Sunday, March 30, 2008

A Different Kind of Student Exam

Jim, a Darien High School junior, does not go to school dances anymore. The 16-year-old is boycotting them because to get in, he has to take a test that he thinks is unfair: Before he and classmates are allowed to enter a dance, they are asked to breathe into a device to determine whether they have consumed alcohol.

One of the Breathalyzers used.

Darien is one of many schools across the state that requires students to submit to a Breathalyzer test to gain entrance. School officials say the test is a fair way to ensure the safety of all students and send a clear message of zero tolerance for underage drinking.

But Mr. Hennessy and some other students see it as a violation of privacy. “I think they are completely ridiculous and a breach of personal freedom,” he said. “What you do off school grounds should be your own business.”

In Simsbury and other districts like Southington and Clinton, students are tested not only at school parties, but also during the school day if they are suspected of drinking. The Breathalyzer, a small hand-held device, is the latest weapon in the arsenal that school officials, with the backing of concerned parents, are using to curb underage drinking.

Some schools are searching purses and bags at the door for alcohol, or prohibiting students from carrying any bags into a dance. Many schools are offering alcohol-free graduation parties and after-parties for proms to help curb drinking after major school functions.

Districts are working with parents who are willing to sign contracts that their homes are alcohol-free zones during student parties or at gatherings before or after school events. School athletes who get caught drinking or appear in pictures on Web sites like drinking are being disciplined and could be suspended from playing sports under new policies at many districts.

In a Connecticut School Health Survey in 2005, more than half of 12th graders, or 59 percent, said they had used alcohol during the month, along with 48 percent of 11th graders, 42 percent of 10th graders and 35 percent of 9th graders.

Over all, 45 percent of high school students surveyed said they had used alcohol, compared with 43 percent nationwide, according to the study, conducted by the State Department of Health with help from the Department of Education.

Nationally, experts say there has been progress in reducing drinking, with 26 percent of 12th graders reporting binge drinking in 2007, down from 30 percent in 2000. And school and health officials say Breathalyzer tests are one way to help reduce alcohol usage among students.

Craig Turner, vice chairman of the Connecticut Coalition to Stop Underage Drinking, said the increased testing in schools is an outgrowth of a state crackdown on underage drinking: In 2006, Connecticut enacted legislation that fined anyone providing alcohol to minors.

“Schools recognize that there is pressure on kids to drink to conform and to be accepted by the group, and they are working to set a standard that it won’t be allowed,” Mr. Turner said.

Administrators at some high schools using the tests said the incidence of drinking at dances prompted them to administer Breathalyzer tests to all students. By doing so, school officials said, they cannot be criticized for singling anyone out.

Simsbury High School purchased Breathalyzer equipment in 2006 and required students suspected by administrators of drinking at the senior prom to be tested. Twenty-one students were found to have been drinking and were suspended from school and the graduation ceremony that year, Neil Sullivan, Simsbury’s principal, said.

“It was very painful for the community,” Mr. Sullivan said. “We were calling into question whether we could even keep holding the dances.”

After consulting with parents, teachers and the School Board, Mr. Sullivan said, the school district decided to enact a new policy to test all students for alcohol before entering dances.

Simsbury now has six Breathalyzer kits, which cost a total of about $300, to test students at every dance this year.

“From my point of view, it has been a successful initiative because we have not had an episode of student drinking since we started,” Mr. Sullivan said.

Darien High School’s principal, Dan Haron, said his district also decided to administer the Breathalyzer tests to all students this year because of problems with alcohol at previous dances.

“We had a few unfortunate incidents at the prom last year where students had clearly been drinking prior to coming, and we wanted to make sure to discourage that behavior,” Mr. Haron said. “Our main goal is to make sure students are safe and, once they are at the dance, have fun in a wholesome way.”

By mandating that all students attending a dance take the test, the school can avoid criticism, which it faced in the past, that educators are unfairly picking on certain students, school officials said.

Mr. Haron acknowledged that many upperclassmen are not happy with the new policy and that attendance at dances has dropped.

“If there is a negative aspect, then it is that we’ve seen far fewer seniors at school dances than in previous years,” he said.

Mr. Haron also said that other schools testing students reported similar declines at dances, but he added that as students became more used to the testing, he hoped attendance would increase.

Lindsay Gordon, 17, a senior at Darien High, said some students skip the dances and drink at private parties instead.

“If kids want to drink, they will drink,” said Ms. Gordon, who is editor of the student newspaper. “They will just go to another party rather than the dance.”

Charlotte Myers, a junior at the high school, said the policy was not a deterrent. “I think it makes kids turn to other substances,” she said.

Margaret Burch, 18, a senior at New Canaan High School, which also requires students to take a Breathalyzer test before entering a school dance, said the testing makes students feel awkward.

“Here you are, all dressed up and ready, and then the principal is sticking a thing in your mouth and it gets everyone angry,” said Ms. Burch. “You just get annoyed, like why can’t they trust us.”

Some students, however, said the testing helped reduce peer pressure to drink.

“It gives kids a chance and a reason to say no; it’s a good excuse,” said McKay Potter, 18, the senior class president at Darien High school.

