How alcohol killed my son at 23

Chris died earlier this year at the age of 23 as a direct result of alcohol abuse. Here his mother Kathy describes how her only son went from a thoughtful little boy to a desperate alcoholic.

"It's funny looking back now, how strongly he objected to alcohol at the age of nine or 10.

His father had been an alcoholic and had committed suicide when Chris was just six. But I had thought that together, we had come to terms with this and moved our lives on.

He wasn't one of these 12 or 13-year-olds you read about downing cider in parks. He didn't have his first drink until he was 15, and he certainly wasn't out bingeing then.

He was working hard at school, and left with 12 GCSEs.

It wasn't until he was 17 and he went to college that I think he started drinking regularly - or at least that was when I started noticing it. There was cannabis too, with his friends.

But I think a lot of the drinking was going on at home, secretly. I clearly remember at Christmas that year noticing that a bottle of spirits was missing.

Violence and shoplifting

At 18, he inherited £20,000. I had no control over how he spent this money. Some went on a motorbike, the other £15,000 was spent on alcohol and drugs.

But the strange thing was he never smelt of alcohol, or even appeared intoxicated. His father was the same, and I think it allowed Chris not just to hide it from other people, but also stopped him from facing up to his own problems.

I was also starting to suffer violence from him. But I never really confronted him over this or called the police in because I was scared stiff of alienating him at a time when I felt he needed to be close to me.

There was shoplifting too. We were in the supermarket together and he concealed a bottle of vodka. He was arrested, but I paid the penalty to avoid him having a criminal record, because I was still convinced he would turn a corner.

He dropped out of college and flitted from job to job. He went to see the doctor who said he was depressed and prescribed him something like Prozac.

Letting go

He started to suffer from great social anxiety, and was unable to go out. During the day he would come to work with me and sit in the car all day waiting for me.

He just got put on more anti-depressants.

One day he said to me: "Mum, today I crossed the road and nearly got knocked down by a car. And do you know what? I just didn't care."

I tried to get him psychiatric help with limited success but I was absolutely terrified that he was about to take his life.

The GP came out to see him, and for the first time he was prescribed a detox programme.

But there was no medical supervision for this. I got rid of all the alcohol in the house, although he must have still had a secret stash. But when this ran out he asked me to go out and buy him a bottle.

I refused, and he assaulted me. I knew this time I had to call the police, and I did. They arrested him, charged him.

Saying goodbye

The police advised me not to take him back.

This was the toughest decision any parent will ever have to make, but I felt then it was the right one. I felt he would have to hit rock bottom if he was ever going to turn a corner.

He stayed with friends, he was due to stay with my sister-in-law in London. He was in contact with my sister so I had tabs on him, but I knew if I spoke to him he would just try to come back.

We did sort out accommodation for him but it didn't work out. He thought he then had a place at a centre, but he had to be completely detoxed for them to let him in.

Then there was nothing - we didn't hear anything.

Finally, there was a phone call from the local hospital. I was told my son was there, and that I shouldn't come in without support.

He had caught streptococcal pneumonia because his immune system was impaired as a result of liver disease. Every organ was affected.

I sat with him through the night. At 4am, the nurse told me he was deteriorating. I had to leave the room at 7am for a shift change, and when I came back it was clear they were scaling down the level of care.

It wasn't long then.

Nobody's problem

I guess I feel let down by the system. With both him and my husband I wanted them sectioned for mental health because I felt that was the only way, but I was told it wasn't possible.

Alcoholics can't take responsibility for their own lives, but then doctors won't step in and take responsibility for them.

Of course the government can also do more, although raising taxes on alcohol probably wouldn't have made much difference to my son. However the fact it is so easily available - and appears so glamorous in adverts - is part of the problem.

But I think both as parents and a society we need to think hard about this. Why are kids now turning to drink at such a young age? I think schools are letting them down a lot of the time by failing to give them any fixed aspirations.

Some of my son's friends at college moved from computer courses to health and safety ones in the blink of an eye, without anyone asking them what they actually wanted to do with their lives.

There needs to be more education in schools on the dangers of drinking, for the kids and for the parents too. That must be a priority.

I wish my son was out there still, although there is some respite in death for someone who was always going to find living hard.

I say to myself: at least I know he is safe now."

source: BBC News

Drunk for £1: Anger as leading supermarkets sell lager for 22p a can

Supermarkets are selling beer at a cheaper price than water, fuelling concern over their role in Britain's binge-drinking crisis.

Despite repeated public health warnings, Tesco, Sainsbury's and Asda now offer lager at just 22p a can - less per litre than their ownbrand-mineral water and cola, and cheap enough to allow someone to get drunk for just £1.

An investigation by The Mail on Sunday has uncovered a fierce alcohol price war between the major supermarkets.

Lager is now so cheap that the stores pay more in excise duties than they charge at the till.

When production costs and overheads are taken into account, experts estimate shops are losing up to 8p a can.

Public-health bodies, doctors and MPs were furious when confronted with the findings.

Don Shenker, director of policy for Alcohol Concern, said: "There is no justification for the sale of lager at such a ridiculously low price.

"The fact that it is cheaper than their own brand of cola per litre is appalling.

Is 22p lager going to encourage binge drinking? Join the debate in readers' comments below...

"This sends entirely the wrong message to the young drinkers we are trying to steer away from alcohol abuse.

"They will think that if it's so cheap, it must be OK. We would urge the supermarkets to seriously review their pricing policy."

The last time lager was this cheap in pubs was 1975, but the supermarket price plunged to a new low last week following "tit-for-tat" measures between Tesco and Asda.

Last Monday, Asda slashed the price of Smart Price Lager to just 22p for a 440ml can following a similar move from Tesco.

Both stores now match Sainsbury's, whose Basics range has sold at 22p since June 2005.

This means that all three supermarkets are now selling cut-price lager, with an alcohol content of between two and three per cent, at 50p a litre - or just over 28p a pint.

By contrast, bottles of own-brand mineral water cost between 56p and 92p a litre, depending on the store.

Furthermore, a six-pack of 330ml cans of own brand cola costs between £1.11 and £1.29, or 56p to 65p a litre.

The situation may be about to deteriorate.

In an unprecedented move, Asda last week cleared their shelves of single cans and replaced them with multi-packs, forcing customers to buy in bulk.

The supermarket is the first of the major stores to introduce such a policy.

But critics fear that rival stores will be forced to follow suit to keep pace in a ferociously competitive market.

Sandra Gidley MP, public health spokeswoman for the Liberal Democrats, said: "Britain is in the midst of a binge-drinking crisis and prices like these do not help. The supermarkets constantly talk about their corporate social responsibility - maybe they should start practising it."

Experts are particularly concerned with the effect of low prices on children's alcohol consumption.

Last week, the Government admitted that the number of youngsters treated for alcohol abuse had rocketed by 40 per cent in just one year.

Figures obtained from the National Treatment Agency showed that children as young as ten are suffering illnesses usually present in ageing alcoholics and entering rehabilitation programmes in ever-increasing numbers.

A day after Asda slashed its beer prices, a report by Alcohol Concern found that supermarket alcohol is now so cheap that children could buy it using just their pocket money.

The Royal College of Physicians is so alarmed at the effect cheap alcohol is having on public health that it is forming an alliance with 21 other health groups to lobby the Government for a ten per cent rise in alcohol tax

Ian Gilmore, president of the Royal College, said: "There is clear evidence that the drinks industry is not behaving responsibly on alcohol pricing. Beer, wine and spirits are not ordinary products.

