Monthly Archives: September 2016

Toot Toot: I’m in The Fix! :)

sobrietycomp2So just tooting the horn for this list of awesome sober bloggers – which just happens to include myself 😉  The list was compiled by Regina Walker psychotherapist and writer for The Fix.

You can read the full article which is entitled: My Top 12 Recovery Blogs here but I’m going to list the names and links here so you can go check them out.

Over to Regina:

The number of “sober” or “recovery” blogs increases every day. The anonymity—and shame—that once shrouded people affected by substance abuse is slowly slipping away. Some blog posts read like journal entries—a diary on the web, in a sense.

I have read many recovery blogs. I am often very moved by the genuineness and honesty that, perhaps, the faceless Internet allows. These writers are sharing some of their deepest secrets and most shamed-filled experiences with, well, everyone. Often the sites almost sound like intimate conversations the writer is having with themselves or a loved one and I, the reader, am eavesdropping.

I compiled a list of 12 of my favorite recovery blogs and had the opportunity to talk with the bloggers, yet this list can never be all-inclusive. I have read posts on many blogs that have stayed with me, written by people who I will never meet, and who have no idea they have touched me so deeply. 

Below (in no particular order) are my 12 favorite recovery blogs.

1. Transformation is Real

2. The Recovery Revolution

3. The Miracle of the Mundane

4. Liv’s Recovery Kitchen

5. The Unruffled

6. The Sobriety Collective

7. Buzzkill Pod

8. Tired of Thinking About Drinking

9. Sober Unicorn

10. The Sober Señorita

11. Walking in Sober Boots

12. Me 🙂

One of the more common themes amongst these bloggers is the importance of the cyber recovery community. For a number of them, it is their primary sober support. And that is true not only for the many bloggers themselves, but for their countless readers and followers. The support, assistance, and connection provides a healing experience for so many, which may explain why sober blogs and sites are gaining such great popularity. You can be anonymous, do recovery your own way, gain support, and make friends—all from the safety of your computer screen.

Blogger Christina Ferri said, “Shortly after I started my blog, the networking and online recovery tribe became, almost overnight, my rock to stand on. I felt stronger than ever. People I’ve never met or heard of began reaching out to me, sharing more resources, sharing their stories and including me in collaborations to further our outreach in recovery. I’ve made true friends and have unlimited resources to assist me and strengthen me every day.” 

This list includes several people I consider both mentors and friends, such as the lovely Belle and Paul, and those I have had the pleasure to *meet* via social media and private groups such as Sondra, Laura and Chris.  Regina  is so right that the community out here is invaluable and I continue to be grateful that you, and I, are here 🙂

Edited to add: And on the 7th September 2016 I was also listed in Port of Call’s 20 best addiction recovery blogs 

What alcohol REALLY does to your body – and how quickly you can repair the damage

12 weeksThis was in the Daily Mail in June and looked at what alcohol does to the body and the time frame needed to begin to repair the damage.

From the pounding headache to the feeling of regret, we all know that alcohol isn’t good for our bodies.

When nursing a hangover it’s not unusual to vow to never allow alcohol to pass your lips again. Yet weeks – perhaps even days – later, social drinkers find themselves in the same situation. 

But a new guide revealing what really happens to your body when you stop drinking may well discourage you from reaching for that chilled glass of white again.

From flawless skin to new levels of energy, Dr Niall Campbell, an alcohol addiction expert at the Priory hospital in south-west London, reveals the timeline – and benefits – of ditching the booze.

WITHIN 24 HOURS 

The most immediate effect of excess alcohol is a hangover. You might suffer sweats or tremors, and in severe cases, a seizure. If you are giving up moderate drinking, your body will begin to clear the alcohol from your system and you can start to ‘detox’, your blood sugar will normalise and you can look forward to the multiple advantages that not drinking will bring you. 

You will feel much more clear-headed, less depressed and you will have more money in your wallet. If you spend, say, around £20 a week on 2 bottles of wine, you will save £1,040 by the year’s end.

