Commission set to dump EU alcohol strategy

This was covered on the EurActiv website in May and had me cursing and making muttered comparison to FIFA under my breath  :(

EU dump alcohol strategy

Vytenis Andriukaitis, the EU’s Health and Food Safety Commissioner, said that the executive has no intention of submitting a new strategy to reduce alcohol-related harm in Europe, suggesting that the issue will be tackled as part of a broad range of “risk factors” affecting chronic diseases.

The EU’s latest strategy to tackle alcohol abuse expired in 2013, after seven years, and was not replaced by a new one.

While it did not impose specific legislation, the strategy provided guidance to EU member states in preventing harmful and hazardous drinking, by tackling areas such as drunk driving, alcohol consumption during pregnancy, and underage drinking.

On Monday (18th May), Andriukaitis gave a speech at the plenary meeting of the European Alcohol and Health Forum (EAHF) in Brussels, where he presented the Commission’s work on reducing alcohol-related harm in Europe.

In the speech, he emphasised the need for a broad and holistic approach to reduce premature deaths related to alcohol misuse. But he made it clear that alcohol-related harm would not be treated in a seperate strategy as was previously done, but would instead be called a “risk factor” in a wider strategy to tackle chronic diseases.

“I would like to place action on the main causes of chronic diseases, including alcohol but also tobacco, nutrition and physical inactivity. It is less important for me what word we are using to define the paper setting out such a joint commitment. What matters is the results,” Andriukaitis said.

Mariann Skar, Secretary General of Eurocare, a network of non-governmental organisations that works on the prevention and reduction of alcohol abuse across Europe, said that it is both surprising and disappointing that the Commission was not responding to calls for a new strategy from the Parliament and the EU member states.

“We have now been waiting since 2012 to see any development on policies to tackle alcohol related harm in Europe. It has continuously been postponed, and now was the time to present new actions. However, it is a great disappointment that the Commissioner is not able to address the calls from the Parliament and the member states for a strengthened policy framework to tackle alcohol related harm,” she said.

No objection from the industry

But the alcohol industry, which has also long been pushing for a new strategy, remained calm over the prospect of the Commission not coming up with a new plan.

Malte Lohan, Global Corporate Affairs Director at AB InBev, the world’s largest brewer, said businesses, NGOs and other stakeholders are already working together in the EAHF to help reduce alcohol abuse in Europe.

“Let’s not get hung up on words. Whether it is called an Alcohol Strategy or something else, the EU needs to renew the political foundation that underpins the EAHF so that we can build on and reinforce this important work,” Lohan stated.

Blah blah blah ….. oh and yes look at this ……

Now what was I muttering?  It would seem I was not the only person disgruntled by this news.  So were these:

NGOs resign from Alcohol and Health Forum as Commission ignores Member State and European Parliament Calls for Alcohol Strategy

Twenty public health organisations have resigned from the European Alcohol and Health Forum (EAHF), a stakeholder platform, to protest against the European Commission’s refusal to submit a new alcohol strategy.

Dear Commissioner for Health and Food Safety, Dr. Andriukaitis, We write to you as a group of public health organisations to express our deep concerns that there are no plans to develop a comprehensive EU Alcohol Strategy and to tender our collective resignations from the EU Alcohol and Health Forum

  • Mariann Skar, Secretary General, European Alcohol Policy alliance (Eurocare)
  • Nina Renshaw, Secretary General, European Public Health Alliance (EPHA)
  • Katrin Fjeldsted, President, Standing Committee of European Doctors (CPME)
  • Wendy Yared, Director, European Cancer Leagues (ECL)
  • Laurent Castera, Secretary-General, European Association of the Study of the Liver (EASL)
  • Jan Peloza, President, Alcohol Policy Youth Network (APYN)
  • Ennio Palmesino, Delegate for European Affairs, European Mutual Help Network for Alcohol related problem (EMNA)
  • Prof Thierry Ponchon, Chair of Public Affairs Committee, United European Gastroenterology (UEG)
  • Mervi Jokinen, President, European Midwives Association (EMA)
  • Peter Allebeck, President, Nordic Alcohol and Drug Policy Network (NordAN)
  • Kristina Mickevičiūtė, Vice-President on External Affairs, European Medical Students’ Association (EMSA)
  • Professor Sir Ian Gilmore, Chair of EAHF Science Group
  • Katherine Brown, Director, Institute of Alcohol Studies (IAS), UK
  • Eric Carlin, Director, Scottish Health Action on Alcohol Problems (SHAAP)
  • Professor Nick Sheron, Representative to the EU Alcohol and Health Forum,
  • Royal College of Physicians London, UK (RCP)
  • Claude Riviere, Association Nationale de Prévention en Alcoologie et Addictologie (ANPAA)
  • Adisa Dizdarević , Secretary General, No Excuse Slovenia
  • Tiziana Codenotti, Eurocare Italy
  • Lauri Beekmann, President, Estonian Temperance Union
  • Suzanne Costello, CEO, Alcohol Action Ireland
  • Gabriele Bartsch, German Centre for Addiction (DHS)

What was it you were saying Malte Lohan, Global Corporate Affairs Director at AB InBev? NGOs and other stakeholders are already working together in the EAHF to help reduce alcohol abuse in Europe – not anymore it would seem …….

Social Recovery

Thanks to the kind person on the FB Club Soda group who kindly shared a link to this article in the Huffington Post by Johann Hari looking at the concept of social recovery.

