Monthly Archives: March 2016

Braving

brene brown courage worksSo I’ve posted this today because it’s my wedding anniversary 🙂  And for me Brene Brown’s work resonates with both my personal journey and my journey as part of a marriage partnership so it feels wholly appropriate to discuss braving.  This was a free online talk she gave at Oprah’s Super Soul Sessions that was part of the launch of her new Courage Works.  I am a massive fan of Brene and have written about her work on shame before here.

So she was discussing the anatomy of trust – a BIG word and as part of the discussion she broke it down and provided an acronym to give the word some form which is braving.

Now you’re probably wondering – what has that got to do with this blog?  Well a big part of the recovery journey for me has been about self-trust.  And as Brene says self-trust is braving self love and self respect, which to me means self-care and that is a HUGE part of the recovery journey.

As she says we have to trust ourselves above everyone else because

“You can’t ask people to give you what you don’t have”

I never trusted myself as a drinker because once I’d had one drink all bets were off and my self-trust has been massively restored through sobriety.

So here is the lovely pdf she designed to explain braving and a worksheet for rumbling with self-trust

BRAVING_Download

Rumbling_with_Self-Trust

I really really like this (along with everything else she does!!)  but this bit really rang loud bells “Did I choose courage over comfort? Did I choose what’s right over what’s fun, fast, and easy?”  Boundaries, reliability, accountability, integrity, non-judgement, generosity towards self and others and the vault of friendship are all hugely important to me and were seriously eroded by alcohol leaving me with guilt and shame.  It wasn’t that I was a ‘bad’ person it’s just that my sensitivity to alcohol meant that it co-opted my normally reliable self and destroyed my boundaries and integrity (particularly with myself).  Now that I’m present all the time that isn’t under threat EVER – not with myself, MrHOF or the kids and that makes me feel so proud.

She also talks about marble jar friends – ‘sliding door’ moments of trust where before with booze I couldn’t be sure I would do the right thing but now it has been made much easier.  Plus I have so many marble jar friends out here in the sobersphere I wouldn’t give you or my sobriety up for anything, much like MrHOF, who is ever so grateful we married a month after Valentine’s Day as it has it’s own alternative celebration you may have heard of 😉

I had to learn to love my dad again – once he sobered up

alcohol chaosThis was in The Guardian in January about family and it’s impact while they are still drinking and once they have sobered up.  Presented without comment.

I wasn’t around to witness my dad’s rapid decline between 2005 and 2007, I would hear stories by the time it was too late to do anything about them, but my conscience finally crept up on me, and with news coming in that perhaps he might not make it beyond the next year, I went back home to visit him for lunch.

It was the first time I’d seen him for two years. He’d been a functioning alcoholic all his life, but now he was unable to do anything but drink, and I was so, so nervous. I felt like I was meeting a ghost. I had convinced myself that he didn’t exist any more.

I felt uncomfortable during the short walk to the Chinese restaurant we’d decided to eat in, but nothing could have prepared me for the next wave of emotions. My dad could barely walk or talk. It seemed that he was under the influence of a terrible mix of both medication and a lot of alcohol. Walking into the empty restaurant that quiet lunchtime, I saw a reaction I didn’t expect from the staff: they looked on with utter fear. My heart sank. My pride fluttered away in front of me, and I felt nothing but embarrassment. I was so ashamed of my dad. I didn’t even want to call him that.

My dad had completely vanished. In his place was somebody who had no idea what day it was, and it broke my heart. When the waiter came over, with a glance in my direction that showed nothing but pity, my dad asked if he could order some poppadoms. He was trying so hard to act sober – in that way drunk people do – that he took about three minutes to pronounce the word “poppadom”.

Without ordering anything, I told my dad I was leaving, that I wanted to go home. The worst thing was that he never questioned why. There was no protest, because I know that he knew what he’d done. He was living in darkness, surrounded by it. As we walked up the road to where I was about to leave him, I pleaded with him to remember who he used to be. But his eyes were glazed over. He wasn’t listening. I ran off and cried my eyes out in private.