Many parents have welcomed the school policies.

Dr. Sandy Gordon, an emergency room physician and the father of Lindsay Gordon, the Darien High School senior, said he was grateful that the school was taking steps to ensure students’ health.

“As an emergency room doc, I’ve seen lots of teens with alcohol poisoning,” he said. “This is another level of trying to ensure our children are safe.”

Captain Fred Komm of the Darien Police Department, who oversees an underage-drinking-tips hot line in town, said schools could be held liable if students left a dance intoxicated and got into driving accidents. He said the Breathalyzer tests were helpful as part of an overall community approach to prevent underage drinking.

“It’s a positive step.” Captain Komm said. “It’s not overly intrusive.”

School officials said they realized that the tests were not going to stop all underage drinking and that they would also continue to rely on alcohol and drug education programs to inform students of the dangers.

“It doesn’t solve the problem of teenage drinking,” said Jack Sennott, chairman of the Simsbury Board of Education. “But it solves the problem of teenage drinking at school dances.”

source: New York Times

Friday, March 21, 2008

DR. HOOK- Alcoholism: Have a problem with liquor?

Bad habits are hard to break. Cracking chewing gum drives me crazy like someone scratching a chalkboard (the birth of dry markers in classrooms?). Throwing cigarette butts from the car instead of putting them in the ash try! (How would litterers feel if someone threw used toilet paper inside their cars?) Bad talent who keep appearing on American Idol try-outs. Paparazzi continuously following Britney Spears.

Alcohol is touted by Americans to be better than peanut butter, iPods, and Desperate Housewives all in one. Cheers! Prost! Chin-chin! Everybody dance and drink! Whew! Seems glamorous, doesn't it? But when does alcohol become a bad habit?

Two-thirds of American adults consume alcohol. I'm one of them. In small to moderate amounts, alcohol has been shown to be good for the heart. However, about 10 percent of drinkers are addicted to alcohol, another 10 percent drink so much it leads to harmful things, and up to 25 percent have risky drinking behaviors. Sounds like college, huh?

But folks in the workforce (age 30-64) have the greatest risk for lifetime alcohol abuse. Lifetime prevalence of alcohol abuse is about 17 percent and of dependency is about 12 percent.

Hollywood has shown us this: 80 percent of people dependent upon alcohol smoke, and 30 percent of smokers have alcohol dependency. Cough, cough, burp. Maybe that's why so many actors die of cancer or liver disease.

I learned from Jewish culture that alcohol should "lubricate," not "inebriate," the body and soul. Consistent inebriation can lead to medical problems such as high blood pressure, dementia, neurological disorders, liver disease, pancreatitis, birth defects, and many cancers. (Sounds like a pharmaceutical ad, huh?)

How much is too much? According to the literature, 80g of ethanol a day for 10-20 years is linked to cirrhosis. That's equivalent to about six 12-ounce beers, six 4-ounce glasses of wine, or six 1.5-ounces of 80-proof liquor a day. Moderate drinking is considered to be one to three drinks per day for men and one or two drinks per day for women. Heavy drinking is considered to be more than 14 drinks a week for men and more than seven a week for women; or for binge drinkers more than three drinks per occasion for men and more than two drinks on each occasion for women.

The Diagnostic and Statistical Manual of Mental Disorders-IV defines alcohol abuse to be at least one of the following: 1) failure to fulfill work, school, or social obligation; 2) drinking despite being in physically hazardous situations; 3) recurrent legal problems; 4) family or friend problems due to drinking, but refusal to stop.

Dependence is defined as having three or more of the following: 1) tolerance (need more and more alcohol to achieve the same effect); withdrawal (tremor, shakes, depressive mood, hallucinations); can't stop drinking-- no limit; constantly working on drinking less; wasted time (hangovers, drinking away valuable time, etc); drinking instead of working or engaging in social/ or recreational events; drinking despite mental or physical problems from the alcohol.

Bad habits? Bad behavior. A huge percentage of traffic fatalities involve driving while under the influence of alcohol. Of convicted DUI drivers, 91 percent of men and 85 percent of women have a lifelong alcohol problem. Alcohol abuse is often involved in accidents, drownings, violence, rape, murder, and crime. Fun party, huh? Not!

Alcohol abuse is also prevalent in people with mental illness. People living with bipolar disorder, anxiety, depression, or PTSD often self-medicate with alcohol. And as with mental illness, there's a genetic component to alcoholism: family history is strongly associated with alcohol abuse.

I could go on for chapters on alcohol abuse, but I hope this article might stimulate some readers to research more on their own drinking or on someone they love. Good resources are AA and Al-Anon. Life is too short to waste it on alcohol abuse.


Monday, March 17, 2008

The battle of the bottle

1. What is binge drinking?

Prime Minister Kevin Rudd believes Australia's binge drinking culture has reached "epidemic proportions". Binge drinking is the dangerous practice of consuming high levels of alcohol, often to "get drunk". Heavy drinking in short periods is increasingly common and socially acceptable among teenagers and young adults.

