Monthly Archives: May 2016

Adult drinking habits in Great Britain

ONS 2014This is the Office for National Statistics report for 2014 looking at the adult drinking habits in Great Britain.  It makes for interesting reading and you can find the whole report here.

Here’s the main findings:

  • 28.9 million people report that they had drunk alcohol in the week before interview.
  • 2.5 million people drink more than 14 units of alcohol on their heaviest drinking day.
  • Almost 1 in 5 higher earners drink alcohol on at least 5 days a week.
  • Young people are less likely to have consumed alcohol in the last week than those who are older.
  • A higher percentage of drinkers in Wales and Scotland drink over the recommended weekly amount in one day.
  • Wine is the most popular choice of alcohol.

In Great Britain in 2014, there were 28.9 million people who reported that they drank alcohol in the week before being interviewed for the Opinions and Lifestyle Survey. This equates to 58% of the population.

Focusing on those who drank alcohol, 12.9 million (45%) drank more than 4.67 units (around 2 pints of 4% beer or 2 medium (175 millilitre) glasses of 13% wine) on their heaviest drinking day. This is a third of the recommended weekly limit – the value you would drink if you drank 14 units spread evenly over 3 days. Of these, 2.5 million (9%) drank more units in one day than the weekly recommended amount of 14 units (6 pints of beer or 1.4 bottles of 13% wine).

Young people were less likely to have consumed alcohol; less than half (48%) of those aged 16 to 24 reported drinking alcohol in the previous week, compared with 66% of those aged 45 to 64.

While overall being less likely to drink alcohol, young drinkers were more likely than any other age group to consume more than the weekly recommended limit in one day. Among 16 to 24 year old drinkers, 17% consumed more than 14 units compared with 2% of those aged 65 and over.

I was really struck by some of the graphics as they paint such a clear picture – so for example this one about earnings and alcohol consumption:

income and drinkingFocusing on frequent drinkers, those who drink on at least 5 days of the week, individuals with an annual income of £40,000 and over were more than twice as likely (18%) to be frequent drinkers compared with those with an annual income less than £10,000 (8%).

It presents a fascinating insight into teetotalism, drinking in the week before interview, frequent drinking and units drunk, including changes in drinking patterns in recent years.

And these were all the news stories that followed:

2.5m Brits bust weekly alcohol limit in a day

Around 2.5 million people in Great Britain – 9% of drinkers – consume more than the new weekly recommended limit for alcohol in a single day, latest figures from the Office for National Statistics show. The 2014 data predates the new limit of 14 units of alcohol per week for men which began in January 2015 | BBC, UK

Younger people drink less but binge when they do, figures show

ONS study reveals picture of UK’s drinking habits and shows higher earners drink at least five days a week | Guardian, UK

Wales tops alcohol binge drinking stats in ONS survey

People in Wales are more likely to be binge drinkers than anywhere else in Britain, new figures have revealed | BBC, UK

I’m sick of explaining why I am teetotal

The UK is slowly drying out but as a teetotaler, I can tell you our attitudes toward drink aren’t changing anytime soon | Independent Voices, UK

The party’s over for young people, debt laden and risk averse

The drinks industry seeks to solve the conundrum of the monastic twentysomething by “premiumisation” (getting them to spend more on the few drinks they will buy). We have to understand it as a challenge broader than the market | Guardian, UK

Any thoughts from you?

 

There’s no such thing as an addictive personality

the conversationAnother excellent piece from The Conversation in March looking at the topic of addictive personality.

“Life is a series of addictions and without them we die”.

This is my favourite quote in academic addiction literature and was made back in 1990 in the British Journal of Addiction by Isaac Marks. This deliberately provocative and controversial statement was made to stimulate debate about whether excessive and potentially problematic activities such as gambling, sex and work really can be classed as genuine addictions.

Many of us might say to ourselves that we are “addicted” to tea, coffee, work or chocolate, or know others who we might describe as being “hooked” on television or using pornography. But do these assumptions have any basis in fact?

The issue all comes down to how addiction is defined in the first place – as many of us in the field disagree on what the core components of addiction actually are. Many would argue that the words “addiction” and “addictive” are used so much in everyday circumstances that they have become meaningless. For instance, saying that a book is an “addictive read” or that a specific television series is “addictive viewing” renders the word useless in a clinical setting. Here, the word “addictive” is arguably used in a positive way and as such it devalues its real meaning.

