Initiative urges thinking before drinking

Web site lets people learn what type of drinker they are

By Mary Brophy Marcus
USA Today

Many young adults socialize on weekends and weeknights at bars and parties where cocktails and beers flow, but most don't give much thought to their drinking habits, said Mark Willenbring, director of the Division of Treatment and Recovery Research at the National Institute on Alcohol Abuse and Alcoholism. If they did, he said, it's likely that fewer people would develop problems with alcohol abuse later in life.

To that end, Willenbring and other experts at NIAAA have developed a "Rethinking Drinking" Web site — Rethinking Drinking.niaaa.nih.gov — to help people who drink alcoholic beverages determine what type of drinker they are and whether they are at a risk for developing a drinking problem.

reducing risks

"Not everybody who drinks more than is medically healthy or recommended realizes they are doing it," Willenbring said. About 30 percent of Americans have too many drinks in one day at least once a year, he says.

The heaviest drinkers are primarily between the ages of 18 and 30, and they are the target population for "Rethinking Drinking," Willenbring said.

"They are a group that drinks more than is healthy, but doesn't have the health problems yet."

Willenbring likens the interactive Web site to a prevention tool. The approach is similar to how a doctor might focus on groups at risk for heart disease — those with high blood pressure or cholesterol — but who haven't had a heart attack yet. "We're really doing risk reduction," he said.

In any given year, about 4 percent of the population has alcohol dependence, or alcoholism, according to Willenbring. About 26 percent are heavy drinkers. "Even if these folks, the heavy drinkers, reduce their drinking, the public health impact is great," he said.

While many associate heavy drinking with liver problems, it can also increase the risk for heart disease, sleep disorders, depression, stroke and stomach bleeding. Consumed during pregnancy, it can cause fetal brain damage, said Fulton Crews, director of the Bowles Center for Alcohol Studies at the University of North Carolina-Chapel Hill School of Medicine. It's also linked to cancer.

"We know if you're a heavy drinker but not alcohol dependent, your risk of oral cavity cancer and also breast cancer are increased," Crews said.

at-risk drinking

The "Rethinking Drinking" site asks if visitors know what constitutes at-risk drinking. Many might be surprised to learn what does, said alcohol-abuse expert Charles O'Brien, a professor of psychiatry at the University of Pennsylvania.

"A heavy drinking day is a lot less than most people think it is," O'Brien said. "We have in college and universities many who do binge drinking and they don't even realize it. When I told my students the daily limits, they laughed at me. Many said that's barely getting started — that they have a few drinks in their dorm rooms even before going out drinking for the night."

The site provides illustrations and tables showing the amount of alcohol in a variety of drinks, including beer, wine and liquor. A calculator can help one estimate how much a typical toddy includes. Drinkers who want to make changes can find some helpful tools and resources, too.

The site isn't meant to promote abstinence, Willenbring says. It doesn't demonize alcohol. In fact, it even points out that light to moderate drinking on a regular basis can lower the risk for heart disease for some.

Schoolteacher, soccer mom, athlete, physician, husband — anyone who cares to find out if their drinking habits are risky or not can now do so on their own, Willenbring said.

Drunken driving connected to mental problems

Stockholm (IANS): Drunken driving is not just an indication of a deeply seated alcohol problem but is also very often connected to psychological disease and chronic criminal background, says a doctoral thesis presented at the Karolinska Institute (KI).

Psychologist Beata Hubicka has in collaboration with the Swedish traffic authority, Vagverket, and the police, carried out a nationwide study involving 1,200 drivers who were charged with drunken driving.

The suspect alcoholic offenders, along with a research group of 786 assuredly sober drivers, were called upon to answer a questionnaire on their alcohol consumption habits. The psychosocial and psychotic health condition of some of the drunken drivers was examined too.

"Earlier research in this area has mostly been undertaken in the US," Hubicka told IANS, after her dissertation at the KI. "However, it became essential to carry out an entirely Swedish study since we have different promille (alcohol in the blood permissible for driving) limits and different attitudes towards drunken driving compared to the US. Such variables have also to be taken into account when dealing with this problem in other countries."

The well-received study shows that "more than a half of the suspected alcohol abusers had earlier committed criminal offences. A large number among the abusers were also found to be suffering serious psychotic problems."

"Since such a large number have psychotic problems and a criminal background," says Hubicka, "one should not direct attention solely towards their alcohol problem in any preemptive efforts to resolve drunken driving".

Hubicka said: "The current limit for drunken driving of 0.2 promille (in Sweden, among the strictest globally) is based on physiological studies in which it has been observed and recorded that our capacity for reaction (reflexes) is dangerously impaired with such an alcohol level (in the blood). Since alcohol abuse is such a big risk factor (cause) for drunken criminality, the result of our study should perhaps form the basis for a reconsidered alcohol limit for driving. I would rather suggest that we follow the few countries that have established zero-tolerance."

One-Third of Americans Have an Addicted Relative

Nearly 1/3 of Americans have an immediate family member who has or have had an alcohol or drug abuse problem and almost half of those families have more than one member who had an addiction problem. For most of those families the most significant negative consequence of that addiction is the embarrassment or social stigma.

These finds were part of the "Attitudes Toward Addiction Survey" conducted by the Hazelden organization.

The telephone survey of 1,000 adults revealed some lingering stigma associated with alcoholism and drug addiction in spite of the fact 78% of those surveyed agreed that drug addiction is a chronic disease rather than a personal failing.

According to Hazelden, when survey participants were asked to describe people who have problems with drugs or alcohol included: "sinner," "irresponsible," "selfish, "stupid," "uncaring," "loser," "undisciplined," "pitiful," "pathetic," "weak," "criminal," "derelict," "washed up" and "crazy."

"What Hazelden's new survey brought home to me is that Americans understand addiction is a disease, yet much more work must be done to explain how effective treatment can be for addicts and to bring an end to the stigma that prevents addicts from pursuing treatment," said William Cope Moyers, executive director of Hazelden's Center for Public Advocacy in a news release.

The Prevalence of Addiction

Here are some of the survey findings about the prevalence of addiction:

* Nearly one-third of Americans reported past abuse of alcohol or drugs in their immediate family.

* Of those households with an immediate family member who had an addiction problem, 44% reported more than one family member with a drug problem.

* A third of the families which reported a drug problem in their immediate family say that a majority of their family members have problems with drugs.

* With one in six of the respondents dealing with substance abuse in their family, every member of the family has a problem with drugs or alcohol.

* When asked about extended family, virtually half of Americans surveyed reported three or more family members have experienced a problem with drugs during their lives.