The National Health and Medical Research Council says there is no safe amount of alcohol for under-ge drinkers. Last year, the council set new safe drinking guidelines for Australian adults, advising them to limit their drinking to two standard drinks a day - a standard drink contains about 10 grams of alcohol. Teenagers and pregnant women are advised to refrain from drinking completely.

As the teenager brain is yet to reach maturity, it is particularly vulnerable to long-term and irreversible brain damage from alcohol. The American Medical Association says adolescents need only drink half as much as adults to suffer learning and memory impairment. Research shows one in every 10 Australian teenagers between 12 and 17 binge drinks every week. Health authorities warn that as the age of "the first drink" plummets to early adolescence, the risk of addiction and severe health problems increases. There are fears the nation could be drinking itself to death, with an average of 10 Australians dying each day from alcohol related causes.

2. Why is binge drinking a concern?

Binge drinking has severe health effects, from brain damage to learning and memory problems. Binge drinkers are also more likely to engage in risk-taking behaviour such as unsafe or unwanted sex, illegal drug taking, vandalism and drink driving. In extreme circumstances, binge drinking can result in coma and death. An increase in violence in Melbourne's CBD - which has resulted in many serious injuries - has also been blamed on binge drinking.

Long-term binge drinking can lead to addiction, cancer, liver problems, heart attack and brain injury. Alcohol is the second biggest contributor to chronic disease in Australia, after smoking. Alcohol abuse also wastes valuable medical resources. Every year, 72,000 Australians are admitted to hospital because of risky alcohol consumption. In Victoria, alcohol-related emergency department admissions have jumped 35% in five years.

The economic impact of alcohol is also significant. In 2004-05, alcohol cost Australia an estimated $15.3 billion a year, through crime, violence, treatment, loss of productivity and premature death.

3. What is the solution?

Prime Minister Rudd has announced a $53 million national program aimed at cleaning up the binge drinking culture across all generations. The plan includes $20 million on shock "in-your-face" advertising, similar to anti-smoking and the TAC road safety campaigns. The government will spend $19.1 million on education and early intervention programs for teenagers, and is considering restricting advertising.

Mr Rudd is also concerned by the relationship between binge drinking and sport. Surveys show 13% of 18 to 20-year-olds drank 13 or more standard drinks when they visited sporting clubs. He has set aside $14.4 million to help sporting clubs develop drinking codes of conduct. Clubs which do not enforce codes face missing out on government grants and funding.

Others have called on the alcohol industry and parents to take responsibility for teenage binge drinking. Some have suggested raising the legal drinking age to 21, as is common in the United States.

VicHealth wants the number of venues supplying alcohol limited. The number of liquor licences in Victoria has risen from about 4000 in 1986 to more than 19,000 in 2004. VicHealth also says tougher regulations are needed on marketing tactics for pre-mixed drinks or ready-to-drink beverages, which it claims are deliberately targeted at teenagers. These popular drinks are sweet and sugary like soft drinks, have bright and colourful packaging, are alcohol-laden and cheap.

Meanwhile, the Australian Drug Foundation believes there should be new laws to prosecute parents who give alcohol to other people's children at teenage parties.

source: The Age

Friday, March 14, 2008

Secular program tackles addiction

How was your week?

It's a simple question, but for one substance abuse recovery group with meetings in Benicia and Vallejo, it's also a touchstone that keeps members coming back to share their small victories and setbacks in their struggles with addiction.

LifeRing is a secular, or non-religious, program. Unlike some other recovery programs, there is no talk of a higher power, no steps and no sponsors.

"We have one bottom line rule: We do not drink or use drugs - no matter what," said John DeYoung, who runs the Benicia meeting and one of the two in Vallejo.

During the meetings, participants sit in a circle, taking turns discussing their week and their plans for the coming one.

Talking about one's week presents a "low entry barrier," according to LifeRing literature, and allows newcomers to participate from day one.

Concentrating discussion on a narrow time period also allows participants to "focus on today," De-Young said. It also prevents them from getting bogged down in "war stories" or romanticizing their past.

Feedback, known as crosstalk, is encouraged.

At a recent Benicia meeting, some group members discussed problems with family and careers, while others shared recent triumphs. But even if their weeks were tough, many of the 13 participants said the connection and support of the LifeRing meeting made things easier.

Founded in 2001 and based in Oakland, LifeRing has about 100 face-to-face meetings, plus online groups, with the largest concentration being in the Bay Area.

While LifeRing is non-religious, it is not anti-religion - about 40 percent of members attend some form of worship services, according to a LifeRing survey.

Richard, a LifeRing member who battled alcoholism after his wife's death, said many people have "trouble with the god concept," in some other programs, which is absent from LifeRing.

But LifeRing does not discourage people from participating in other programs, such as Alcoholics Anonymous, DeYoung said. In fact, many participants work on their sobriety through multiple programs at the same time, customizing their own recovery, he said.

"There's a lot of overlap," DeYoung said. "It's not a competition, just another option."