Healthy enthusiasm … or real problem?

The question I get asked most – particularly by the broadcast media – is what is the difference between a healthy excessive enthusiasm and an addiction? My response is simple: a healthy excessive enthusiasm adds to life, whereas an addiction takes away from it. I also believe that to be classed as an addiction, any such behaviour should comprise a number of key components, including overriding preoccupation with the behaviour, conflict with other activities and relationships, withdrawal symptoms when unable to engage in the activity, an increase in the behaviour over time (tolerance), and use of the behaviour to alter mood state.

Other consequences, such as feeling out of control with the behaviour and cravings for the behaviour are often present. If all these signs and symptoms are present then I would call the behaviour a true addiction. But that hasn’t stopped others accusing me of watering down the concept of addiction.

The science of addiction

A few years ago, Steve Sussman, Nadra Lisha and I published a review examining the relationship between eleven potentially addictive behaviours reported in the academic literature: smoking tobacco, drinking alcohol, taking illicit drugs, eating, gambling, internet use, love, sex, exercise, work and shopping. We examined the data from 83 large-scale studies and reported a prevalence of an addiction among US adults ranged from as low as 15% to as high as 61% in a 12-month period.

We also reported it plausible that 47% of the US adult population suffers from maladaptive signs of an addictive disorder over a 12-month period and that it may be useful to think of addictions as due to problems of lifestyle as well as to person-level factors. In short – and with many caveats – our paper argued that at any one time almost half the US population is addicted to one or more behaviours.

There is a lot of scientific literature showing that having one addiction increases the propensity to have other addictions. For instance, in my own research, I have come across alcoholic pathological gamblers – and we can all probably think of people we might describe as caffeine-addicted workaholics. It is also common for people who give up one addiction to replace it with another (which we psychologists call “reciprocity”). This is easily understandable as when a person gives up one addiction it leaves a void in the person’s life and often the only activities that can fill the void and give similar experiences are other potentially addictive behaviours. This has led many people to describe such people as having an “addictive personality”.

Addictive personalities?

While there are many pre-disposing factors for addictive behaviour, including genes and personality traits, such as high neuroticism (anxious, unhappy, prone to negative emotions) and low conscientiousness (impulsive, careless, disorganised), addictive personality is a myth.

Even though there is good scientific evidence that most people with addictions are highly neurotic, neuroticism in itself is not predictive of addiction. For instance, there are highly neurotic people who are not addicted to anything, so neuroticism is not predictive of addiction. In short, there is no good evidence that there is a specific personality trait – or set of traits – that is predictive of addiction and addiction alone.

Doing something habitually or excessively does not necessarily make it problematic. While there are many behaviours such as drinking too much caffeine or watching too much television that could theoretically be described as addictive behaviours, they are more likely to be habitual behaviours that are important in a person’s life but actually cause little or no problems. As such, these behaviours should not be described as an addiction unless the behaviour causes significant psychological or physiological effects in their day-to-day lives.

Agreed and feel like this would be a useful discussion, for me not about booze but about some of my new reciprocities and the Shutterstock image that was used in the original article of syringes filled and labelled with the words ‘internet, news, social media’ seemed particularly pertinent to me!

Edited to add 19th May 2016:

This article nails pretty accurately many of the other substances, habits and behaviours I’ve struggled with since getting sober

7 Types of Addictions in Sobriety

Liverpool Drink Less Enjoy More intervention evaluation

Drink less enjoy moreIn March the Centre for Public Health at Liverpool John Moores University was commissioned to evaluate the Liverpool Drink Less Enjoy More intervention and these are the evaluation findings that caught my eye:
Key findings:
Pre-intervention (phase one) nightlife user survey:
The majority (96%) of nightlife users surveyed had consumed alcohol prior to taking
part in the survey (referred to as drinkers).
Two thirds (65%) of drinkers reported preloading and 20% en route loading before entering the night-time economy (NTE)
Preloading was significantly more common in younger people and students.
 
