Veronica Valli and I (5) discuss ‘recovered’ vs ‘recovering’

Veronica and I met a couple of weeks ago on Skype and during this conversation we discuss how the AA fellowship perceives ‘recovered’ alcoholics as opposed to ‘recovering’ and the difference between the ‘fellowship’ of AA and the ‘programme’ of AA.

As someone who has a copy of the Big Book, which is the ‘programme’, but who has only been to one 12 step meeting, which is the fellowship, I find AA fascinating and over the next 12 sessions we are going to discuss each of the 12 steps.  I am interested to learn how the steps can be used to resolve the ‘spiritual malady’ that AA talks of without necessarily attending a 12 step meeting and Veronica has very kindly agree to be my guide, and because it’s recorded, you can see the journey too :)

Look out for the next conversation in the coming weeks or subscribe if you don’t want to miss it!

Veronica Valli is an Addictions Therapist and the author of Why you drink and How to stop:…


2013 How to Stop Cover 960x1280

PS Over 450 of you have subscribed to receive my e-book since it launched and I am so grateful for the support.  You can now buy it on Amazon and it is being well-received there with three 5 star reviews already! Please feel free to go add a review yourself if you’ve read it and benefited from it.  If you are reading this and haven’t subscribed I’m offering a free place on my newly launched Udemy course for the 500th subscriber so go sign up at the top of the page if you haven’t all ready! :)

Civil service chief under fire for keeping second job in alcohol industry

John Manzoni waives £100,000-a-year SABMiller salary amid criticism from doctors that his role is incompatible with health goals.  Read the full story hereThis really makes my blood boil ……

John Manzoni, the new chief executive of the civil service, will waive his £100,000-a-year salary from a major drinks company as he comes under fire from more than 70 leading medical professionals and charities over his second job in the alcohol industry.

Challenging the government’s claim that there is no potential for a conflict of interest, the letter to Heywood said: “We write to you as public health professionals to express our deep concerns about the alcohol industry interests held by the newly appointed chief executive of the UK civil service, John Manzoni.

“We find it inexplicable and troubling that Mr Manzoni retains a paid position as non-executive director of one of the world’s largest brewers, SABMiller, while stepping down from two other paid positions in the energy sector. This appears to be only partial fulfilment of the Nolan principles, which require holders of public office to ‘take steps to resolve any conflicts arising in a way that protects the public interest.’”

The signatories, who include Prof Sir Ian Gilmore, special adviser on alcohol to the Royal College of Physicians, Prof Klim McPherson, chairman of the UK Health Forum, Prof Sir Simon Wessely, president of the Royal College of Psychiatrists, and Alison Cox, of Cancer Research UK, list two potential conflicts of interest:

• Manzoni’s remuneration for his post with SABMiller – taken in the form of company shares – means he has a pecuniary interest in growth of the company’s sales and profits and therefore an interest in government policies that may affect this.

The letter says SABMiller has conducted a “well resourced and wide-reaching lobbying campaign against UK government policies aimed at tackling alcohol harm that potentially threaten the interests of the drinks industry, such as minimum unit pricing”.

It adds: “It is problematic that the chief executive of the UK civil service has such clear links to an organisation with strong vested interests on one side of such debates.”

• SABMiller has commercial ties to the tobacco industry through its shareholder Altria. The letter says the Altria group (formerly known as Philip Morris Companies Inc) is the parent company of Philip Morris USA and also a 27% economic and voting interest in SABMiller plc, with representation on its respective board.

The letter says: “We seek clarification on whether Mr Manzoni’s commercial links to the tobacco industry are considered to be compatible with the UK government’s obligations under article 5.3 of the WHO [World health Organisation] framework convention on tobacco control and its implementation guidelines, requiring that public health policies should be protected from commercial and other vested interests of the tobacco industry.”

It goes on to argue that Manzoni’s continued interest in SABMiller “poses a serious threat to the perceived neutrality and integrity in the role of the UK civil service in policy-making” and calls for full disclosure of the details surrounding his appointment.

One of the organisers of the letter, Katherine Brown, director of the Institute of Alcohol Studies, said she found the situation an astonishing example of the revolving door between business and the government.

“In this instance they haven’t even bothered with a smokescreen,” she said. “Having the chief executive of the UK civil service receive private funds from an industry whose impact and activities are so highly contested is seriously problematic. This presents a major risk of conflict of interest and exposes public policy to interference by big business financial goals.”

Oh yes and SABMiller is one of the key leading partner’s in the Public Health Responsibility Deal and you can read their current pledges here:

Words fail me ……..

