Daily Archives: 07/03/2015

Exposure – When Pregnant Women Drink

https://www.itv.com/itvplayer/exposure-when-pregnant-women-drink/series-1/episode-1-exposure-when-pregnant-women-drink

It’s unusual for me to post more than once a day but I watched ‘Exposure – When Pregnant Women Drink’ last night and as it is only currently available on itvplayer that means it expires in 27 days and I wanted to give you the opportunity to watch it before it disappears.  I’ve checked Youtube and as yet it  hasn’t been uploaded there.  Thank you to a member of the Sober Women’s Awareness Group (SWAN) on FB who alerted me to it (and if you want to join this group go to yoursobriety.com)

This was the blurb:

Ranvir Singh investigates the impact of drinking alcohol in pregnancy, addresses confusion over the correct guidelines and meets with sufferers of Foetal Alcohol Spectrum Disorder.

This was an excellent documentary looking at Foetal Alcohol Syndrome (FAS) and Foetal Alcohol Spectrum Disorder (FASD).  It was balanced, compassionate and did not shy away from the truth.

There were some superb professionals who spoke out about how alcohol is a toxic poison, a drug, a teratogen which means it is no different from thalidomide.  They showed the in-utero impact on a foetus of alcohol – how its movements slow.  They interviewed four children and their families who’s lives were impacted by FAS including an exceptionally brave mother who drank during pregnancy and who’s son had been affected.  She has been in recovery for 10 years now and said that if she’d known of the impact and had been offered rehab at the time she would have taken it.  Each family had a child at different ages so a 5 year old, a 10 year old and two older grown children – one who had been in prison because of the impact of FAS on his behaviour and the other who was campaigning to raise awareness of the disorder.

They quoted the stats that I’m aware of:

1 in 1000 babies born in the UK have FAS – with the facial abnormalities that identify them as FAS

FAS

1 in 100 babies born in the UK have FASD – the biggest preventable learning disability.

They cited US research by the American Association of Pediatrics in 2013 who did a meta-analysis and literature review of the impact of substance abuse during pregnancy and tabulated the findings which you can review here:

http://pediatrics.aappublications.org/content/131/3/e1009/T2.expansion.html

and the full research findings here:

http://pediatrics.aappublications.org/content/131/3/e1009.full

Unsurprisingly they found that alcohol posed the greatest harm to a foetus and mother, greater than heroin, in terms of in-utero damage and long term impact.

They also discussed the anomaly here in the UK as regards drinking during pregnancy guidelines and how in other western countries, including the US, Canada, Germany and many many others, it has been standard advice for 34 years that no alcohol be consumed during pregnancy as there is no safe amount.  Suffice it to say no one from the govt was available to be interviewed.

It really is very good and very worth the hour of your time.

Edited to add: 23/06/2015 Further research and reporting:

Drinking in pregnancy ‘significant’ cause of childhood brain damage

Prof Nutt: We need to introduce minimum pricing on alcohol and legalise other drugs

This was an interesting blog in The Spectator by Professor David Nutt at the end of January entitled ‘Let’s face it, we need to introduce minimum unit pricing on alcohol – and legalise other drugs

“In the last few years alcohol has become the leading cause of death in men under 50 years of age, and it will soon achieve a similar deadly status in women. Alcohol-induced liver deaths have quadrupled in the past 40 years whereas deaths from heart and lung disease have halved.

The reasons for this are well established – alcohol is cheaper and more easily available than it has been since the gin-epidemic of the 1700s and half of all 15-16 year olds are becoming dangerously intoxicated at least once a month. A 21 year woman was recently given a liver transplant for cirrhosis induced by her having essentially an alcohol-only diet since aged ten.

Alcohol misuse costs the UK about £30 billion per year of which about £3.5 billion is in health care costs with over 1 million hospital admissions for alcohol-related disorders at the last count. Policing public disorder and alcohol road accidents cost the taxpayer over £6 billion a year.

Despite the scale of the problem alcohol is easily the most tractable health problem in Britain since there are a number of proven interventions. Alcohol treatments give a remarkable return on investment or over 500 per cent — every £1 spent gives £5 in health-cost savings.

But, as with other medical disorders, prevention is preferred to treatment and here we have a number of proven strategies that focus on reducing dangerous levels of consumption. The easiest and least intrusive of these is minimum unit pricing of alcohol (setting a floor price below which a unit of alcohol can’t be sold by law, with a unit being 8 gm of alcohol so 1/2 pint of ordinary beer or half a glass of wine).