Social Recovery

It is now one hundred years since drugs were first banned — and all through this long century of waging war on drugs, we have been told a story about addiction by our teachers and by our governments. This story is so deeply ingrained in our minds that we take it for granted. It seems obvious. It seems manifestly true. Until I set off three and a half years ago on a 30,000-mile journey for my new book, Chasing The Scream: The First And Last Days of the War on Drugs, to figure out what is really driving the drug war, I believed it too. But what I learned on the road is that almost everything we have been told about addiction is wrong — and there is a very different story waiting for us, if only we are ready to hear it.

If we truly absorb this new story, we will have to change a lot more than the drug war. We will have to change ourselves.

I learned it from an extraordinary mixture of people I met on my travels. From the surviving friends of Billie Holiday, who helped me to learn how the founder of the war on drugs stalked and helped to kill her. From a Jewish doctor who was smuggled out of the Budapest ghetto as a baby, only to unlock the secrets of addiction as a grown man. From a transsexual crack dealer in Brooklyn who was conceived when his mother, a crack-addict, was raped by his father, an NYPD officer. From a man who was kept at the bottom of a well for two years by a torturing dictatorship, only to emerge to be elected President of Uruguay and to begin the last days of the war on drugs.

I had a quite personal reason to set out for these answers. One of my earliest memories as a kid is trying to wake up one of my relatives, and not being able to. Ever since then, I have been turning over the essential mystery of addiction in my mind — what causes some people to become fixated on a drug or a behavior until they can’t stop? How do we help those people to come back to us? As I got older, another of my close relatives developed a cocaine addiction, and I fell into a relationship with a heroin addict. I guess addiction felt like home to me.

If you had asked me what causes drug addiction at the start, I would have looked at you as if you were an idiot, and said: “Drugs. Duh.” It’s not difficult to grasp. I thought I had seen it in my own life. We can all explain it. Imagine if you and I and the next twenty people to pass us on the street take a really potent drug for twenty days. There are strong chemical hooks in these drugs, so if we stopped on day twenty-one, our bodies would need the chemical. We would have a ferocious craving. We would be addicted. That’s what addiction means.

One of the ways this theory was first established is through rat experiments — ones that were injected into the American psyche in the 1980s, in a famous advert by the Partnership for a Drug-Free America. You may remember it. The experiment is simple. Put a rat in a cage, alone, with two water bottles. One is just water. The other is water laced with heroin or cocaine. Almost every time you run this experiment, the rat will become obsessed with the drugged water, and keep coming back for more and more, until it kills itself.

The advert explains: “Only one drug is so addictive, nine out of ten laboratory rats will use it. And use it. And use it. Until dead. It’s called cocaine. And it can do the same thing to you.”

But in the 1970s, a professor of Psychology in Vancouver called Bruce Alexander noticed something odd about this experiment. The rat is put in the cage all alone. It has nothing to do but take the drugs. What would happen, he wondered, if we tried this differently? So Professor Alexander built Rat Park. It is a lush cage where the rats would have colored balls and the best rat-food and tunnels to scamper down and plenty of friends: everything a rat about town could want. What, Alexander wanted to know, will happen then?

In Rat Park, all the rats obviously tried both water bottles, because they didn’t know what was in them. But what happened next was startling.

The rats with good lives didn’t like the drugged water. They mostly shunned it, consuming less than a quarter of the drugs the isolated rats used. None of them died. While all the rats who were alone and unhappy became heavy users, none of the rats who had a happy environment did.

At first, I thought this was merely a quirk of rats, until I discovered that there was — at the same time as the Rat Park experiment — a helpful human equivalent taking place. It was called the Vietnam War. Time magazine reported using heroin was “as common as chewing gum” among U.S. soldiers, and there is solid evidence to back this up: some 20 percent of U.S. soldiers had become addicted to heroin there, according to a study published in the Archives of General Psychiatry. Many people were understandably terrified; they believed a huge number of addicts were about to head home when the war ended.

But in fact some 95 percent of the addicted soldiers — according to the same study — simply stopped. Very few had rehab. They shifted from a terrifying cage back to a pleasant one, so didn’t want the drug any more.

Professor Alexander argues this discovery is a profound challenge both to the right-wing view that addiction is a moral failing caused by too much hedonistic partying, and the liberal view that addiction is a disease taking place in a chemically hijacked brain. In fact, he argues, addiction is an adaptation. It’s not you. It’s your cage.

After the first phase of Rat Park, Professor Alexander then took this test further. He reran the early experiments, where the rats were left alone, and became compulsive users of the drug. He let them use for fifty-seven days — if anything can hook you, it’s that. Then he took them out of isolation, and placed them in Rat Park. He wanted to know, if you fall into that state of addiction, is your brain hijacked, so you can’t recover? Do the drugs take you over? What happened is — again — striking. The rats seemed to have a few twitches of withdrawal, but they soon stopped their heavy use, and went back to having a normal life. The good cage saved them. (The full references to all the studies I am discussing are in the book.)

When I first learned about this, I was puzzled. How can this be? This new theory is such a radical assault on what we have been told that it felt like it could not be true. But the more scientists I interviewed, and the more I looked at their studies, the more I discovered things that don’t seem to make sense — unless you take account of this new approach.

Here’s one example of an experiment that is happening all around you, and may well happen to you one day. If you get run over today and you break your hip, you will probably be given diamorphine, the medical name for heroin. In the hospital around you, there will be plenty of people also given heroin for long periods, for pain relief. The heroin you will get from the doctor will have a much higher purity and potency than the heroin being used by street-addicts, who have to buy from criminals who adulterate it. So if the old theory of addiction is right — it’s the drugs that cause it; they make your body need them — then it’s obvious what should happen. Loads of people should leave the hospital and try to score smack on the streets to meet their habit.

