Addictions Mental Health Issues

Addiction: The Biggest Killer

July 9, 2013
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Question: What is the biggest killer of Australians today?

If you are somewhat clued up about health matters, you may very well say, “Oh, definitely heart disease.” Or you may argue that that unenviable honour goes to cancer. Indeed, here are some statistics which would seem to validate your claim:

  • The Australian Institute of Health and Welfare (AIHW) reported in 2011 that heart disease is the biggest killer, causing over 50,000 deaths a year, or 34 per cent of all deaths in 2008.
  • The report said that that was followed by cancer, at 29 per cent of all deaths in 2008 (Mandal, A, 2011).
  • The largest contributor to premature death in the 2002 AIHW report was heart disease, at 96,000 person-years of life lost (Australian Institute of Health and Welfare, 2002).
  • Heart disease is the most expensive illness to treat, costing about $5.9 billion in the financial year of 2004-2005, with over half that money being spent on patients admitted to hospital. The disease was responsible for 475,000 hospital admissions and played a secondary role in 797,000 admissions in 2007-2008.

These statistics would seem to suggest that you are correct, with no argument possible; it seems to be a matter of “case closed”.

But wait just a minute. Situations, especially in the field of health, are not always as simple and straightforward as they seem. According to the Burden of Disease and Injury in Australia, the most recent estimates are that over one-fifth of cardiovascular disease (21.3 per cent) and colorectal, breast, uterine and kidney cancer (20.5 per cent) are caused by obesity, which also causes nearly one-fourth of type 2 diabetes (at 23.8 per cent) and osteoarthritis (24.5 per cent). These figures do not include the impact on reproductive systems, mental health, bone deterioration, or sleep apnoea, which are also largely affected by obesity. The overall cost of obesity to Australian society and governments was $58.2 billion in 2008 alone (Preventative Health Taskforce, 2008).

“Ok,” you say, “obesity may have caused a good chunk of disease, but this is supposed to be an article on addiction. What have all these statistics got to do with that?”

Addiction at the base of it

Ah, good question. Going back one step further in the chain of causation, we find an alarmingly strong correlation between obesity and food addiction, also known as compulsive overeating. There is accumulating evidence to show how neural and hormonal pathways are shared by both substance abuse and food addiction. Many of the brain changes reported for compulsive overeating and obesity are also seen in various forms of addictions. Most importantly, overeating and obesity may have an acquired drive like drug addiction with respect to motivation and incentive (Hyman, M., 2011; Obesity and Food Addiction Summit, 2009; Liu, Y., von Deneen, K.M., Kobeissy, F.H., & Gold, M.S., 2010). Put in simple terms, the obesity that engenders so much health misery appears to be spawned largely by addiction. Thus, reviewing that chain in a forward direction, we see that eating certain refined foods can cause the brain changes that create the food addiction, which creates the obesity, which in turn gives rise to the heart disease, cancer, diabetes and other health problems that kill Australians.

We can show a similar pathway for alcohol and drug addiction, which, like obesity, gives impetus to cardiovascular disease, cancer, and other health issues, and costs our community dearly in other ways as well. According to some estimates a combined $30 billion was spent or lost in 2010 on health care, lost productivity, premature death, crime and auto accidents related to alcohol and drug abuse alone. Roughly 75 per cent of all that money was paid for by public sources, which means Australian taxpayers footed three quarters of the bill. With some 12 million taxpayers in Australia the average sum paid by each individual taxpayer just for drug and alcohol addiction amounted to approximately $2,500 (Mittiga, R., 2011).

Thus, as Martin, Weinberg, and Bealer (2007) explain, it is addiction at the base of the problems, providing the behavioural underpinnings not only for obesity, but also for many of the other common “lifestyle-related” diseases. This leads to their assertion that addiction is actually the number one health problem, and that this is the most widespread and costly of all illnesses. Let’s look at facts arising from some of the common addictions that Australians deal with.

Alcohol addiction

Australia has a well-established drinking culture, where everything — from sporting events to births, marriages, graduations, and new jobs — is celebrated with a drink, or several. Thus it should be no surprise that the average Australian consumes over nine litres of pure alcohol annually, putting Australia in the top 30 countries for alcohol consumption, behind France, the United Kingdom, Ireland and Germany (Drug and Alcohol Rehab Asia (DARA), 2011).

  • Over 3000 deaths per years are attributed to excessive consumption of alcohol in Australia.
  • Over 5000 (5 per cent) of all cancers are due to chronic, long-term abuse of alcohol. Alcoholism is a factor in the development of liver, breast, and oesophageal cancer, among others.
  • Excessive alcohol consumption is the cause of up to 81,000 hospitalisations annually.
  • The cost of alcohol on the Australian community between 2004 and 2005 was estimated to be up to $15 billion.
  • The Alcohol Consumption in Australia: Snapshot, 2004-05 report (Australian Bureau of Statistics, 2006) stated that one in nine Australians drank at risky or high-risk levels.
  • Half of men and one third of women reported binge drinking, with 12 per cent of men and 4 per cent of women stating that they had done so in the last week.
  • About 15 per cent of Indigenous Australians drank at risky or high-risk levels.
  • About 8 per cent of drinkers reported that they consumed alcohol daily, and 40 per cent drank on a weekly basis (DARA, 2011; Australian Bureau of Statistics, 2006).