"They are legal drugs and should not be sold as a loss leader."

Last month, a Competition Commission inquiry into supermarket dominance of the retail market found that stores were selling alcohol at a loss to entice customers through their doors.

That commission revealed that during the 2006 football World Cup, Britain's four biggest supermarkets sold £12.7million of beer, wine and spirits below cost price.

However, the figures were disputed by some supermarkets.

Evidence from Finland also suggestsa link between price and consumption. There, tax on alcohol was slashed by 40 per cent in 2003.

Since then, drink sales have soared 11 per cent.

The glut of cheap beer on supermarket shelves has sounded alarm bells at top levels.

Professor Mark Bellis, from the North West Public Health Observatory and the Government's leading adviser on alcohol, said: "Of 15-year-olds, nearly two-thirds have drunk in the past four weeks, and around one in seven of those drinkers consumed enough to vomit.

"The reality is that about 30 per cent of all 15-year-olds think it is OK to get drunk once a week.

"We need to tackle a youth culture in which drunkenness is commonplace-underage access to alcohol relatively easy and alternatives to drinking far too scarce."

Robin Touquet, a consultant in the accident and emergency department at St Mary's Hospital, London, said: "Alcohol is a drug. It's a toxin and in inexperienced drinkers it can be dangerous.

"It doesn't matter what the level of alcohol in the drink is, if you drink enough it's going to have exactly the same adverse effects that higher percentage drinks such as wine and spirits have."

The Department of Health has announced a review of drink supply rules which may mean new restrictions on the sale of alcohol and tougher action against stores that sell to under-18s.

A spokesman for Asda said: "We were reluctant to bring our price down but we are the price leader and we cannot afford to be exposed by our rivals. It is a competitive market and if someone is offering something at a ridiculous price, we have to match it."

A spokesman for Tesco declined to comment on specifics but released a statement that read: "In common with other retailers, we sell a range of beers at different prices to suit all budgets.

"Our research shows that most of the alcohol purchased by our customers is bought as part of the weekly family shop."

A spokesman for Sainsbury's said: "The vast majority of our customers who buy alcohol do so as part of their regular, large grocery shop.

"Our research shows that they consume it over a period of weeks and months or they buy it for a special occasion such as a party."

A Department of Health spokeswoman said: "The Government has commissioned an independent national review of evidence on the relationship between alcohol, price, promotion and harm and following public consultation the need for regulatory change will, if necessary, be considered."

source: BBC News

First-Time Offenders Cause Most Alcohol-Related Deaths, Injuries

Those who study Wisconsin drunken driving issues said that chronic, repeat drunken drivers are a significant but small part of the overall problem.

Officials said that repeat offenders don't kill or injure most of the people involved in alcohol-related crashes. Experts said that to really cut down on injury and death on Wisconsin roads, we must address the most frequent offender: the regular citizen who has absolutely no drunken driving background.

One such man warned that if people don't think they will kill people while driving drunk, they should think again.

"I was on my way up north and I had been drinking. I drank and drove in the car, and I drifted across the center line of the road, and I hit another car head on," said John Luznicky. "The woman in that car, her name was Sharon Warner. She was 34 years old. She had a little boy and a little girl and she died instantly."

Luznicky said it is difficult to describe his thoughts after the crash.

"I don't know how to explain that feeling. It's a numbness; it's a shock. It's despair, hopelessness; it's helplessness," Luznicky said. "I don't know what the words are. I don't know if there are words to describe that feeling."

Luznicky's blood-alcohol level was 0.14 after the crash. The legal limit to operate a motor vehicle is 0.08 in Wisconsin.

It was the first time he had been arrested on drunken driving charges.

"I never thought it was going be me. I never thought it was going to be me. I thought it was going to be the other guy," Luznicky said. "I didn't think I was drunk. I didn't think was too impaired too drive. Was I? Oh, yeah, you bet. But did I know that was going to happen? No."

Experts said the people with no prior drunken driving history, not repeat drunken drivers, kill and injure the vast majority of people involved in alcohol-related crashes.

"And you hear the stories about the repeat driver and you hear the stores about people doing all these other things and you just think it's going to be somebody else, just not going to be me. But I'm here today to tell you it is me. It was me. I did what I did, and I've got to live with that," Luznicky said.

"The problem is people who drive drunk, and yes, the people who are ninth and tenth offenders. That's very offensive to us because we can't understand it. But they're just part of the big problem, and it's the overarching problem that will kill," said Nina Emerson, of the Resource Center for Impaired Driving at University of Wisconsin-Madison Law School.

Luznicky was married with four children when he was convicted of homicide by intoxicated use of a vehicle in 2001.

"I went to the school plays. I went to the parent-teacher conferences. I go to church. I owned a business. I didn't hang out at the bars -- that wasn't what I did. But I drank and I did drive and one woman had to pay for that with her life," Luznicky said. "I've been able to figure out how to live with it. I've been able to figure out how to make peace with it. But it doesn't go away."

"A woman's dead and there's two kids who don't have a mom because of me, because of what I did, and I've got to live with that," Luznicky said. "I mean, the damage is tremendous, absolutely huge. You can't begin to fathom how far it goes."

For more than five years, Luznicky has been speaking to anyone who would listen. He promised the victim's family that he would.

"I promised I would do whatever I could to try to prevent this from happening to somebody else, and that's what I'll try to do," Luznicky said.

Luznicky said he has to live with the hurt he caused his own family as well. His wife came upon the fatal crash scene as he was being taken away in an ambulance. Luznicky, a former landscaper, is now an alcohol and drug abuse counselor.

Many might think they can drink and still make it home, but statistics show that is a dangerous misconception, WISC-TV reported. One Department of Transportation study looked at more than 10,450 drivers over 12 years. All the drivers were drinking and in a crash that resulted in one or more deaths or incapacitating injuries.

The study found that three out of four drivers had no prior convictions for operating while intoxicated or related traffic offenses on their driving records.

So what can be done to combat the problem of drunken driving on Wisconsin's roads?

Experts said that when it comes to penalties for a first drunken driving offense, the humiliation of getting arrested works for the vast majority of people and they don't do it again.

But experts pointed to a couple of issues for debate when it comes to deterring people altogether.

They said one possibility would be for Wisconsin to criminalize a first-time operating while intoxicated offense. Wisconsin is the only state in which it is still a civil offense.

First-time offenders are fined between $150 to $300, given a $355 surcharge, a six-to-nine month license suspension and a mandatory alcohol assessment.

But even those civil penalties are watered down for drivers who are prosecuted under the Prohibited Alcohol Concentration Law. Drivers who have a blood-alcohol level between 0.08 and 0.99 lose their license for a time and pay a flat $250 fine.

"It just makes it an absolute joke that somebody could be stopped, arrested, convicted of OWI and just because they're 0.09, which is still above the legal limit, that they pay $250 and that's it. They pay $250. That's it," Emerson said.

Emerson and Dane County prosecutors said that one factor contributing to the problem is that alcohol is so widely accepted and promoted in Wisconsin. But they said that's not a problem as long as people act responsibly. They said people should make a plan for how they are going to get home before they go out drinking.

source: WISC Madison

Addiction Treatment May Benefit From Nicotine-Alcohol Interaction Study

The interaction between nicotine and alcohol, two of the most abused and co-abused drugs, can impact a person's ability to learn and could have implications for treating addiction, according to researchers at Temple University.