But here’s the strange thing: It virtually never happens. As the Canadian doctor Gabor Mate was the first to explain to me, medical users just stop, despite months of use. The same drug, used for the same length of time, turns street-users into desperate addicts and leaves medical patients unaffected.

If you still believe — as I used to — that addiction is caused by chemical hooks, this makes no sense. But if you believe Bruce Alexander’s theory, the picture falls into place. The street-addict is like the rats in the first cage, isolated, alone, with only one source of solace to turn to. The medical patient is like the rats in the second cage. She is going home to a life where she is surrounded by the people she loves. The drug is the same, but the environment is different.

This gives us an insight that goes much deeper than the need to understand addicts. Professor Peter Cohen argues that human beings have a deep need to bond and form connections. It’s how we get our satisfaction. If we can’t connect with each other, we will connect with anything we can find — the whirr of a roulette wheel or the prick of a syringe. He says we should stop talking about ‘addiction’ altogether, and instead call it ‘bonding.’ A heroin addict has bonded with heroin because she couldn’t bond as fully with anything else.

So the opposite of addiction is not sobriety. It is human connection.

When I learned all this, I found it slowly persuading me, but I still couldn’t shake off a nagging doubt. Are these scientists saying chemical hooks make no difference? It was explained to me — you can become addicted to gambling, and nobody thinks you inject a pack of cards into your veins. You can have all the addiction, and none of the chemical hooks. I went to a Gamblers’ Anonymous meeting in Las Vegas (with the permission of everyone present, who knew I was there to observe) and they were as plainly addicted as the cocaine and heroin addicts I have known in my life. Yet there are no chemical hooks on a craps table.

But still, surely, I asked, there is some role for the chemicals? It turns out there is an experiment which gives us the answer to this in quite precise terms, which I learned about in Richard DeGrandpre’s book The Cult of Pharmacology.

Everyone agrees cigarette smoking is one of the most addictive processes around. The chemical hooks in tobacco come from a drug inside it called nicotine. So when nicotine patches were developed in the early 1990s, there was a huge surge of optimism — cigarette smokers could get all of their chemical hooks, without the other filthy (and deadly) effects of cigarette smoking. They would be freed.

But the Office of the Surgeon General has found that just 17.7 percent of cigarette smokers are able to stop using nicotine patches. That’s not nothing. If the chemicals drive 17.7 percent of addiction, as this shows, that’s still millions of lives ruined globally. But what it reveals again is that the story we have been taught about The Cause of Addiction lying with chemical hooks is, in fact, real, but only a minor part of a much bigger picture.

This has huge implications for the one-hundred-year-old war on drugs. This massive war — which, as I saw, kills people from the malls of Mexico to the streets of Liverpool — is based on the claim that we need to physically eradicate a whole array of chemicals because they hijack people’s brains and cause addiction. But if drugs aren’t the driver of addiction — if, in fact, it is disconnection that drives addiction — then this makes no sense.

Ironically, the war on drugs actually increases all those larger drivers of addiction. For example, I went to a prison in Arizona — ‘Tent City’ — where inmates are detained in tiny stone isolation cages (‘The Hole’) for weeks and weeks on end to punish them for drug use. It is as close to a human recreation of the cages that guaranteed deadly addiction in rats as I can imagine. And when those prisoners get out, they will be unemployable because of their criminal record — guaranteeing they with be cut off even more. I watched this playing out in the human stories I met across the world.

There is an alternative. You can build a system that is designed to help drug addicts to reconnect with the world — and so leave behind their addictions.

This isn’t theoretical. It is happening. I have seen it. Nearly fifteen years ago, Portugal had one of the worst drug problems in Europe, with 1 percent of the population addicted to heroin. They had tried a drug war, and the problem just kept getting worse. So they decided to do something radically different. They resolved to decriminalize all drugs, and transfer all the money they used to spend on arresting and jailing drug addicts, and spend it instead on reconnecting them — to their own feelings, and to the wider society. The most crucial step is to get them secure housing, and subsidized jobs so they have a purpose in life, and something to get out of bed for. I watched as they are helped, in warm and welcoming clinics, to learn how to reconnect with their feelings, after years of trauma and stunning them into silence with drugs.

One example I learned about was a group of addicts who were given a loan to set up a removals firm. Suddenly, they were a group, all bonded to each other, and to the society, and responsible for each other’s care.

The results of all this are now in. An independent study by the British Journal of Criminology found that since total decriminalization, addiction has fallen, and injecting drug use is down by 50 percent. I’ll repeat that: injecting drug use is down by 50 percent. Decriminalization has been such a manifest success that very few people in Portugal want to go back to the old system. The main campaigner against the decriminalization back in 2000 was Joao Figueira, the country’s top drug cop. He offered all the dire warnings that we would expect from the Daily Mail or Fox News. But when we sat together in Lisbon, he told me that everything he predicted had not come to pass — and he now hopes the whole world will follow Portugal’s example.

This isn’t only relevant to the addicts I love. It is relevant to all of us, because it forces us to think differently about ourselves. Human beings are bonding animals. We need to connect and love. The wisest sentence of the twentieth century was E.M. Forster’s — “only connect.” But we have created an environment and a culture that cut us off from connection, or offer only the parody of it offered by the Internet. The rise of addiction is a symptom of a deeper sickness in the way we live — constantly directing our gaze towards the next shiny object we should buy, rather than the human beings all around us.

The writer George Monbiot has called this “the age of loneliness.” We have created human societies where it is easier for people to become cut off from all human connections than ever before. Bruce Alexander — the creator of Rat Park — told me that for too long, we have talked exclusively about individual recovery from addiction. We need now to talk about social recovery — how we all recover, together, from the sickness of isolation that is sinking on us like a thick fog.