In total, median expected alcohol use amongst drinkers over the course of the night
out (including alcohol already consumed and expected to be consumed post survey)
was 15.7 units. Median alcohol use was significantly higher among males, non-
Liverpool residents and preloaders.
Over one in eight (13%) of all participants intended to drink more alcohol after leaving
the city’s nightlife (e.g. at home).
The majority (over 70%) of participants: expected their level of drunkenness to be high
when they left the city’s nightlife that night; reported their ideal level of drunkenness
as high; thought that the typical level of drunkenness that people reach on a
night out in the city centre was high; and believed that getting drunk was socially accepted in Liverpool’s nightlife.
Over six in ten participants agreed that: bar staff in the city centre do not care if people
get drunk on their premises; if someone was drunk and tried to get served alcohol on
a night out in Liverpool they would usually be served; and in the city centre it is easy
for people who are drunk to buy more alcohol.
Less than half (45%) of participants correctly reported that it is illegal for
a bar server to sell alcohol to someone who is drunk and only a third (33%) that it is illegal
for someone to purchase alcohol for a friend who is drunk.
Alcohol Policy UK’s blog on the subject:
Liverpool project reduces sales to ‘drunks’
It stands to reason that if you are a bar and your product is alcohol then you are going to sell as much as you can irrespective of the inebriation of the person asking for it right?  After all it’s all about personal responsibility as that what the drinks industry say don’t they? ……

Why do some 11-year-olds drink alcohol? (Hint: it’s to do with their parents)

the conversationThis was a piece featured on The Conversation in March looking at some new research into why some 11-year-olds drink alcohol.

Official guidelines from the Department of Health are clear: children aged 15 or under should not drink alcohol. But they do. While the number of young people who say they drink alcohol has recently fallen, the teenage years are still the time most of us have our first experience of alcohol. And some children are drinking before they become teenagers.

Now in new research we published in BMC Public Health we have found that 11-year-olds whose parents drink heavily are almost twice as likely to drink themselves than if parents are non-drinkers – and particularly if their mother rather than their father is a heavy or regular binge drinker.

Many parents fear that absolute prohibition will lead to secret drinking and a loss of trust in the relationship with their child. It would appear to be common sense that a child drinking a small amount of watered-down wine with a family meal may develop quite different later adolescent behaviours to a child swigging vodka with friends in a bus shelter. Common sense it might be, but there has been little robust research around this.

Our study made use of the detailed and rich data available in the Millennium Cohort Study, which has followed the lives of nearly 20,000 children born between 2000 and 2002. At age 11, just under 14% of children in the cohort said they drank alcohol. When asked whether their friends drank, 78% of children said “no”.

Their parents were also grouped into three categories based on their own reported drinking frequency: non-drinkers, light to moderate drinkers and heavy or binge drinkers. Around 20% of mums and 15% of dads were non-drinkers, 60% of mums and dads were light or moderate drinkers, while about a quarter of dads and just over 20% of mums were heavy or binge drinkers.

We found that for non-drinking mums, 8% of 11-year-olds drank. For light to moderate drinkers this rose to 12% and for heavy drinkers, it rose again to 16% of 11-year-olds. So overall, compared to children whose mums did not drink, children whose mums were light or moderate drinkers had a 60% increased risk of drinking at age 11, while those whose mums were heavy or binge drinkers had an 80% increased risk. A father’s drinking appeared to have about half as much impact, regardless of whether he was a light to moderate or heavy/binge drinker.

Children who said their friends drank were also more than four times as likely to drink themselves as those children who had friends who didn’t drink.

The children were also asked about other risky behaviours such as smoking or truanting and what they felt about their family.

Predictably, those children who reported being happy at home were less likely to drink than those who reported frequent family battles. Where there were low levels of parental supervision, combined with a dad who drank heavily, the risk of the 11-year-old child drinking was, again, higher.

A child’s view about the harms of alcohol also seemed to be an important factor. The more dangerous a child thought alcohol to be, the less likely they were to drink. Children who did not see drinking alcohol as a risky activity – and who also had a mum who drank heavily – were much more likely to be drinking alcohol at age 11.

It is not possible for our study to judge whether parents’ level of alcohol consumption actually causes their 11-year-old to start drinking, but our findings show us a strong association between 11-year-olds’ drinking and their friends’ and mothers’ behaviour. Family relationships, perceptions of risk and expectations regarding alcohol are also important, as are some more general characteristics of the family unit such as socioeconomic circumstances.

The fact that there are multiple likely causes of early drinking means that measures to counter these risks need to be aimed at a number of different aspects of a child’s life. One size will not fit all.

The vast majority of children at the age of 11 are yet to explore alcohol. But children certainly need to have a better understanding of the risks involved in drinking. Schools and parents are clearly well placed to provide the best advice, information and guidance to children of this age.

