Monthly Archives: December 2015

New Years Eve – 2016 here we come!

Russell Brand

 

 

 

 

 

 

So I saved one of the images that Arthur from A Royal Hangover produced for me for the sober advent calendar for New Years Eve 😉   Why?  Well partly because he is one of the patrons at the drug and alcohol treatment centre where I volunteer – so he has a special place in my heart.  But also because today is a biggie for many – so many new possibilities lie beyond the strike of midnight tonight and the virgin minutes of a New Year.  What will 2016 bring for you and me?

Well in the words of the delectable Mr Russell Brand – my life has improved immeasurably since I no longer drink alcohol or use drugs.  I can’t say it’s been 10 years for me but it has been 831days and in the first half of 2016 I will hit 1000.  I’m not thinking about drinking anymore, I’m thinking about hitting 1000 days and the excitement of life that lies ahead.  The HOF clan have saved all of their ex-booze fund up and will be travelling to Australia in 2016 to visit family on an extended holiday.  This truly amazing sober treat of visiting the other side of the world for the first time will be realised as a direct result of us not drinking anymore and I can’t bloody wait!!

I don’t need to get pissed today to improve the night or add to the expectation of a brand new year.  And neither do you.  But if you think or feel you do that’s okay too and I’ll be here tomorrow whatever so come on by and if you do decide you want 2016 to be different to 2015 on the drinking front then say hello or email me and I’ll do all I can to help turn that into a reality for you 🙂

And finally a tune – aptly titled Dance Yourself Clean and featuring a band I love – LCD Soundsystem, a place I love – Brighton & the irreverence of  the Muppets raving! (watch until at least 3 mins 10 secs in when they drop the tune) What more could you ask for on NYE? 🙂

Or two? 😉 If you prefer your NYE soundtrack more mellow – how ’bout this amazing Radiohead track that was commissioned for the James Bond film Spectre & then never used!!! (why oh why?)

Happy New Year lovely soberverse and thank you for being here with me these last two years <3

In 2014 the blog had 100,000 views and this year?

The Louvre Museum has 8.5 million visitors per year. This blog was viewed about 150,000 times in 2015. If it were an exhibit at the Louvre Museum, it would take about 6 days for that many people to see it.

Full 2015 annual report

Does alcohol really make you better in bed?

booze & sexSo this article appeared in The Guardian in November.  And every post I’ve written and booze and sex is here.

Over to Dr Sally Adams:

Alcohol “…provokes the desire, but it takes away the performance” said Shakespeare, but was he right? It is common belief that alcohol helps us lose our inhibitions and can also act as an aphrodisiac (sometimes!). But it’s not often thought of as a performance enhancer in the bedroom. I refer you to “brewers droop”, the age-old nickname for temporary erectile dysfunction induced by alcohol.

The notion of too much alcohol as a passion killer is backed up by anecdotal and scientific evidence, but this doesn’t seem to dampen the media fascination with it as a libido enhancer. Is there any truth behind the notion that a couple of pints can really make you a better lover or is this just another “sexy” science story?

There is a significant body of research that suggests alcohol is associated with heightened sexual response (increased arousal and enhanced orgasm) and loosening of sexual inhibitions. Historically, alcohol also has a long association with romance and sex in terms of advertising. On the other hand, alcohol is linked with an increase in risky sexual behaviours, which can result in unwanted pregnancy and sexual transmitted diseases. Given these opposing effects, why do media articles tend to focus on the positive association between alcohol and sex, and what do the research studies behind the media stories tell us?

A recent story in the Independent reported on the claims made by a new book called the “The Married Sex Solution”. Sex expert Dr Kat Van Kirk believes that drinking beer can lead to four distinct improvements in the sexual experience for males: (1) delayed ejaculation, (2) enhanced libido and more intense erections, (3) increased sexual stamina and (4) that beer can help “your overall health” and thus make you less “sluggish in sex”. Interestingly, the only point to reference a peer reviewed research article is the third – that “alcohol improves sexual stamina”.