Alcohol and older people

From Alcohol Policy UK:

A new report explores influences on older adult’s drinking as an area of increasing significance within an ageing population. Researchers from Keele University and University College London aimed to help improve understanding of drinking in later life and to inform possible interventions and guidelines.

The report’s introduction states:

Older people tend to drink less than any other age group. However, in recent years British survey data on alcohol consumption has shown that while younger age groups have experienced a decline in the quantity and frequency of consumption, drinking behaviours among the elderly have not declined in the same way… Yet relatively little is known about the (a) diversity of patterns of drinking in later life; (b) how drinking is associated with key socio-demographic characteristics and health conditions; (c) and how drinking changes over time and which life course events, such as retirement and partnership change, might influence this process.

Main findings include:

  • Older men tend to drink more and to drink more often than women.
  • For both men and women, those in higher income groups and with higher levels of education drink more and drink more frequently.
  • Both the amount that older people drink and how often they drink declines over time, though the rate of decline in quantity and frequency varies according to health and partnership status.
  • Men who are not in a partnership drink more compared to men with a partner, though there is no difference in the frequency of men’s drinking by partnership status. For women loss of a partner is associated with a faster decline in weekly alcohol consumption and with drinking less often.
  • Poorer self-rated health is associated with not drinking. Among drinkers, there is no evidence that a moderate amount of alcohol consumption improves health in later life compared to heavy drinking.
  • Over time older people with poor health and deteriorating health report a steeper decline in the quantity and frequency of alcohol consumed. This finding suggests that older people moderate their drinking in response to health events.
  • Those who stopped drinking at the start of the period of observation and remained in the study were more likely to experience an improvement in health compared to drinkers.

Older people drinking (graphic representation of statistics)

This report coincides with a new initiative being launched in the UK with flagship work taking place in Glasgow, Sheffield, Devon, South Wales and Northern Ireland.  This is to help tackle the issue of drinking in later life and the Big Lottery Fund is investing £25 million into this alcohol-related harm prevention and awareness programme for the over fifties, called ‘Drink Wise, Age Well’, in partnership with support charity Addaction.  Read more here: £25M to help over-fifties enjoy booze without the blues.

Edited to add: further news stories last week about alcohol and the over 60’s can be read here too:

And here:

Liver disease: a preventable killer of young adults

Reblogged from the Public Health Matters, the blog of Public Health England and written by Julia Verne.

Liver disease has changed over the years but my commitment to reducing deaths hasn’t.

I’ve had a fascination and passion for treating and preventing it since I was a medical student, training at the Royal Free School of Medicine under Dame Professor Sheila Sherlock who was the founder of liver disease as a speciality.

As a junior doctor I worked on both medical and surgical liver units, assisting in the first transplant conducted at the Royal Free when liver transplantation in the UK was in its infancy.

I vividly remember the terrible suffering of patients with end stage liver disease, coming in as an emergency, vomiting vast quantities of blood from oesophageal varices or with huge pregnant looking bellies distended with ascites which had to be drained. Patients were restricted to drinking very small quantities of water and eating virtually no salt. Others suffered psychoses or coma and then multiple organ failure resulting from their end stage liver disease.

In those days we didn’t wear gloves because we didn’t want to upset patients and make them feel untouchable. Hepatitis C had not yet been discovered and our options were very limited.

Since then, we know about Hepatitis C, Hepatitis B can be subtyped there are new treatments for both. There are 600-700 transplants per year and liver disease has gone from being a rare disease to one seen frequently in every hospital and general practice.

But though treatments have improved we have to tackle the increase in disease which is mainly preventable. There are also large inequalities in liver disease – it is a no brainer that as a Public Health Physician, I see that we should be making a concerted effort to reverse these trends.

Here are some hard facts:

  • Liver disease is the only major cause of mortality and morbidity which is on the increase in England, whilst it is decreasing among our European neighbours
  • Over a decade the number of people dying with an underlying cause of liver disease in England rose by 40% from 7,841 to 10,948
  • Most liver disease deaths are from cirrhosis (a hardening and scarring of the liver) or its complications – people die from liver disease at a young age with 90% under 70 years old and more than 1 in 10 in their 40s
  • Liver disease is the third biggest cause of premature mortality and lost working life behind ischaemic heart disease and self-harm
  • Most liver disease is preventable – only about 5% of deaths are attributable to autoimmune and genetic disorders – over 90% are due to three main risk factors: alcohol, viral hepatitis and obesity
  • It’s a disease of inequalities. Mortality rates from liver disease in people aged 75 years and under varied significantly by Primary Care Trust. People who live in the most deprived fifth of areas in England are more likely to die from liver disease than those who die in the most affluent fifth.
  • Liver disease, and death from it, is associated with stigma mainly because of the risk factors. This sometimes makes it hard for the patients to access care and hard for the families especially in bereavement
  • 70% of patients with liver disease die in hospital and while one in five of those who die have had five or more admissions to hospital  in the last year of life one in five are admitted only once and die in that first admission and 4% die in A&E without getting admitted to hospital. This reflects the often dramatic complications accompanying death from liver disease