But this new evidence isn’t just a challenge to us politically. It doesn’t just force us to change our minds. It forces us to change our hearts.

Loving an addict is really hard. When I looked at the addicts I love, it was always tempting to follow the tough love advice doled out by reality shows like Intervention — tell the addict to shape up, or cut them off. Their message is that an addict who won’t stop should be shunned. It’s the logic of the drug war, imported into our private lives. But in fact, I learned, that will only deepen their addiction — and you may lose them altogether. I came home determined to tie the addicts in my life closer to me than ever — to let them know I love them unconditionally, whether they stop, or whether they can’t.

When I returned from my long journey, I looked at my ex-boyfriend, in withdrawal, trembling on my spare bed, and I thought about him differently. For a century now, we have been singing war songs about addicts. It occurred to me as I wiped his brow, we should have been singing love songs to them all along.

I completely agree with what he says about morphine usage in hospital for pain management as I saw it hundreds, no probably thousands, of times.  People were given opiates to manage pain and there were no long term effects or addiction concerns.

But what about the genetic component of addiction – with alcohol addiction specifically?  This isn’t addressed in his argument here.

And I want to believe everything he writes but I started drinking, smoking and using drugs with my friends. It was a very social experience that cuts across what he writes. God the rave culture was built on connection through dance music (and drugs!). So although I get that we isolate when we are deep in our addiction it doesn’t start out that way so that part of the story remains unexplained for me. Maybe I need to read the whole book and he answers that question as part of it?  What do you think?

How alcohol makes you friendlier – but only to certain people

This was in The Conversation in May and looked at some new research to do with whether we were friendlier after consuming alcohol as relates to in groups and out groups of friends.

friend or foe

Drinking alcohol is associated with aggressive behaviour, accidents and ill health. Yet many of us choose to drink socially. This may reflect alcohol’s actions on specific brain circuits which make us feel euphoric and less anxious. Alcohol may also make us more empathic and cause us to see other people as more attractive. But why do these reactions occur and are the positive effects of alcohol expressed towards everybody we interact with?

Alcohol is a drug, one of the three most commonly used in the world, along with nicotine and caffeine. When we drink, the alcohol binds to a specific type of receptor in the brain and boosts the activity of a natural brain chemical called GABA. The effect the alcohol has on us depends in large part on the dose, and the location of these GABA receptors within the brain.

Early on in a drinking session, the alcohol acts on GABA systems to boost the levels of dopamine, the brain’s reward chemical. This gives a sense of well-being and a sense of mild euphoria. Alcohol also acts on GABA receptors to impair the activity of the brain circuits that make us feel anxious and, at higher doses, alcohol inactivates a second set of brain circuits that control fear. So threatening stimuli no longer seem quite so scary. Alcohol also compromises our ability to compute risk so that situations we would normally shy away from may now seem quite inviting.

All of this points to alcohol as a facilitator of social interactions. As well as making us more empathic, laboratory studies have also shown that drinking alcohol can make us trust others more and make us temporarily more generous.

On the other hand, heavy drinking is associated with violent behaviour. This situation, however, is complex. Laboratory studies have shown that alcohol increases aggression. For example, it increases the willingness with which individuals will administer electric shocks to others. However, this effect seems to be largely restricted to those who are intrinsically aggressive in the first instance.

Equally, alcohol can corrupt our ability to understand the intentions of others. The brain contains specific circuits, which connect parts of the prefrontal cortex, amygdala and temporal parietal junction, that handle our social cognitive abilities. So our ability to understand somebody else’s mental perspective and their motivations for acting in a certain way become unreliable.

Very big doses of alcohol can leave the functioning of these circuits so compromised that individuals can appear to be as impaired as patients with some forms of dementia. This is quite a disturbing thought given the number of people who end up in this state in city centres at the end of a good night out.

Alcohol also impedes our ability to accurately interpret emotional expressions in faces. As we drink, we have a tendency to erroneously assume that some facial expressions of negative emotions are happy, and we find it particularly difficult to identify sad and angry faces. This leaves us prone to making embarrassing social errors.

One important, but often overlooked, aspect of alcohol’s effect on social functioning relates to how we perceive members of our in and out-groups. Alcohol appears to encourage us to bond to members of our in-groups. However, this may come at the cost of the way we treat people outside of these groups. Similarly, alcohol makes members of our ethnic in-group appear more attractive but this effect does not extend to members of other ethnic groups.

It must be emphasised that the effects described so far are potentially reversible once the drinker has sobered up. However, chronic heavy drinking can lead to brain damage and irreversible cognitive impairments, especially poor memory function, and psychiatric problems including depression, psychoses, anxiety and suicide.

So overall, alcohol may be a friend, and indeed make us friendlier, but only to a select group of people – and they may not always reciprocate.

Alcohol Friend or Foe? is part of the Pint of Science festival where academic experts talk about the latest in scientific research – at the pub.

As someone whose undergraduate psychology research focused on Tajfel’s Social Identity Theory where the concept of in-groups and out-groups were researched and developed this makes perfect sense to me.  What do you think?

Edited to add: Subscriber no 1200  has now signed up so the free Udemy online course place offer is now extended to subscriber 1400! :)

Supporting women with alcohol issues: what social workers need to know

I’ve included this on my blog because I think it gives a valuable insight into the modern thinking of the world of social workers when it comes to women and alcohol.  Historically women have been afraid to seek medical help for alcohol because of the fear of their parenting ability being called into question and the risk of their children being removed because of this.  Having worked professionally with social workers this is not my experience and this piece shows their approach now.  This article is taken from Community Care.

women and alcohol

Alcohol is a pleasurable and attractive drug, easily accessible and socially acceptable. It helps with relieving anxiety and stress, and beginning to use it is part of the process of achieving and demonstrating adulthood. It helps us to try out other ways of being ourselves, what is sometimes called ‘acting out’.