Attitudes About Prevention, Treatment

The survey also revealed attitudes about prevention and treatment efforts:

* 79% percent feel the War on Drugs has not been successful.

* 83% agree that much more should be done to prevent addiction.

* 83% believe that first-time drug offenders should get chemical dependency treatment rather than prison time.

* 77 percent agree that many addicts who complete treatment go on to lead useful lives.

* 71% agree health insurance should cover addiction treatment, but most have no idea if their own insurance will pay.

As a result of the survey, Hazelden's Center for Public Advocacy will launch a public advocacy campaign in Washington, D.C. and across the United States this year.
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source: http://alcoholism.about.com

New Recovery

ALL ADDICTS ARE DIFFERENT — NOW THERE'S A TREATMENT THAT IS TOO

As a professional experienced with alcohol and drug addiction, you know those struggling with this debilitating disease face a long journey towards sobriety – one that requires a customized, leading-edge recovery program with a personalized approach. Unfortunately, there are few programs today that go above and beyond the standardized treatment formula to improve the odds for long-term sobriety. That's why Enterhealth, a premier alcohol and drug addiction recovery center, with its proven therapeutic approaches, neurology, technology, and leading anti-addiction medications, is earning a reputation as the better way to recover.

Here are just a few reasons why Enterhealth stands out from more traditional alcohol and drug addiction treatment programs. To learn more on how Enterhealth can help you and your clients, call 800.388.4601 or visit us at enterhealth.com.

Reason 1: Neuro therapy. In order to help clients overcome physical trauma to the brain caused by addiction, Enterhealth utilizes neurological therapy techniques. This integration of state-of-the-art diagnostics of the brain with clinical therapies involves an MRI to assess any damage caused to the brain by alcohol and/or drug use, an EEG to assess risk level of seizure, and a written neuro-psych test to check for cognitive brain function loss. The results of this evaluation support a personalized treatment plan.

Reason 2: Anti-addiction medications. Rather than rely on talk therapy alone, Enterhealth offers clients access to the latest, most effective anti-addiction medications such as Suboxone, Campral, and Vivitrol. This can help not only repair damage to the brain caused by alcohol and drug use, but also reduce cravings, providing them the opportunity to more fully participate and benefit from treatment.

Reason 3: Length of stay. In contrast to most residential treatment facilities that offer a typical length of stay of 28-30 days, Enterhealth recommends a customized length of stay based on the client's unique needs and recovery progress. This better ensures the client has the tools they need to continue sobriety post residential treatment.

Reason 4: Dual diagnosis. The Enterhealth facility is designed to diagnosis and treat both the addiction as well as other mental health disorders – which in most cases is what creates the desire for alcohol or drugs in the first place. By treating the mental disorder in tandem, typically with personalized, private therapy, the odds for relapse are greatly reduced.

Reason 5: Wellness emphasis. Enterhealth's personalized wellness program includes individual time with a trainer as well as a dietician to address physical and dietary patterns that are recommended for balance and healthy living.

Reason 6: Balance of group & private therapy. The Enterhealth facility is limited to 16 clients, offering an industry-low therapist-to-client ratio of 1:3. This intimate setting allows more focus to be placed on individualized, one-on-one therapy, while also supporting a menu of both small and large group therapies.

Reason 7: Post Residential Support. As your clients transitioned back to your care from the residential addiction treatment program, Enterhealth’s online Life Care program can assist them in continued recovery through access of Enterhealth's online recovery tools 24 hours a day from anywhere in the world.

We invite you to schedule a tour and meet our team. To learn more about what makes Enterhealth a better way to recovery and how it can help your clients, call 800.388.4601 or visit us at www.enterhealth.com

JOIN TOGETHER MERGES INTO CASA

NEW YORK, N.Y., January 15, 2009 – The National Center on Addiction and Substance Abuse (CASA) at Columbia University announced today that Join Togethertm will be merged into CASA and David L. Rosenbloom, Ph.D., will become the President and Chief Executive Officer of CASA on May 1, 2009, succeeding Joseph A. Califano, Jr., the former U.S. Secretary of Health, Education, and Welfare who founded CASA in 1992 and has been its Chairman and President since that time. Califano will continue to serve as CASA chairman.

“Naming David Rosenbloom CASA’s new president is the result of more than two years of work by the Board which involved an analysis of CASA’s first 16 years, discussions with 100 individuals and institutions about CASA achievements and potential, the needs of the substance abuse field, and an intensive search involving a number of qualified candidates. The Board and I are convinced that David Rosenbloom is the individual best suited to move CASA forward and increase its influence and activities,” said Califano. “Merging Join Together into CASA will greatly strengthen CASA’s ability to inform the American people of the economic and social costs of substance abuse and its impact on their lives, make CASA’s research findings and recommendations widely available to those working on the front lines to prevent and treat substance abuse and addiction, and significantly expand our nationwide advocacy capacity. The combination of CASA and Join Together will produce a total far greater than the sum of the parts.”

Rosenbloom, 64, has been Director of Join Togethertm since he founded it in 1991. He is a Professor of Public Health at the Boston University School of Public Health. For eight years, from 1973 to 1985, he was Commissioner of the Department Health and Hospitals for the city of Boston and CEO of Boston City Hospital. For several years after that he was president and CEO of Health Data Institute, a company that pioneered the clinical analysis of medical claims data and developed managed care techniques. He received his BA from Colgate University in 1965 and his Ph.D. from the Massachusetts Institute of Technology in 1970.

“Progress in addiction prevention and treatment is essential in order to reform America’s health care system and address most other critical social problems facing the nation. Combining the resources of CASA and Join Together creates the critical mass needed to focus the attention of our nation and its leaders on the need for effective prevention and treatment policies to achieve such progress. It blends the formidable research of CASA and the public and policy attention that CASA has attracted with the unique web based education and advocacy and tools of Join Together. I am excited by the opportunity to combine and lead these talented teams and work with Joe Califano,” said Rosenbloom.

Join Togethertm is the leading provider of news, information and continuing education on tobacco, alcohol and illegal, prescription and performance enhancing drugs to policy makers, community leaders, parents, and front line prevention and treatment practitioners; all free of charge to more than 50,000 subscribers and 7,000 daily users of its website http://www.jointogether.org/. Its advocacy campaigns promote adoption of prevention and treatment policies and practices that research has shown to be effective.

“CASA is the premier think/action tank in the field with the brightest group of professionals ever assembled under one roof to research and combat substance abuse and addiction. David has the right experience, talent and creativity to enhance this national asset. We are fortunate that he has accepted this challenge,” said Califano. “I look forward to working with him.”