With these statistics in mind it’s unsurprising that liver disease has received a high profile over the past few years. In 2014, The Chief Medical Officer devoted a chapter to liver disease recommending a need for preventative measures involving a combination of public health policy initiatives and increased awareness of liver health and the risk factors for liver disease among the public.

The All Party Parliamentary Hepatology Group Inquiry into Improving Outcomes in Liver Disease produced their report ‘Liver Disease: today’s complacency, tomorrow’s Catastrophe’, earlier this year. The Lancet also launched a commission on Liver Disease which will publish its findings and recommendations this autumn.

Following a meeting between the chairs of the APPG, liver charities and PHE, independently it was agreed that PHE would produce a framework outlining its scope of activities to tackle liver disease. I am leading the co-ordination of this framework which will involve input from colleagues across all PHE departments and directorates, as well as input from the liver charities and Directors of Public Health in local authorities. PHE has extensive programmes of work to tackle all three major risk factors; alcohol, viral hepatitis and obesity.

On the 16th October, PHE will publish Liver Disease Profiles for local authorities in England. These will support the work of Health and Wellbeing Boards and Joint Strategic Health Needs Assessments by providing vital information about liver disease prevalence in their areas.

The challenge will be significant. Liver disease develops silently and obvious signs and symptoms may only appear when changes are irreversible, therefore the identification of people with risk factors for liver disease in primary care is a critical first step in the pathway.

Many patients come from marginalised groups with unstable accommodation, many don’t speak English and many may have difficulty attending or sticking to treatment because of addiction to alcohol and or drugs.

These liver disease profiles did not disappoint in terms of painting a stark picture and I discussed them here. It is not what people say but what they do that is important so let’s see action that matches the words ….


Alcohol Marketing to Children

Following up on the post on the Drinkwise Campaign Launch report discussed before here the section on marketing to children was particularly worrying in terms of statistics.
There is a link between advertising and the amount that young people under-18 drink:
  • Alcohol advertising increases the likelihood that young people will start to consume alcohol
  • If young people already drink, alcohol adverts increase the likelihood they will drink more
  • 96% of 13-year-olds have encountered alcohol advertising in more than five different media
  • 0-15-year-olds view more alcohol adverts on TV than adults aged over 25

And where do they see this marketing?  These statistics taken from a piece of work done looking at awareness of UK 13 year old’s of alcohol marketing showed:

  • 60% special price offers
  • 53% billboard or posters
  • 55% in-store promotions
  • 77% on TV adverts
  • 66% branded clothing other items
  • 61% sponsorship of sports or teams
  • 34% sponsorship of music events/venues
  • 24% mobile logos or screensavers
  • 12% web pages or pop-ups
The industry has switched the focus of its estimated £800 million per annum marketing war chest to focus predominantly on digital marketing. As this is a form of communication heavily used by young people, this is a very worrying development. 67% of 12-15-year-olds have a social media profile and the voluntary safeguards that industry have put in place for television, radio and print advertising are virtually non-existent in the digital world.
“Whether deliberate or not, our results show that children are not protected from online marketing of alcohol”
Professor Theresa Marteau, University of Cambridge


Liver disease profiles highlight the role of alcohol

New liver disease profiles released by Public Health England and covered in a report by Alcohol Policy UK highlights that liver deaths in England increased 40% between 2001 and 2012.

A picture paints a 1000 words as the old adage goes:

liver disease mortality

Alcohol specifically accounts for 37% of all liver disease deaths, although over 90% are due to one of the three main risk factors: alcohol, viral hepatitis and obesity. One in ten people who die in their forties die of liver disease, whilst 90% of people who die from liver disease are under 70 years old.  See reports in the Telegraph, Guardian, and BBC for more about alcohol-related liver disease (ARLD)

In 2009 the Department of Health said it would deliver a National Liver Strategy to combat the rise of liver disease. By 2012, more reports indicated it was soon coming, but never appeared.

