The Irish thing

Dr Garry Fitzgerald: Ireland has a drink problem, what does it mean for our population

In young American cities, it became known as "The Irish Thing". Drink. The Micks always had a strong weakness for it. The immigrant Italians, Germans, Lithuanians, Jews, could never understand it. Like father, like son. Many the man could have been President only for it. Whiskey, they said, was invented to stop the Irish from ruling the world. Alcoholism is the Irish Catholic disease treated in the basements of Protestant churches – at Alcoholic Anonymous meetings. Two or three million members in groups around the world, Pat in the driving seat. Bad genes, bad example, bad pints.

Nothing has changed in the past century and the Irish remain undisputed world champions. At home last year, we spent more on draught pints than we did on primary education. Our alcohol consumption per capita is greater than that of half of western Europe combined. And going up. We have no near competitor. Recently, the English, who have lately abandoned centuries of Protestant temperance, are to be seen in increasing numbers vomiting and fighting at 2am on weekends in the centres of their cities. They are still no match for Paddy. The schoolchildren here drink steadily at 13 and are hard chaws by 16. Six pints of cider and six shots are par for the Junior Cert results. Treatment centres for alcoholism are seeing a rapidly reducing average age of persons being referred for treatment. These facilities cater for the tip of the alcoholic iceberg. Possibly, one in 20 people who have alcoholism get treatment.

Fortunately, only about 4 to 7 per cent of the population become alcoholics, a condition in which there are persistent adverse consequences of drinking in any combinations of health, family, vocational, financial, and social domains of life.

An alcoholic is usually different to the rest of the drinkers in that alcohol has an abnormal effect on his brain. Put a first-ever drink into the average five-eight (probably five-ten nowadays), and he'll "improve" in his sense of well-being by, say, 15 to 30 per cent. The alcoholic will give 600 per cent of a "gee-up". He will be astonished by its effect. The world will become the place he always thought it should be and wanted it to be. His enemies will be rendered harmless. He will understand George Dubya and wish him well. His social awkwardness will disappear. He will not regret the past nor wish to shut the door on it. He will absolve himself of his sins. He will be confident and self-assured. He will think benignly of his fellow man. He will become Mother Teresa. He will forgive Saddam, the English, and the taxman. Alcohol does for him what he could never do for himself. He will intuitively know how to handle situations which used to baffle him in the past. He will comprehend the word serenity and will know peace. He will feel unbounded joy and at-oneness. He will experience the approach of nirvana. Oh, yes, I remember it well.

Naturally enough, the alcoholic will want to hold on to the effects, so his next move will be to say, "Fill it up again" - with that magical potion. He will keep drinking the stuff until he can get no more of it. He'll want to return to the effects as often as possible. Ordinary life, full of doubt, anxiety, self-pity and disappointments will no longer attract him. He's found utopia. He's going to take an awful lot of persuading not to go to the trough again at the next possible opportunity. And the next opportunity after that again. He will go through years of hangovers, subject his family to dysfunction and ruin, fail in his vocation and health, and perhaps end up in the gutter, still chasing the increasingly elusive nirvana, if necessary, to the grave. He will leave the tornado effect after him.

Alcoholism and alcohol abuse in Ireland is a raging endemic. It will worsen, as it has been doing for decades. The prevalent culture will deny attempts to curb it. Michael McDowell's reasonable effort to facilitate a culture of associating alcoholic drinks with food consumption, as in France and Italy, died an early death at the hands of vested interests. The publicans used their veto on such reforms that might have kick-started a change in the public's approach to alcohol abuse. The national response is underwhelming. 'Twould drive you to drink.'

Garry Fitzgerald is a medical doctor based in Waterford and a columnist with the Irish Medical Times