WITHIN A WEEK 

Alcohol is very bad for sleep, leading to a fitful night. You may think it gets you off to sleep but you are likely to wake up and want to go to the bathroom. 

Alcohol is a diuretic, which means it encourages the body to lose extra fluid though sweat, making you dehydrated which means you will wake up wanting water. The good news is that if you give up alcohol, your sleep patterns are likely to improve within a week.

WITHIN A FORTNIGHT 

Alcohol is an irritant to the stomach lining and causes symptoms like reflux (where stomach acid burns your throat). Give up alcohol and this feeling will be a thing of the past.

You will also start to notice weight loss within a fortnight. The ‘hidden’ calories in alcohol are significant. Drinking a large glass of wine (250ml) with 13 per cent ABV can add 228 calories to your dinner. So two large glasses will add roughly the equivalent of an extra ham and cheese sandwich with mayonnaise a day. And we are talking empty calories, which means they contain no nutrition. 

If you stop drinking, and start eating healthily and exercising, you will lose weight.

WITHIN 3-4 WEEKS 

If you drink too much alcohol, this raises your blood pressure over time. The calories in alcohol also make you gain weight, which also increases your blood pressure. By quitting alcohol, your blood pressure will reduce.

WITHIN A MONTH 

You will look visibly better. Alcohol is toxic to your largest organ – your skin. The toxins make your skin less elastic and it is very ageing. Ageing through alcohol is something your best friend won’t tell you about. If you stop drinking, you prevent premature ageing of your skin.

WITHIN 4-8 WEEKS 

Your liver will improve. It can handle small quantities, but excessive drinking causes it to get inflamed – which is what we call ‘alcoholic hepatitis’, a silent disease. In the early stages, you can’t feel that, but it can lead to cirrhosis, which is permanent. 

Drinking a couple of 175ml glasses of wine a day if you’re a woman, for two or three weeks, and you’re likely to develop ‘fatty liver’, when the liver turns glucose into fat. Alcohol affects the way the liver handles fat, so your liver cells just get full of it. 

The good news is your liver will start shedding the excess fat if you stop drinking. If your liver function has not been too badly affected by alcohol, it can recover in 4-8 weeks.

WITHIN 12 WEEKS 

Heavy drinking causes blood cells to become larger and that makes you more tired because they are unable to transport oxygen efficiently around the body. 

After giving up drinking, your blood cells will start to renew within three months and you will feel much more energetic and healthier all round.

And that’s after only 12 weeks!  Imagine what you’ll feel like after 6 months or a year or in my case almost 3 years 😉

Friday Sober Jukebox – World Shut Your Mouth

2016-drinking-guidelines-amendmentsSo I’m coming out swinging with my mouth open!  Or does that description actually pertain to the alcohol industry?  This was published by Alcohol Policy UK earlier today and it’s a dozy of a post so I’m sharing my edited highlights and strongly urge you to go read it in full.  The tune is in honour of the booze lobby brigade and I need to eat my words as I was utterly convinced these guidelines would be diluted or diminished in some way but no!

The Department of Health (DoH) have released its response to the consultation on communicating the new recommended drinking guidelines announced earlier this year.

Following heated debate over the guidelines, this week a new industry led group – the Alcohol Information Partnership – has also been announced which it says aims to ‘bring balance to the debate’. A recent Wall Street Journal article also recently reported that with ‘moderate drinking under fire’ alcohol companies across the globe are ‘on the offensive’ in a ‘multimillion-dollar global battle‘.

DoH consultation response & qualitative insights

The consultation response captures many of the themes played out in media coverage of the guidelines as of course many of the responses were from health and industry groups. As such, the responses to most of the questions were evenly split between positive and negative when excluding the 785 responses from individuals through the Campaign for Real Ale (CAMRA), who have been active in opposing the idea of a ‘no safe level’ message in particular.

The consultation response includes a number of tables highlighting revised wording and rationale (see figure above on regular drinking).

In addition, a qualitative research report [pdf] was also commissioned by Public Health England to gather a sample of public attitudes and beliefs regarding the new guidelines. Focus groups were conducted covering a range of demographics including low, increasing and higher risk drinkers.