The researchers, Thomas J. Gould and Danielle Gulick, presented their findings, "Acute, chronic, and withdrawal from chronic nicotine interacts with acute ethanol to modulate fear conditioning," at the annual meeting of the Society for Neuroscience in San Diego. The study has also been accepted for publication in the peer-reviewed journal, Psychopharmacology.

"Whenever someone uses these two drugs together, there must be a reason why," says Gould, an associate professor of psychology at Temple. "The goal of our research is to understand the interactive effects of these two drugs and, by understanding how they are altering behavior and producing neural changes, we will hopefully be in a better position to develop treatments for drug addiction."

In examining the drugs' interactive effects on learning, the researchers looked at the ability to learn and process contextual information, which is important for multiple reasons. According to Gould, contextual learning taps into the part of the brain that is involved in declarative memory processes that define who we are, such as memories of our family, our wedding day, or graduating from school. This type of learning involves an area of the brain called the hippocampus, an area that is involved in strengthening short-term memories, and putting them into long-term memory storage, thus making those memories the ones that define who we are.

"We wanted to see if nicotine and alcohol are interacting in the hippocampus, or at another level, and what processes within the brain are they interacting with," Gould says. "If we can understand how these neural processes are changing and how they interact, then when someone is going through withdrawal or experiencing a cognitive deficit because of one of these two substances, we then may be able to use a therapeutic that blocks or activates a receptor, or that blocks a certain pathway which prevents the occurrence of the withdrawal symptoms and falling back into relapse."

Using an animal model, Gould and Gulick examined the effects of alcohol and nicotine on learning to determine what happens as the drugs are combined at different doses and different stages of administration.

"Our study showed that initially nicotine in a dose-dependent manner reverses alcohol-induced deficits in learning, but tolerance develops for this effect of nicotine with continued administration," he says. "We also found that a low dose of alcohol reverses nicotine withdrawal-associated deficits in learning. Furthermore, we found that chronic nicotine produces cross-tolerance to the effects of a low dose of alcohol on learning."

What does this all mean in terms of addiction?

"Think of a situation in which somebody is drinking and having cognitive difficulties," says Gould. "Smoking may take the edge off of it at first, so they begin smoking and they smoke more and more until tolerance develops and they lose that edge.

"Now they are drinking and smoking and they are addicted to both," he adds. "But if they try to quit smoking, they go into nicotine withdrawal, which results in a learning deficit. Maybe a drink will actually help them out initially, but then they consume more and they develop even worse learning deficits, so now they begin smoking again and they end up relapsing."

According to Gould, this could feed into a spiral in which initially nicotine and alcohol each block the adverse effects of the other. But as that happens, he says, smokers and drinkers develop tolerance and consume greater amounts of each drug, and then when they try quitting one or the other, they then have this cognitive deficit and may reach for either alcohol or nicotine or both to try and reverse it, but they just spiral into the addiction again.

_____
This study was funded by the National Institute on Alcoholism and Alcohol Abuse (NIAAA) and the National Institute on Drug Abuse (NIDA).

Source: Preston M. Moretz
Temple University

Old habits die hard

"For those of us who had spent every day of the past 10 years completely wasted, even the idea of getting through a couple of days without drugs felt like some kind of miracle."

Twenty years ago, Will Keighley started on the road to recovery from addiction. Now he wonders whether he will be the last survivor of his Narcotics Anonymous group.

It was a very English funeral. Half-stifled tears in a small church in Essex; professional pall-bearers with professionally solemn faces; a slightly awkward, tentative address from an older brother; solid Victorian hymns that sang of a triumph over death that no one really felt. Apart from the two heart-breaking readings from his children, I'm not sure Adam would have recognised his own funeral. But then, funerals are for the living, and this was the way his family had chosen to say their goodbyes. And when it is such a pointlessly early death - Adam was 52 - there probably isn't a right way of saying goodbye.

I hadn't seen Adam for four or five years before he died. I had wondered, though, why he had stopped replying to my Christmas cards. Then I heard rumours that he was using again. At first, I didn't want to believe them; he had been clean for more than 15 years and had always seemed so strong. But when he ended up in intensive care with acute renal failure and was given less than 24 hours to live, I was forced out of my denial.

He had been living alone, having lost his marriage and his job, and had been taking anything and everything he could lay his hands on. In his usual perverse way, Adam survived another 18 months or so. He flirted with recovery and his family tried everything they could to help, from taking him in to kicking him out, but the self-destruct button was full on. He was found dead from an overdose, alone in a rundown basement flat, a few weeks ago.

Adam and I had been members of the Narcotics Anonymous (NA) class of '87. We hadn't known each other while we were using, but we spent a great deal of time together when we first cleaned up. We were the wrong side of 30, had been junkies for the best part of 10 years, were unemployed and, to all intents and purposes, unemployable. So we would get up late, go to a lunchtime NA meeting, hang out in coffee bars and snooker halls, maybe catch another NA meeting in the evening and go home.

Back in 1987, NA wasn't that big. It had been founded in the UK seven years previously by a few recovering addicts who had split away from Alcoholics Anonymous. There were probably only about 100 regular faces in London. It may have looked to an outsider like a large, dysfunctional family, but it kind of worked. Status was measured in clean time. The very few who had made it to seven years clean were gods; the small number with five years were living legends; even those with two or three years got big respect. And they deserved it. For those of us who had spent every day of the past 10 years completely wasted, even the idea of getting through a couple of days without drugs felt like some kind of miracle. I had come to NA through a rehab centre. The first two weeks had been spent without sleep, sweating, shaking, cramping and shitting as I went cold turkey. The next two were spent in intensive group therapy but only one session stands out: the counsellor eyeballed us - we were probably annoying her - and said: "Take a look around you. Statistically speaking, 30% of you will be dead within 10 years. That's how serious this disease is."

I've thought about that statement a lot over the years. At the time, we all laughed - albeit nervously. We thought it was the kind of shock-jock crap that counsellors were paid to threaten us with, to frighten us into staying clean. Since then, I've come to wonder whether she wasn't rather conservative.

The first few deaths didn't affect me that much. They were addicts who had flirted with recovery but always left you with the feeling they were keeping their options open. I hadn't got to know them - the NA motto "Stick with the winners" had become my mantra.

Harder to bear

Recovering addicts are generally judgmental, and drugs were a black-and-white issue. If you were clean, you were on the side of the angels; if you were using, you deserved what you got. Somebody overdosing was a modern morality tale - both a kick up the arse to remind you of the consequences of using and a pat on the back for not having done so.

As the years passed, it got harder to bear. Maybe I had developed a little compassion, maybe the deaths were closer to home, or maybe the body count was just getting frightening. Many of us had shared needles at some point, so an Aids test became a logical part of the recovery process. Many of us were lucky, but a significant number weren't.

After the initial shock of diagnosis, most HIV-positive addicts seemed to cope well. Most got jobs and talked of being grateful for being able to extend their lives by cleaning up. But back in the late 80s and early 90s there were no retrovirals, and people, including several close friends whom I had known almost from day one in NA, started to get sick and die.