At specific times, such as Friday and Saturday evenings, or at Christmas, it is seen as an acceptable way to stretch boundaries a little – or a lot – to enjoy a sense of carnival, even transgression. These are all behaviour patterns common – though not always acknowledged as such – to all societies, and more accessible to some social groups, such as the rich, celebrities or young men, than others.

Escaping miseries

However women, in particular, may sometimes drink not so much for pleasure as to be acceptable to their peers; and, more worryingly, an estimated 50%-90% (Women’s Aid, 2005) may also drink to escape briefly from such miseries as domestic abuse and depression. Other reasons include loneliness, mental health issues and poverty, conspiring to make a woman take refuge in alcohol in the first place.

As a society we expect ‘femininity’ in, especially, young women, and drunkenness is seen as interfering with its performance. ‘Women who drink’ may be seen as greedy, immoral and shamed. It would be naïve to believe that either social workers, or those working within the alcohol treatment sector, including GPs, nurses and other specialists, are unaffected by such feelings themselves. Shame, embarrassment, and concern about professionals’ reactions are among the reasons why women may be less likely than men to admit to an alcohol problem.

From self-respect to shame

A major factor in the recovery process is regaining self-respect, thus moving away from shame. Those who work with women recovering from alcohol issues should do so ‘in a manner that is empowering, compassionate, and respectful, and to allow people self-determination and risk taking where no one else is harmed’ (Galvani, 2015, p.5).  This approach is similar to the ‘unconditional positive regard’ advocated by Carl Rogers (Rogers, 1951) – but throughout the alcohol treatment sector, this is often inadequately supplied.

In addition, women benefit particularly from women-only treatment.  Also very much appreciated are identification and brief advice (IBA) centres, These resources are not available in all areas, and are too little advertised, but some support on similar lines is also provided online. An example of this is the Club Soda website

Women-only support

The shaming nature of the condition means that women-only support may be needed in dealing with the loss of family and other social networks, and in discovering what their own real needs are. This is much more likely to be problematic in a mixed-sex environment, where women may take on a mothering role to help male members of the group and not attend enough to their own needs. Some may also enter a relationship with men in recovery. Not only is this likely to be too early to take on new emotional ties while they may still be vulnerable, but there is also the considerable risk that should one of them start drinking again (often called ‘slipping’) the other is likely to follow.

Women frequently feel too embarrassed to share freely in mixed groups, particularly if their drinking has been associated with, or been a response to, sexual, physical or emotional abuse of any kind. Painful and humiliating experiences need to be disclosed in a safer place.

There may also be issues with childcare, so the times of their groups need to be chosen carefully, for example so women can get to and from the group while their children are at school); and they may worry about how much to tell their families.

Peer support

Facilitators should be female, and ideally one of them will be a woman who has herself recovered from alcohol issues – for at least a year – who can talk from personal experience about the different strategies and tactics that were of help to her. Such a group will begin to develop life-skills, and life-long friendships may develop.

This is the approach we have adopted at our small, third sector organisation in Bristol, an approach which research consistently recommends as being the best way to restore confidence, side-step the ‘revolving door’ syndrome, recognise the person you are and what are your needs, and to move forward with a good chance of achieving these.

What can social workers do if they find that their area lacks the breadth and the depth of provision which is recommended? For social workers in London, Gloucester, Milton Keynes and Buckinghamshire a new approach is being provided by the Family Drug and Alcohol Court, which tries to keep drug and alcohol using families together, under supervision. The scheme is to be extended to other parts of the country, following its success in these areas.

Link with domestic abuse

It is also important to remember that over half of the women who develop alcohol issues will have suffered from, or will still be suffering from, domestic and sexual abuse, including having been abused as a child. Such abuse may not be evident initially, but responding to it appropriately will be an enormous step forward in helping a woman recover from alcohol misuse.

Women’s Aid and Refuge jointly run a national helpline for domestic abuse survivors (0800 2000 247) and can refer callers to local support services  which offer expert advice and support which may well be a crucial turning point in the recovery journey. Other useful support organisations might include NAPAC (National Association of People Abused in Childhood), and The Survivors Trust, an umbrella organisation that holds information on lots of rape and abuse support services around the country.

Self-harm

Many women who are using alcohol as a prop are also using other methods to try to deal with their distress. For example, self-harm is a common strategy which women might use to try to deal with their feelings of shame and worthlessness, including actions such as cutting, starving and bulimia. Social workers need to be aware of support groups and services in their local areas, and ensure that their leaflets are readily available (preferably on display).

Many women’s services are offered by small, third sector organisations, often set up by women who themselves experienced problems. Their variety is their strength, for each person’s alcohol journey is different, their recovery road will be different, and it is only in recognising the need for multiple responses to a complex set of problems that we can succeed in helping women to improve their lives.

For example, Self Injury Support (previously Bristol Crisis Service for Women and now a national organisation), now a national organisation,  offers support for women and girls who self-harm: clients can access the service themselves and speak with or text and email with the workers. The section of the Mind website dealing with self-harm may also be of help to some women.:

Building social capital

Additionally, increasing clients’ social capital is central to their recovery from alcohol and development as people (Bogg with Bogg, 2015), and encouraging participation in almost any social activity is likely to have beneficial effects, whether it is volunteering to help in a play-group or joining a zumba class.