Some key findings of note from the report include:

  • Virtually all drinkers were aware of the dangers of drinking to excess, especially the long term health problems, but few felt they were at risk.
  • Guidelines were often discussed in terms of how much they allowed or permitted people to drink, rather than being a guide to what consumption levels mitigate the risks of drinking.
  • Response to the new draft guidelines was generally favourable, and they were preferred to earlier drafts.
  • Most drinkers believed the information about the risks of alcohol and accepted the advice and tips on reducing the risks.
  • The exception to this general acceptance was higher risk drinkers, particularly those over about 35, who saw the guidelines as an attempt to stop them enjoying themselves, and felt the advice was irrelevant to them (my bolding as I was struck by this fact – what is it about those born before the 1980’s and our drinking?)
  • Higher risk drinkers project the risks onto other people who they believe are not in control of their drinking.
  • Many drinkers had difficulty grasping how and where the guidelines would be used. In current form – words on paper – they did not attract attention or invite reading.
  • In tone the guidelines were perceived as measured, neutral and focused on information. There was little sense of the tone being nannying, except among a heavy drinking minority, who disagreed with the principle of the guidelines.

The qualitative research report suggests that the guidelines were generally considered plausible and well constructed, except among higher risk drinkers who ‘see guidelines as unnecessary and object to recommended limits. They regard drinking as a reward for coping with demanding lives, and they want to guard their freedom to drink as they wish. They see advice from government sources or from the medical profession as challenging and possibly threatening this freedom.’ This is consistent with evidence suggesting many risky drinkers do not consider their own drinking as problematic, in part owing to normative misperception.

I really do think the drinks industry would quite like the world to shut it’s mouth 😉

Public health 1 – Alcohol Industry 0

 

What I’m really thinking: the son of an alcoholic

what I'm really thinkingThis anonymous piece was in the Saturday Guardian in June looking at what the son of an alcoholic is really thinking ….

I love you, Mum, but I worry that you’ll tear our family apart. I’ve seen Dad at his worst – he can barely cope. Your daughter is trying to study for her A-levels, but I know she cries at night.

I worry that nobody will be watching when you slip over in the kitchen, reaching for the bottle on the top shelf. You used to get angry at me. Then I grew up; I realised that you weren’t angry – you were frustrated, depressed and lonely.

Sometimes I wish you’d just “snap out of it” but, of course, I know that’s not how it works. So I’ll just keep helping you to get up every time you fall down, and I’ll keep turning off the oven every time you think it needs to be turned on, and I’ll keep hugging you and telling you, “It’s fine, we understand,” when really we can never know what it’s like.

It’s clear to me that soon you and Dad will separate. When that time comes, I’ll come and visit you and call you twice every day – just to make sure. I’ll drive you to your appointments and I’ll pick up your prescription. I’ll come to your house at Christmas and I’ll be the first by your side at the hospital – after you slip reaching for that bottle.

I hope I don’t have to do those things, because it won’t be easy for either of us and I’m worried I’ll resent you for it. I don’t want to do that.

I still remember the mum who took me to the cafe where we’d get a slice of carrot cake and do my spellings. I remember the mum who planned my birthday parties meticulously, and who tied my shoes every morning, and, even though I know you’re still the same mum, I can’t help wishing I could have the old you back.

25% of males age 15-39 die due to alcohol

fatal alcohol poisoningThis was in the Irish press in June looking at the number who die due to alcohol in young males and it is shocking.

One in four deaths of young men aged from 15 to 39 in Ireland is due to alcohol and drink is a factor in half of all suicides, according to the Health Research Board.

Alcohol is also involved in more than one third of cases of deliberate self-harm, peaking around weekends and public holidays.

Those grim statistics are among the challenges for the medical professional nationwide and yesterday the first regional Alcohol Strategy to tackle the damage caused by alcohol in counties Cork and Kerry was launched at Cork County Hall.

“Our overarching principle in terms of strategy is to reduce the harm caused by alcohol in Cork and Kerry,” said David Lane, co-ordinator of Drug & Alcohol Services at HSE South.