CASA is the only national organization that brings together under one roof all the professional disciplines needed to study and combat all types of substance abuse as they affect all aspects of society. CASA and its staff of more than 50 professionals has issued 66 reports and white papers, published one book, conducted demonstration programs focused on children, families and schools at 224 sites in 87 cities and counties in 34 states plus Washington, DC and two Native American tribal reservations, held 17 conferences attended by professionals and others from 49 states, and has been evaluating the effectiveness of drug and alcohol treatment in a variety of programs and drug courts. CASA is the creator of the nationwide initiative Family Day—A Day to Eat Dinner With Your Childrentm –the fourth Monday in September—the 28th in 2009—that promotes parental engagement as a simple and effective way to reduce children’s risk of smoking, drinking and using illegal drugs. In May 2007, CASA’s Chairman Joseph A. Califano, Jr., called for a fundamental shift in the nation’s attitude about substance abuse and addiction with publication of his book, HIGH SOCIETY: How Substance Abuse Ravages America and What To Do About It. For more information visit http://www.casacolumbia.org/.
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source: http://www.casacolumbia.org

States Unleash New Ignition Lock Laws

Starting this month, drivers convicted of driving while intoxicated in at least six new states will face a hi-tech hurdle to repeat offenses: ignition interlocks. After a high profile national campaign, Mothers Against Drunk Driving and other organizations convinced several state legislatures to pass laws mandating the dashboard installation of small ignition interlock device activated by a breathalyzer.

“It’s amazingly inconvenient, “ David Malham of the Illinois MADD group told Associated Press. “But the flip side of the inconvenience is death.”

Will high technology really help keep drunk drivers off the streets and highways? Malham, quoted in the Chicago Tribune, insisted that “it’s not about changing human nature, it’s about science interfering and preventing reckless behavior.” Maltham also said he is looking forward to technology that will be able to sniff a car’s interior, scan the eyes of drivers, and test sweat on the steering wheel before allowing the driver to turn the key.

In addition to Illinois, states that passed laws requiring the use of ignition locks for drunken driving convictions of varying degrees include Nebraska, Colorado, Washington, and Alaska. Other states with similar but unevenly enforced laws on the books include South Carolina, Arizona, New Mexico, and Louisiana.

Illinois is attempting to work around the program’s most obvious flaws—the convicted drinker could drive someone else’s car, or get someone else to blow into the breath-monitoring device—by instituting heavy penalties for non-compliance if the driver is caught cheating.

Lined up in opposition to ignition lock legislation, thus far, is the American Beverage Institute, a lobby group for restaurant owners. In the AP article, the Institute’s Sarah Longwell objected to the fact that states might decide to apply the laws to people other than repeat offenders—to anyone who, on any given night, blows a 0.08 or a 0.10, the common denominators of alcohol intoxication in most states.

Sounding a bit more like the National Rifle Association (NRA) than perhaps it intended, the Beverage Institute offered a dire vision of a slippery slope: “We foresee a country in which you’re no longer able to have a glass of wine, drink a beer at a ball game or enjoy a champagne toast at a wedding. There will be a de facto zero tolerance policy imposed on people by their cars.”

My modest prediction: A tangle of state lawsuits and questions over civil liberties, the more so since many of the laws are first-pass efforts and subject to interpretation.

source: Addiction Inbox

Florida Drug Rehab Center Now Offering Extended Stay Programs

Ambrosia Treatment Center, a holistic-based drug rehabilitation center located in Port St Lucie Florida, now offers extended stay addiction treatment programs specifically tailored to the needs of the patient.

When it comes to health problems, a quick and neat solution is preferred nowadays. We have pills and syrups to ease every possible symptom. Surgery procedures that can be performed the same day and leave minimal scarring. However, when it comes to drug and alcohol addiction there is no such thing as a 'quick and neat solution.' Recent scientific studies have shown that the longer the treatment, the better the recovery and the more permanent the sobriety.

Therefore, drug rehab centers nationwide have begun lengthening their programs and making recommendations to possible patients for longer treatment stays that are still cost effective. Ambrosia Treatment Center, a world-class holistic drug rehab facility located in Port St. Lucie Florida, has begun offering both 60-90 day programs and 6-12 month programs, in addition to their shorter programs, in order to provide specialized treatment for all of their clientele.



According to the National Institute on Drug Abuse, over forty to sixty percent of people 'will relapse after drug treatment.' Addiction experts are now proving that longer treatment where client's specific needs are taken into account will alleviate the massive weight of addicts relapsing and cycling between 30-day hospitalizations for years and years. Dr. David Lewis, director of Visions Rehabilitation Center in Malibu, says that 30-day treatment programs were originally established for the Air Force and were only scheduled in that manner for bureaucratic reasons--'men and women didn't need to be reassigned if they were away from duty for more than 30 days. Other treatment centers followed suit.'

However, there was at the time no direct scientific evidence that showed that 30 days was adequate time for treatment. Today, we know that there are no 'magic numbers' when it comes to drug and alcohol abuse treatment and those 30 days is not nearly enough. The Ambrosia Treatment Center, as a holistic-based drug rehab facility, follows this pattern by treating the 'whole' person in order to resolve the underlying issues that may be causing the addiction in the first place. Often times, treating the 'whole' person requires more than simply 30-days.

However, many people find that an extended stay beyond 30-days is too much for addiction treatment. People argue that they have jobs, school, families--the normal day-in-day out routine that needs attention. What they want from rehabilitation is a quick fix. Yet, as stated before, there is no quick fix for drug and alcohol addiction and abuse. Studies have shown that addiction is best analogized to a chronic disease, such as heart disease--addiction requires critical attention and perseverance in terms of treatment in order to remain healthy. The Ambrosia Treatment Center family provides strong and capable staff, each of which carry over 20 years experience treating substance abuse and addiction treatment clients from all walks of life. Their attention to detail enables them to provide each client with an individualized regiment of treatment and not necessarily 'cookie cutter' their therapy.

At the end of the day, this is what sets The Ambrosia Treatment Center different from other rehabilitation clinics--they care. They want to see your loved ones get well. They never give up on an addicted person. And, at the end of the day, they believe that you never fail unless you just quit trying.

For additional information on the AMBROSIA TREATMENT CENTER and drug abuse treatment please call 1-866-616-0069 or visit www.ambrosiatreatmentcenter.com.
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source: topix.net

Drug And Alcohol Abuse Double Risk Of ICU Admission

While the personal health and safety risks of drug and alcohol abuse are well-documented, a new study by researchers at LDS Hospital and Brigham Young University suggests substance dependence increases medical costs by way of the intensive care unit.

Analysis of intensive care unit admissions at LDS Hospital in Salt Lake City shows drug and alcohol abuse make a patient twice as likely to be admitted to intensive care, according to the new study, published in the December issue of Intensive Care Medicine.