The latter is particularly good at boosting feelings of well-being, perhaps previously only encountered by using alcohol. Increasing a variety of social interactions, wherever possible, whether in person or on social networks, is most likely to help women in moving away from the despairing circle of detox, slip, relapse which we have seen far too much in alcohol treatment services to date.

This article is based upon workshops run at the British Association of Social Workers and the Social Perspectives in Mental Health Network (SPN) conference on 15 February 2015. Dr Patsy Staddon, a trustee of SPN, recovered from alcoholism in 1988.

She runs Women’s Independent Alcohol Support, the small peer-led charity, which is able to discuss issues around women and alcohol with social workers and treatment providers. For more information visit its website.

Women and alcohol: social perspectives,which Staddon has edited, has just been published by Policy Press. 

References

Bogg, D, with Bogg, T (2015) ‘The social model in alcohol treatment services: the impact for women’, in Women and Alcohol: social perspectives, ed. Staddon, P. Bristol: Policy Press.

Galvani, S (2015)  Alcohol and other Drug Use: The Roles and Capabilities of Social Workers. Manchester Metropolitan University.

Rogers, Carl R (1951) Client-centered Therapy: Its Current Practice, Implications and Theory. Boston: Houghton Mifflin.

Women’s Aid (2005) The Survivor’s Handbook. Bristol: Women’s Aid.

Alcohol and Hypertension

A new factsheet from Alcohol Concern, released on Monday 18 May, looks at the increasing risk alcohol has on hypertension.

Alcohol-and-blood-pressure

Hypertension, a form of continued high blood pressure, is a condition experienced by more than one in four adults in the England, with alcohol being a major contributory factor in its development.

Regularly drinking alcohol increases the risk of developing hypertension.  Just one drink a day makes people more likely to develop hypertension and drinking two or three increases the risk substantially. Currently there are over five million people in England unaware they suffer from it and without treatment; hypertension significantly increases the risk of stroke, heart disease, vascular dementia and chronic kidney disease. 

The factsheet from Alcohol Concern highlights:

  • Health risks quickly escalate with higher amounts of alcohol
  • More than three alcoholic drinks a day can increase the chance of developing hypertension in later life by up to 75%
  • Despite being largely preventable, high blood pressure costs the NHS over £2 billion each year
  • Alcohol-attributable hypertension accounted for over 300,000 hospital admissions in 2010/11, making it the most prevalent alcohol-related health condition

Jackie Ballard, Chief Executive at Alcohol Concern, said: “There is a well documented relationship which shows people have a higher risk of developing hypertension the more alcohol they consume. Having just one drink a day can increase the risk, and the overall risk climbs higher for every drink after that.  

“The relationship between alcohol and hypertension stays significant even when age, weight, gender, ethnicity, diet, exercise and smoking habits are taken into account. This means alcohol is one of the most controllable and preventable risk factors for hypertension.”

Professor Sir Ian Gilmore, Chair of the Alcohol Health Alliance said: “Alcohol is no ordinary product and people need to be aware of the risks associated with its use. Evidence-based health warnings on alcohol labels would allow people to make an informed choice.

“Research from the Alcohol Health Alliance shows that the public are largely unaware of the range of health risks associated with alcohol. From a consumer rights point of view, people have a right to this information.”

To read the full factsheet, please click here.

This factsheet is the first in a series to be published by Alcohol Concern, highlighting the risks alcohol has on different health conditions.

Lundbeck Ltd, a pharmaceutical company, has provided funding support for the development and printing of this factsheet. Lundbeck has had no editorial control over the content which has been reviewed for factual accuracy only.

I’m so pleased to see this kind of fact sheet being produced but remain wary as although it is provided by the charity Alcohol Concern its production has been supported by funding from Lundbeck the maker of the pharmaceutical drug Selincro, also known as Nalmefene. Although the raising of awareness is welcome being cynical one could argue that this companies involvement is motivated by its need to drive the prescription of its drug ……

Friday Sober Jukebox – temptation

So this is an acknowledgement that temptation has been on my mind the last few weeks and I have had some wobbly moments.

Temptation

I fessed up to Prim on email recently to be accountable.  Background info is that I started a new job last week and in less than 2 weeks time we move house!  I was feeling overwhelmed and stressed and found myself buying chocolates that had been reduced in the supermarket.  So far no biggie.  But then I found myself deliberately looking out for the flavours that were alcohol inspired so champagne truffle and the amaretto based one.  And the thought accompanying eating them was ‘oh how nice it would be to have the real thing’ …….  Notice twice there I wrote ‘found myself’ – suggesting reverting to old habits without conscious choice.

And then me and MrHOF were discussing moving stuff including the alcohol we still have!!  Why do we still have it?  I hate waste and  when we stopped drinking we moved it all into the garage and have gifted it away as opportunities have arisen.  But we still have quite a stock – including champagne, port, whisky, wine of all colours, Pimms and Disaronno (why do I feel the need to list them?).  And the thought goes through my head – but I like champagne and Amaretto ….. and there was a fleeting sadness.  *Alarm bells were now ringing loudly in my head*

To be clear I did not drink and have no intention to but this is the first time in a LONG time I have had these kind of thoughts.  I knew that this was going to be a tricky time and had flagged it to myself and others, even joking during the relapse management part of my ‘How to Quit’ workshop recently that I needed to revisit my own relapse prevention plan because of these upcoming major life events!