A study published in the European Journal of Epidemiology reports on a meta-analysis of 13 studies looking at cardiovascular risk and beer consumption. The findings suggest a J-shaped curve, suggesting a reduced risk of cardiovascular disease in those who drink 55g of beer a day or less. It is important to note that this study did not actually measure sexual stamina, instead reduced cardiovascular risk was taken as a proxy. Also, it is not fully clear what “grams of alcohol” means here. If the measure reflects pure ethanol, 55g of beer is equivalent to approximately 7 units or 3 and a half pints of fairly weak beer per day. This seems like a lot of alcohol to be consumed each day!

An article in The Telegraph reported on a 2009 study conducted by the Western Australia’s Keogh Institute for Medical Research. This study examined the impact of alcohol use on male erectile dysfunction. The Telegraph article did not provide a link to a peer reviewed article, but I found a study on this published in the Journal of Sexual Medicine. It collected information from 1,580 men on erectile function, alcohol, and tobacco use. The Telegraph reported that the men who drank a moderate amount of alcohol reported 30% fewer erectile problems than non-drinkers. The article interprets this finding as a “favourable association” between moderate drinkers and erectile function.

The authors of the research paper indicate that none of the reported associations between drinking status and erectile function were “statistically significant” until cardiovascular disease and smoking status were controlled for in analyses. It is also important to remember that the study used self-report measures of alcohol consumption and erectile dysfunction, meaning any associations observed are dependent on the ability and willingness of participants to accurately report their alcohol use and erectile problems

A third study reported in The Independent this year looked at whether alcohol can boost women’s sex drives. The study showed that following moderate alcohol consumption, levels of testosterone increased in women, but not men. This might be evidence of alcohol increasing the libido of women via a temporary surge in the male sex hormone. Despite being reported in The Independent this year, the research in question appears to come from a study published in Nature by Alko (a large Finnish alcohol retailer) in 1994.

The research itself is a one-page report on an experimental study where men and women were given either an alcoholic beverage or a non-alcoholic juice, and hormone levels were measured (although it is not clear how). When controlling for contraceptive use and menstrual cycle (which affects hormone levels) alcohol increased testosterone compared with the placebo in women, but not men.

There are a number of methodological questions that cannot be answered from the information in this short report – did the participants know if they were receiving an alcoholic or placebo beverage? In what conditions were participants tested? However, for me the biggest question is why would the media report on a study conducted over 20 years ago, which is a considerable amount of time in the fast moving world of scientific research?

Interestingly, the publication of the article in The Independent coincided with a press release for a new vodka by a company called Alko-plus. (It is not clear whether this company is affiliated with Alko). In the press release, the vodka is specifically aimed at women, with claims made regarding the capability of alcohol to increase female libido: “Hey Gals: Put New Meaning Into Your July 4th Fireworks; Alko-Plus Creates ‘Lust Vodka’ that it says Increases Female Sexual Desire”.

Reviewing these articles and the corresponding research studies has made me think about the issues involved in studying sex and alcohol and in reporting and interpreting research findings. There are many complex individual differences in the psychological and physiological factors that influence the response to both sex and alcohol. The association between sex and alcohol is dependent upon alcohol dosage, alcohol expectancy, and measurement of alcohol and sexual behaviour.

In terms of dose, there may be an optimal amount of alcohol to induce these positive effects on sexual arousal or performance. Once past that threshold the effects may be more negative. This notion is supported by the biphasic nature of alcohol, with stimulant effects as blood alcohol concentration increases, but depressant effects as it decreases again.

Alcohol expectancy can also impact sexual behaviour during intoxication. Simply believing that drinking alcohol increases sexual arousal may lead to actual arousal during intoxication. Expectancies about alcohol consumption are a key element of research examining the effects of alcohol on any behaviour. It is important that research determines the impact of both the direct pharmacological effects and expectation.

Finally, the way alcohol use is measured can impact on the association with sexual behaviour. The administration of alcohol in an experimental study versus self-report of alcohol use by drinkers is likely to yield different study findings. Furthermore, it is very difficult to directly measure sexual behaviour. Most studies have to rely on self-report of sexual arousal and performance or use proxy measures such as cardiovascular and physiological function.

Accurate representation of research evidence on alcohol and sex may not yield a “sexy” headline. However, clear and honest reporting of research findings and at least a link to the original published study should allow the reader to make up their own mind when faced with the scientific evidence.

In this case alcohol’s ability to increase prowess in the bedroom does not appear to be as straightforward as presented in the media. The link between sex and alcohol is a complex one and best interpreted when a clear and balanced picture is available, rather than a “sexed-up” story.