This is not surprising but yet again having research to support is useful and instructive – particularly around mum’s who drink and the impact that has in terms of role-modelling.

Edited to add 25th June 2016:

Alcohol – who is drinking or drunk age 11?

Child of our Time editor, Professor Yvonne Kelly was among a group of experts looking at drinking behaviour across the life course this week. She presented her recent thought-provoking work on 11 year-olds and drinking at a seminar for policy makers and third sector workers on alcohol and health,  organised by the ESRC International Centre for Lifecourse Studies at UCL | Child of our time Blog, UK

The seduction of the drinks industry

Alcohol_by_CountryThis was an excellent interview with Professor David Nutt in March looking at the seduction of the drinks industry.  The diagram to the left is the recorded alcohol by capita consumption in litres of pure alcohol and as you can see the UK is one of the highest.

You’re waking up at midday. You’ve been sleeping off the antics of last night, in which there was undeniably a lot of alcohol involved. Facebook and Snapchat have begun heralding relics of the night that you failed to commit to memory. Your friends will soon be helping you piece together the rest with embarrassing stories, and a good laugh will be had by all. We know drinking gets us in trouble, and it’ll do so again. But maybe we need to have a serious look at it.

“People know it’s dangerous, I don’t think they know how dangerous it is.” David Nutt is a professor of Neuropsychopharmacology at Imperial College London. Aside from his research into the neural circuitry involved in anxiety and addiction, Nutt spends a lot of time on public outreach, giving lectures and media broadcasts. He aims to set the record straight about the evidence on drug and alcohol use – evidence and not exaggeration as he is clear to point out. “There’s new data which shows that alcohol is the leading cause of death in men under the age of 50.” Nutt continues. “And it’s going to be the leading cause of death for women as well. The first thing [people] need to know is that it is dangerous.”

Over 87 per cent of the British population drink. A great deal of those will drink to excess, particularly students. What needs to be done to make the dangers more widely understood? Nutt suggests that the sources of our drinking may be much more sinister than previously thought.

“Modern drinking is being essentially subsidised by tax payers. The reason you guys drink more than I drank when I was a student is because in real terms alcohol is a third of the price of what it was when I was at university. And then we drank heavily. Alcohol is disproportionately cheap. And it’s cheap because the drinks industry has lied to us about the harms… and it’s also perpetuated this myth that there’s a lot of benefits from drinking and that’s not true.”

Throughout history, alcohol has been widely prescribed for various medicinal purposes. Brandy for fainting, Guinness for tuberculosis, gin for fevers. Even today, the media frequently produces claims about the benefits of alcohol – protection from cardiovascular disease, Alzheimer’s and diabetes being most popular. On his blog, drugscience.org, Professor Nutt hopes to clear up confusion surrounding these myths by providing drug information supported by the scientific research. “They need to know that they’ve been seduced into drinking by the drinks industry. They’ve been sold this myth that alcohol is almost a necessity in life – the only way you can have fun is through drink… alcohol is the opium of the masses. It’s become a necessity and the access has been made more available. What we’ve got to do is get people to invest in change so alcohol is more expensive and we should be drinking better quality alcohol.”

But how can we even begin changing a drinking culture that’s so firmly ingrained in our social norms? Nutt suggests we need to look no further than the situation across the pond. “The American drinking experiment has been one of the most remarkable health interventions in the world.” Back in the USA in the 1980s, the organisation Mothers Against Drunk Driving (MADD) lobbied the US Department of Transport to increase the drinking age. Slowly, states began increasing their drinking age, until eventually a federal law was passed in 1984 that raised the drinking age across all states to 21. A 2014 review suggests that since the implication of this law, the USA has seen a huge reduction in road traffic accidents linked to alcohol and many lives have been spared as a result.

“The reason that works is because every year you get older you get considerably more sensible”, suggests Nutt. “So the longer you delay people from taking drugs the less damage they get from drinking.”

From current research, the neuroscience behind this phenomenon has been well described. It is thought that in adolescent development, the mesolimbic system has a greater need for reward fulfillment. This comes at a time when the prefrontal cortex is still underdeveloped, thus lowering your ability to make informed decisions. As a result, adolescents are more likely to engage in impulsive behavior and risk-taking. All this considered, Nutt recognises the obvious protestations against raising the legal age. Not least to do with free will. “I can see the arguments against it. I can see if you can go and get blown up in Afghanistan maybe it’s fair that you should drink. I can see the arguments against it, I just think it’s a discussion that needs to be had in a mature way.”