There were no tearful, bedside farewells surrounded by family for Nico. He reached the stage where he couldn't hack it any more and killed himself in the bath. Then there was Paulo, who had befriended me and let me sleep on his sofa until I could find somewhere to live. He had had good jobs, but once Aids took hold of him he fell to pieces. First, he disappeared back to Italy to take as much smack as he could, and then he returned to England. I didn't recognise him the last time I saw him; all his teeth had fallen out and he was utterly emaciated. The Terrence Higgins Trust found him a flat, but he couldn't really cope. He was furious with life and furious with Aids and addiction. He committed suicide alone, having first smeared the walls of his bedroom with shit.

There were other suicides, people who couldn't stand the thought of going back to using but who couldn't handle the pain of living. Those were really hard to take. Then there were those who died prematurely from cancer and heart disease. Their postmortems probably put the cause of death down to natural causes, but I found it hard to see it that way; no one I knew who hadn't thoroughly abused their bodies with drugs, booze and fags was dropping dead from these diseases in their 30s and 40s.

The number of Aids deaths had tailed off by the late 1990s, but there followed a new disease on the NA block: hepatitis C. About 50% of those who had used needles were infected and no one quite knew what the prognosis was. They still don't, really. A few people have died from liver disease, some have been treated with combination drug therapies and appear to be clear of the virus, and a great many appear for the time being to be walking wounded. They don't seem to be getting much worse, but are permanently tired.

Then there are the people like Adam - people with years and years of clean time, who have worked hard to build meaningful lives for themselves, and then decide they can't really cope after all. It's these that get to me the most, because it really does look as though there's no escape from addiction. It doesn't matter what you have done or how long you've been in recovery, play one wrong hand and the whole deck collapses.

I'm sure there are addicts who have started smoking dope and drinking again and are doing OK. But it seems a hell of a gamble for them to take. I couldn't predict what would happen to me if I started using again - though I've a pretty good guess - so how can they? And if they do get away with it, what are they getting away with? Imagine what it must be like to live in the knowledge that things could go pear-shaped at any time.

I'm no longer bothered by the esoteric debates that go on in social policy about whether addiction is a disease or not - it feels like a minor intellectual distraction. I'm not much interested in the political battles on how best to treat addicts, as every suggestion I've heard sounds like another useless sticking plaster on a huge festering wound. There are no guarantees or easy treatments for addicts.

None unscathed

Back in 1987, Adam, Paulo, Nico and I thought we were the lucky ones. We were the survivors who had found recovery. And maybe we were lucky. I've no idea what happened to most of the people I took heroin with, but I'm sure that most must be dead if they didn't manage to stop. Doctors had given me six months to live if I didn't get my life together, and I was no better or worse than many.

Twenty years on, the mortality rate of those attending the NA meetings in 1987 is horrifying. Even the survivors haven't come out unscathed. I and several others have been in institutions for mentally ill people and have struggled with depression; many others have been in therapy for years, still trying to piece together fractured lives and relationships.

If this was cancer, the rate of attrition would be a national scandal. But it's just a bunch of junkies and alkies fucking themselves up, so no harm done. I'm increasingly beginning to wonder if I'm not in some bizarre reality freak show to find the last man standing.

· Will Keighley is a pseudonym. All names have been changed.

____

source: http://www.guardian.co.uk/

African-American and Hispanic alcohol abusers need more residential alcohol treatment

The negative consequences of alcohol use and abuse have a disproportionate impact on racial and ethnic minorities in the United States. New research findings indicate that racial disparities in treatment completion could be reduced by increasing enrollment in residential alcohol treatment for African American and Hispanic alcohol abusers.

Results are published in the November issue of Alcoholism: Clinical & Experimental Research.

“Both the National Longitudinal Alcohol Epidemiologic Survey from 1991-1992, and the 2001-2002 National Epidemiological Survey on Alcohol and Related Conditions found that African Americans have similar or lower rates of heavy drinking, binge drinking, and alcohol dependence as White Americans,” said Ricky N. Bluthenthal, senior scientist at the RAND Corporation and corresponding author for the study.

Yet despite these similarities in alcohol consumption, observed Laura A. Schmidt, associate professor of health policy in the School of Medicine at the University of California, San Francisco, minorities experience more adverse health and social consequences as a result of their drinking.

“For example, as a white woman, I might drink three drinks per day, which might increase my risk of dying from cirrhosis by 50 percent,” she explained. “A black or Hispanic woman with the same age or health status who drinks the same amount as me might have a 75 percent increased risk of dying from cirrhosis. We think that this disproportionate disease burden has something to do with other factors that ‘go with’ race/ethnicity, such as poorer nutrition. This means that a minority person can do everything possible to avoid alcohol-related problems – cirrhosis, criminal victimization, traffic fatalities, etc. – and still have a higher risk of these problems compared to whites.”

For this study, researchers analyzed the discharge records of 10,591 alcohol-treatment patients who attended publicly funded treatment facilities in Los Angeles County during 1998 to 2000 in order to calculate completion rates. The sample comprised 4,141 African American, 3,120 Hispanic, and 3,330 white patients; furthermore, 5,795 were in outpatient and 4,796 were in residential treatment.

“This is one of the first studies to find consistently lower alcohol-treatment completion rates for African American patients as compared to White patients in a large publicly funded alcohol-treatment system,” said Bluthenthal. “This occurred regardless of treatment setting, that is, outpatient or residential treatment.”

Furthermore, African American patients appeared less likely to be enrolled in residential alcohol treatment despite having more severe alcohol abuse characteristics on average.

“We calculated that if African American patients were assigned to residential treatment at the same rate as White patients,” said Bluthenthal, “the racial disparity in alcohol-treatment completion might decline by as much as 20 percent between African Americans and Whites.” He added that this would also apply to Hispanics, although findings indicated a smaller racial disparity in alcohol-treatment completion between Hispanic and white patients.

“Because it is so much harder for a minority person to get into treatment, only the most persistent, motivated people are likely to get into care,” said Schmidt. “Thus, we would expect that minorities in treatment have higher completion rates and greater success in treatment than comparable minorities. What Dr. Bluthenthal and colleagues are showing is that, despite all this, minorities are less likely than whites to stay in treatment, other factors being equal. Thus, there are multiple racial/ethnic disparities in play here: minorities have a disproportionate risk of alcohol-related harm, they are less likely to get treatment, and when they do get treatment, they are less likely to stay in it and complete the program.”

Bluthenthal suggested that one way to increase access to residential treatment for African American alcohol abusers might be to more consistently assign alcohol-treatment patients with higher alcohol-abuse severity to residential treatment programs, which generally provide more intense services and have higher completion rates, as compared to outpatient treatment programs.

Schmidt agreed. “This is one of several policies that need to be put in place to reduce racial/ethnic disparities in alcohol treatment,” she said. “There are numerous disparities and therefore, more than one policy solution is required. My research shows that the most severely affected minorities are the least likely to receive treatment. When they do get treatment, it is in less intensive settings, and now we see from this report, for a shorter duration of time. Despite all this, minorities who drink at the same levels as whites will experience higher rates of alcohol-related harm. Therefore, the need for treatment is greater in minority communities and yet the care is diminished on multiple levels. It is important to underscore that heavy drinking is not just a problem on its own, but is also a risk factor for a whole host of conditions, including coronary heart disease, stroke, cancers, and trauma.”