As we say here, all mouth and no trousers then booze? 😀  All I know is that it is one hundred times better sober 😉

‘I think my colleague is an alcoholic. What should I do?’

This was covered in The Telegraph back in October and was an excellent response to the reader question about concerns about a work colleague and their drinking.

work dilemmaI’m worried about a colleague and would like your advice. He’s known in the office as a bit of a party boy and often arrives late looking like he’s had a big night out – it’s become a standing joke. But I’m concerned the problem is worse than people think; I recently went on a week-long business trip with him and when he did show up for meetings – he missed most – he either seemed drunk or badly hungover. I’ve been asked by our mutual boss to give feedback on how he performed, but don’t know whether to tell the real story. He’s had one warning already for poor performance and I really don’t want him to lose his job – but I think he needs help. What should I do?

The wider problem

Alcohol and substance abuse in the workplace can create challenges for employers, the employee concerned and their colleagues. There is no ‘one size fits all’ rule for how such issues should be handled.

If a concern is identified, firms can approach it as a disciplinary, health or performance issue (or a combination) with support likely to include specialist counselling, referral to occupational health practitioners, a formal professional intervention – and/or the use of internal disciplinary procedures.

Employees with an alcohol problem have the same rights to support and confidentiality as they would if they had any other medical or psychological condition.

And the problem is huge. The TUC’s Worksmart initiative estimates that up to 17 million working days – between three and five per cent of all absences – are lost each year due to alcohol, while sickness absence due to alcohol is estimated to cost the UK economy over £7.3 billion a year.

In a 2007 survey by the CIPD, Managing Alcohol and Drug Misuse at Work, four out of ten respondents identified the consumption of alcohol as a significant cause or very significant cause of employee absence and lost productivity.

Where to start

You think that your colleague is drinking too much and that it’s impairing his ability to work, based on your recent experience of being on a business trip together.

Your concern for his health and your fears for his job security are absolutely understandable – although it’s important not to make assumptions. Heavy drinkers aren’t necessarily alcoholics.

If your question has been purely about how to act on these concerns, I’d have advised you to have a quiet and tactful talk with your colleague, with the aim of being collaborative rather than confrontational – remembering that if he is in denial then he may quickly become defensive.

However, you’ve been asked explicitly by your boss to comment on his performance – and you need to respond honestly.

Don’t feel guilty

Your fundamental dilemma here arises because you cannot dictate your employer’s response to this issue, and you need to accept that. Once in receipt of new information, your manager will need to take it forward and you will likely be left out of the loop in order to protect your colleague’s right to confidentiality.

While it may feel uncomfortable to ‘hand over’ responsibility, please keep in mind that you cannot and should not deal with this on your own – and shielding your colleague from the consequences of his actions out of kindness may actually do more harm than good.

Remember too, that it’s in your firm’s interests – business as well as human – to offer proactive support. Addiction is a disease, and it can be treated successfully. Ideally, your company should have a clear policy on drug and alcohol use, which would set out the support mechanisms in place for employees. It’s likely to be more cost-effective for them to allow him time off to obtain expert help rather than trying to replace him.

If they ignore the problem, there are likely to be implications on team productivity and morale, as well as your colleague’s health.

Disciplinary action should be a last resort, and indeed a dismissal could be deemed unfair by a court, if an employer makes no attempt to help someone whose work problems are related to alcohol abuse. And if he does eventually lose his job because of this, remember it’s not your fault, and it could be the trigger he needs to seek help.

What to say to your boss

You can try set the tone for your firm’s initial response by emphasising your concern and personal support. Your boss may simply be expecting you to send a quick email summarising what happened on your business trip.

Don’t do this.

Instead, meet face to face, and explain verbally and compassionately why you’re concerned about your colleague. Try not use to judgemental, accusatory or labelling language – at this stage focus on what you observed, rather than expressing any assumptions you’ve made.

If you feel your boss may not handle the information well – he’ll need to be aware of your company’s policy but may not necessarily be – you could bring HR into the conversation too, so they can take it forward together.

For more information about spotting signs of alcohol and substance abuse, and managing these issues in the workplace, check out the following sources:

  1. Drink Aware: Fact checker if you’re concerned about drinking
  2. Health and Safety: A guide for employers on alcohol at work
  3. Alcoholics Anonymous: Is there an alcoholic in the workplace?
  4. British Heart Foundation guide to alcohol at work

Good luck.