Anyway the booze stash has been carved up and dolled out to those helping us move.  Chocolate is being inhaled as necessary and the feeling has passed.  So it’s a Friday night and booze can seem like a shimmering mirage in a desert as if heaven sent 😉  But stay strong and the temptation will pass 😀

That said I will not be about as much over the next few weeks as I need to reduce the stress levels to ensure I stay sure footed.  Blog posts will appear but I may take a while to respond to comments and my activity on other blogs may dip even further.  Normal service should be restored once we get into the second half of August and all packing and unpacking of boxes has ceased!

I moved my car the morning after a party. It ruined my life’

There has been an increase in the calls for the drink driving limit to be reduced in the UK and I first talked about it here.  Here’s a snapshot of some of the headlines from May:

drinkDriving

This particular article in The Telegraph caught my eye though because (a) it is from a female drivers perspective and (b) it’s about the morning after drinking risk which I now know with hindsight that I flirted with on a regular basis.

Police are calling for the legal drink-driving limit to be halved, amid concerns over the number of female drink-drivers.

The change would mean drivers could be over the limit after just one pint, in line with changes introduced in Scotland last year.

Levels are not falling quickly enough, according to the Police Federation of England and Wales, who want to crack down on female drink-drivers.

A police representative told the BBC Radio 4 Today programme that the message isn’t “getting through” to women’s drivers. Over the last decade, the number of men caught drink-driving has halved, while the number of women was “about the same”.

Research shows women now account for 17 per cent of convictions, compared with just nine per cent in 1998. Academics suggest the drastic increase is partly because women think they are less likely to be stopped by the police.

Holly*, 34, was one of those women – until she was arrested for drink-driving 10 years ago.

Here she tells Telegraph Wonder Women what happened:

It was back when I was 24 years old. I’d been at a friend’s house party where we’d been drinking all night and into the early hours. In the morning, I had to move my car off the driveway to let someone else get theirs out.

It was about 8am and I’d been asleep for two hours. I did feel like I was still a bit drunk but I wasn’t really thinking about it properly. I shouldn’t have done it really. But I got in the car thinking, it’s only around the corner, I’ll be fine.

Only, as I moved the car round the corner, I was pulled over by a policeman and breathalysed. It showed I was more than three times over the legal limit.

I was horrified. I was taken to the police station where I had to do another breathalyser test, have my fingerprints taken and was put in a cell for a few hours. I remember crying and couldn’t believe that this had happened. When I moved my car, the thought that I could be over the limit just hadn’t occurred to me.

I don’t think I thought about it rationally. Or you think it won’t happen to you, you’re not going to hurt anybody. I know I felt tired and groggy but because I’d had some sleep and I’d stopped drinking about 1am, I thought I’d slept it off.

I wouldn’t have got in the car and driven 20 miles down the road. But I thought I’d be alright to drive around the corner. When the police officer came over, I didn’t even think he was going to say anything about drink driving. He’d seen me get into the car in my pyjamas without any shoes on, so I thought that was the problem.

When he said, ‘do you know why I have pulled you over?’ I said, ‘because I’m not wearing shoes’. He laughed but I genuinely thought that’s what it was. I wasn’t stumbling around drunk. I’d never done it before. I’m not a person that takes massive risks.

I carried the shame for months

Then he asked me whether I’d been drinking. My first thought was ‘no, of course not’ as it had been hours since my last alcoholic drink and at the time I had no idea that alcohol could stay in my system for that long. But the breathalyser test proved otherwise.

The next few months were the hardest part. It was the shame and embarrassment of telling my parents and work. I was worried; I was scared for two to three months before I had to go to court. I was still carrying the shame.

You try and justify it to yourself but as soon as people know, the details are irrelevant. You have drunk driven and you have broken the law. It was so hard – I felt like everyone was judging me. Maybe they weren’t, but I would have judged people for drink driving, so I felt like they were doing the same.

I even had to go to a tribunal at work. I could have got the sack. In the end, I was put on probation for two years. When my case went to court, I was eventually banned from driving for three years, given a £350 fine and received three points on my driving licence.

My friends still do it

As part of my punishment I also opted to take part in a drink drive education course, which taught me how to work out how much it’s safe to drink before driving. If I hadn’t have done the drink driving course and learnt how long alcohol still stays in your system, I probably would have done it again. Now I won’t drive home the next morning, or drop my friends off. You think, after a good night’s sleep I’ll be alright, but that’s not the case.

I know lots of my friends do it because they don’t know there’s still alcohol in their system. I tell them, ‘you know, you’ll still have booze in you’, and they say, ‘don’t be ridiculous’. They think I’m being mumsy, or trying to be their parent.

When we go to Glastonbury festival, all my friends drink the day before and all that night, and I say, ‘you’re going to drive home for six hours’. I wouldn’t preach to anybody but all I can say is, don’t forget you drank the day before. I normally end up doing the driving now.

I really think that this should be part of driving lessons. You do under the bonnet stuff, but I don’t recall getting tested on alcohol limits. There should be more focus on the effect of drink and drugs before you pass your test.

It affects your whole life

Even now, 10 years later, it still makes an impact on where I go on holiday. You can’t just forget about it. You have a constant reminder. When it comes to job applications, holidays… everything in your life can be messed up because of that one act.

It affects your whole life. When I went travelling it was hell because of my criminal record. I could have been refused entry into other countries. It’s an inconvenience you put on yourself. This is what people need to hear.

Saying you can kill someone, or hurt someone in an accident, sounds dramatic. It sounds so far from reality. It’s like when you smoke you can’t see you’re killing yourself inside. But there are other consequences that inconvenience your life and your parents’ lives. You need to remember that.