I saw him once more after that. It took another few years of zero contact before I could muster the courage to put myself through it again. By this point, he was very unwell. We were aware that he was drinking at least a bottle of neat vodka a day and barely eating – sometimes soup if he could remember to buy it. We went round on Boxing Day for a late Christmas dinner. He fell asleep halfway through our conversation and we all left.

Then, after a few failed attempts, he agreed to live in a rehab centre, thanks to the will of my oldest sister. For the first year, my dad sent me texts I didn’t reply to. I blocked his number so he couldn’t call me. I had convinced myself that I had no dad any more. That man had gone. It made me feel lost, scared, like a little child, to tell myself that, yet I still did. It was my way of coping, I suppose.

The hardest thing I’ve noticed for anybody who’s hurt a lot of people is that even when they accept that they’ve done wrong, they still can’t understand why you haven’t forgiven them yet.

It just felt to me like he was getting away with it. That if I just suddenly forgave him, I’d be the fool. It made me angry. I would swear and say nasty things about him. I would feel ashamed by what he’d become. I’d envy anyone with stability in their home life. There’s the shame; the shame of letting the outside world know that your father has a problem, that you feel he has failed you, or that others might look down on you because of what he is.

That feeling doesn’t go away, but it does subside. There were still unhappy times; The first time I saw him in the rehab centre, he terrified me. But as each Christmas visit passed, I started seeing glimmers. Gone was the skinny, hard-working grafter of a dad I once knew, but there was in his place a jolly, pot-bellied man who still loved me more than anyone else in the world.

Every time you see them, you know it may be the last. Because you can’t see inside their body, can’t see the damage that’s been done that the doctors have told you is irreparable. Even though the future might look bright on paper, there will always be that fear of relapse or worse in all of us – most of all him.

It’s a strange feeling to have to learn to love a parent again; somebody you thought was beyond help; someone you felt let you down so badly that you couldn’t call them for help in times of real need. Someone who had made you feel so alone you couldn’t ever imagine having a relationship with them again.

But, at the same time, life really is short. So I’m going to make sure that he’s rewarded for the hard work he’s done, if only by making sure there are never any more regrets between either of us. Because more darkness cannot drive out the darkness. Only love can do that.

Friday Sober Jukebox – Wishing

Digital StillCameraSo recently MrHOF & I went out to dinner to celebrate our wedding anniversary.  I’d been missing and wishing to revisit somewhere we used to dine pretty regularly pre-kids because the food was so good.  We lived in a different city then so the trip down nostalgia lane took us to a different one in our nearest city now.  With a name like Hotel du Vin it’s not hard to guess that wine and booze feature pretty heavily as part of the experience back in the day but even I was unprepared for just how much it was being promoted now ….

The link to the image is tenuous but on the menu there were flights of wine being advertised.  And these have been discussed by myself and some other sober friends only recently!   So in my brain that goes flight – bird – flock of seagulls (see tune below!) 😉

So I attach here as evidence exhibit one: the dessert menu.  Now as a girl who no longer drinks alcohol desserts feature pretty strongly in my world view and their selection was good as you can see.  But as you can also see underneath each option and the cheeses was a recommended accompanying wine and one could be forgiven for mistaking the dessert menu for a drinks menu such was the promotion of wines and ports, cognacs, whiskies, calvados, armagnacs, rum & liquers, and not after dinner coffee, but after dinner cocktails!!  And not only that but the creme normande that was served with the apple tarte tartin was loaded with calvados  which neither of us appreciated and we only realised after having put the first spoonful in our mouth and swallowed it!!