I’m no HR manager but that seemed a pretty fair response to the issue.  What do you think?

A British Cop Tells Us Exactly How Our Boozing Makes His Job a Nightmare

This was an article featured in Vice in October that I’ve adjusted the, what I felt was slightly inflammatory and accusatory headline, of ‘A British Cop Tells Us Exactly How Your Boozing Makes His Job a Nightmare’

police and alcohol abuseIf I’m on duty on a Friday night, I might be doing the half-night shift. That starts at 5PM, and goes on until about 4AM. In the old days, only the first half of the night would have been busy, but things go on so much later now. There will be so many spikes in the night – when the pubs start kicking people out, when people are queuing to get into clubs, when the clubs start kicking people out – there are so many potential flashpoints.

The trouble always starts around the kicking out times, when all the drunk people come out into the fresh air at the same time. You have the people waiting in queues for taxis, or they’re at the kebab shop, and that’s a tense moment.

It sounds trivial, but kebab shops or taxi queues can start major disorder.

You have 50 people trying to get into a small kebab shop, and there’s limited space. Someone will order a burger, and they’ll get served before someone who’s already ordered their kebab or whatever, and that’s enough. Literally, someone getting served ahead of somebody in a fast food shop is a very common reason for fights to start. That, or someone jumping in front of someone in a taxi queue. You can end up with a full-on brawl in the street, over a kebab.

Policing 24-hour licensing is a numbers game, and we don’t have the numbers. We’ll be in the town centre on a Friday night, and there are only a few of us officers, and you can be faced with 30 or 40 people mass-fighting. That’s when it gets scary, because we know we don’t have the capacity to get control of the situation and restore order, because we’re hopelessly outnumbered.

Politicians promised this café-culture but all they’ve done is create binge-drinking problems. And those people with dependency issues, mental health factors, depression, the people who look to alcohol to cope with everyday life – well, what about them? There are shops near me where you can buy a litre of cider cheaper than you can buy a litre of mineral water.

You get punched a lot in our game. It’s always around the end of the month, when people have been paid and they have more money for alcohol. I probably get assaulted at least once a month – that varies from being kicked or someone starting on you, to being collateral damage in a battle between other people.

About ten years ago, when I’d just started, I got my front two teeth knocked out. I was trying to break up a drunken fight, and this guy just swung at me. I had to go to the hospital to have the shattered parts of my teeth removed, because the dentist couldn’t get them out. That’s not actually that bad as injuries go, all things considered. It wasn’t pleasant, mind.

Most of my colleagues – male and female – will have been punched, scratched, hit. Being spat at is quite common, actually. Women love spitting for some reason. I don’t know where the spitting thing has come from, but it’s become really common in the last few years.

I’ve definitely noticed more women fighting in the last ten years. You wonder if it’s the way the alcohol industry markets to women – smaller bottles and fruity drinks that don’t taste that alcoholic. Thing is, if two men have a pub brawl, they head-butt each other, punch each other in the face, and then they’ll be buying each other drinks and shaking hands five minutes later. But when two women have a fight, it’s almost to the death. Hair pulling, fingernails, everything.

I’ve been injured with stiletto heels more than once. Metal-bottom stiletto heels – they’re the worst. They’re really painful. I still have a scar actually, from this woman – we were arresting her boyfriend – and she had these lovely leather stiletto-heeled boots on. And she literally walked up to me and scraped her heel down my leg. Honestly, half the time the women can be as, if not more, violent than the men.

The verbal abuse – well, you don’t even notice it. I get called pig, the F-word, everything you can think of. You become hardened to it – it’s just like normal conversation to me.

The vast majority of the British public never see the police. Mr and Mrs Smith, in their nice house might see us if they’re unlucky enough to get burgled, or something. But apart from that, they’ve got no idea what all the fuss is about. They don’t see what we see.

For example, in the last 12 months there was this incident where we broke up a brawl outside a fast food restaurant. The club had just closed, and it was a brawl over nothing – someone probably jumped a queue to get served pizza or something. There were six people brawling, and we broke it up. And then one of the guys involved, he was so angry he put his whole arm straight through a shop window.