However whenever this is discussed publicly it provokes a barrage of attacks from the right-wing press, probably driven by lobbying from the drinks industry with claims of ‘punishing the responsible drinker’ and politicians of both colours meekly accede. The truth is exactly the opposite, minimum unit pricing of 50p per unit would in practice save the ‘responsible’ drinker significant amounts of money.

To understand how this works we need to realise that almost every drinker – and certainly every subscriber to the Spectator – will already be drinking alcohol that is priced at more than 50p/unit as this translates into £3.50 per bottle of wine or £15 per bottle of spirits. In fact the only people drinking alcohol that costs less than 50p per unit are those that contribute the most costs of alcohol harm to our society. These are the young binge drinker and the older alcoholic. Increasing the minimum price of alcohol to these two groups would reduce consumption and harm.

Today the cost of alcohol misuse in the UK is around £30 billion per year —about £1000 per tax-payer. This sum might be thought acceptable to those who drink heavily but surely not to responsible drinkers. The 10 per cent of the population who are non-drinkers are particularly penalised since they get no benefit from using alcohol at all.

Estimates from the Sheffield centre that has modelled the value of minimum pricing suggest that a 50p unit price would lead to at least a 10 per cent reduction in consumption. The relationship between alcohol intake and harm shows an exponential curve; drinking a litre of wine each day is 5 times (not twice) more harmful than drinking half a litre. Reducing consumption in those who drink a litre of wine a day (or its equivalents in other alcohol products) by 10% would reduce harms by 25 per cent. Real life experience in a province in Canada showed that introduced minimum pricing recently found a 10% increase in minimum unit price led to a 30% reduction in alcohol deaths.

Our two groups of consumers of cheap alcohol (the young and the alcohol dependent) contribute about 30 per cent the total burden of costs of alcohol (about £10bill/year) so reducing this by a quarter would save around £2.50 billion a year — the price of 8 new hospitals – or a tax-rebate of £100 or so per taxpayer.

What this analysis tells us is that current policy means that each taxpayer is contributing a significant amount of money to in effect subsidise drinking in these two groups of people so allowing them to damage themselves more and create huge costs to society. Truly a lose-lose situation!

Properly pricing alcohol can lead to a virtuous circle of health and wealth. France is a remarkable example of this. Twenty five years ago the French made three significant changes to their alcohol policy. They priced out cheap alcohol, reduced the drink-driving limit to 50mg and banned broadcast alcohol advertising including in sport.

These changes have had a major impact to reduce deaths on the road and from alcohol-induced medical disorders with cirrhosis. Amazingly where in the 1970s the French had deaths rates from liver cirrhosis five-fold greater than the UK, now they are only a third of ours. What is even more remarkable is the fact that the French alcohol industry has become more profitable; more expensive wine has greater profit margins.

The UK alcohol industry is well aware of these data, and must accept that they would be more profitable under a more-expensive minimum-priced alcohol policy. So why do they resist any attempt to develop a more rational policy even one as minor as minimum pricing? One view is that they rely on the cheap super-strength ciders and lagers that have come on to the market in recent years to get young drinkers addicted.

My view is that they have taken a collective position to oppose any change in drink regulations on principle even if it would in the long run benefit them. Their profits are so enormous; they just can’t be bothered to innovate. Moreover they fear that accepting the need for change might open a sensible debate about broader alcohol policies.

If we can’t improve alcohol harms from rational minimum pricing then what other alternatives are there? One way would be to allow controlled and taxed access to other intoxicant drugs that are less harmful than alcohol such a cannabis and MDMA [ecstasy]. An argument can be made that a society that actively encourages the use of alcohol to provide tax income as the UK does has a moral (as well as utilitarian) obligation to allow its citizens access to other safer recreational drugs. These would also bring in tax revenue and because they are safer and less violence-inducing than alcohol would reduce the net cost to UK taxpayers.

In effect the Dutch have been doing this for 30 years and have reaped significant benefits in terms of reduced harms, less alcohol damage and, in the case of cannabis, improved medical care for patients needing medical cannabis which despite the 2000 House of Lords recommendations supported by the recently resigned Drugs Minister Norman Baker is still banned in the UK.”

Professor David Nutt is professor of Neuropsychopharmacology at Imperial College London, Chair of DrugScience.org.uk and a former Chair of the Advisory Council on the Misuse of Drugs.

I happen to agree with Prof Nutt and feel that we need a complete overhaul of the current classification of drugs and legislation surrounding them.  We should be learning from countries like Portugal, Holland, France and Canada as to the way forward with both drugs and alcohol policy.  Russell Brand was featured in a documentary late last year looking at this very issue and you can see it here.