Nutt went on to give us some staggering statistics about the toxicity of alcohol. “You know the maximum annual exposure levels to toxins – poisons get into water, you can’t get water pure so there’s stuff in there like benzene, all sorts of shit in water, right? If you apply the same rule to alcohol – the maximum safe dose of alcohol per year is a glass of wine. So we make enormous exceptions for alcohol. Isn’t that staggering? It is truly remarkable how we close both our eyes when we talk about alcohol toxicity.”

You can read the rest of the article here and the following presentation is well worth your time 🙂

Investing in prevention: is it cost-effective?

Investing in preventionThis was an interesting blog from Public Health England that looks at investing in prevention and its value as cost-effective.  As a public health nurse I would say yes unequivocally but around alcohol there is an argument that says why bother.  Here’s PHE’s view:

In the first blog of this series I explained why it is so important that we make the case for investment in preventive activity, as highlighted in the NHS Five Year Forward View.

If we are to ‘get serious’ about prevention, we need to look at the economic arguments that justify these types of initiatives and public health investments more broadly.

Two of the key questions that we need to address are: how cost-effective is prevention activity in general? And what are the most cost-effective public health interventions?

These questions are of course even more important in the context of tightening budgets in both the NHS and local government. Frequently quoted is the £30bn NHS funding gap, while the gap between local government income and expenditure is forecast to rise to around £14bn by 2019-20.

As well as focusing on the cost-effectiveness of new interventions, we have to be sure that we are using resources efficiently now.  Are we allocating resources to the right activities (the ones that achieve the best outcomes within the resource envelope) and are we delivering those outcomes in the most efficient ways?

This blog will explain why most public health investments are cost-effective, meaning they generate a better outcome than the next best alternative use of resources.

Owen et al (2011) summarised evidence relating to around 200 public health interventions, including smoking and alcohol prevention and physical activity. The research showed that the vast majority of these interventions are highly cost-effective, in most cases far below the typical NICE threshold of £20,000 per Quality-Adjusted Life Year (QALY).

More recently, the WHO report The Case for Investing in Public Health highlighted cost-effective interventions that provide returns on investment and/or cost savings in either the short or longer term.

In assessing the cost-effectiveness of preventive interventions, compared with treatment, it’s only fair to take into account the longer time horizons of most public health interventions.

The blog then goes on to look at discount rates and perverse incentives before concluding:

Economics students are rightly taught that economics is an aid to decision-making; it will not provide all the answers, but its value does lie in structuring problems. Pragmatically, faced with making the business case for investing in prevention, we must consider how we approach a number of key factors including:

  • Long-term return on investments in prevention;
  • Incentives for investing in prevention and early intervention activities; and
  • The evidence on the cost-effectiveness of public health interventions.

In the third and fourth blogs in this series I will look at the issue of public health and cost savings, and the benefits of prevention to the wider health and social care system.

This pragmatic and sensible approach would require some long term planning and investment though and as the election cycle is only 5 years long some inter-party agreement too if it is to be successful.  Short-termism doesn’t work for preventative strategies – they have to be given long enough to follow through longitudinally to assess success …….

Friday Sober Jukebox – Burn the Witch

thom yorkeSo having been struck down with a cold (and as a nurse after 958 days in recovery finally recognising that self care is important when you’re sick and previous so called attempts to ‘power or burn through it’ is not the answer!) I’ve not been at uni this week which has given my brain extra thinking space and time.

If you hadn’t guessed already I’m a massive Radiohead fan and was lucky enough to see them in 2003 and missed seeing them in Berlin in 2013 when a crew member accident had them cancel and reschedule tour dates.  They have an eagerly anticipated new album Dawn Chorus due out in June and this is their new single ‘Burn the Witch’ which released on Wednesday and has already had over 7 million views on Youtube.  IT IS SUPERB!

For those of a certain age it is the use of the Trumpton children’s programme animation blended with references to The Lord of the Flies and The Wicker Man that is so striking when combined with the lyrics.

Stay in the shadows
This is a low flying panic attack
Burn the witch
We know where you live

Abandon all reason
Avoid all eye contact
Do not react
Shoot the messengers

And yes alcohol and it’s ability to anaesthetise painful realities through its consumption is featured!  For those who lived a less than perfect childhood where alcohol,  scapegoating  and group think were present behind a facade of normalcy, as represented here, then this video is perfect.  Darkly resonant but also triggered cognitive dissonance for me – but that’s okay as I can handle that now this far into my recovery 🙂

10/10 Radiohead & Thom Yorke and I can’t wait to hear the new album!