"Since these patients are admitted to an intensive care unit, which is geared to treat patients with a much higher acuity, medical costs are higher than for those admitted to a general ward in the hospital," reported Mary Suchyta, M.D., lead author and a physician at Intermountain Medical Center and LDS Hospital.

The researchers reviewed records for 742 patients admitted to LDS Hospital's intensive care unit over a one-year period. Nineteen percent of those patients had a history of drug and alcohol dependence prior to becoming critically ill. That's twice the rate of the population served by LDS Hospital.

"It appears that that patients with drug or alcohol dependence are at higher risk for intensive care unit admission compared to the general population, which would increase overall medical costs," said Ramona Hopkins, a psychology professor at BYU and researcher at Intermountain Medical Center and LDS Hospital.

Patients with drug or alcohol dependence were on average six years younger than the rest of ICU patients.

"What's alarming is that substance dependence meant that these individuals were critically ill and admitted to the ICU at a much younger age than the general population," Hopkins said. "If these individuals do not completely recover and return to work, that represents large potential societal costs."

The new study earned praise from the editors of Intensive Care Medicine, who noted that there are significant gaps in this type of knowledge in most ICU settings and while this article did not answer many of the questions posed by these gaps, it should stimulate further research and collaboration.

Both Drs. Suchyta and Hopkins agree that the detection of substance dependence earlier would allow doctors to address those issues and this may improve recovery.

"Dr. Hopkins and myself have thought for many years that patients with drug and alcohol dependence were over represented in the ICU populations that we have studied over the last 10-15 years and this study suggests that we were correct," noted Dr. Suchyta.

BYU undergrad Callie Beck is also a co-author on the new study. It's her second time publishing an academic paper alongside Hopkins. In 2006 she co-authored a study on brain imaging, a field she would like to pursue in graduate school. Beck is applying to nine graduate schools, including UCLA, Vanderbilt and the University of Maryland.

"Callie is an amazing student," Hopkins said. "She was involved in many aspects of the research, including data analysis and writing. That level of experience will make her stand out as she applies to graduate school."
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source: MediLexicon

Binge drinking linked to increased stroke risk

Binge drinking linked to increased stroke risk. It’s well-known that binge drinking is not good for your health and a new study shows it may have an even more pronounced effect on your brain than you thought. In fact, the researchers say that making binge drinking a habit could increase your risk of a stroke.

Binge drinking often occurs at parties or in social settings where people take in large amounts of alcohol at one time. In this study, researchers defined it as consuming six or more alcoholic drinks for men or four or more drinks for women in one session. They looked at almost 16, 000 Finnish men and women age 25 to 64 years. They participated in a risk factor survey and were followed up for 10 years afterward.

In that time there were 249 participants who had a first stroke. The researchers found that while average alcohol consumption did not seem to be associated with the strokes, sessions of binge drinking showed a clear link with the occurrences. The binge drinkers were 1.85 times as likely of having a stroke compared to the non-binge drinkers and 1.99 times as likely when adjusting for the risk of ischemic (clotting) stroke alone.

The researchers concluded that heavy sessions of alcohol consumption might be an independent risk factor for stroke.

The Heart and Stroke Foundation does not recommend that you drink alcohol for the purpose of reducing your risk of heart disease and stroke. For those healthy adults who drink alcohol, consumption should not exceed 2 drinks* a day with a weekly limit of 14 drinks for men and 9 drinks for women. Binge drinking should be avoided.

(A standard drink is 341 ml of 5% beer, 142 ml of 12% wine, and 43 ml of 40% spirits.) *
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source: On the Pulse News

Huesik: Korean for binge drinking

A classic South Korean working day usually ends up in Huesiks, binge drinking sessions cast as social events. But behind the drunken smiles lurks an alarming variety of health problems that stem from heavy drinking.

Night falls on Seoul as workers leave their offices. It is time for Huesiks, boozy meals shared by coworkers at least twice a week. Taking part in them is highly recommended as those who do not can find themselves quickly ostracized from the group.

This means drinking a lot; and quickly. Part of the aim is to find summon courage to lose one’s inhibition and criticize the boss. We follow one group as they treated a client in a Japanese restaurant. They are going to talk business. But, above all, they will raise toast after toast. That's already four in less than ten minutes.

Soju is Korean people’s favorite drink. It is made of rice, potatoes or barley, is very cheap and usually contains about 25% of alcohol. So, a few hours and several bars later, these employees aren’t exactly in professional shape anymore.

Having left the bar, these heavy drinkers drunkenly wait on subway platforms or stumble out onto Seoul’s streets. One businessman we come across has drunk one bottle of whisky every day for the last 20 years. Despite a recent recovery from stomach cancer, he remains a heavy drinker.

In Korea, warnings against heavy drinking are still very rare. Advertising is legal. Yet, for the local authorities, the cost of alcohol abuse is mounting. One in 10 korean adults suffers from various health problems stemming from heavy drinking. And it is not about to change as average alcohol consumption rose again in September.
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source: France 24

Vodka makers may have to pay for addicts' treatment

Amid criticism from alcohol producers, a bill was introduced in the lower house of the Russian parliament (Duma) according to which
producers of vodka and other alcoholic beverages will have to pay for the treatment of chronic alcoholics.

Lawmaker Viktor Zvagelsky of the ruling United Russia party has introduced the bill which will bound the producers of alcoholic beverages to bear the 'moral and financial responsibility' and pay for the treatment of chronic alcoholics, according to a report.

Zvagelsky proposes to set a mandatory mechanism for compensation of damage to health of citizens caused by consuming alcoholic drinks

Earlier last month, Russian interior minister Rashid Nurgaliyev had recommended to restore the Soviet-era system of forced treatment of alcohol abusers.

According to the lawmaker, the alcohol producers will have to pay approximately four roubles for per litre of vodka produced by them into a self-regulated fund to finance the network of clinics and sanatoria involved in the treatment of alcoholics.
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source: Times of India

Avoiding alcohol's temptations in 'overwhelming' war zone

Once each week, in a fluorescent-lit room in a stout building near the heart of Kandahar Air Field, a multinational mix of troops and civilians gather to take on a battle that can't be fought with conventional weapons.

Sitting around a table, or on overstuffed furniture, they talk about bad days, frustrating bosses and how it is that a fellow soldier can become a drunk on a dry base in a mostly dry country.

Called Sober in the Sand, the group is this base's own chapter of Alcoholics Anonymous. For many who spend much of the year living abroad in Afghanistan, their weekly meetings have become a lifeline to staying sober far from the supports of home.