Why is that?  It is clear from the above graph that this is a health priority in terms of morbidity and mortality.  Plus campaigns have been launched for all of the other areas highlighted and they are all dropping which suggests that it is a successful strategy.  Even if it was launched looking at reducing deaths from obesity as the leading issue  it leaves me scratching my head as to why this hasn’t happened yet.   Obesity is recognised as a major public health issue in it’s own right and as I said in a previous post I wonder how much of the obesity epidemic is created by alcohol consumption not just food over-consumption?

Why is the Department of Health looking the other way on this issue?  Is it because real longer term outcomes would also depend on action on price, availability and marketing of alcohol and junk food and that is where the conflict of interest lies with our govt?  It would involve reigning in the vested interests of corporations that fund the govt through lobbying and donations and impact on their profitability.  Are the financial interests of the corporations being put before the best interests of the health of our nation?  I have to conclude that the answer is yes.  What do you think?

Guest post on Mumsnet and Udemy course launch

Well it’s been a busy and happy week here in the HOF household.  Last week Mumsnet approached me to write a guest blog post for them as it is Alcohol Awareness Week here in the UK and it’s titled ‘The moment I knew I had to give up drinking’ and you can read it here.

Plus I’ve mentioned that I’ve been busy working on something that I would tell you about when it was ready.  Well it’s ready and the sharp eyed amongst you may have noticed the new image that has appeared to the right of this post that looks like this:


If you click on it (and I’m sure some of you probably already have) it will take you to my new course hosted on a platform called Udemy.  The course title is the same as my blog: A Hangover Free Life and here’s what it says on Udemy about the course:

Since I stopped drinking in September 2013 I have saved over £2500, lost 10lbs in weight and any symptoms of anxiety or depression have all but gone. Life is better in every way!

Before we stop, we think quitting drinking will be impossible and too hard, so we decide not to even try, but this course will give you all the information and tools to make it possible. There are presentations, an e-book, hand-outs and online resources for you to use. The course is designed to be completed in 3-4 hours but deciding to change your relationship with alcohol, and changing it, can be a process which takes some time and as this course gives you lifetime access it will be there for you as long as you need it.

It looks at ways to cut down through moderation, gives you the structure and time to reflect on your drinking while thinking about stopping or preparing to stop.

It gives you knowledge about the impact that alcohol has physically and emotionally and the skills to manage life alcohol free. Then once you are living hangover free tools are provided to ensure that you can stay that way as long as you wish.

It gives supportive resources in terms of books, films and online communities. A one on one support consultation via email, telephone or Skype is also included in this course should you wish to take advantage of it.

This course is for you if you want to look at your relationship with booze and want to change it, be that temporarily or permanently. What have you got to lose? You can always go back to drinking if you change your mind. Although you might find, like me, that life is so much better without it that you’d rather stay hangover free. Enroll now!

If you want to go take a look and view the free preview materials then you can do so here:

Udemy is sharing a promotional offer in the run up to Black Friday and I’d like for you to be able to take advantage of this.  The course is listed as $49 but if you click on the image to the right and sign up before Saturday 29th November you’ll get the course for only $10!  As this is a new feature and I want to ensure you access the savings – you can click HERE also.

As a valued reader of my blog I would greatly appreciate your feedback on email at if you have any recommendations for changes or improvements to the course.  If you sign up and think it’s great just the way it is then a review on Udemy would be fabulous!

I’ve found since I stopped drinking that you can never have too much support or too many tools in your sober toolbox.  For the price of a sober treat if you’re living alcohol free, or a bottle of wine if you’re drinking, lifetime access to this course can be yours today.  I hope you’ll join me on the course and we get to talk one on one soon :)

I’d love to hear what you think about the guest post and the Udemy course!


Alcohol Concern Conference

This morning’s post will be brief as I’ve scheduled my full one to be published this evening with some exciting news to share!

Yesterday I attended the Alcohol Concern Conference in London which was an excellent day.  So many brilliant speakers including Professor Sir Ian Gilmore, Professor Linda Bauld and Gabrielle Weller & Arthur Cauty  showing clips and discussing ‘A Royal Hangover‘.

There was representation from both the Conservative/Liberal Democrat Coalition govt and Labour party speaking also, and I have to say I was underwhelmed by the major political parties future direction on alcohol policy.  It felt like they said the right things but I wasn’t entirely convinced about the strength of political will to tackle the issue we have in this country with this drug and it’s impact on our children, our health and society more widely through public health.  It’s a general election next year so time will tell.

The alcohol industry were also present, Diageo mainly  …….