While welcoming the new Public Health (Alcohol) Bill, Mr Lane said its slow progress through the legislature was frustrating.

“We need this new legislation as a matter of urgency,” he said.

“In fact, the minimum unit pricing which is a central plank of the Bill should have been put in place years ago. In the meantime, more than one person every week in this country dies of alcohol poisoning. They just consume alcohol and no other drug and die from it. That is quite shocking.”

Among the HRB findings: n Alcohol consumption in Ireland almost trebled between 1960 (4.9 litres) and 2001 (14.3 litres); n Almost two thirds (63.9%) of males started drinking alcohol before the age of 18; n Four in five (80.3%) male drinkers consumed six or more standard drinks on occasion.

Those attending the launch of the strategy heard that liver disease rates are increasing rapidly in Ireland and the greatest level of increase is among 15- to 34-year-olds, who historically had the lowest rates of liver disease.

As well as that, 900 people are diagnosed with alcohol-related cancers with around 500 people dying from these diseases every year. Drink driving is also factor in one third of all deaths on Irish roads.

The bill aims to reduce alcohol consumption in Ireland to 9.1 litres per person per annum by 2020 and to reduce the harms associated with alcohol. It consists of 29 sections and includes five main provisions.

These are: Minimum unit pricing; health labelling of alcohol products; the regulation of advertising and sponsorship of alcohol products; structural separation of alcohol products in mixed trading outlets; and the regulation of the sale and supply of alcohol in certain circumstances.

However, Mr Lane lamented the absence in the proposed legislation of any attempt to tackle seriously the marketing of alcohol, particularly in its association with sporting events.

“We might be turning a corner,” said Mr Lane.

“The Public Health (Alcohol) Bill outlines some positive steps to tackle the issue for the first time in a meaningful way.

“It might be the first step in introducing minimum unit pricing which we, as an Alcohol Strategy Group for Cork and Kerry, will fully support. But Ireland needs to strengthen its resolve to tackle the availability and marketing of alcohol in a meaningful way too.

“Finally, we must include alcohol as part of our response to substance misuse and when our National Drugs Strategy runs out at the end of 2016 we must include alcohol in a new National Substance Misuse Strategy from the start of 2017.”

And the same day this study abstract was published too:

Alcohol dependent individuals show greater risk of suicide in evening hours

A new study found that there is a circadian pattern of peak and nadir in the incidence of suicides committed in alcohol dependent individuals.

Subjects who consumed heavy amounts of alcohol had a peak incidence of suicide at 9PM, and a low around 5PM. In contrast, the peak incidence was around 12 PM for those individuals who did not drink or drank moderately and a low at 4 AM.

What struck me about the Irish news story was how even though they the Public Health (Alcohol) Bill has been passed it’s implementation is being slowed.  Why is that and by whom?

To which there was no answer but an impassioned plea:

Royal College of Physicians of Ireland calls for the urgent enactment of the Public Health Alcohol Bill

Access to alcohol and heart disease among patients in hospital

alcoholic cardiomyopathyThis was some research published in the BMJ in June looking at ‘access to alcohol and heart disease among patients in hospital: observational cohort study using differences in alcohol sales laws’.

I’ll detail the abstract and then the relevant bits of the discussion which caught my eye:

Abstract

Objective To investigate the relation between alcohol consumption and heart disease by using differences in county level alcohol sales laws as a natural experiment.

Design Observational cohort study using differences in alcohol sales laws.

Setting Hospital based healthcare encounters in Texas, USA.

Population 1  106 968 patients aged 21 or older who were residents of “wet” (no alcohol restrictions) and “dry” (complete prohibition of alcohol sales) counties and admitted to hospital between 2005 and 2010, identified using the Texas Inpatient Research Data File.

Outcome measures Prevalent and incident alcohol misuse and alcoholic liver disease were used for validation analyses. The main cardiovascular outcomes were atrial fibrillation, acute myocardial infarction, and congestive heart failure.