Jennifer, a 31-year-old from Winnipeg, has been sober for 10 years. Still, when she arrived to work at the base five months ago as a civilian, she was anxious about the strain that living in a war zone might cause.

"It's not like I'm shaking for a drink all the time," she said.

But she added that the base, which serves as a temporary home for more than 10,000 people from dozens of countries and is the frequent target of insurgent rocket attacks, can be "overwhelming" at times.

"It's a really crazy place."

That craziness was tempered, though, when she walked into her first AA meeting.

Instantly, she felt she belonged.

"There's a base level of understanding between alcoholics. They know you, you know them. It's almost like family."

The group operates like most conventional AA groups, meeting once a week and setting up links between new recovering alcoholics and those with more sober years under their belts. But there are unconventional elements that come with operating in a war zone.

"Here we worry about our fellow alcoholics going out and not coming back alive, which is a little harder to deal with," said Ed, a 47-year-old mechanic from Midland, Ont.

Typically, the group has about five regular members, but has swelled to more than 15 at different times.

Often, the group will gather for special meetings if soldiers are coming through who are normally stationed off base at one of the smaller outposts.

"If they need a meeting, well, darn it all, somebody should be there," said Ed, adding that those who come to the AA group for support but have to leave to work off base are usually given literature, including copies of The Big Book, a step-by-step guide to getting sober that explains the Alcoholics Anonymous tradition.

"My book I was carrying around for 14 years went out to a forward operating base with them," Ed said. "If you have no meetings out there and guys at least have something to read, at least you have some comfort."

John, a 31-year-old U.S. Army soldier from the Bronx, said it took some work to find the AA meetings when he arrived on base.

At times the program has nearly faded away, largely because of the transience of people at the base. But it has always been revived.

"People are not only coming here to talk about problems with alcohol," he said. "We come here for peace of mind. I've actually had the opportunity to help people."

For that reason, no matter how many troops and contractors move on and off the base, the group will always exist, said Chuck, a 55-year-old civilian from Minnesota who with 26 years of sobriety, is the unofficial dean of Sober in the Sand.

"AA is a program of principles. If everybody shipped out, the next recovered alcoholic coming through Kandahar would initiate it again.

"This meeting will always be here after we've gone. The AA will keep reconstituting itself, just like the Taliban."
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source: Globe and Mail

Alcoholics Have Problems Recognizing Danger

Alcoholics have trouble recognizing and avoiding dangerous situations because the area of their brain that is used to appreciate those kinds of concerns is functioning at a reduce level, stunting their ability to perceive danger. This may help explain why they do not react to the concerns of their friends and family members about their drinking.

Previous studies have shown that alcoholics have problems recognizing facial expressions and many other studies have shown cognitive deficits in alcoholics. A new study indicates that alcoholics may also have emotional processing deficits also.

Researchers studied 11 alcoholics and 11 healthy males and used fMRI brain imaging to track their brain-blood oxygenation level dependent (BOLD) responses while they were given facial-emotion decoding tasks.

Sensation Seekers

The subjects were ask to determine the intensity of happy, sad, anger, disgust and fear displayed via facial expressions. The results showed that alcoholics were most deficient at recognizing negative emotional expressions.

These deficits showed up on the fMRI images in the affective division of the anterior cingulate cortex -- part of the prefrontal brain area.

"The cingulate is involved in many higher order executive functions such as focused attention, conflict resolution and decision making," said Jasmin B. Salloum, research scientist at the National Institute on Alcohol Abuse and Alcoholism, in a news release. "Alcoholic patients are known to be sensation seekers and are less likely to shy away from signals that suggest danger."

Findings Have a Silver Lining

"Both sensation seeking and avoidance of danger are characteristic of subjects with axes II personality disorders, which many of our subjects had," Salloum said. "The findings in this study may shed some light on some of the problematic and psychopathological behaviors that are manifest in this patient group. It remains to be determined if the dysfunction of the anterior cingulate precedes alcoholism or is a result of long term drinking."

The study did have a silver lining, according to Andreas Heinz, director and chair of the department of psychiatry at Charite – University Medical Center Berlin.

"Now we can begin to understand why patients have problems avoiding dangerous situations and, particularly, why they may not react to the concerns of their friends and relatives: the brain area that should help them appreciate these concerns is functioning at a reduced level," said Heinz.

But Happy Faces Work

"Furthermore, we observed a normal or even increased brain response to happy faces. Our group recently made a similar observation, in that patients with strong brain responses to pleasant pictures have a reduced relapse risk," Heinz said. "So, relatives and friends may want to support alcoholic patients with positive messages that strengthen their self-esteem while being particularly careful, and even repetitive, in pointing out the dangers of alcohol and alcohol-associated environments. Otherwise, the patients may miss the message."

The study was published in the September 2007 issue of Alcoholism: Clinical & Experimental Research.
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source: about.com

Third of routine drinkers get potentially fatal liver damage

One third of routine drinkers sustain enough liver damage to put themselves at risk of an early death, researchers have found.

A study at University College London found an unexpectedly high level of liver abnormalities among "normal working people" who consume more alcohol than average but would not regard themselves as alcoholics.

Professor Rajiv Jalan, head of the liver failure group at University College London hospitals and one of the authors of the study, said: "These are people working in offices who we routinely encounter.

"They are representative of working people in our society and they are at risk."

The study looked at results from more than 1,000 men and women, mostly aged 36 to 55, who used home testing kits to measure liver damage.

The kits measure specific enzymes in the blood, high levels of which indicate liver abnormalities.

More than 70 per cent of those involved in the study said they regularly drank more than the government's recommended limit of 14 units of alcohol a week for women and 21 units for men, and 41 per cent of them said they drank every day.

The results showed at least 30 per cent of the people tested had liver abnormalities.

The worrying findings will be published this week in the medical journal Hepatology and come as the government considers the introduction of national screening to counter rising levels of liver disease.

Up to two million people in Britain have chronic liver disease and many are unaware of their illness.

Deaths from the disease have increased by eight times in men aged 35 to 44 and by seven times in women over the past 30 years.

Doctors warn that symptoms of liver disease are not felt until too late and by that time patients have up to a 50 per cent chance of dying early.

A Medical Research Council study found that intelligent people can be at greater risk of alcohol problems as they seek to cope with stressful jobs.
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source: http://www.telegraph.co.uk

Struggling With Alcohol? Better Quit Smoking, Too

Overcoming alcoholism is tough enough. That's one reason many alcoholics who smoke continue to light up even while they're in recovery from alcohol dependency.

But new research suggests that tackling both addictions simultaneously may offer the best chance of success.

Recovering alcoholics often admit they're using nicotine as a drug, said Dr. Michael M. Miller, president of the American Society of Addiction Medicine.