Thursday, March 13, 2008

Self Experimenters: To Purge Binges, Alcoholic Cardiologist Self-Prescribed an Experimental Drug

The last time Olivier Ameisen formally practiced medicine was in the early summer of 1997. After two decades in the field, the French-born physician, then running a clinic on Manhattan's Upper East Side, abruptly rang up his secretary one morning and told her to clear his schedule. She laughed in disbelief when he explained why. He was ill, he told her; he was an alcoholic, and he was afraid his drinking might interfere with his patients' care.

Anyone familiar with his resume would have responded the same way. Ameisen was a stellar medical student at the University of Paris—which he entered at the age of 16. Moving to the U.S., he began a fellowship in 1983 at New York–Presbyterian Hospital in Manhattan, swiftly becoming an attending physician there in 1986. (The same year, he added teaching appointments at the hospital-affiliated Weill Cornell Medical College of Cornell University.)

But things began to sour in 1994, when the then 41-year-old bachelor opened a private practice. Although the venture was initially successful—he broke even in four months instead of the usual two years—he became gripped by an irrational fear that he might not be able to provide for a future family. "That's when I started binging at home," says Ameisen, now 54. As time went by, "my fear," he says, "was to be drunk and have a patient call me and say, 'I have chest pain,' and have me tell him, 'Okay, go play tennis.'"

After putting his practice on hold, Ameisen spent nine months over two years in various rehab clinics trying to quell his alcohol cravings, or "motivations," as he calls them. He gave Alcoholics Anonymous a shot—or more like a round of shots; he estimates that in a single year he went to 700 meetings, as often as four a day. He also tried naltrexone and acamprosate, the only two drugs approved by the U.S. Food & Drug Administration to treat alcohol dependency, without success.

Finally, convalescing in Paris in 2004 (where he went to be close to his parents and relatives), he read about a study of a muscle relaxant that had stifled the cravings of a cocaine addict. The drug, baclofen, had also shown efficacy against anxiety and depression. Eager to try it, he prescribed a high dosage for himself. Within a few months of starting the regimen, his craving for drink evaporated. Fourteen months into his self-experiment, he published a case study of his self-treatment in the journal Alcohol and Alcoholism, and he is now writing a book called The End of My Addiction, chronicling his successful journey.

Researchers believe that baclofen may increase the brain's levels of the neurotransmitter GABA (gamma-aminobutyric acid), involved in regulating the desire for addictive substances, by stimulating a subset of GABA receptors. But, contrary to Ameisen's experience, a recent double-blind study of 80 alcoholics at the University of North Carolina School of Medicine in Chapel Hill found no difference in outcome between those taking baclofen or a placebo. Ameisen points out, however, that the dosage of 30 milligrams a day given to study participants was far lower than his up to 270-milligram daily dose, which studies had shown people could tolerate without displaying side effects such as somnolence and muscle weakness.

"The story on baclofen is really still out," says James C. Garbutt, a U.N.C. psychiatry professor and senior investigator on the study. He notes that the drug may reduce the anxiety and insomnia that often accompany alcohol withdrawal, which might ease the transition to sobriety, but adds that researchers cannot accurately predict who might benefit from the drug absent a larger study.

Still, Ameisen insists that for him the drug was a lifesaver. Now, instead of downing a quart and a half of Scotch a day, he takes as little as 70 milligrams of baclofen. He is contemplating a return to medicine, he says, but for now he takes satisfaction in corresponding with addiction researchers from his Paris apartment and encouraging them to conduct further clinical trials of baclofen.

"I know that case reports are there" on baclofen's efficacy, Ameisen notes. "But, even if you have 10 case reports, that's no better than one."

source: Scientific American

Monday, March 10, 2008


MANOREXIA. Orthorexia. Diabulimia. Binge Eating Disorder.

All are dangerous variations on the eating disorders anorexia and bulimia, and have become buzzwords that are popping up on Web sites and blogs, on television and in newspaper articles. As celebrity magazines chronicle the glamorous and the suffering, therapists and a growing number of researchers are trying to treat and understand the conditions.

The latest entry in the lexicon of food-related ills is drunkorexia, shorthand for a disturbing blend of behaviors: self- imposed starvation or bingeing and purging, combined with alcohol abuse.

Drunkorexia is not an official medical term, but it hints at a troubling phenomenon in addiction and eating disorders. Among those who are described as drunkorexics are college-age binge drinkers, typically women, who starve all day to offset the calories in the alcohol they consume. The term also is associated with serious eating disorders, particularly bulimia, which often involve behavior like bingeing on food - and alcohol - and then purging.

Anorexics, because they severely restrict their calorie intake, tend to avoid alcohol, but some drink to calm down before eating or to ease the anxiety of having indulged in a meal. Others consume alcohol as their only sustenance. Still others use drugs like cocaine and methamphetamine to suppress their appetites.

"There are women who are afraid to put a grape in their mouth but have no problem drinking a beer," said Dr. Douglas Bunnell, the director of outpatient clinical services for the Renfrew Center, based in Philadelphia.

The center, like a small but growing number of eating-disorder and addiction-treatment facilities, most on the West Coast, offers a dual focus on substance abuse and eating disorders.

Bunnell, former president of the National Eating Disorders Association, said the obsession with being skinny and the social acceptance of drinking and using drugs - along with the sense, lately, that among celebrities, checking into rehab is almost a given, if not downright chic - are partly to blame.