Drug addiction

While Australia’s proportion of people who have used drugs (40 per cent) is small compared to some countries, the impact is felt widely. The Drugs in Australia 2010 Report (Australian Institute of Health and Welfare, 2011) tells us that:

  • Nearly 15 per cent of all Australians aged 14 years and over had used a drug in the 12 months prior to the report. Of those,
  • 10 per cent had used cannabis (other drugs were used by 3 per cent or fewer of users).
  • Eight per cent of Australians have had a drug addiction problem (this estimate excludes alcohol).
  • Of drug users, about 47 per cent had used prescription drugs for non-medical purposes more than once in the previous month.
  • In 1997, there were over 70,000 heroin addicts in Australia (it is predicted that this number would have been higher were it not for Australia’s geography as an island nation, combined with effective policing).

Gambling addiction

Then there is gambling. The Productivity Commission released a report in 1999 which attempted to quantify the costs and benefits of gambling in Australia. Some of the report’s key findings were that:

  • Over 80 per cent of Australians gambled in the last year – losing around $11.3 billion, with 40 per cent gambling regularly.
  • Problem gamblers represent over 290,000 people, or 2.1 per cent of Australian adults.
  • Problem gamblers comprise 15 per cent of regular (non-lottery) gamblers and account for about $3.5 billion in expenditure annually — about one-third of the gambling industries’ market.
  • Problem gamblers lose on average around $12,000 each per year, compared with just under $650 for other gamblers (Productivity Commission, 1999).

These figures, of course, only represent the financial losses. The report also concluded that gambling addictions had adverse effects on the personal, legal, interpersonal, community services, and work/study aspects of respondents’ lives.

In addition to compulsive overeating, substance abuse, and problem gambling, people get caught in behavioural addictions such as hypersexuality, spending, video game-playing, and others. Regardless of the behaviour that is being done to excess, there are two common threads: The person is out of control, and cannot stop seeking the substance or performing the behaviour; and the behaviour is self-destructive.

This article was adapted from the Mental Health Social Support Specialty Course “Aiding Addicts”. For more information, visit www.mhss.net.au.

References

  • Australian Bureau of Statistics. (2006). Report 4832.0.55.001. Alcohol consumption in Australia: A snapshot, 2004-05. Australian Bureau of Statistics. Retrieved on 1 May, 2012 from: http://bit.ly/W75l7H
  • Australian Institute of Health and Welfare. (2011). Drugs in Australia 2010: tobacco, alcohol and other drugs. Australian Policy Online © apo.org.au 2011. Retrieved on 7 May, 2012 from: http://bit.ly/WLupOL
  • Drug and Alcohol Rehab Asia (DARA). (2011). Alcoholism in Australia. Drug and Alcohol Rehab Asia. Retrieved on 1 May, 2012, from: http://bit.ly/VIF54A.
  • Hyman, M. (2011). Food addiction: Could it explain why 70 per cent of America is fat? Dr Hyman.com. Retrieved on 7 May, 2012, from: http://bit.ly/109MTLw
  • Liu, Y., von Deneed, K.M., Kobeissy, F.H., & Gold, M.S. (2010). Food addiction and obesity: evidence from bench to bedside. J Psychoactive Drugs. 2010 Jun; 42(2):133-45. Retrieved on 7 May, 2012, from: http://1.usa.gov/WvW6Ai
  • Mandal, A. (2011). Heart disease: The largest killer in Australia. Medical Condition News. Retrieved on 1/5/12 from: http://bit.ly/109N35t
  • Martin, P.R., Weinberg, B.A., & Bealer, B.K. (2007). Healing addiction: An integrated pharmacopsychosocial approach to treatment. Hoboken, New Jersey: John Wiley & Sons, Inc.
  • Mittiga, R. (30 January, 2011). Effects of gambling addiction: Australia. Addiction treatment Australia: the GATS Program. Retrieved on 1/5/12 from: http://bit.ly/13I4Llw.
  • Obesity and Food Addiction Summit. (2009). Food addiction: What is food addiction? Retrieved on 7 May, 2012 from: http://bit.ly/WV5JJm
  • Preventative Health Taskforce. (2008). Technical Paper 1: Obesity in Australia: a need for urgent action. Preventative Health Taskforce 2.1: Health, social and economic impact of obesity. Retrieved on 1 May, 2012 from: http://bit.ly/WV5MEX
  • Productivity Commission. (1999). Australia’s Gambling Industries, Report No 10, AusInfo, Canberra. Retrieved on 1 May, 2012 from: http://bit.ly/XSI1Kk