Results Residents of wet counties had a greater prevalence and incidence of alcohol misuse and alcoholic liver disease. After multivariable adjustment, wet county residents had a greater prevalence (odds ratio 1.05, 95% confidence interval 1.01 to 1.09; P=0.007) and incidence (hazard ratio 1.07, 1.01 to 1.13; P=0.014) of atrial fibrillation, a lower prevalence (odds ratio 0.83, 0.79 to 0.87; P<0.001) and incidence (hazard ratio 0.91, 0.87 to 0.99; P=0.019) of myocardial infarction, and a lower prevalence (odds ratio 0.87, 0.84 to 0.90; P<0.001) of congestive heart failure. Conversion of counties from dry to wet resulted in statistically significantly higher rates of alcohol misuse, alcoholic liver disease, atrial fibrillation, and congestive heart failure, with no detectable difference in myocardial infarction.

Discussions The relation between heart failure and alcohol use has been one of the more complex associations to elucidate. On the one hand, alcohol is known to cause cardiomyopathy.29 30 On the other hand, some studies have suggested that alcohol may have a protective effect when consumed in moderation.14 15 Both atrial fibrillation and myocardial infarction can lead to heart failure,31 32 with myocardial infarction likely being much the more important of the two.

The discordant results, showing more atrial fibrillation but less myocardial infarction and congestive heart failure in wet compared with dry counties, are particularly remarkable given that these outcomes generally share all of the same risk factors and that each can lead to the other. Specifically, atrial fibrillation predicts myocardial infarction and congestive heart failure,31 35 36 37 just as myocardial infarction predicts atrial fibrillation7 38 39 and congestive heart failure predicts atrial fibrillation.7 31 Therefore, given these potential “downstream” influences, these discordant results may suggest that the direct effects of alcohol are more potent than the point estimates reported.

Conclusions Greater access to alcohol was associated with more atrial fibrillation and less myocardial infarction and congestive heart failure, although an increased risk of congestive heart failure was seen shortly after alcohol sales were liberalized.

I’ve often wondered about alcohol and the heart and wanted to see some research to validate my experience.  The youngest patient I ever nursed whose death was alcohol-caused was a 36 year old female who died of alcohol induced cardiac failure.  Plus in the TV twin study  a cardiologist used ultrasound to observe their heart during drinking and noticed cardiac dilation.

There was an editorial in the BMJ the same day titled Pinpointing the health effects of alcohol that critiqued this study that concluded with:

Both proponents and skeptics of the hypothesis that alcohol consumption reduces cardiovascular risk should recognize that nothing short of a randomized trial of alcohol consumption will provide the quality of data necessary to answer this question with confidence, because any observational design will be subject to serious limitations. All interested parties should press for such a trial quickly and wholeheartedly. It is time to move forward.

I look forward to reading the results of this RCT and also the detailed limitations and confounding variables!!

Edited to add:

The MailOnline reported research about atrial fibrillation in its article ‘Why drinking just ONE glass of wine a day could now be bad for you.’ | Alcohol Policy UK

Edited to add: 6th Feb 2017

The Express reported on research that found alcohol abuse was associated with a doubled risk of irregular heartbeat, a 1.4-fold increased risk of heart attack and a 2.3-fold increased risk of heart failure.

 

 

Understanding the relationship between poverty and alcohol

CPH poverty and alcohol misuse 2016This rapid review examined evidence of the association between poverty and alcohol use. The research primarily focused on work undertaken in the UK and was commissioned by the Joseph Rowntree Foundation as part of their programme to develop Anti-Poverty Strategies for the UK. The purpose of the rapid review was to provide an evidence base that the Joseph Rowntree Foundation could use in developing their strategies, and to inform how alcohol misuse was addressed.