"Both disorders are behaviors that are glorified and reinforced. Binge drinking is almost cool and hip, and losing weight and being thin is a cultural imperative for young women in America. Mixing both is not surprising, and it has reached a tipping point in terms of public awareness."

Psychologists say that eating disorders, like other addictions, are often rooted in the need to numb emotional pain with substances or the rush provided by bingeing and purging. The disorders are often driven by childhood trauma like sexual abuse, neglect and other sources of mental anguish.

Manorexia is the male version of anorexia. Orthorexia is an obsession with what is perceived as healthy food - eliminating fats and preservatives, for example. But people with this condition can dangerously deprive themselves of needed nutrients.

Diabulimia refers to diabetics who avoid taking insulin, which can cause weight gain, to control their weight. Despite the name, the disorder does not typically involve purging.

Binge Eating Disorder refers to obsessive overeating, especially of foods high in salt and sugar, that does not involve excessive exercise or purging to compensate for the high caloric intake.

Judy Van De Veen, 36, who lives in Gillette, N.J., became anorexic at 24. She said she starved herself, meting out small bites of low-calorie food for two months. Then she began bingeing and purging, throwing up entire boxes of cereal, whole pizzas and fast food from drive-throughs that sometimes cost her $80 a day.

She went into treatment, both inpatient and outpatient, for her eating disorder for several years in the late 1990s, with mixed results. In 2001, still struggling with bulimia, she took up drinking. If she ate while drinking, she said, she would purge, but then consume more alcohol to make up for the loss, because she wanted to remain drunk.

Many bulimics who drink use alcohol to vomit, experts on eating disorders say, because liquid is easier to purge. They also tend to vomit because they often drink on empty stomachs.

"In the beginning of my eating disorder I wouldn't touch alcohol because it is so high in calories," said Van De Veen, who later found herself regularly hospitalized for dehydration.

"But I have the disease of more: I just want more no matter what it is."

Two years into her drinking problem, she joined a 12-step program. She spent the next two years in and out of six residential rehab programs, spending about $25,000 of her own money because she didn't have health insurance. But none of the programs were equipped to address eating disorders, so she binged and purged and her eating disorder raged.

Van De Veen said she has been sober for three years, but is still struggling with bulimia. She now has a 14-month-old daughter, Cheyenne, and she said that her pregnancy and support groups had helped her make progress on her eating disorder.

"I had an excuse to eat," she said of being pregnant. "I didn't care and I loved it."

But she said the temptation to binge and purge is haunting her again.

Trish, 27, who has had an eating disorder for 10 years, recently checked into Renfrew, her fifth stint in a treatment center or hospital.

Like Van De Veen, Trish, who agreed to be interviewed on the condition that only her first name be used to protect her privacy, struggled with anorexia first and then found alcohol. Before she was admitted to Renfrew, she said she was blacking out from lack of food and suffering from excruciating stomach pain.

Trish, a nurse who lives in Ohio and works with cardiac patients, said she would starve herself through her 8- or 12-hour shifts, staring at the clock and fixating on when she could have her first drink.

Drinking, she said, relaxed her when she had to eat in front of other people, a huge source of stress.

"The alcohol is probably what kept any weight on me," she said in an interview in February at the Renfrew Center, which she entered on New Year's Eve for eight weeks of treatment.

"Drinking helped me be less anxious,. It helped me be more of Trish. The two go together: If I drink more, I'm more into my eating disorder and vice versa."

Studies show that binge drinking and alcohol abuse are on the rise among women, who also are more prone than men to eating disorders.

About 25 percent to 33 percent of bulimics also struggle with alcohol or drugs, according to a study published last year in the journal Biological Psychiatry. Between 20 percent and 25 percent of anorexics have substance abuse problems, the study found.

A growing number of researchers are examining the psychological and neurological links between eating disorders and substance abuse: Does eating a chocolate bar, or bingeing and purging, stimulate the same pleasure centers in the brain as drugs or alcohol?

Dr. Suzette M. Evans, a professor of clinical neuroscience at Columbia University, recently began a study of the connection between bulimia and substance abuse, a field she said has been neglected.

"People are finally beginning to realize that food can function in the same way as drugs and alcohol."

As more patients seek treatment for both eating disorders and substance abuse, a complicated set of mixed messages can arise. The response to addiction is abstinence; but quitting food is not an option.

"We're trying to get our patients to find effective behaviors and life skills," said Dr. Kevin Wandler, the vice president for medical services at Remuda Ranch, which addresses eating disorders and addiction at its facilities in Arizona and Virginia, near Bowling Green.

"Eating normally would be an effective behavior, but it's easier to give up alcohol and drugs because you never need it again. If your drug is food, that's a challenge."

By Sarah Kershaw

The New York Times

Sunday, March 9, 2008

Right down to the dregs

You drink regularly and have the odd morning-after trauma, but it never affects your career, family or social life. That's what Alice King thought – until her addiction to alcohol swallowed up her marriage, her job and almost her life...