Schmidt said that another concern is the growing use of outpatient alcohol treatment in the US. “The trend towards outpatient care began in the early 1990s,” she said. “Currently, about 60 percent of the care for alcohol problems provided in the US is in outpatient settings and this figure will likely grow in the years to come. Based on what this ACER paper reports, we can expect to see a widening gap in completion rates between minorities and whites as more and more care is delivered in outpatient settings.”

Source: Clinical & Experimental Research

Crack Users Do More Time Than People Convicted of Manslaughter

When crack cocaine possession means 24 years in prison and manslaughter means only 3, you know something is seriously wrong with the U.S. criminal justice system.

By Jessica Pupovac, AlterNet. Posted October 17, 2007.

The death of Alva Mae Groves on Aug. 9 of this year went largely unnoticed outside of her family and fellow inmates at the Tallahassee Federal Corrections Institution, where she lived out the last 13 years of her life. She never went to high school, lived her entire life dirt-poor and raised her nine children for the most part without the help of her abusive husband.

In 1994 Alva Mae "Granny" Groves was locked up for conspiring to trade crack cocaine for food stamps. It was largely her son, whose trailer home she lived in, who ran an operation that her family and neighbors contested, but some customers testified that Alva Mae would sell them small bags when he wasn't around.

"The only money I received came from SSI (Supplementary Security Income) and what money I could earn selling eggs from my laying hens (I had about 100 chickens)," Alva Mae wrote shortly before her death in a letter asking for a pardon so that she could die near her family. "I also cleaned houses when I was able, and sold candy bars and soft drinks to the kids coming from school in the afternoons."

Because she refused to testify against her son, and because of the money she had saved in the bank, which was weighed against her for its value in crack, and most of all because of the current sentencing system for crack cocaine offenders, Groves was condemned to 24 years in jail at the age of 72.

In 1986, Congress passed a law that established an unprecedented five-year mandatory minimum sentence for anyone found in possession of two sugar packets worth of crack, regardless of whether or not that person had a criminal record. Beyond the minimum, additional "sentencing guidelines" tack on extra months or even years for obstruction of justice (which, in some cases, means refusing to admit guilt), whether or not there was a weapon on the premises and prior convictions.

Crack cocaine is treated more harshly than any other drug on the streets right now, mostly because of the "tough on crime" response that was en vogue at the time of its introduction. Marc Mauer, executive director of the Sentencing Project, a D.C.-based advocacy group that works for fairness in sentencing, explained that Congress attributed the sentencing tiers at the time to a desire to "protect the black community."

Ron Hampton, a retired D.C. police officer and executive director of the National Black Police Association, takes issue with that rationale. "It's hard for me to believe that you are going to have legislation that severely cripples and victimizes members of our community in order to do something good for us," he said.

Nonetheless, 20 years later, the sentencing structure still stands, and it is precisely the black community that is suffering the most.

According to the U.S. Sentencing Commission (USSC), a division of the judicial branch that monitors and advises Congress on sentencing policy, in 2006, more than four-fifths of crack cocaine offenders in federal courts were black.

The 1986 drug laws have had a devastating effect on the U.S. criminal justice system. Drug offenders in prisons and jails have increased 1100 percent since 1980, from 41,000 people to nearly 500,000.

Nearly 6 out of 10 people in state prison for a drug offense have no history of violence or high-level drug-selling activity but are often receiving harsher sentences than people who do. People caught with the drug in 2004, the last year for which data is available, served an average of ten years in federal penitentiaries, while the average convict served 2.9 years for manslaughter, 3.1 years for assault and 5.4 years for sexual abuse.

Many legislators, police officers and even federal judges have been vocal critics of the sentences being handed to crack cocaine offenders.

In 2002, Roger Williams University Law Professor David Zlotnick conducted a series of interviews with Republican-appointed federal judges to survey their views of various sentencing tiers. He found the majority of them saw crack cocaine sentencing as "completely unacceptable," "a grave injustice" and a "discrepancy that has no basis in fact."

However, says Monica Pratt, spokesperson for Families Against Mandatory Minimums, "Because crack cocaine mandatory minimums have applied mostly to people of color and poor people, there has been a lack of political will to do something about it."

Until now. The massive mobilizations in Jena, La., last month shined a much-needed spotlight on continuing disparity in the U.S. justice system. With a Supreme Court case addressing the issue starting on Oct. 2, a promising reform bill currently in the Senate and proposed USSC amendments just weeks away from taking effect (pending congressional opposition), a confluence of forces just might create the perfect storm that advocates for sentencing reform have been hoping for.

Said Mauer, "We have more momentum now than we have seen at any time since the laws were passed in 1986."

The main rallying point for many critics is the sentencing disparity between crack cocaine and powder cocaine, two drugs that are pharmacologically identical. The main difference, they contend, is who does them and in what neighborhoods.

A drug abuser whose drug of choice is powder cocaine would have to be found with more than two cups of it (500 grams) before receiving the same sentence as a person caught with two sugar packets worth (5 grams) of crack. All along the sentencing tier, 100 times more powder cocaine is required to trigger the same mandatory minimum penalty as crack. It is a system referred to as the "100-to-1" drug quantity ratio.

Since crack is made by cooking powder cocaine with baking soda or another base when it reaches the street retail level, the 100-to-1 ratio has served to exact harsher punishments on low-level dealers than the kingpins supplying the raw material. According to USSC data, low-level crack sellers are punished 300 times more severely than high-level, international cocaine traffickers on an imprisonment-per-gram basis.

There are two different types of sentences given to drug offenders: the mandatory minimums established by Congress and the sentencing guidelines tacked onto those minimums by federal prosecutors and accepted or denied by federal judges.

"The congressional wheel in many ways is the most important right now, because without congressional action, the mandatory sentences are still going to stand, whether the USSC changes the guidelines or the Supreme Court changes the way the judges administer them," says Pratt.

There are three bills currently introduced in Congress that attempt to address the 100:1 disparity, but only one that would eliminate it. The Drug Sentencing Reform and Cocaine Kingpin Trafficking Act of 2007 ( S.1711), introduced by Sen. Joseph R. Biden Jr., D-Del., would bring the penalties for possessing crack cocaine in line with those for cocaine in its powder form. It offers, according to the American Civil Liberties Union, a "long-awaited fix to discriminatory federal drug sentencing" that will take place only with increased pressure.

The sentencing guidelines are also slated to change, unless Congress moves to block them. The USSC sets the guidelines, barring congressional objections, and has proposed amendments to crack penalties in the past, which have been shot down. They forged ahead this year, however, bringing crack cocaine guidelines in line with powder guidelines in a list of amendments introduced last spring. They will go into effect on Nov. 1 unless somebody notices and tries to stop them. If implemented, the commission predicts the change would shorten 69.7 percent of incoming crack cocaine sentences, resulting in an average reduction of nearly 13 months.

In a highly unusual move, the USSC is also considering making the amendments retroactive and are seeking public comment on the issue. FAMM has been mobilizing its base, consisting predominantly of people incarcerated on drug charges and their families, to get involved in the political process and voice their opinions. "The public information officer for the USSC told our president, Mary Price, that they have received 10,000 letters on this issue already," Pratt said. The USSC predicts that retroactivity would reduce the sentences of approximately 19,500 current inmates.