It’s amazing what you notice when you don’t drink anymore but the heavy handed promotion of booze and reaction of the sommelier when we said we would be dining and drinking only sparkling mineral water was pretty shocked and shocking.  Does anyone really need three types of dessert wine or port with cheese?  It was all very excessive and we couldn’t fail not to notice.  And as for non-alcoholic options, apart from water, nothing in sight.

So flock of seagulls – anyone else as old as me remember this 80’s new romantic band?  Had to show my favourite track – ‘wishing’ while wishing that Hotel Du Vin would tone down their booze pushing as it really did put me off ever returning, irrespective of how good the food is (and sadly that wasn’t as good as we remember it either).

This is why we need minimum unit pricing ….

Cheap-BoozeThis headline makes me so sad – not because I don’t want supermarkets to be successful but because it’s the unvarnished truth about pricing sensitivity and its impact on consumption.  This was featured in The Guardian in January.

Supermarkets raise a toast as cheaper booze helps shift the units

Soaring sales of sparkling wine, beer and gin at bargain prices helped supermarkets to a much happier than expected Christmas, figures show.

Total sales of beer, wine and spirits rose 2.2% across the grocery market in the three months to 3 January, according to analysts at Kantar Worldpanel, boosted by an 11% increase in sales of sparkling wines.

Sales were driven by bargain prices, with 16 out of the top 20 spirits cheaper than a year earlier, according to Nielsen. The market research group said the grocers had used discounts to pull in shoppers.

Sales of gin in the major supermarkets rose by more than £14m to £121m, making it the fastest growing spirit, followed by cream liqueurs, including Bailey’s Original, which was on offer at Asda and Morrisons, Nielsen said. But the researchers also marked out sparkling wine as the standout category, with nearly 16% more bottles sold as prices fell.

Harmful drinking and dependence: PHE release resource

PHE 2016 harmful drinking resourcesAlcohol Policy UK wrote an excellent summary of the new PHE resources launched in January to support harmful drinking and dependence.  So good that I’m going to share in their entirety 😉

Public Health England (PHE) have released a new resource Health matters: harmful drinking and alcohol dependence – see PDF and links here.

The resource aims to support the ‘commissioning and delivery of evidence based treatment interventions to address harmful drinking and alcohol dependence in adults’, and includes infographics, video, a commissioning toolkit and a local service case study.

PHE say around 1.6 million adults in England have some level of alcohol dependence, many of whom may be suitable for treatment, although this question and much of the content are not explored in detail. As such the resource mainly sets out a broad level overview of the impacts of harmful drinking and main treatment response to addressing dependency. Key stats and issues associated with harmful and dependent drinking are highlighted, including mental health, employment, hospital admissions, health inequalities, key groups, and resources for developing treatment services.

Answering the tough questions?

Certainly championing investment in alcohol services may be considered valid; treatment is an ‘invest to save’ measure for which it can be argued that greater numbers should be receiving it, with alcohol services historically having played second fiddle to the drug treatment agenda. However local commissioners may feel there are many ongoing challenging and complex questions in the development of local systems that meet the needs of a range of harmful or dependent drinkers.

One such area may be how the needs of harmful drinkers with no or low severity of dependence might be better engaged. As part of NICE CG115 released in 2011, it identified that 84% of those with a level of dependency are only ‘mildly’ dependent, yet only 1.13% of this population receive specialist treatment, versus 33.69% with moderate or severe dependence. However such drinkers are unlikely to seek or access specialist treatment, in part because they may be unlikely to consider their drinking problematic, or at least not enough to warrant treatment. Whilst ‘extended brief interventions’ or ‘brief treatment’ approaches in non-specialist settings may be most appropriate, there still remains limited examples or guidance on this issue.

It should be noted that in 2011 NICE CG115 released an exhaustive review of the evidence and a comprehensive series of supporting tools and resources. NICE Quality Standard 11 also directly set out the expectations for local treatment provision. PHE too have since released other resources, most notably self-assessment tools, hospital guidance and JSNA support packs. However numbers in treatment have not climbed significantly, and assessing the impact of such guidance on commissioning practice may be questionable.