He sliced his arm literally from wrist to elbow, down the main artery. And the blood was spurting out – it was like it was coming out of a hosepipe; like a horror film or something. The bloke was still so pissed that we had to pin him down, and there were five police officers holding him down and putting pressure on the wound. We were all absolutely covered in blood, just shouting “where’s the ambulance?”. One of the officers took off his belt, and made a tourniquet, and the surgeons at the hospital told us later that saved his life – he’d have died from the blood loss otherwise.

You have to love a job like this, to be able to do it at all. You definitely don’t do it for the money, I can tell you that. I love my job. But I’d like to be able to come home from work some days, and tell my wife about how my day was. I used to talk about the job, when I started. But now I don’t talk about it, because otherwise my wife would just worry herself to death. If she knew the full story, she’d demand I left the police tomorrow.

The real test is, would I encourage my children to join the force? I wouldn’t now, not for the whole world. Five years ago, I’d have said yeah, I’d have encouraged my kids to join. Our social values have degraded. The safety of officers, the way they’re treated, and the way society is now – it’s all different now.

I worry about what will happen when the policing cuts come in. The senior officers are going to have really difficult resourcing decisions to make. They’re going to have to remove officers from other departments, to deal with alcohol-related disorder, and that obviously has a knock-on effect. You wonder – who’s going to do that other police work whilst the officers are out dealing with alcohol-related crime?

Scenes like this:

Boujis nightclub fight video: Huge brawl at London venue captured on film as club’s licence is suspended

This is just one of the realities of our drinking excesses, and the one that the govt like to focus on and why alcohol remains a law and order issue.  But there is also the more hidden reality of drinking at home and the partners and children bearing the brunt of the anger, verbal and physical abuse and violence described here be it at the time when drunk or afterwards when hungover ……

What’s life in recovery like?

Back over the summer Sheffield Hallam University ran a survey which I took part in and encouraged you to also.  They were looking at what life was like in recovery and they’ve now published their findings.

life in recoveryI’ve chosen this image as this is what life is like in recovery for me because it isn’t just about giving up booze.  All of these changes I think and feel are positive both to me and those around me as I have become more pleasant to be around now I’m not chasing a drink or mired in a hangover!

These were their findings:

First National UK survey of addiction recovery experiences

Professor David Best and colleagues from Sheffield Hallam University in partnership with Action on Addiction have conducted the first national UK Life in Recovery survey.

The survey was based on similar surveys undertaken in the US and Australia and was successful in getting 802 completed survey responses.

The respondents were almost equally men (53%) and women (47%) with 90% living in England. Interestingly, three quarters of the respondents were aged 40 years or older, perhaps reflecting the time it takes to recover from addiction, but also the fact that 74% survey respondents were primarily dependent on alcohol. Dependent alcohol users tend to enter treatment later than dependent drug users.

The survey is a comprehensive tool which asked people in recovery about their:

  • Relationships, education and employment
  • Health and well-being
  • Primary addiction profile
  • Recovery status
  • Engagement in treatment and mutual aid
  • Finances
  • Family and social life
  • Criminal justice involvement

Findings

Some of the findings which I found most interesting were:

  • The average length of time respondents had been addicted was 20.4 years
  • The average length of time this group had been in recovery was 8.3 years
  • Women tended to have shorter addiction “careers” (17.7 vs 22.4 years) and to start their recovery journeys at a younger age (37.2 vs 39.2 years)
  • Almost two thirds of respondents (65%) considered themselves in recovery while 7% saw themselves as having recovered.
  • 70% people had attended at least one 12-step recovery meeting
  • 69% had received specialist treatment
  • 51% had received medication to help with their addiction
  • The increasing use of online recovery resources with a total of 254 people having ever participated in an online recovery group (46 people were actively using SMART Recovery, 33 NA and 29 AA online)
  • 124 individuals had used an addiction recovery app (almost a quarter of those who had ever owned a smartphone)

Conclusions

The authors are recovery advocates and their conclusions focus on the positive consequences of recovery:

  • Marked reductions in children being taken into care and clear net benefits in terms of family reunifications, particularly among those stable in their recovery journeys;
  • Rates of domestic violence dropping from 39% in active addiction to less than 7% in recovery;
  • Increased employability with 74% of those in recovery reporting that they have remained steadily employed and 70% reporting that they pay taxes, repay debts and have credit ratings restored during recovery; and
  • Much reduced arrest and prison rates following the start of recovery and increasing disengagement associated with longer recovery duration.

