I spend time with people in healthy ways?

Spiritual
Is having a spiritual connection important to me?

What does spirituality look like for me?

How can I connect with my spiritual self?

What are my core values?

What are my natural skills and gifts?

Benefits of Abstinence from Alcohol

The video names a few benefits that may be enjoyed with abstinence from alcohol – money saved, improved mental focus, more productive use of time, better physical health, deepened relationships, and longevity of life. What are some of the benefits you anticipate enjoying/have enjoyed in your abstinence from alcohol? 

Finally, the video encourages reaching out for support should you feel like it would be helpful for you. On the Finding Support page are some ways that you can do that for both alcohol consumption and liver disease.

And our printable version can be found here.