What struck me about this review was the section on stigma and marginalisation:

How people respond to others’ alcohol use exacerbates harm (World Health Organization, 2007). Alcohol dependence is a highly stigmatized health condition and as Room (2005) argues, “the use of alcohol [and drugs] is strongly moralized, and those transgressing moral norms are subject to stigma and social marginalization”. The relationship between alcohol dependence and stigma particularly manifests itself through the perception that those affected have personal control over their illness (Livingston et al., 2011). The WHO Expert Committee on Problems Related to Alcohol Consumption noted that “there a clear tendency for many cultures to marginalize particularly those who are both poor and habitually intoxicated, and that there are many pathways by which poverty can enable or exacerbate the stigmatization of intoxication” (World Health Organization, 2007). People who are poor or living in poverty may be less able to avoid or  buffer the social consequences of their drinking unlike their more affluent counterparts. Police surveillance of ‘anti-social behaviour’ such as public drunkenness may also be heightened in poor communities. Thus in affluent societies, the WHO Expert Committee (World Health Organization, 2007) highlighted “that there is a very strong overlap between the most marginalized population and those defined as having serious alcohol problems”.

What is the extent of problem alcohol use among people living in poverty?
As there are no figures available to determine what proportion of the estimated 13 million adults who live in poverty overlap with the categories of problem drinkers the extent of the problem is unknown.
According to Public Health England (2014), around 9 million adults in England are hazardous drinkers with 2.2 million also harmful drinkers. An estimated 1.6 million adults in England may have some degree of alcohol dependence. Of these, around 250,000 may be moderately or severely dependent on alcohol.  According to the 2007 Psychiatric Morbidity Survey, 8.5% of men and 3.0% of women in the lowest income quintile had experienced any symptoms of alcohol dependence in the last 6 months; 2.5% and 0.1%, respectively, had experienced moderate or severe symptoms of dependence that would indicate a need for assisted alcohol withdrawal.
You can read the full report here:

Gut instinct helped me save an alcoholic’s life

Quotation-Alain-De-Botton-control-despair-events-hope-Meetville-Quotes-163579This was featured in The Guardian in June as part of the ‘day I made a difference’ voluntary sector anonymous blogs and was about a volunteers gut instinct helping an alcoholic.

Rick had once been a successful, self-employed tradesman, working hard, playing hard and spending his disposable income on upmarket cars, caravans, jet skis and other expensive toys. But, following a family trauma his drinking escalated and he became increasingly isolated. When I met him he was living in a small, rented flat and spending his savings on cider – usually 24 cans a day, more than 50 standard units daily compared to the recommended healthy weekly limit of 14.

Obviously his health – both physical and mental – had suffered as a consequence. He was often too anxious to leave his flat and would give taxi drivers his credit card and pin number to buy alcohol for him. He had been diagnosed with cirrhosis of the liver and pancreatitis. His skin had a waxy yellow pallor and his abdomen was distended by ascites – the retention of fluid in the abdominal cavity. To be blunt, his chances of long-term survival were slim.

At a small charity in West Yorkshire, my job is to support people like Rick and help dependent drinkers who have been admitted to our local hospital to take charge of their addiction and recovery. That moment in hospital is often a turning point for people and we try to take advantage of that.

I had been working with Rick for a couple of months when one Friday afternoon, following a cancellation, I found myself at a rare loose end and for some reason I just couldn’t shake the feeling that I should visit him. He lived nearby, so I told my colleagues where I was going and left the office. When I arrived I could see immediately that Rick’s health had taken a turn for the worse; his eyes were clearly jaundiced, he was confused and anxious and experiencing severe abdominal pain.

Despite his protests, I called an ambulance and stayed with him until I was sure that he was on his way to hospital. I then called the office, told them what had happened and went home. On Monday morning my manager’s first words were “good work on Friday, Rick has been in intensive care all weekend”. This was his turning point, he spent over a month in hospital where I visited him regularly and after he was discharged he attended our recovery centre to complete a 12-week structured recovery programme.

Rick has now completed over two years of sobriety, he has returned to work and remains a passionate advocate of our service – a month seldom goes by when someone doesn’t come into reception saying, “I know Rick and he says you can help me”. From a personal point of view, Rick’s story gives me hope – he reminds me that no one is a lost cause and I must never stop trying to make a difference; their turning point might be today.

Rick is a pseudonym and other identifying features have been changed.

The day I made a difference is the Guardian Voluntary Sector Network’s series that showcases the work of people involved with charities. If you have a story you want to share email voluntarysectornetwork@theguardian.com with a short summary of your experience.