The authors’ final conclusion notes that recovery is not just about stopping negative behaviour; it is also about making a positive contribution and engaging in society:

79.4% of survey participants reported having volunteered in community or civic groups since the start of their recovery journeys.

I think this is a fantastic result that shows that there are LOTS of us out here with long stretches of sobriety – the average respondent having 8 years!  Plus lots of us doing it online and increasingly so 😉  And giving back in the process 🙂 Come join us!

What did you think of the findings?

Alcohol use disorder: the urgent issue we can’t continue to ignore

So this was covered in The Guardian in October and I thought it might be good for today – the day after perhaps one of the most excessive days for drinking in this country (after Black Eye Friday and New Years Eve).  For me Boxing Day was an excuse to keep going and thereby delay the pain of the monumental hangover I had been drinking myself towards.  Like a cold shower this piece will sober you up fast as alcohol use disorder remains an urgent issue we can not ignore!

ignore“What is most unhealthy is this identification we have … where we identify having a good time with drinking alcohol, having a shit time with drinking alcohol, being happy with drinking alcohol, being sad with drinking alcohol. It is too much of an ever-present, regardless of our mood.”

Nicola Sturgeon, speaking to Alastair Campbell in this month’s GQ, has a point. Sturgeon was referring to Scotland but her comments could easily be applied to the rest of the UK. Indeed with almost a quarter of men and 18% of women in England exceeding the recommended weekly limits for alcohol consumption, it seems the time has come for an urgent discussion about the implications of our infatuation with booze.

The UK, however, is not alone in this respect. A major new study of more than 36,000 Americans reports that 14% of those interviewed met the criteria for alcohol use disorder (AUD) in the previous 12 months. Scale up the results of this large and nationally representative sample and we’re looking at perhaps 32 million US adults experiencing significant problems with alcohol.

Alcohol use disorder is a new term, introduced in the most recent edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM used to differentiate between alcohol dependence and abuse. Now it lists 13 symptoms, such as drinking more than intended; being unable to cut down or control alcohol use; craving alcohol; failing to fulfil major role obligations at work, school, or home because of drink; and increased tolerance – ie needing to drink greater amounts of alcohol to get drunk. The more of these symptoms an individual presents with, the more severe their AUD: two to three is classed as mild; four to five as moderate; and six or more as severe.

The US study shows that men are much more likely to experience alcohol problems than women. No surprises there: this is a finding familiar from previous epidemiological surveys. Almost one in five of the males interviewed reported two or more AUD symptoms in the previous year: 9% were classified with mild AUD, 4% moderate and 5% severe. For women, the overall figure was 11%, of which 6% described mild AUD, 3% moderate and 2% severe.

As with many physical and psychological problems, the researchers found that AUD correlates to socioeconomic status. The lower your income, the more likely it is that you’ll suffer from the disorder. Youth is a risk factor too, with rates in the sample highest among those aged 18-29 and subsequently declining with age. From a developmental point of view, if nothing else, alcohol abuse during adolescence is particularly hazardous. Scientists who regularly MRI-scanned 134 adolescents over a period of 12 years found that the natural development of the brain was altered in those who drank heavily. Some areas of the brain had accelerated pruning of excess neurons, others failed to show normal levels of growth.

The long-term consequences of these changes in the brain, and whether they can be reversed by cutting back on alcohol consumption, are unclear. But what we do know is that alcohol is linked to a range of illness, including heart and liver disease and certain types of cancer, and can be a significant cause of injury. In EU nations, one in seven deaths of men aged between 15 and 64 is due to alcohol; for women, the figure is one in 13. Most of these deaths are the consequence of regular heavy drinking, defined as five or more drinks per day for men and 3.33 drinks for women.

Given that the majority of adults in the UK drink, what marks out the people who develop problems? Genes play a part: heritability is thought to be around 50%. (In other words, half of the differences in levels of alcohol disorders across the population are a product of genetic factors.) One of the ways in which that genetic susceptibility exerts itself may be a reduced sensitivity to alcohol. Studies have shown that people with a family history of drink problems report less intoxication after a set dose of alcohol than those without such a background. If you have to consume larger amounts of alcohol in order to experience the pleasurable feelings many of us associate with a drink, you elevate your risk of slipping into abuse and dependence.