Then there is Kimbrough v. United States, a crack-related case that just got under way in the Supreme Court. The case challenges a judge's discretion in sentencing a crack cocaine convict below federal sentencing guidelines and centers around the sentencing hearing for Derrick Kimbrough, a Desert Storm veteran in Norfolk, Va., who pled guilty in 2005 to possession with intent to distribute 56 grams of crack. Although he had no previous felony convictions, his mandatory minimum and federal sentencing formula recommended he be sentenced to 19 to 22 years. However, Federal District Judge Raymond A. Jackson called the guideline "ridiculous" and instead handed Kimbrough a 15-year sentence, a move that an appeals court later challenged his authority to make.

However, according to retired D.C. Officer Hampton, the crack problem that plagues many low-income communities across America won't go anywhere without a more "holistic" approach that considers responses that are more than punitive. "If they wanted to help, one of the best things they could do is treat people who use crack cocaine much like they do for powder cocaine," Hampton suggested. "They need to look it as a disease. That's another problem embedded in the disparity, not just the sentences, but the amount of treatment that is available to them."

Indeed, a "significant number" of dealers are also addicts, who might not find themselves in the courthouse without their addictions, according to Zlotnick's research.

"But more than that," says Howard, "we need to develop some strategy that focuses on the systemic issues that cause people to look for it in the first place. I think a lot of the problem is the despair in our community, because of lack of housing, lack of jobs, a poor educational system -- they all have a lot to do with why people do it. If we were to address those problems in our society, we'd probably see a lot less people doing crack."

But, for the meantime, he says, the laws are as good a place as any to start.
____
Jessica Pupovac is an adult educator and independent journalist living in Chicago.

Crack Users Do More Time Than People Convicted of Manslaughter

When crack cocaine possession means 24 years in prison and manslaughter means only 3, you know something is seriously wrong with the U.S. criminal justice system.

By Jessica Pupovac, AlterNet. Posted October 17, 2007.

The death of Alva Mae Groves on Aug. 9 of this year went largely unnoticed outside of her family and fellow inmates at the Tallahassee Federal Corrections Institution, where she lived out the last 13 years of her life. She never went to high school, lived her entire life dirt-poor and raised her nine children for the most part without the help of her abusive husband.

In 1994 Alva Mae "Granny" Groves was locked up for conspiring to trade crack cocaine for food stamps. It was largely her son, whose trailer home she lived in, who ran an operation that her family and neighbors contested, but some customers testified that Alva Mae would sell them small bags when he wasn't around.

"The only money I received came from SSI (Supplementary Security Income) and what money I could earn selling eggs from my laying hens (I had about 100 chickens)," Alva Mae wrote shortly before her death in a letter asking for a pardon so that she could die near her family. "I also cleaned houses when I was able, and sold candy bars and soft drinks to the kids coming from school in the afternoons."

Because she refused to testify against her son, and because of the money she had saved in the bank, which was weighed against her for its value in crack, and most of all because of the current sentencing system for crack cocaine offenders, Groves was condemned to 24 years in jail at the age of 72.

In 1986, Congress passed a law that established an unprecedented five-year mandatory minimum sentence for anyone found in possession of two sugar packets worth of crack, regardless of whether or not that person had a criminal record. Beyond the minimum, additional "sentencing guidelines" tack on extra months or even years for obstruction of justice (which, in some cases, means refusing to admit guilt), whether or not there was a weapon on the premises and prior convictions.

Crack cocaine is treated more harshly than any other drug on the streets right now, mostly because of the "tough on crime" response that was en vogue at the time of its introduction. Marc Mauer, executive director of the Sentencing Project, a D.C.-based advocacy group that works for fairness in sentencing, explained that Congress attributed the sentencing tiers at the time to a desire to "protect the black community."

Ron Hampton, a retired D.C. police officer and executive director of the National Black Police Association, takes issue with that rationale. "It's hard for me to believe that you are going to have legislation that severely cripples and victimizes members of our community in order to do something good for us," he said.

Nonetheless, 20 years later, the sentencing structure still stands, and it is precisely the black community that is suffering the most.

According to the U.S. Sentencing Commission (USSC), a division of the judicial branch that monitors and advises Congress on sentencing policy, in 2006, more than four-fifths of crack cocaine offenders in federal courts were black.

The 1986 drug laws have had a devastating effect on the U.S. criminal justice system. Drug offenders in prisons and jails have increased 1100 percent since 1980, from 41,000 people to nearly 500,000.

Nearly 6 out of 10 people in state prison for a drug offense have no history of violence or high-level drug-selling activity but are often receiving harsher sentences than people who do. People caught with the drug in 2004, the last year for which data is available, served an average of ten years in federal penitentiaries, while the average convict served 2.9 years for manslaughter, 3.1 years for assault and 5.4 years for sexual abuse.

Many legislators, police officers and even federal judges have been vocal critics of the sentences being handed to crack cocaine offenders.

In 2002, Roger Williams University Law Professor David Zlotnick conducted a series of interviews with Republican-appointed federal judges to survey their views of various sentencing tiers. He found the majority of them saw crack cocaine sentencing as "completely unacceptable," "a grave injustice" and a "discrepancy that has no basis in fact."

However, says Monica Pratt, spokesperson for Families Against Mandatory Minimums, "Because crack cocaine mandatory minimums have applied mostly to people of color and poor people, there has been a lack of political will to do something about it."

Until now. The massive mobilizations in Jena, La., last month shined a much-needed spotlight on continuing disparity in the U.S. justice system. With a Supreme Court case addressing the issue starting on Oct. 2, a promising reform bill currently in the Senate and proposed USSC amendments just weeks away from taking effect (pending congressional opposition), a confluence of forces just might create the perfect storm that advocates for sentencing reform have been hoping for.

Said Mauer, "We have more momentum now than we have seen at any time since the laws were passed in 1986."

The main rallying point for many critics is the sentencing disparity between crack cocaine and powder cocaine, two drugs that are pharmacologically identical. The main difference, they contend, is who does them and in what neighborhoods.

A drug abuser whose drug of choice is powder cocaine would have to be found with more than two cups of it (500 grams) before receiving the same sentence as a person caught with two sugar packets worth (5 grams) of crack. All along the sentencing tier, 100 times more powder cocaine is required to trigger the same mandatory minimum penalty as crack. It is a system referred to as the "100-to-1" drug quantity ratio.

Since crack is made by cooking powder cocaine with baking soda or another base when it reaches the street retail level, the 100-to-1 ratio has served to exact harsher punishments on low-level dealers than the kingpins supplying the raw material. According to USSC data, low-level crack sellers are punished 300 times more severely than high-level, international cocaine traffickers on an imprisonment-per-gram basis.

There are two different types of sentences given to drug offenders: the mandatory minimums established by Congress and the sentencing guidelines tacked onto those minimums by federal prosecutors and accepted or denied by federal judges.

"The congressional wheel in many ways is the most important right now, because without congressional action, the mandatory sentences are still going to stand, whether the USSC changes the guidelines or the Supreme Court changes the way the judges administer them," says Pratt.

There are three bills currently introduced in Congress that attempt to address the 100:1 disparity, but only one that would eliminate it. The Drug Sentencing Reform and Cocaine Kingpin Trafficking Act of 2007 ( S.1711), introduced by Sen. Joseph R. Biden Jr., D-Del., would bring the penalties for possessing crack cocaine in line with those for cocaine in its powder form. It offers, according to the American Civil Liberties Union, a "long-awaited fix to discriminatory federal drug sentencing" that will take place only with increased pressure.