I learned a great deal and there will be several blog posts to follow to share that knowledge here which means next week will see more daily posts until I’ve exhausted the subject for the moment! ;)

Check back later for another post today! :)


Passive Drinking

A really excellent Campaign Launch Report was shared by Drinkwise recently called ‘Alcohol and Childhood Don’t Mix’ and you can see the full report here and you can find their website at:

It opens with “this investigation uncovers a shocking truth – we are failing to protect our children from the negative consequences of alcohol.”
I was really struck by some of the statistics in this report, some I’ll discuss here and one other set deserve a blog post of their own.
These statistics relate to the impact of other people’s drinking on children:
  • 8% neglected or not well looked after
  • 8% missed school
  • 6% mentally affected
  • 12% anxious, upset or worried
  • 2% missed health appointments
  • 5% missed leisure activities
  • 3% in physical danger

They may seem small numbers but children are dependent on adults for their physical and emotional health and well-being and so are not able to be responsible for themselves.  Plus a report by the children’s commissioner has found that social services support for alcohol misuse is failing to look beyond the impact on the individual.

Joanna Manning, national lead on substance misuse for The Children’s Society, said: “Children and young people are suffering the impact of their parents’ drinking for a long time before it comes to the notice of the authorities – if at all. Even then, the routes to help and the services available are ad hoc and vary across the country.

“Local authorities tend to focus on young people’s own drinking without consideration that it might be learnt or normalised behaviour from their parents. Equally, not enough is being done to address and support parents who drink, in order to reduce the impact upon children and families.”

Statistics relating to drinking patterns and behaviours of 14-17 year olds who drink alcohol:

  • 72% think that getting drunk is fun
  • 57% believe that it is normal to get drunk
  • 40% are not worried about the long term health effects
  • 54% binge drink
  • 37% drink just to get drunk
Underpinning these trends is a surprising connection from very young children to the adult drinking world, and also misperceptions about what level of alcohol consumption is “normal”. A survey of 9-11 year-olds showed that 3-in-5 think it is normal to drink to forget your problems, 27% think beer drinkers consume 4-6 pints in an evening and 30% think wine drinkers drink 5 or more glasses a night.
Plus the impact of living in a home where alcohol abuse is an issue can last a lifetime. And the behaviours unfortunately can be self-perpetuating as reflected in these statistics:
  • 30+ sexual partners:  3.6 times more likely
  • Sexually transmitted diseases: 2.5 times more likely
  • Anxiety: 2.5 times more likely
  • Severe obesity: 1.9 times more likely
  • Current smoker: 1.8 times more likely
  • Alcoholism: 7.2 times more likely
  • Perpetrating partner violence: 2.5 times more likely
‘Passive drinking kills. It causes family breakdown and violent crime. It costs the economy billions of pounds.  It causes misery. It affects many spheres of life and leaves no communities untouched.’
Sir Liam Donaldson, 2009 CMO Report

Do you worry about having a hangover in the week or not?

I was recently approached by Adam at Voucher Codes Pro and was happy to share the results of a poll they conducted.

Voucher Codes Pro decided to conduct a poll asking 1,673 working UK adults, aged 18-40 years old, from all over the country whether they worried about suffering a hangover during the week or not?

The participants were of an even gender split of males and females, with the results revealing some surprising information.

When questioned how many times a week during Monday to Friday does each individual enjoy an alcoholic drink, more than half (57%) said they drank twice a week.

However, interestingly nearly a third (32%) would go out on a weekday, with others (68%) opting to drink at home. Of these participants, the majority (65%) would regularly go into work the following day with a hangover, while shockingly nearly a quarter of these (23%) were also sick during office hours.

When asked for their reasons for drinking on a weekday, even with work looming the following morning, the most popular answers were as follows:

  1. To let off steam after work – (32%)
  2. To help break up the week – (28%)
  3. Boredom – (21%)
  4. To celebrate an occasion – (15%)
  5. Lack of responsibility – (4%)


Taking a closer look into the results, the polls also revealed that just under half (46%) of those that had suffered a hangover the following morning, resulted in them calling in sick and taking the day off.

Interestingly, results suggested it was mainly (74%) males that found going to work with a hangover was too much to deal with. Could this kind of self-inflicted behaviour be contributing to the UK’s wide scale problems concerning the increasing number of sick days taken by staff? 

stages of a hangover

You can read the full article here

I particularly like the hangover model which mirrors the Kubler Ross grief cycle which I have talked about in a previous post.  It also accurately represents how my hangovers used to feel too which reminds me of why I stopped! ;)  If this is how you are feeling today as you overdid it last night why not give yourself a break?