Daily Archives: 27/08/2016

Saturday Sober Jukebox – When Everything Was New

G’day sober lovelies!  Long time no write but boy have I been busy exploring lots of new things.  Getting up early with the sunrise and the sound of kookaburra’s as my alarm clock, going to bed early and happily exhausted from so much travelling, doing and seeing; watching possums crawl across my tent roof at night, sand tobogganing, running along beaches, stroking kangaroo’s, eating concrete – an extra hard ice-cream (and how about liqourice flavour? – it’s delicious!), snorkelling among the turtles, rays, reef sharks and tropical fish with my children at the Great Barrier Reef and watching hump back whales and their calves.  I could go on and on and on  🙂

Australia was AMAZING.  I love everything about the place, the people and the food – being eaten alive by sand flies not so much.  I won’t bore you with all my holiday photos but will share these three which sum up the whole experience so well.  Magical beaches, sunsets and memories – like seeing pods of wild dolphins 5 times and feeding them by  hand not once but TWICE!!

Did the thought of drinking cross my mind?  Maybe fleetingly once or twice.  Did the thought of managing a hangover with all the activities we were doing puncture my consciousness?  God yes.  I would have wanted to stay up late after the kids (we went to bed at the same time as them pretty much all holiday) drinking.  Those early morning wake-ups would have been a nightmare and I would have been a grumpy tired resentful parent.  My focus would have been finding an excuse to drink at all times and time, activities and experiences would have been prioritised around that or the resulting hangover.  I suspect we wouldn’t have done half as much as we did or travel as extensively as we did.  We were so lucky as the family member we were travelling with also doesn’t drink and decaff tea was the drink of choice for all of us.  Yes the family we were staying with drank but when we went out for dinner at another of their friends houses my sis in law said we were teetotal and that was that 🙂

Australian supermarkets are very sensible and you can only buy alcohol free products in them – I found and sampled a couple of AF beers which were very nice and saw a small selection of AF wines.  You have to go to a bottle shop or liquor store for booze – although there were plenty about including drive through!   Plus RBT (random breath tests) are a big thing both on the roads and water at any time of day.  And my new favourite AF drink?  Lemon, lime and bitters (from Bundaberg the biggest rum distillery in Oz who do a great range of AF drinks too).

brew-lemon-lime

 

 

 

 

 

 

And as for sober treats?  How about an organic doughnut with macadamia nuts, mascarpone and fresh strawberries (this was sampled at Byron Bay)  😉

organic doughnut oz

 

 

 

 

 

 

 

And as it’s a Saturday sober jukebox an Aussie tune too by Flume aptly titled When Everything Was New.  It’s nice to be back, but truth be told I’d have happily stayed ……

Will be back tomorrow as taking my daughter to see Little Mix tonight!

Detecting alcohol use disorders with a single question

QuoteMarksSo we fly back into the UK from Australia today and I’m writing this in May!  I’m guessing I’m going to feel pretty tired and jet-lagged and will have an overflowing email inbox from the cyber break too to contend with once my sleep and time zone’s are realigned so I’m cutting myself some slack and lining this up to give me a bit of breathing space 🙂  It’s important and valuable research about the power of a single well-defined question to boot from Drug and Alcohol Findings.  Here’s the research abstract:

A US study of young people in rural primary care settings finds that alcohol use disorders can be identified with a single question about frequency of drinking.

Summary In the United States, a national study of young people aged 12 to 18 found that past-year drinking frequency was an accurate proxy for alcohol-related problems – considerably more so than quantity of alcohol per occasion or frequency of heavy episodic drinking. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) subsequently adopted the use of alcohol frequency to screen for problematic drinking in young people. This study explored the accuracy of NIAAA drinking frequency screening thresholds for detecting alcohol use disorders (as defined by Diagnostic and Statistical Manual of Mental Disorders, 5th Edition or DSM-5 diagnostic criteria).

1193 young people (aged 12–20) attending six rural primary care clinics opted into the study. They were provided with a tablet computer and asked to enter information about past-year drinking and alcohol-related symptoms. This took around three to six minutes of their time.

The researchers gauged the accuracy of the screening thresholds using measures of “sensitivity” (the proportion correctly detected as having an alcohol use disorder), and “specificity” (the proportion correctly ruled out of having an alcohol use disorder). Together, sensitivity and specificity (reported as percentages) tell us how well a screening tool can pick up on risky drinking, without drawing into the net large numbers of non-risky drinkers.

From the sample, 2% of younger adolescents (aged 12–14), met DSM-5 criteria for an alcohol use disorder in the past-year, compared with 10% of those aged 15–17 and 10% aged 18–20. When applied to the same age range as the earlier national study (i.e. 12–18), the NIAAA thresholds for moderate risk showed acceptable levels of accuracy (85% sensitivity and 87% specificity) as a screen for any DSM-5 alcohol use disorder symptom; and the NIAAA thresholds for the highest level of risk showed acceptable levels of accuracy (91% sensitivity and 93% specificity) as a screen for severe DSM-5 alcohol use disorders.

In practice, “an alcohol use frequency screen followed by an [alcohol use disorder] evaluation among those who screen positive would constitute a simple, brief, and cost-effective clinical assessment procedure” – and it would enable practitioners to check whether those who have screened positive, do indeed have an alcohol use disorder. The researchers found that, for those in the age band 12–17 years, around 44% of those who screened positive could be expected to have an alcohol use disorder (based on a calculation of a statistical measure called the “positive predictive value”), and around 99% of those who screened negative could be expected to not have an alcohol use disorder (based on a calculation of the “negative predictive value”).

Overall, the findings suggested that drinking frequency can be a useful and accurate indicator of alcohol use disorders among young people, and that at-risk young people can be identified with a single question on alcohol use frequency.

CommentaryThe study considered here used computer-based self-assessments to screen young people for alcohol use disorders. Modern technologies present new opportunities for increasing rates of screening among young people, as explored in other Effectiveness Bank analyses including assessment and feedback by email for university students, web-based alcohol screening and brief intervention for university students, and text-message-based drinking assessments and brief interventions for young adults discharged from the emergency department.

Clark D.B., Martin C.S., Chung T. et al. (2016) Screening for underage drinking and Diagnostic and Statistical Manual of Mental Disorders, 5th Edition alcohol use disorder in rural primary care practice. Journal of Pediatrics: In press

‘Modern technologies present new opportunities for increasing rates of screening among young people’  I completely agree and hope that this work is built on to put these new screening tools into place!