Genes aren’t the whole story, of course. Environmental pressures – sometimes in combination with genetics – are clearly hugely influential. A person may, for example, be born with a genetic vulnerability to alcohol abuse. But if alcohol isn’t freely available, or is discouragingly expensive, the risk of that person developing a problem is much reduced. On an individual level, stressful experiences like divorce or job loss can push people into excessive drinking. Similarly, people who have suffered mistreatment in childhood tend to prove more vulnerable to AUD in later life.

Given that problem drinking is so prevalent – and so dangerous – what can be done to help those most at risk? Thinking seriously about the ubiquity of alcohol in our culture would constitute a step forward, as would measures to moderate availability. But we also need to ramp up treatment options for those drinking at risky levels: at present most people get no help at all.

One positive development is the increasing prevalence of primary care screening: this is why your GP asks about your drinking habits. Once a possible problem is detected, the kind of treatment that individuals require will depend on the severity of their particular problem. For some people – especially middle-aged males – just a brief information session with a GP can help.

But this very limited type of intervention doesn’t work for everyone. The consensus among professionals suggests that a “stepped care” approach is probably required, tailoring the treatment to the needs of the individual and providing intensive or highly specialist care only if other approaches are unlikely to succeed. What exactly those levels of treatment might comprise, however, is a matter for debate.

Psychological approaches can be fruitful. For example, helping people to recognise that they may need to alter their drinking habits is a crucial component in any recovery plan. So motivational interviewing (systematically weighing up the advantages and disadvantages of both drinking and reducing drinking) can be useful]. And by employing techniques drawn from CBT, therapists and patients can try to identify the reasons behind their excessive drinking, the triggers that prompt this behaviour, the negative thoughts that keep people locked into their habits, together with strategies to face down cravings, and tackle the depression and anxiety that so often lurk behind alcohol abuse. Incidentally, medication isn’t often prescribed, but it can help people who have been dependent on alcohol to maintain their abstinence.

Alcohol-related hospital admissions in the UK have jumped by 5% in just a year. The ten-year perspective is just as alarming, with an estimated 493,760 alcohol-related admissions in 2003-04 and 1,059,210 in 2013-14. Addressing a problem that’s so deeply rooted is certainly not going to be easy, but for how much longer can we ignore it?

Add to this the desperately disappointing news reported in the BMJ that ‘the supposedly independent National Institute for Health and Care Excellence (NICE) bowed to political pressure from ministers and removed references to a controversial alcohol policy from its guidance on the prevention of dementia, disability, and frailty in later life.’

“The idea that ministers would meddle with supposed independent public health advice to suit their own political agenda is alarming,” said Katherine Brown, director of the Institute for Alcohol Studies  “It brings into question whose interests are being prioritised: the public’s or big business.”

So if you’re fed up with your drinking after the excesses of December and would like 2016 to be different let me help you realise that goal.  From now until 16th January I’m continuing to offer my Udemy online course at 25% discount so £60 or $99 when the price will increase to £99 or $149 .  Just click here: New Years Resolution 2016 or sign up for my next London workshop on January 30th 🙂

Care, feel, notice – don’t be afraid

mindful-activity-at-christmas

 

 

 

 

Hokusai says read by Mark Williams [who developed MBCT (Mindfulness Based Cognitive Therapy) and wrote the books ‘Mindfulness: Finding peace in a frantic world’] at the start of the Mindfulness Summit this October.

So much to learn from this poem about presence and being afraid.  Beautiful just beautiful.

When I turned 2 years sober I said: Prim shared an excellent guide to recovery that year one was physical, year two was emotional and year three was spiritual.  I’m still wading through the emotional stuff so we’ll see how I go with the spiritual! 😉

I’m finding with mindfulness and its grounding in Buddhism I am working on my emotional and spiritual growth at the same time.  Win:Win! To help you do the same I’m attaching a gift from Tara Brach I received earlier this month – enjoy 🙂

RAIN-of-Self-Compassion2

I hope you have a wonderfully sober and present Christmas wherever you are in the world.  Stay strong sober warrior 🙂