On a broader level, the effects of changes to the commissioning landscape and indeed ongoing cuts are still to be navigated. Last year Alcohol Concern’s review of alcohol treatment in England revealed a mixed picture; services may be holding steady for the time being, but challenges were by no means limited. PHE state they will be releasing further resources to help local areas identify and target drinking population needs. On how the picture develops, only one thing may be called with a degree of certainty – it will probably vary depending on where you look.

Thank you James (and Libby!) for a great summary and this video does a great job of explaining it all clearly and succinctly.  I was really struck by the numbers in the top featured image so I’m going to re-iterate them here:

The use of naltrexone in treating heavy drinking among young adults

naltrexoneThis was the study results that were featured in The DRAM Vol. 12(1) looking at the use of naltrexone to treat heavy drinking among young adults.

Young adults experience many social and environmental situations that encourage heavy drinking, including turning 21 and being able to legally drink alcohol for the first time. Some young adults grow out of this behavior, yet some do not—they continue to drink heavily and experience the negative consequences that follow. Recently, a team of researchers led by Stephanie O’Malley studied the effectiveness among young adults of a medication called Naltrexone, designed to reduce how fast a person consumes alcohol and their desire to drink. This week, the DRAM reviews their study[1].

What was the research question?

Does Naltrexone help heavy drinking young adults drink less?

What did the researchers do?

The researchers studied a sample of 128 young adults (18 – 25 years of age) who reported heavy drinking[2]. Over an 8-week trial, half received Naltrexone and half received a placebo, in addition to motivational counseling. The study design was a double-blind randomized clinical trial, meaning that neither the researchers nor the participants knew who received Naltrexone and who received the placebo. The researchers measured participants’ self-reported drinking over the course of the trial.

What did they find?

O’Malley and colleagues found that the participants taking Naltrexone drank less per drinking day and had a lower blood alcohol content (BAC) on days they drank when compared to the placebo group (see Figure 1). On the other hand, Naltrexone did not make much of a difference in increasing the percentage of days the participants were abstinent from alcohol, or in reducing the number of heavy drinking days.

Why do these findings matter?

Medications that control the urge to drink and make people drink less are becoming more and more important in treating substance abuse. For those suffering from the harmful consequences of prolonged heavy drinking, new research is key to understanding whom these medications help and how.

Every study has limitations. What about this one?

To be in the study, participants had to be willing to start and stick to a medication intervention, a commitment not all individuals with drinking problems are willing to make. Therefore, these results might not apply to all young adult heavy drinkers. Reports of drinking behavior also relied on the memory of participants who were engaged in heavy drinking behavior, so these reports might not be very reliable.

Figure 1. Drinking Behaviors in the Naltrexone Group Compared to the Placebo Group

DRAM1201

Note. Differences between groups in the number of drinks per drinking day and the percent of drinking days with BAC > 0.08 were both statistically significant.

[1] O’Malley, S., Corbin, W., Leeman, R., Demartini, K., Fucito, L., Ikomi, J., … Kranzler, H. (2015). Reduction of Alcohol Drinking in Young Adults by Naltrexone. The Journal of Clinical Psychiatry, 76(2), 207-213.

[2] Those who had a history of serious mental health problems, a physical disease, or a recent episode of drug/opioid use were excluded from the study.

The fact that the findings were statistically significant is important.  What do you think?

Millennials and drinking

MillennialsSo there’s an interesting dichotomy I’m noticing as these two news stories that appeared on the same day and relating to millennials show.

Online music videos ‘expose teens to smoking and drinking’

Online music videos are heavily exposing teenagers to positive depictions of smoking and drinking alcohol, research suggests.

Such portrayals posed a “significant health hazard that requires appropriate regulatory control”, researchers said.

YouTube videos of songs in the top 40 singles chart were examined by the University of Nottingham study.