"They can tell you, 'I don't want to quit [smoking], because it changes the way I feel. I use it to deal with stress,' " added Miller, who's also director of NewStart, a chemical dependency rehabilitation program at Meriter Hospital in Madison, Wis.

A study of alcoholics in treatment for their alcohol problems used brain scans to examine how performance on cognitive tests changes with abstinence from alcohol. Twenty-five alcoholics stopped drinking for six to nine months, but the 12 who smoked continued to smoke.

"We found that the smoking alcoholics over six to nine months of abstinence did not recover certain types of brain function as the non-smoking alcoholics did," said study author Dieter J. Meyerhoff, a professor of radiology at the University of California, San Francisco. Decision-making skills, thinking speed, 3-D visualization and short-term memory were affected, calling into question the prospects of long-term sobriety, he noted.

And while smoking and non-smoking alcoholics improved on several other cognitive tests, such as learning and remembering words, smokers' brain function, in general, took longer to recover.

The findings were published in the journal Alcoholism: Clinical and Experimental Research.

Studies indicate that 60 percent to 75 percent of people in alcohol-treatment programs smoke cigarettes, and 40 percent to 50 percent are "heavy" smokers, consuming more than a pack a day.

Yet treatment for tobacco dependence is not routinely included in alcohol treatment programs, Boston University researchers reported recently in the journal Alcohol Research & Health, published by the U.S. National Institute on Alcohol Abuse and Alcoholism.

"I would say that over half of chemical dependency treatment agencies now talk about nicotine, encourage patients to stop [smoking] and provide them assistance to stop, such as with nicotine-replacement therapy or prescriptions for Zyban or Champix," Miller said. "So that's a tremendous advance."

Oftentimes, though, smoking is excused. "What you don't see," Miller said, "is building nicotine into the treatment plan and considering tobacco use to be a relapse of addiction."

The concern had been that addressing both dependencies concurrently would pose "too great a difficulty for the patient" and impede recovery from alcoholism, the Boston researchers noted. But studies now suggest that quitting smoking does not derail alcohol treatment -- and may even improve the likelihood of longer-term sobriety, they said.

In fact, Miller said studies show that people in recovery for other addictions who delay smoking cessation can later relapse to their chemical dependency because of the stress of quitting smoking six to 18 months later.

"So stopping everything at once -- getting all the psychological stress out of the way at once -- is the best way to go, and also getting all the physical withdrawal syndromes out of the way at once is the best way to go," he concluded.

Meyerhoff agreed that tackling smoking as part of an alcohol treatment program is a smart tactic.

"The alcoholics have shown that they are willing to change one behavior, namely excessive drinking," he said. "If they are in that mindset, it is a great opportunity for treatment specialists to also convince them of the negative effects of continued chronic smoking."
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source: U.S.News & World Report

Gene mutation in worms could further understanding of alcoholism in humans

Scientists at the University of Liverpool have found that a genetic mutation in worms could further understanding of alcoholism in humans.

The work follows a study carried out by Oregon Health and Science University, which suggested a link between a gene mutation in mice and tolerance to alcohol. Researchers at Liverpool have investigated this in worms, looking specifically at the role the gene plays in communication between cells in the nervous system.

This gene specifies the ways in which amino acids arrange themselves into a protein called UNC-18 - or Munc18-1 in humans, an essential component of the nervous system. Researchers found that a naturally occurring change in this gene can result in a change in the nature of one of the amino acids, which then alters communication between cells in the nervous system. As a result of these changes the nervous system becomes less sensitive to the effects of alcohol, allowing the body to consume more.

Professor Bob Burgoyne, Head of the University's School of Biomedical Sciences, explains: "Alcohol consumption can affect the nervous system in a number of ways. Low concentrations of alcohol can make the body more alert, but high concentrations can also reduce its activity, resulting in motor dysfunction and a lack of coordination. Some people, however, are more susceptible to these effects than others, but it has never been fully understood why this is.

"We used the nematode worm as a model to look at the role genes play in alcohol tolerance because all of the worm's genome has been characterised and we can therefore identify its genes easily. The gene we looked at corresponds to a gene in humans that performs the same function in the nervous system. Mutations in genes can occur naturally without any known cause and will persist if they are not particularly harmful."

Dr Jeff Barclay, co-author of the research, added: "We investigated alterations in amino acids in two genetically identical worms. One carried a mutation that was exactly the same as the genetic change our American colleagues found in mice and the other carried a different change within the same gene. Both these mutations altered the way communicate occurs between cells in the nervous system. The mutations reduce the negative behavioural effects of alcohol and so more can be consumed before the body starts to react badly to it.

"Now that we have shown the link between the gene and alcohol tolerance in worms, it is possible to search the human gene to see if there are any spontaneous changes that could help identify individuals with a predisposition to alcoholism."

The research is published in Molecular Biology of the Cell.
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source: http://www.news-medical.net

12-stepping Alcoholics into the 21st century

After 73 years, program continues to help addicts and loved ones

God grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference.

Editor’s note: Anonymity is the spiritual foundation of all of the traditions of Alcoholics Anonymous, according to the organization’s literature. For that reason, we have chosen to identify by first name only the AA members quoted in this story.

On May 16, 2004, Bob awoke at 2 a.m. in the driver’s seat of his car with a bottle of vodka in his lap. He was in the parking lot of a convenience store, but he had no idea where the store was.

“I had developed a tendency to get angry and drink and drive and be gone for a couple of days,” Bob says. “This was one of those crazy excursions. I could have been in Arkansas or Minnesota. I figured it would seem stupid to stagger into the store and ask where I was, so I drove around until I figured it out.”

He shakes his head. “Great logic.”

Luckily, he was in Conyers.

“When I got home, my heart was pounding, I was sweating and the room was spinning, like a thousand times before. But I’d scared myself so much that the fear of continuing to live like that overcame my fear and reluctance of turning my life and will over to God.”

Bob was willing to admit that he was powerless over alcohol and prayed to God to take the burden from him.

“It sounds stupid, but I felt the presence of something in the room,” he says. “I could feel it, and then it felt like an elephant had been sitting on my chest, and it got up and walked away. Something big and good had happened.”

Bob hasn’t had a drink since, and attributes his abstinence to the five Alcoholics Anonymous (AA) meetings he attends every week.

“Every time I go, I’m reminded that I’m an alcoholic and I have a problem,” he says. “But it can be overcome, and I am overcoming.”

It’s been 73 years since AA began, and the 12-step concept it fathered is more popular than ever. Twelve-step programs now treat millions around the world for everything from drug addiction, gambling and overeating to clutter, sexual compulsion and workaholism.