Exploring end-of-life care around substance use

manchester metropolitan universitySUBSTANCE use and palliative care researchers are joining forces with five charities to explore end-of-life care for people with drink or drug issues through a comprehensive new study.

Supported by the Big Lottery Fund, it will be the first study of its kind in the UK and will chronicle the prevalence and frequency of substance problems in palliative and end-of-life care, as well as the experiences of individuals, family members and professionals living and working with these overlapping issues.

Sarah Galvani, Professor of Adult Social Care at Manchester Metropolitan University, is leading the research. She said: “The idea for this research came from the concerns of some charities about whether they were supporting people with substance problems in need of palliative or end-of-life care as well as they could.

“Anecdotal evidence suggests that people with substance problems who are very unwell avoid seeking the health care they need because of their concerns about how they will be treated. It also suggests that professionals need some support to know how to respond when people with both issues do access services. This research will start to explore these concerns.”

Partners

Researchers will work closely with charity partners Aquarius in Birmingham, Phoenix Futures, which is nationwide, St John’s Hospice in Lancaster, Trinity Hospice in Blackpool, St Catherine’s Hospice in Preston, and community organisation VoiceBox Inc in Manchester, as well as with carer and service user advisers. The team will use a £425,000 grant from the Big Lottery Fund to spearhead the two-year project.

There are no known figures of the extent of people with substance problems in need of palliative or end-of-life care and this forms one strand of this research. However, there is emerging evidence of older people’s substance use, alcohol in particular, leading to increased levels of mental and physical harm and increasing rates of hospital admissions. Currently, the 55-64 age group has the second highest admissions to hospital for alcohol-related conditions or injury, with the 45-54 age group the highest.

The problematic use of substances is linked to many forms of chronic and life-threatening conditions including liver cirrhosis, cardio-obstructive pulmonary disorder, various forms of cancer, heart disease and dementia. The majority of these conditions affect people in their later years of their life, although not exclusively. With a rapidly ageing population, this is predicted to increase and place escalating demands on end-of-life, palliative care, and substance use services.

While some people may reduce or stop their substance use when they get older and/or become ill, not everyone does. For some people their problematic substance use can lead directly to their chronic or terminal illness, while for others their substance use may co-exist with their illness. In addition, the impact of a loved one’s problematic substance use on family members can be considerable. If they are in a caring role this impact and stress is likely to be exacerbated, particularly when the loved one is nearing the end of their lives.

‘Valuable resource’

The research team, comprising social care and nursing academics at Manchester Met, also want to establish what good practice exists and to determine whether there are any inequalities in the care received by people with substance use issues at the end of their lives compared to those without. The research will also include speaking to people in receipt of end-of-life care and/or substance use services, as well as family members and carers. The team will also be talking to professionals about how they are currently responding to these overlapping issues and what additional support they might need.

Existing government policy on palliative and end-of-life care seeks to offer all people approaching end of life a needs assessment and high-quality care but it is not known if this applies to people whose use of substances is problematic, said Prof Galvani.

She said: “This will be a timely and valuable resource for policy makers and practitioners. For the first time, it will present the available evidence on the scale of the overlap between substance problems for people receiving, or in need of, end-of-life care.

“End-of-life or palliative care for people with substance problems is likely to become a major issue in the near future given our ageing population, the trends in its substance using behaviour, and the increasing chronic/terminal illness that longevity will bring. In partnership with end-of-life and substance use services, and community and public involvement, this study seeks to ensure services have practice models and policy guidance which are grounded in the experience of those receiving, and delivering, end-of-life and substance use services.

“This is a new area of research and practice development which will provide additional data and perspectives from a range of stakeholders on which practice can be developed more fully.”

When I worked on the ward where I cared for alcoholic liver disease patients many of them were there for end of life care so this is particularly close to my heart.  I look forward to reading the findings of this ground-breaking research.

Plus in support of those bereaved from substance misuse:

New BEAD groups launched last month

The BEAD Project – a partnership between Adfam and Cruse Bereavement Care – is launching two new peer-led support groups for people bereaved by drug or alcohol use. The groups are being piloted in London and Birmingham from April to June 2016 and are open to any adult who has been bereaved through drug or alcohol use | Adfam, UK

Alcohol service launches anti-stigma film

nottinghamshire healthcareThis is a new video that has been produced by Nottinghamshire Healthcare to help promote anti-stigma around alcohol dependence and the perceived inability to change.