The sentencing guidelines are also slated to change, unless Congress moves to block them. The USSC sets the guidelines, barring congressional objections, and has proposed amendments to crack penalties in the past, which have been shot down. They forged ahead this year, however, bringing crack cocaine guidelines in line with powder guidelines in a list of amendments introduced last spring. They will go into effect on Nov. 1 unless somebody notices and tries to stop them. If implemented, the commission predicts the change would shorten 69.7 percent of incoming crack cocaine sentences, resulting in an average reduction of nearly 13 months.

In a highly unusual move, the USSC is also considering making the amendments retroactive and are seeking public comment on the issue. FAMM has been mobilizing its base, consisting predominantly of people incarcerated on drug charges and their families, to get involved in the political process and voice their opinions. "The public information officer for the USSC told our president, Mary Price, that they have received 10,000 letters on this issue already," Pratt said. The USSC predicts that retroactivity would reduce the sentences of approximately 19,500 current inmates.

Then there is Kimbrough v. United States, a crack-related case that just got under way in the Supreme Court. The case challenges a judge's discretion in sentencing a crack cocaine convict below federal sentencing guidelines and centers around the sentencing hearing for Derrick Kimbrough, a Desert Storm veteran in Norfolk, Va., who pled guilty in 2005 to possession with intent to distribute 56 grams of crack. Although he had no previous felony convictions, his mandatory minimum and federal sentencing formula recommended he be sentenced to 19 to 22 years. However, Federal District Judge Raymond A. Jackson called the guideline "ridiculous" and instead handed Kimbrough a 15-year sentence, a move that an appeals court later challenged his authority to make.

However, according to retired D.C. Officer Hampton, the crack problem that plagues many low-income communities across America won't go anywhere without a more "holistic" approach that considers responses that are more than punitive. "If they wanted to help, one of the best things they could do is treat people who use crack cocaine much like they do for powder cocaine," Hampton suggested. "They need to look it as a disease. That's another problem embedded in the disparity, not just the sentences, but the amount of treatment that is available to them."

Indeed, a "significant number" of dealers are also addicts, who might not find themselves in the courthouse without their addictions, according to Zlotnick's research.

"But more than that," says Howard, "we need to develop some strategy that focuses on the systemic issues that cause people to look for it in the first place. I think a lot of the problem is the despair in our community, because of lack of housing, lack of jobs, a poor educational system -- they all have a lot to do with why people do it. If we were to address those problems in our society, we'd probably see a lot less people doing crack."

But, for the meantime, he says, the laws are as good a place as any to start.
____
Jessica Pupovac is an adult educator and independent journalist living in Chicago.

Slowhand is slow with the details about his life

Legendary rock guitarist Eric Clapton's book doesn't put the reader in his shoes

"It's difficult to talk about these songs in depth, that's why they're songs," Eric Clapton writes of "Tears in Heaven," the wrenching song he wrote in the aftermath of the freak death of his young son, Conor, in 1991.

Yes, it is difficult, Mr. Clapton. But as you sit pecking on your computer with one finger "like a demented chicken," as you say, let's remember that you have a book to write here — "Clapton: The Autobiography," released last week — and the occasion calls for, um, writing: serious introspection, context, scene setting, an acknowledgement that one has lived an extraordinary life, the hum and throb of real human emotion.

Unfortunately, Clapton, ever the ambivalent frontman, can't or won't offer that up in "Clapton" and for that, the book joins a vast and deep collection of unsatisfying rock tell-alls. The problem isn't that he doesn't bring his best stuff to the table.

We're talking about a guy who first dropped acid in the company of the Beatles and the Monkees while listening to an acetate of "Sgt. Pepper's"; who openly schemed for years to steal George Harrison's wife, Pattie Boyd (dating Boyd's sister in the meantime), and remained friends with Harrison; who, while in Cream, shared a bill with Tiny Tim (!); who shamelessly shagged birds across the globe; who drugged and drank and courted death for decades before falling to his knees and praying for help to get sober; and who, lest we forget, remains one of the greatest and most influential guitarists of the rock era.

But while he tells us what happened, time and again he pulls away from telling us, in vivid, writerly, you-are-there detail, what it really felt like. This is dancing about architecture, and Clapton, for all his talent, discipline and drive, is no Gene Kelly. It feels very English.

True, we're talking about a man who poured his pain and passion into song — a sustaining and lifelong love for the blues, the soul-incinerating grief of losing a child, the cycle of wretched addiction and denial and the crushing agony of unrequited, impossible love. And no, it's not fair to expect Clapton to have the prose chops to spill his heart out on the page as capably as when he straps on a Strat. Except that he can: In Boyd's own recent autobiography, "Wonderful Tonight" — named for a Clapton song he says he wrote in annoyance at her dallying before a dinner out — she says one of Clapton's missives to her was "the most passionate letter anyone had ever written to me."

When he's lovesick, junk-sick or buckled by grief, the guy can say what he needs to, can connect and communicate. When the transaction involves merely fulfilling a contractual obligation to Broadway Books, not so much.

The one facet of his life where Clapton really lays it out — and the reason he was able to live to tell the tale at all — is in depicting his heroin addiction, followed by even worse alcoholism, two trips to Hazelden, sobriety now at the 20-year mark and his commitment to help others in need. This, he tells us, is his priority in life — above even wife Melia and a house (or mansion, or mansions, oh, and the yacht, about which he's kind of embarrassed) filled with little daughters — and to his vast credit, Clapton has done much more than talk the talk. At great personal expense, he's opened a treatment center in Antigua, organized the Crossroads Guitar Festivals in Dallas and given up for auction guitars from his personal collection that have fetched as much as almost $1 million each. Legions of people wrestle with addictions, and Clapton's example and efforts have doubtless saved lives, which he says is crucial to staying sober himself. This is evangelical zeal of the very best kind.

And the taproot, the "reason," such as there is a single one, of and for this proclivity toward self-medicating and decades of destructive behavior? Clapton chalks it up to his illegitimacy, abandonment by his mother, never having known his father and the fiction of being raised by his grandparents, whom he believed for some time to be his mum and dad.

It's hard to believe that rock stars who travel the world, collect art, designer clothes, Rock and Roll Hall of Fame inductions, Patek Philippe watches and manual-transmission Ferraris they don't know how to drive (because George Harrison had one) suffer from insecurity powerful enough to drive them to the precipice of oblivion. But this they do. As he has long since given up taking drugs for taking naps, a much healthier pursuit, it would be at minimum uncharitable to suggest Clapton let his attention stray from the unceasing work that has allowed him, at 62, to be busier and happier than ever before. Maybe that focus means he's written the book the only way he could have.

But like Muddy Waters said, I just can't be satisfied.

source: statesman.com

By Patrick Beach
AMERICAN-STATESMAN STAFF

Iowa's drinking called epidemic

It has been more than 12 years since the death of University of Iowa student Matthew Garofalo, and it's likely that few, if any, students on campus even know who he was or how he died.

On Sept. 7, 1995, Garofalo, 19, of Elgin, Ill., passed out drunk about 11 p.m. at the Lambda Chi Alpha fraternity house, where he was a pledge. It wasn't for another 12 and a half hours that Garofalo's lifeless body was found. In the hours between, Garofalo had vomited while on his back and inhaled some of his vomit. His lungs became irritated and filled with fluid until they stopped producing oxygen. About 7 a.m. his heart stopped, and he died.