SHE was not a park-bench drunk. Not a bag lady with a life so shrivelled it could be carried in two plastic carrier bags. She didn't smell of rain-soaked clothes and stale urine and yesterday's booze. No, Alice King was not that kind of drunk. She was a leading wine expert who wrote for the Daily Mail and Marie Claire, appeared regularly on television and radio, published a dozen best-selling wine books, and became Tesco's face of wine. She earned a fortune, lived in a 19-room Victorian townhouse, flew on Concorde and wore designer clothes. Her biggest problem? She injured herself falling off bar stools with a glass of Krug in her hand.

Maybe you find that alienating. Too middle-class a story of alcoholism. Too clean. What's her excuse with all that good fortune? But pain is pain and alcohol has no regard for class or status. King's story gets pretty messy by anyone's standards. The wine-merchant husband went. The house went. The job went. But the most important loss was herself. Here she is at the height of it all, standing alone in a wet, deserted London street. It's 4.30 in the morning and she can't get another drink. She calls a taxi to take her 75 miles home to Hungerford and a stranger walks by, a man with arresting grey-green eyes. He wants another drink too. Maybe he should come with her? If you like, King says.

So she takes him home, because her alcoholism makes her oblivious to her own safety. They drink champagne, end up in bed together, but nothing happens. "He had just split up with his girlfriend and we lay in bed laughing," recalls King. "It could have had any end result but it didn't, because we were like two little kids, two little lost souls, lying in bed, laughing."

In the morning, she woke to find him gone, a champagne cork placed on the pillow.

He came back to her when she was writing her book, High Sobriety, a compelling, honest account of a descent from high living into degradation and humiliation, and her subsequent recovery with the help of Alcoholics Anonymous. When King shut the door of her office to write it, she was physically alone but felt as if the people who had inhabited her life were in that room with her, looking over her shoulder. "The skeletons danced off the page," she says.

It was hard, confronting what she had become. "There were times when the person coming off the screen more than alarmed me." Parts of it were excruciatingly painful to write. One day, she sat in her office with her head in her hands, wondering why she was doing it. "Every time you went somewhere you pulled up all sorts of other stuff about your life, your children, your father and so on." Then she heard the ping of an e-mail and the e-mail gave her the answer.

The year before, King had written two series of columns for The Times and for You magazine about her alcoholism, and a tidal wave of e-mails, from people who were desperately trying to deal with their own addiction or that of someone close to them, had washed over her as a result. Here was another. "Dear Alice… as a result of your column we got our daughter into rehab. She is one year sober today and is now the daughter we always loved and a mother to her little boy. We are writing to thank you for giving us our daughter back."

If you are reading this and you have a drink problem, you are Alice King's motivation. "I knew this book had a purpose," she says, explaining her reaction to that e-mail. "It's a book of hope. For anyone who has a drink problem or knows someone who has, this book will give them hope that if I can get better, they can."

WE ARE sitting in Tiffany's library, a small, elegant, wood-panelled room with books and paintings and an open fireplace, in London's Covent Garden hotel. It's interesting to watch King's obvious admiration for these opulent surroundings. She stayed in places like this all the time when she was earning big money. Not that she was from a very rich family, she says, because her parents had nine children – although since she recalls her parents taking all of them to France for a holiday in the 1960s, when it was quite unusual to travel abroad, they clearly weren't poor either.

Her father was a wine shipper and it was this that gave King her first interest in champagne and fine wines. She remembers her very first taste as a child, the immediate love affair with taste and sensation. From that first sip she found she could distinguish the explosion of different elements that made up the whole flavour – black cherry and strawberry and cinnamon and cocoa. She had, she discovered, an innately discerning palate. She loved the sense of power this ability gave her. She was good at something. Despite coming from a happy, secure family, there was always something missing for the young Alice. She was sixth out of the nine children and therefore well down the pecking order. There was an insecurity in her, a need to prove herself, a need for approval and unconditional love.

People associate big families with happiness and of course that's part of it. But there are also problems in asserting your individuality in such a crowd. "It does sort of encourage the show-off part of you, and I could see that sitting round the table. It was whoever could have the last laugh. Everyone would tell funnier and funnier stories and when I look at the girl I became in the '80s, I did lose myself. The real me was sidelined by the show-off."

This was yuppie, Thatcherite Britain, and King admits to "delusions of grandeur". Looking back, alcohol simply became a cover. "Alcohol is just a symptom of something else. For me it was a symptom of something missing inside me. For some reason I never really developed an adult way of expressing my emotions and the little child in me was just drowned in wine so there wasn't really a proper growth emotionally. I didn't really grow up as an adult."

She trained to be a fashion writer, but there were so few jobs that she applied to a wine magazine, citing her experience between school and college as a tour guide in the champagne cellars of Reims. She was hired and the good life began. But outward success only provides a skin-thin veneer for inner insecurity. "The more successful I got, the more scared I got. You often hear that with people." She was good at her job, but wondered if her skill was mere fluke – she'd got it right this time, but what about next time? But her alcoholism, she believes, was not because of her job. "My belief is that had I become a fashion writer, I would still have been an alcoholic. I would just have been a lot better dressed."