“Twelve-step programs are very helpful for a lot of people, especially when it comes to substance abuse issues,” says Dr. Tommie Richardson, a staff member of the Ridgeview Institute. “They are the most successful modality we know of right now. The fact that they’ve been around so long and continue to thrive tells you that.”

“It’s a brilliant program,” says Tere Tyner Canzoneri, a minister and pastoral counselor at The Emmanuel Center for Pastoral Counseling in Atlanta. “There’s not a person on the planet who couldn’t benefit from working the steps.” Robby Carroll, a minister at Shallowford Presbyterian Church and a marriage and family therapist, regularly refers clients to 12-step programs because “they’re the only programs that understand the challenge of addiction.”

Addiction has resisted the best efforts of science, medicine, psychiatry, social workers and social pressure before and since the providential meeting in 1935 of Bill Wilson, a New York stockbroker, and Dr. Bob Smith, an Akron, Ohio, surgeon.

Both were alcoholics, but Wilson used spiritual principles and the insight that alcoholism was a disease to get sober. After he persuaded Smith to follow suit, they began working with other alcoholics and started the first AA group that same year.

Favorable publicity and the publication in 1939 of Wilson’s book “Alcoholics Anonymous” anchored the program’s status and popularity.

Today AA is the largest of the 12-step programs (followed by Narcotics Anonymous and Al-Anon) with an estimated worldwide membership of 2 million. Experts, citing the difficulty of estimating anonymous fellowships, believe the numbers are much higher.

There are more than 400 groups and 1,100 AA meetings a week in the Atlanta area alone. Dr. Steven Lee, medical director of Summit Ridge Hospital and director of Addiction Services in Gwinnett County, estimates addictions affect 15 to 20 percent of the population in Gwinnett alone.

“We’re just touching the tip of the iceberg that needs treatment,” he says.

The 12 steps are a rigorous program of spirituality, self-examination and self-renewal that Smith, affectionately remembered as “Dr. Bob” by 12-steppers, summarized as “Trust God, clean house and help others.”

Trusting God doesn’t come easily, however. Many participants either don’t believe in God or blame Him for their difficulties, which is why the steps refer to “a Power greater than ourselves” and “God as we understood him.” Mention of religion during meetings is forbidden, and rigorously enforced.

Nevertheless, therapists say that some find spirituality of any stripe objectionable and don’t return. Nor do 12-step programs always work with those in the early stages of addiction.

“I see folks who have gotten into treatment after a DUI or who think it’s an aberration,” says Bob Fredrick, a clinical social worker and therapist in Atlanta. “They say ‘I just don’t connect there’ or ‘I’m not as bad as them.’ There’s a lot of denial with addiction.”

Lee says there is an organization for physicians that relies on conventional therapy and medication rather than meetings. “I disagree,” he says, “but they’re not the core of the recovery community. It’s hard for them to admit they’re powerless.”

There are other recovery groups, says Scott Maddox, an addiction counselor and executive director of Alpha Recovery in Atlanta and Brunswick, “but all the evidence shows that the 12-step approach is the most successful.”

And while individual therapy gets to core issues faster, he says, 12-step programs are superior because, “You have people who have common problems and experience with solutions to those problems. They provide a support network for ongoing recovery that therapy doesn’t provide.”

“They’re one of the few places that folks really feel understood,” AA member Frederick says. “Folks ready to deal with addictions find kindred spirits who understand that they’re dealing with a disease, and it’s not a willpower or moral issue.”

Bob says he thinks the steps are pure genius.

“When they started to take hold,” he says, “I realized it wasn’t about stopping drinking, it was really about living sober.”

The program, he says, offers a systematic formula for living life.

“It’s a toolbox,” he says, “to get me through life. Before, I had one tool, and that was a bottle opener.”

Al-Anon Helps Spouse Deal With Disease

Peggy knows how long she’s been in Al-Anon by calculating how long her husband’s been sober: 25 years.

“I’ve been in 27 years,” she says. “In the beginning I didn’t really want it, but I needed it. Then I realized I really wanted it, that it was good for me. I knew what was going on. He couldn’t con me anymore. I went to a lot of AA and Al-Anon meetings, so I was very aware of the disease.

“The alcoholic is drinking, and we’re hugging the alcoholic. We’re perfectionists, sensitive, fun and caring. It’s almost the same disease, except we’re not allergic to alcohol.”

She attends two or three Al-Anon meetings a week, and accompanies her husband to AA meetings a couple of times a month.

“It’s a miracle,” she says. “I’ve learned so much, but I don’t know it all, so I keep going. I think it’s for all people, not just those with alcohol problems. It just makes for a better life.”

‘Your Part Is The Only Thing You Have Control Over’

Karen, a single mother with a 9 1/2-year-old daughter, is a recovering alcoholic who’s been sober and attending AA meetings for 22 years. Two years ago, she began going to Al-Anon as well.

“I was dating a crack addict,” she said. “It was the most insane thing I could do. I knew I loved alcoholics; that’s the gist of it. They’re fabulous people, exciting. In Al-Anon, you learn to focus on yourself because your part is the only thing you have control over.”

Karen’s daughter attends a weekly meeting of Alateen (for children and teens affected by alcoholism in a family member) and “loves it. She’s never known me to drink, but she gets a lot of help with what she’s going through with her father.”

Karen says the meetings “taught me to apply spirituality in a way I didn’t learn in church. I have freedom to do anything I want to do, to be anything I want to be… .”

THE 12 STEPS OF ALCOHOLICS ANONYMOUS

1. We admitted we were powerless over alcohol —- that our lives had become unmanageable.

2. Came to believe that a Power greater than ourselves could restore us to sanity.

3. Made a decision to turn our will and our lives over to the care of God as we understood Him.

4. Made a searching and fearless moral inventory of ourselves.

5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

6. Were entirely ready to have God remove all these defects of character.

7. Humbly asked Him to remove our shortcomings.

8. Made a list of all persons we had harmed, and became willing to make amends to them all.

9. Made direct amends to such people wherever possible, except when to do so would injure them or others.

10. Continued to take personal inventory and when we were wrong promptly admitted it.

11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

Note: Other 12-step groups have adapted AA’s steps, sometimes changing the wording to accommodate the needs of their constituents. Al-Anon, for example, changed one word, replacing “alcoholics” in Step 12 with “others.”
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source: Atlanta Journal-Constitution

Alcohol admissions triple at central London hospital

Adult alcohol-related admissions to an inner London hospital have tripled in the last four years, according to new research.

Trends in admissions were studied at the emergency departments and in medical admissions at two inner London hospitals – University College Hospital and the Whittington Hospital from 2004-8.