Although this may be the most extreme example of the effects of binge drinking, health professionals warn that the culture of excessive drinking in Iowa City and at UI is creating problems for students right now that will continue for the rest of their lives.

They point to Garofalo's death, the death of 20-year-old Joseph Domke -- who fell from a balcony after drinking downtown underage -- drunken driving deaths, countless drunken assaults and attacks and a 2005 Harvard School of Public Health study that states UI has a binge drinking rate of nearly 70 percent -- the highest in the Big Ten -- as reasons for their concern.

Binge drinking is defined as five or more consecutive drinks in a sitting in a two-week period for men and four or more for women.

Harvard's statistics also show that although the percentages of occasional binge drinkers have declined since the study began in 1993; the percentage of frequent binge drinkers has increased.

UI students rate much higher than college students on average, where only two of five students nation wide report binge drinking.

It's for all of those reasons and the adverse health and societal effects of binge drinking that medical professionals and many others are in support of the proposed 21-only ordinance, which would ban 19- and 20-year-olds from bars. Proponents of the legal age measure argue that by restricting access to alcohol, the binge-drinking rate would significantly drop.

Will binge drinking decrease?

However, opponents argue such a measure would not decrease binging and simply would push underage people out into the communities and into unsupervised and potentially dangerous house parties.

Atul Nakhasi, a UI junior who founded the anti-21 group, the Student Health Initiative Task Force, said the proposed ordinance "directly impacts student health and safety," by potentially driving underage students to house parties.

"We're going to end up seeing more underage drinking," said Nakhasi, a pre-medicine student. "Now instead of using ID checks, you could have middle schoolers at the party. Instead of serving checkers (who can control the number of drinks served), you're going to have students with greater underage drinking. And what we're going to see is a likely increase in DUIs (and) sexual assaults."

Richard Dobyns, a clinic professor of family medicine at the UI, said it's difficult to speculate whether or not there would be more house parties.

"Could there be? Sure. You can speculate in either direction," Dobyns said. "There's always been house parties, there's always been pre- and post-drinking. Basically, what this initiative will instigate, not by itself, is a reduced alcohol consumption culture."

Dobyns said he believes the drinking rate among students has reached epidemic proportions. That belief has caused Dobyns to take action and act as a spearhead for the 21-only proposal.

"I mean, if you saw that the state of Iowa had twice the influenza numbers of any other state, you would hope your community would do something about it," he said. "You need to respond. It's not ethical to walk away from something like that."

Dobyns said he has a broad definition of the health effects of binge drinking and although students' binge drinking doesn't do much immediately, there are consequences later on. People who develop alcohol-related issues are more likely to have difficulty forming meaningful relationships and experience trouble holding down a job, as well as an increased likelihood of developing mood disorders, unwanted pregnancies, unwanted sexually-transmitted diseases, premature coronary disease, liver disease, vascular disease and neurological disease.

"If you define health a little more broadly, you would include those things as well," Dobyns said.

Dobyns added that public policy should not be based on random events, such as Garofalo's death.

"It's extremely sad for everyone," he said. "However, you have to look past those sad issues and look at the everyday sad issues."

Effects: now and later

Dr. Peter Nathan, a professor emeritus in community and behavioral health, was acting UI president at the time of Garofalo's death. He said it was hard to predict whether Garofalo's death would have been prevented by a 21-only measure.

"Would this have happened to Matthew if the referendum happened at the time?" Nathan said. "Matthew didn't drink in the bars."

Like Dobyns, Nathan -- an alcoholism researcher for 40 years --said binge drinking at a young age doesn't immediately do much to students, health-wise. However, he said frequent binge drinking can lead to cutting classes, less studying, an increased risk for injury, forgetting things or doing regrettable things.

The long-term effects are more severe, Nathan said. Frequent binge drinkers -- which represent about 46 percent of the student body -- are at a much greater risk to develop alcoholism after college.

"Alcoholism, in turn, is associated with a lot of sociological, psychological and physical problems," he said. "Alcoholics, on average, die several years early."

That's not to say Iowa City is inundated with alcoholic graduates from the university. Nathan said well-educated communities like Iowa City tend to have fewer alcoholics than other places.

Nathan said out of each graduating class, there could be up to 5 to 10 percent of the students who meet the criteria for alcohol dependence. Many of them don't stick around Iowa City, though.

"Students who graduated from here do a whole lot of things," Nathan said. "Some stay here, many don't."

Nathan said if parents are worried about sending their kids to the UI and having them come home with alcohol abuse problems, their concerns are valid, although coming to the university does not doom students to a life of alcoholism.

"The damage is still there"

However, centers that treat people for substance abuse problems, such as MECCA, are seeing people in their late teens and early 20s. Steve Steine, the clinical coordinator for MECCA's Iowa City location, said students are coming to the facility for outpatient programs.

"Most of the college students that we are seeing are those that have had a first or second OWI offense," Steine said. "Or, they may have what we would call recurrent alcohol-related issues; two or more public intoxications, two or more PAULAs, that really would have them meeting the criteria."

Steine said the facility doesn't track whether or not their patients are students, but of the 24 people enrolled in the current outpatient program -- an entry level program aimed at younger people and those experiencing first time substance abuse problems -- there are 10 people 21 or younger. He did not know whether or not they were university students.

"It's difficult to track," Steine said.

Steine didn't wish to weigh in on his view of the ordinance but said the problems with alcohol consumption might not be solved by laws and fines.

"If students get charged with a PAULA in a bar, they usually just get a ticket, pay a fine, that's it," he said. "They don't get any attention until there's something recurrent. I've known some students who have had multiple possession tickets and aren't mandated to doing some substance abuse program."

Ed Haycraft, an abuse counselor for UI Student Health, said the health center already is treating students for secondary effects of alcohol abuse. In 2006, 600 to 700 students came to Student Health for alcohol-related issues. Haycraft said they either attended the Seminar on Substances, an educational program, or the Brief Alcohol Screening and Intervention for College Students (BASICS) program.

"There's quite a few young people that come in and say, 'Well, I'm depressed,' and we ask them, 'How much are you drinking?' " Haycraft said.

Haycraft said drinking releases dopamine -- a chemical that triggers a pleasurable feeling -- into the brain. When the drinking stops and the production of dopamine halts, drinkers come down from that high and feel depressed.

However, in terms of physical effects, outside of getting sick or falling and hurting themselves when they're drunk, Haycraft said binging won't do much to younger drinkers.

"When you are 18 to 20 years old, you snap back real quick," Haycraft said. "But the damage is still there. It's one of those things that people don't realize when they're 18 to 20."

But some damage is being done right now. According to an annual report compiled by Student Health, of the 875 surveys completed, 73 percent reported they had experienced hangovers from drinking, 52 percent said they had vomited, 32 percent said they had injured themselves while drinking and 29 percent said they had unintended or regretted sex.

Students like Nakhasi, UI Student Government President Barrett Anderson and many others said they don't refute the negative health effects of binge drinking, just the approach taken by the 21-only measure.

"This is not going to fix these issues of underage drinking," Nakhasi said. "We recognize there's a problem...Our goal is not to only address and oppose this measure, but propose a possible solution."

Still, Ralph Wilmoth, the outgoing director of Johnson County Public Health, a 21-only supporter, said something must be done.

"The whole idea that we have an environment that supports that behavior is a contradiction to the very principles that public health is based on," Wilmoth said.

source: Press Citizen