The Trust’s Alcohol Related Long Term Conditions (LTC) Team has created a short film to challenge the stigma associated with severe alcohol problems and the notion that people cannot change their behaviour.

The short film shares Greg’s inspiring story, a service user who feels the ongoing support he has received from the team has played a key role in his recovery. The film also includes perspectives from healthcare professionals from Nottingham University Hospitals and East Midlands Ambulance Service on how the intensive case management approach works.

The Alcohol Related LTC Team supports people with alcohol dependence that has led to long term physical health conditions and a high risk of repeated admissions to hospital. The team works with this group of service users that usually do not engage easily with normal healthcare pathways and place a significant burden on health services, with one patient alone costing approximately £137,000 in a 12 month period. The team works by assessing the individual’s needs from their own perspective and assertively engaging with and coordinating wider health care services for more appropriate use of the healthcare system. By effectively working with other healthcare providers, the team is able to reduce costs and help service users make remarkable behaviour changes. 

We hope to raise the profile of the fantastic outcomes services like ours can achieve, not only for the service user but the overall healthcare system. We believe the film is a great way to do this and we would like to thank Greg for sharing his story.
– Mark Holmes, Team Leader for Long Term Condition Nurses 

Last year the service was independently evaluated by Alcohol Concern and recognised by them as ‘an example of good practice with change resistant drinkers’. Their full report along with information on cost savings made can be found on the alcohol concern website.

The full film can be viewed here: 

Pour Me A Life

pour me a life aa gillSo I was lucky enough to be lent a signed copy of AA Gill’s new book Pour Me A Life by a fellow Cambridge student who happens to be a friend of his and was at the book launch *thank you lovely person!*  I’ve been busy reading it and have devoured it in between our course texts.

AA Gill has been in recovery for over thirty years and this book talks about one particular year between his wife leaving and entering rehab – but that’s not entirely true because this is an autobiography so we learn a great deal about him and his life leading up to that point.  The book was an education where I learned about something I had experienced and couldn’t put into words – until now, Stendhal’s syndrome: being overcome by beauty.  This happened to me at St Peter’s Church in the Vatican City in Rome …..

There were a couple of passages that really resonated so to wet your appetite (and not risk infringement of copyright!)  I shall share just those and then links to some of the other reviews that have been written.

“It was for those whom the licensed day was not long enough to fit in the required pintage, for those of us who did alcohol overtime”

This next passage is beautiful and explains my experience of drinking so well:

“Booze is a depressant, a close relative of anaesthetic.  The symptoms of getting drunk are like those of being put out for an operation – initially, fleetingly, it offers a lift, a sense of transient joy, of confident light-headed freedom, it’s a disinhibitor; relaxes your shyness and natural reserve so you can feel socially optimistic in a room, can make a pass, tell a joke, meet a stranger.  But this is just the free offer to snag a punter.  Drink is, at its dark, pickled heart, a sepia pessimist.  It draws curtains, pulls up the counterpane.  It smothers and softens and soothes.  The bliss of drink is that it’s a small death.  The difference between you and us, you civilian amateur hobbyist drinkers and us professional, committed indentured alcoholics is that you drink for the lightness, we drink for the darkness.  You want to feel good we want to stop feeling bad.  All addictions become not about nirvana, but maintenance.  Not reaching for the stars but fixing the roof.”

This is what The Guardian had to say:

He delights in his own similes; they are produced one after the other as if spotlit and accompanied by canned laughter.

And The Telegraph:

And yet his inspirational passage on the joy of the English language, a thing “of peerless beauty and elegance”, should become a school-curriculum essential.

However, almost despite himself, his post-drinking life cannot fail to give hope to “those who still stagger” and despair.

A book that began by discussing lost time becomes one of recovered time, of a new way of life that is worth not only living but also celebrating.

And you can read Mrs D is Going Without’s review here.

Hear hear!  I love AA Gill’s writing & completely concur about his use of similes and that passage which displays his obvious delight in the English language.  This book is well worth your time and money 🙂

Edited to add: 10/10/16

AA Gill dies weeks after revealing he had cancer in restaurant review

RIP AA Gill – you will be missed.