The total number of adult in-patient admissions at the two hospitals rose from 998 in 2004-05, to 2,690 in 2007-08. Adult attendances linked to alcohol in the emergency departments rose too - from 2,560 in 2004-05 to 3,434 in 2007-08.

Dr Andrew Smith, lead researcher, and colleagues found the figures for University College Hospital demonstrated a clear trend. This was not the case with the Whittington data.

University College Hospital is located in an area with a high concentration of pubs and nightclubs whilst the Whittington is not, which might be the reason for the increase in alcohol-related attendances at this hospital, they suggested.

Separately, they examined trends in teenage alcohol-related presentations. No increase in hospital admissions was observed, although the number of A&E attendances for under-18s rose from 98 in 2004/05 to 165 to 2007/08.

‘This increase coincides approximately with the change in the licensing laws. While under-18s might not generally be expected to be drinking in licensed premises, the law changes also affected off-licenses which may be of relevance,’ said Dr Smith.

The Licensing Act 2003 came into effect in November 2005. This change appears to have been paralleled by an increase in the presentation of alcohol-related illnesses in these two hospitals, conclude the authors.

‘A three-fold increase in the total number of adult admissions is noted at one hospital which if repeated at other centres, would have significant ramifications on NHS resources if this trend continues,’ they added.

The data were presented at the Royal College of Psychiatrists’ Faculty of General and Community Psychiatry Annual Meeting in Manchester today.

It follows last week’s calls for strong public policy measures to counter the alcohol problem in society. Dr Nick Sheron and colleagues said changes to price and availability of alcohol would work better than clinical treatments or Government initiatives to cut alcohol-related harm.

Writing in Gut, they say evidence from the WHO, the Academy of Medical Sciences and the EU, show that the best way of reducing consumption and alcohol-related harm is to tackle price.
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source: On Medica

Don’t wait for cops to detect alcohol abuse

Rightful outrage over dangerous drunken drivers has fueled new demands for tougher laws and penalties.

And who can argue?

But with Wisconsin on top of most lists for binge drinking or drunken driving, you know there are many more folks out there who are risks but have yet to become a statistic or headline.

So let’s not overlook another, better way to get at the nub of the problem.

A pilot prevention program, if broadened as many respected medical associations say it should be, would screen many more people for problem drinking or drug use before it’s too late. It would intervene with information and, where needed, treatment, before these problem drinkers end up in highway carnage or handcuffs.

It would start at the doctor's office.

One of my doctors requires me to complete an annual survey that asks, among other things, about alcohol or drug consumption. The trouble is, most doctors don't have time to talk about it. They can barely deal with your high blood pressure or arthritis or other painful ailment as it is.

Waukesha's Family Practice Center is one of 20 clinics participating in the promising prevention effort through the Wisconsin Initiative to Promote Healthy Lifestyles, financed with a $12 million, five-year federal grant. (See www.wiphl.comfor information.)

Betzaida Silva-Rydz is the specially trained health educator at the Waukesha clinic. She describes a woman who came to the clinic for medical issues and, like others, completed four screening questions - like when was the last time she had four drinks in one sitting.

After she was provided information, without judgment, the woman recognized that both she and her husband had a problem in ways they hadn't considered, affecting their health, their family, their finances.

Through a few more sessions, the couple saw their way to changes that put more effort into family and less into social drinking.

It's the kind of story repeated last week at a meeting of health care professionals where early screening and intervention were hailed by the likes of Milwaukee Commissioner of Health Bevan Baker and Milwaukee County District Attorney John Chisholm.

Baker, quoting his wife, said it's not just taking the bull by the horns - which can leave you gored - it's removing the horns.

The National Institute on Alcohol Abuse and Alcoholism says one in four Wisconsinites is a problem drinker or drug user, but only 10% to 20% of them get help. The state estimates the consequences cost $5 billion a year in health care, social services and criminal justice. One brief screening and intervention saves $1,000, a state study reports.

The National Commission on Prevention Priorities, which tries to identify the biggest bang for the buck in public health spending, has an eye-opening ranking of how to best make us healthier:

First, men older than 40 and women older than 50 should take a daily aspirin for cardiovascular health. Second, children should be immunized. Third, help people quit smoking.

And fourth? Have routine alcohol screening and intervention. It's ahead of cholesterol screening, blood pressure screening. even cancer screenings.

It's that important. So more clinics should get involved. More insurance plans should cover it. And more people desperate to do something about drunken drivers should demand it.
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source: Milwaukee Journal Sentinel

Doctors can't treat your drinking problem

The rise in alcohol abuse should be a matter for social policy not the GP's surgery

‘Your GP is the first place to turn if you are concerned about your drinking.’ This was the concluding advice of a recent eight-page Guardian supplement devoted to ‘Britain’s harmful relationship with alcohol’. Once regarded as a manifestation of moral turpitude, excessive drinking is now defined as a medical condition. GPs have taken the place of evangelical ministers at the head of the modern temperance crusade. The fact that these same doctors come second only to publicans in terms of death from alcohol-induced cirrhosis of the liver has not diminished medical authority in this area.

The rise of GPs in dealing with alcohol problems is based on claims for the effectiveness of ‘brief interventions’. This means doctors giving patients a quick, but empathetic, lecture on the adverse health consequences of alcohol before advising them to stop. But close scrutiny of these studies reveals that their high success rates are achieved at a cost. They exclude patients who are alcohol dependent (including only those deemed to have ‘hazardous’ levels of drinking). They follow up for a short period (usually less than 12 months). And they define success in terms of a reduction in total consumption or episodes of binge drinking (rather than achieving abstinence).

If doctors suggest to patients drinking over the odds that they should consider cutting back, they do, for a while, before resuming their old habits. A desperate resort to old-fashioned medical paternalism? – yes. A solution to ‘Britain's harmful relationship with alcohol’? – no.

Prominent doctors and medical organisations instinctively recognise the ineffectiveness of medical intervention – and indeed of medical treatment. They have campaigned for prohibitionist measures to deal with excessive drinking. No newspaper or television feature on alcohol is now complete without a leading liver specialist, psychiatrist or GP demanding more regulations on the sale of alcohol. They call for banning advertising, raising prices and for tougher policing of licensing laws. But if doctors cannot treat alcoholism in their surgeries, why should anybody accept their proposals in the sphere of social policy? After all, they have no expertise there whatsoever.

The notion that doctors can treat the nation’s alcohol problem is a delusion that is convenient for the medical profession and for politicians eager to respond to the latest moral panic. But it marks an evasion of the real issues. Self-destructive patterns of alcohol consumption express personal and social demoralisation. This is not susceptible to medical – or political – quick-fixes.
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source: The Times