The British Board of Film Classification started putting age ratings on online pop videos last year.

The research, in the Journal of Epidemiology and Community Health, said girls between the ages of 13 and 15 were the most exposed to cigarettes and alcohol in videos.

Using pollsters YouGov, researchers asked 2,068 11- to 18-year-olds and 2,232 over-19s whether they had seen the videos, taken from the chart between 3 November 2013 to 19 January 2014.

The average viewing percentage across the 32 music videos was 22% for the younger group and 6% for the elder.

“It is well established that young people exposed to depictions of tobacco and alcohol content in films are more likely to start smoking or to consume alcohol, but the effect of imagery in other media, including new online media such as YouTube music videos, has received relatively little attention,” research author Dr Jo Cranwell said.

Her research calculated the number of “impressions” – any verbal or visual reference – of alcohol or tobacco imagery in the videos.

When Dr Cranwell extrapolated the data to estimate the overall affect on the British population, she concluded the 32 videos were responsible for 1,006 million impressions of alcohol and a further 203 million of tobacco.

“If these levels of exposure were typical, then in one year, music videos would be expected to deliver over four billion impressions of alcohol, and nearly one billion of tobacco, in Britain alone,” she said.

“Further, the number of impressions has been calculated on the basis of one viewing only, however, many of the videos had been watched multiple times, so this number is likely to be much bigger.”

And yet:

Generation Abstemious: More and more young people are shunning alcohol

According to a report last year from the Office for National Statistics, Britain’s young people are turning away from alcohol in droves. The proportion of 16-24-year-olds who do not drink increased by more than 40 per cent between 2005 and 2013. Today, one in five is teetotal. Binge drinking has fallen by more than a third and just one in 50 young adults describe themselves as a frequent drinker.

In reality, a number of factors – less disposable income, a reaction to the overindulgence of the previous generation, the prominence of social media – have apparently converged to call time at the bar for Britain’s young people.

Similarly, says Dr James Nicholls, director of research and policy development at Alcohol Research UK, children of hedonistic generations often turn away from alcohol.

People just don’t want to look like their parents. It happened in the 1930s, it happened in the 1980s and it’s possibly happening again now.”

Generation X (which was my generation) and the X could so easily have stood for eXcess has been replaced by Generation Y, or whY bother drinking?  Curiouser and curiouser and good news to boot 🙂

Alcohol Use and the over 50s in the UK

Drink Wise Age WellDo you drink more the older you get? Why? Well the biggest ever survey of its kind has been conducted by researchers at the University of Bedfordshire into the drinking habits of the over 50s.

They found that stigma and shame are stopping many people in that age group from getting help and that the most frequently reported reasons for those who drink more now than in the past are age-related

Around 4 in 5 over 50s at risk of harm from alcohol said no relatives, friends, doctors or other health workers been concerned about their drinking. 1 in 4 said they would not tell anyone if they needed help.

Report: Drink Wise Age Well – Alcohol Use and the over 50s in the UK

Our report Drink Wise, Age Well – Alcohol Use and the over 50s in the UK – based on initial study findings from the Substance Misuse and Ageing Research Team at University of Bedfordshire and compiled by the International Longevity Centre UK.

Download Drink Wise, Age Well Alcohol use and the over 50s Report

Here is a link to Alcohol Policy UK’s view too:

‘Drink Wise, Age Well: Alcohol Use and the Over 50s in the UK’
The alarming rise of alcohol-related health problems in our elderly population

A new campaign has been launched called Drink Wise, Age Well which will provide practical advice on how to make healthier choices about drinking | Wales Online, UK

Plus a friend of mine was interviewed discussing her success in stopping over 2  years ago.  Go Sarah!! 🙂

http://www.itv.com/news/anglia/2016-01-19/over-50s-with-drink-problems-too-ashamed-to-seek-help/

Edited to add 22/12/2016:

‘Drink Wise, Age Well’: older adults and the labour market