People say that the good news when you recover from alcoholism is that you get your emotions back. And the bad news is that you get your emotions back. Certainly, the most important part of King's recovery has been confronting what she really feels. "I didn't know how to deal with my feelings. I've learned that the most positive thing you can do is articulate your worries, fears or joys. The minute you open your mouth about something that is concerning you, it starts to dissipate."

Our own weaknesses can be destructive enough. But sometimes they attract us to others whose vulnerabilities combine with our own to create an even bigger problem. That's the situation King found herself in when she married Niall, a wine merchant whose passion for wine was matched only by her own. Together, their life became one long hangover, oiled by the best champagnes but marred by competitive, aggressive behaviour and alcohol-fuelled rows. Niall's business collapsed and the marriage was already faltering when he smirkingly boasted to King in front of their nanny that one of the guests at a party to mark their 15th wedding anniversary "gave me a blow job in the hall".

The couple separated. King's drinking continued to spiral out of control. She has three boys and her middle son, aged 12, wrote an introduction to her book in which he describes her unreliability, painting a picture of a chaotic if glamorous figure, "trying not to fall over in her spiky red high-heels, looking for her kids". But while obviously no one would choose the example of an alcoholic mother, on the other hand, King's children have been given the positive example of a woman who has turned her life around. When she wrote her column for The Times, that same son e-mailed her from boarding-school. "Mummy," he wrote, "I am so proud of you."

King agreed to have joint custody with her ex-husband, but the most painful moment of her alcoholism concerns her children. She was standing in a supermarket in a Versace mini-dress and black satin boots. She had nipped in en route to the station on her way to a London party. And there they were, her three boys, with their new stepmother, a former friend of hers. The woman was carrying King's baby and her other two boys were laughing and joking.

"Nothing ever prepares you for that sight," says King, and even years on she's clearly still fighting the emotion of that moment. "It makes me almost cry just talking about it. It was a really painful moment. Some bits of the book were easy to write and that bit just came. It came from so far down, as far down as the bottom of your womb where you have to push from to have the babies."

In the supermarket, she said, "See you at the weekend," to the boys, went through the checkout without a backward glance, headed to the station and was sick on the platform with the emotion of it all. Then she got on the train and ordered a double gin and tonic. "I dealt with it the only way I knew how. It would have been hard enough to deal with what went on sober, let alone with a drink inside you. There is no problem that alcohol doesn't make worse."

In recovery, she had to regain her eldest son's respect. "To some degree he had been the parent and I had been the child, and when I first got sober I had to work hard to turn that around. He had to have a reason to respect me. Now I have a proper relationship with my children, and because I so nearly lost everything I don't take anything for granted. I really do value my time and interaction with them. If I get things wrong, I apologise to them. They don't have me on a pedestal. Well, they wouldn't, would they?" But similarly, she doesn't blame herself for everything they do that she doesn't like. "It's easy to guilt-trip. When someone says, 'My child is a complete pain and won't do this, won't do that,' I think, 'Thank God. How bad? Oh, that's much worse than mine!'"

What makes King's book different and clever is that she writes it with the limited insight of the alcoholic. She tells the reader only what she saw in the thick of her illness, not what she sees now in sobriety. It's a disciplined way of writing. "I could have written the whole book retrospectively. I could have explained it, blamed people, but I wouldn't be sitting here now as the person I am." A few years ago, there would still have been too much bitterness to write this way.

As she wrote, she found herself exasperated by her own stupidity. She describes losing her driving licence and having to go to a liver specialist before she could get it back. Alcoholic Alice got furious with the doctor. All she wanted to know was when she could get her licence back. All he kept wittering on about was the state of her liver. What on earth was wrong with the man?

We only have to think of stories like Bruce and the spider to see the resonance that determination and tenacity have for people. If there's one thing we admire, it's the person who never gives up. But when it comes to addiction, King says, you reach a point where you simply have to surrender. You cannot keep fighting for control over something that controls you. "The day I realised I was powerless over alcohol and couldn't control my drinking was the day I was empowered to get better. That is the paradox of recovery. It's only when you say, 'I can't do this,' that you get better."

Perhaps that's because surrendering means admitting the problem. Denial in alcoholics goes deep. King would once have claimed that she drank because she had problems, rather than that she had problems because she drank. "That was all part of the denial. The depth of denial is very, very complex. My denial was never about how much I drank or what I drank, because I was always very open – I was never a secretive drinker and always drank in company. My denial was more about what effect my behaviour had on everyone around me."

When an ex-alcoholic friend took her to an AA meeting, she said she was going out of curiosity – not, he must understand, because she was an alcoholic herself. But, confronted by other people's illness, she recognised her own. In fact, discovering that the World Health Organisation actually defines alcoholism as an illness helped her. Using words such as 'bad' and 'weak-willed' is very destructive for alcoholics, she says.

But if sobriety means facing reality, is it not a cop-out to say it is an illness? You could argue that a cancer sufferer doesn't have a choice, but an alcoholic does. "I don't think it's a cop-out," says King. "When you look at it, can you be of sane mind and tip gallons of poison down your throat? But I take responsibility for my illness and that's the crux of the matter. I am responsible for doing something about it. I seek to blame nobody. The buck stops, the bottle stops, with me."