Forgotten holidays and lost birthdays leave English drinking underestimated

Researchers say English drink equivalent of 12m bottles of wine a week more than they thought because surveys overlook alcohol-heavy celebrations.  Good old drinkers amnesia – the alcohol dependents friend 😉  This would be laughable if it wasn’t so bloody serious but yes we underestimate how much we drink ……

underestimated

The Guardian reported that:

Alcohol consumption in England has been underestimated by the equivalent of 12m bottles of wine a week because surveys turn a “blind eye” to drinks swigged during holidays, weddings and birthdays, researchers have warned.

Most research focuses on “typical drinking” and does not account for alcohol-heavy celebrations, according to scientists at Liverpool John Moores University, an oversight they claim could have important implications for public health.

Their findings – based on normal drinking patterns and those outside usual circumstances – suggest every week the equivalent of over three-quarters of a bottle of wine for every drinker goes unaccounted for.

Lead scientist Dr Mark Bellis said: “The problem is that surveys usually ask about typical drinking. This means summer holidays, bank holidays, weddings and many other special occasions when consumption often increases are left out.

“As a result, nationally we underestimate how much we drink and as individuals we can turn a blind eye to our heavier drinking periods when we calculate personal consumption.

“For many people though, these sessions add substantial amounts of alcohol to their annual consumption and inevitably increase their risks of developing alcohol-related ill-health.”

Drinking alcohol is related to about 200 different health conditions and in 2012 was responsible for 3.3m deaths worldwide.

The researchers, whose findings are reported in the journal BMC Medicine, conducted telephone interviews with 6,085 randomly selected members of the public in England.

Most categories of drinkers, based on age groups and levels of typical consumption, reported increased consumption during holidays or special occasions. The biggest increase was seen in 25- to 35-year-olds, who had the highest level of typical consumption.

People in this drinking category drank an extra 18 units (144 grams) of alcohol a week on special occasions.

James Nicholls, from Alcohol Research UK, said: “Patterns of consumption have a significant influence on the health impacts of alcohol.

For instance, it is widely recognised that any protective effects of moderate drinking on the heart are cancelled out by heavy drinking episodes.”

So as The Telegraph also chimed in:

Data from these studies in England accounts for only 60 per cent of the alcohol sold in England, according to experts from John Moores University, Liverpool, and Bangor University.

Lead author on the study, Professor Mark Bellis said: “nationally we underestimate how much we drink and as individuals we can turn a blind eye to our heavier drinking periods when we calculate personal consumption.”

Shock horror meets no sh*t sherlock.   When as healthcare professionals we doubled whatever you told us you drank or smoked – well we were pretty close.  If people are under-reporting by 40% we weren’t that far off were we?  Oh boy, we are so seriously in denial about our drinking problem in this country …..

Worrying is using your imagination to create something you don’t want

So a while back feeling mentioned ‘The Law of Attraction’.  This was a concept I don’t remember hearing about before so off I went to the local library to see what I could find.  The heading of this post about worrying comes from Abraham Hicks and you can subscribe to a Daily Quote from them here.

Thatwhichisholdingyoudown

And you know how one book leads you to another?  Well having read two books about it I then heard about ‘The Untethered Soul’ and boy oh boy was this an eye-opener.  This book really blew my mind!!

If you are working on meditation and changing your inner landscape then this book is for you and you can find further details at http://www.untetheredsoul.com/

And of course he’s been on Oprah! 😉

Author Michael Singer says spiritual growth can begin by silencing the negative thoughts in our minds. Watch as Michael shares a spiritual solution to use to regain inner peace when thoughts become distracting.

I am working really hard to practice what he suggests and much of it chimes hugely with Andy over at Headspace and what he advocates :)
The longer time goes on and the further into my recovery journey I go I realise that putting down the drink was just the tip of the iceberg of the path I was on and it is ALL good.  Over Easter I had a difficult family experience and although I recognised the anticipatory anxiety and the post event emotional hangover at no point did the thought of picking up a drink even cross my mind.  I was desperate to meditate instead!! 😀
Anyone else read this book and care to chime in?

 

Employers pledge support to improve workers’ health

This was featured in The Guardian in May and looked at how businesses are starting to recognise their public health role, with almost 400 signing up to a Department of Health ‘responsibility deal’ to improve workers’ health.

Working-age ill-health costs the UK economy an annual £100bn, so there are clear business benefits for employers to improve the health of their workers.

business_benefits_of_a_healthy_workplace

Wellbeing initiatives can prevent absenteeism and improve productivity. The government-sponsored Frost/Black report in 2011, for example, outlines how avoidable sickness absence could be tackled through early intervention with occupational health support, including physiotherapy.

Employers are starting to recognise their public health role; almost 400 organisations have, according to latest figures, pledged support for the Department of Health’s public health “responsibility deal”.

The voluntary pledge involves businesses and public-sector bodies promising to take action in four areas: alcohol, food, health at work and physical activity. A report in March by the House of Commons health committee, which looked at the impact of diet and physical activity on health, underlined the role of the responsibility deal, adding that it could have even more of an impact if it was supported by more regulation.

Camden and Islington NHS foundation trust has joined the responsibility deal’s health pledge. Promoting public health among healthcare professionals is vital. According to the government’s 2009 Boorman Report, more days are lost through staff sickness in the NHS than elsewhere in the public sector, with sick leave costing the health service £1.7bn a year. In addition a report last year by Arthritis Research UK revealed musculoskeletal problems are a major cause of ill health among NHS staff, costing about £400m per year.  “We need to practice what we preach,” says Zipporah Jempeji, the trust’s human resources, wellbeing and benefits manager.

This is definitely a step in the right direction and I wonder how many workers will feel safe about approaching their employer about alcohol issues?  Would you have?