The whole concept of AA rests on acknowledgement of 'a higher power'. That doesn't need to be God (though King, who was brought up a Catholic, has no difficulty with the concept of God – it was just that she'd abandoned Hail Marys for Bloody Marys). But the acknowledgement of a higher power may simply be recognition of the power of the group, seeing that people are stronger together than as individuals. You can go to AA meetings feeling very down. But King has never come out of one without feeling uplifted. There is a step in recovery where you have to tell someone everything you have done. A few weeks after that, King says, her compulsion to drink completely left her.

Some experts believe there may be a genetic component to alcoholism, and after a certain point there is a chemical addiction. But if it is largely a psychological illness, and King now understands her own compulsions, what stops her picking up a glass of champagne and drinking in moderation? "The brain tells me I could have one glass of champagne, and indeed I could. Nothing would be better to celebrate my book. However, I'd have one now and in a few weeks' time I'd think, 'Well, I was fine. I'll have two now.'" If she feels tempted, she talks to someone about it and the desire leaves her almost as soon as it's articulated. "I just fast-forward the video," she explains. "I fast-forward to waking up and not being able to remember what I've been doing. Do I want that back? Do I want that for my children? Absolutely not."

We all recognise alcoholic down-and-outs. We understand the physical and material difficulties that lead there. We can see them. But perhaps we are less good at recognising disabling psychological distress. King may be middle-class but she doesn't think her experience with alcohol is different from that of the park-bench drunk. Anyway, she could have ended up there, she acknowledges. She could have died. Alcohol, she says, cuts across class, gender, age and race. High-functioning alcoholics operate in offices all round us, surviving in work and anaesthetising themselves out of it.

Alice King had to discard not just alcohol, but a job and indeed an entire lifestyle. She has since been employed as a taster for a major tea company and hopes there will be other food contracts – sauces and ice-cream, for example. But she has primarily been a writer for 25 years and she sees that as her future. She has attended psychotherapy for years and is discussing the possibility of a newspaper column on the subject. She also hopes to turn her hand to fiction.

Sadly her father, with whom she shared her love of wine, died before seeing her solve her problems. But her mother has read her book and King waited like a five-year-old to hear her verdict. "It's marvellous," she told her daughter. It made her laugh and it made her cry. "Beautiful. You should be very proud." And King is. Her brother told her, "I loved it, I hated it, but I couldn't put it down."

King smiles. "Anything that helps me come to a position where I re-find me, and where they get their daughter and sister back, they are happy with. They are just content to have Alice back." r

• High Sobriety: Confessions of Drinker (£16.99, Orion) is published this weekend
source: Scotland On Sunday

Saturday, March 8, 2008

Teenagers suffering alcohol-style health problems

Teenagers are suffering health problems normally seen in long-term heavy drinkers.

In the last 18 months, the number of people admitted to the Royal Bolton Hospital with serious medical problems caused by alcohol has rocketed by more than 20 per cent.

And staff say people as young as 18 are being treated for conditions such as stomach ulcers and inflamed stomachs, brought on by drink.

The alcohol liaison team at the hospital, which helps problem drinkers, dealt with 76 referrals in February alone.

Just 18 months earlier the team was handling 60 referrals a month and staff say they expect numbers to keep rising.

Alcohol liaison nurse Emma Dermody said: "It amazes me how much younger people are drinking and what they think is acceptable. People need to be aware of what sensible limits are because drinking above these can be harmful."

Some patients are admitted with problems such as liver disease or alcohol withdrawal.

In other cases, staff only pick up on people's drink problems when questioning a patient treated for other complaints and then refer them on to the alcohol liaison team.

Nurses then point people in the right direction for suitable treatment in the community, such as rehab, residential detox or counselling.

A spokesman for Alcohol Concern said: "Sometimes the focus on crime and disorder is so intense that we forget a large number of people are doing themselves real long-term physical harm by drinking excessively.

"It's more crucial now than ever to ensure there are enough treatment spots to deal with problems before they become, in some cases, terminal."

Bolton Primary Care Trust has recently invested £120,000 into improving access to alcohol treatment services, cutting a six-month waiting list for treatment to less than two weeks.

Jan Hutchinson, director of public health for Bolton's PCT, admitted the figures were a concern.

She said: "People need to reflect on their own drinking and if they think they need help to contact their GP as soon as possible.

"The damage to their health might not be obvious but it will become apparent in years to come."

Chairman of Bolton Council's health scrutiny committee, Cllr Andy Morgan, is calling for more to be done to stop youngsters falling into the booze trap.

He said: "Binge drinking and alcohol-related crime continues to spiral out of control. Cheap alcohol and allowing bars to open around the clock has only served to exacerbate the problem.

"We need to radically re-think our alcohol strategy and make it harder for youngsters to get hold of alcohol."

The recommended weekly limits for men is 21 units and 14 units for women.

A unit is the equivalent to a small glass of wine or half a pint of lager.

source: Bolton News