Monthly Archives: November 2016

Ho Ho Ho Tis the season to be sober ;)

12-days-of-christmas-drinking-wine-memeSo it’s almost that time of year again, the season where your social media feed will be more full than usual with memes celebrating everything that is great about this booze sodden month (such as this one to the left) peaking with Christmas and New Year.

I’ve been in touch with Arthur Cauty and he has pulled a rabbit out of the ‘A Royal Hangover‘ hat again for us!! If you haven’t yet watched his superb British documentary film go to the image of Queenie on a postage stamp with a bottle in her hand to the right of this blog post and click and it’ll take you to iTunes where you can rent or buy the film.  It really is fabulous (you can read my review here) and will help you gird your loins for the drinking mayhem that is about to descend upon  us ….

Following the success and popularity of last year’s sober advent calendar (which is archived under sober heroes & heroines in the ‘life without booze’ tab at the top of the blog or you can find them here) we have a NEW 2016 sober advent calendar to support you on a daily basis during these sometimes trying times.  Starting tomorrow and rolling all the way to the big day itself 😉

Today and for the next month we raise an AF glass & remind ourselves of our choice of why we don’t drink anymore in the company of the good and the great of the screen, music and written word.

Tomorrow Arthur’s quote and image delights will begin and we hope you like and it keeps you on the straight and narrow fellow sober warriors during this trickiest of times.  I’ll be here so reach out if you need support.

Friday Sober Inspiration: Is there a formula for happiness? (Come As You Are)

TheHappinessEquationI read this article a few weeks ago because of the subject but also because one of the writers is an old friend of ours who we’ve lost contact with.  It was lovely to connect with her again through reading her words.  Plus the first contributor is also in recovery so it felt doubly apt to share it here.  It was in The Telegraph and looking at whether there is a formula for happiness.

A new publication, The Book of Joy, written by the Dalai Lama and Archbishop Desmond Tutu, has sparked debate over their theory that joy can be achieved by embracing “eight pillars of joy” – these being perspective, humility, humour, acceptance, forgiveness, gratitude, compassion and generosity.

Here, four writers discuss their own rules for happiness.

‘I found happiness when… I learnt to be unhappy’

Bryony Gordon, 36

A friend of mine in recovery once said to me that to be truly happy you had to hit rock bottom. I didn’t really understand what she meant.

Perhaps that’s because I was drunk or high at the time – it was many years ago, when I would self-medicate my obsessive compulsive disorder through alcohol and cocaine, and everyone wanted to be my friend ‘because you’re so fun!’.

I thought fun equated to being happy. I was wrong. It’s only after five or six breakdowns (I lose count) that I have realised that the real key to happiness is to embrace unhappiness – to allow yourself to go to that rock bottom my friend mentioned without trying to shoo it away.

You don’t take your unhappiness and try to water it down with five pints of strong continental lager. You don’t run away from your unhappiness towards the nearest drug dealer.

You sit with your unhappiness, no matter how much of an arsehole you think it is. You talk to your unhappiness, however creepy it makes you feel. Maybe only for an hour each week, with a therapist there, but you talk to it all the same.

Try to at least make an acquaintance of it. Get to know it. Attempt to work it out, so it doesn’t keep getting the better of you. I did this last year when I wrote a book about my mental health, Mad Girl.

It made me very unhappy. Depressed even. Sitting with your unhappiness day in, day out is difficult, like scratching away at a scab. 

Even when the book came out at the beginning of the summer, I had not learnt properly how to deal with it. How to cope with it. But being able to cope with unhappiness is, I realise, all that happiness really is. It is nothing more complicated than that.

To find yourself in a real bind, wondering how you might get out of it, and to realise that you do not have to. You can just ‘be’ and not beat yourself up for just being.

And one day you catch yourself, maybe when you are having lunch with your family or watching someone you love run free across a park, and you get a pang of a memory of the misery you once used to feel all the time. You don’t freeze. You don’t panic. You say, ‘Hello unhappiness, my old friend. How are you?’

Then you smile, and you get on with your day. 

The other contributors are:

  • Elizabeth Day
  • Kerry Potter 🙂
  • Laura Powell

I particularly liked the last box:

It’s okay to embrace your darker side

Learning to cope with emotional states such as anger, envy and boredom can boost happiness, according to Dr Tim Lomas, psychologist and author of a new book, The Positive Power of Negative Emotions. He argues that allowing yourself to feel darker sensations boosts those feelings of joy and elation and can spark them too.

“Often people will think that if they feel pessimistic then something must be wrong with them and they shouldn’t be feeling like that, but negative feelings can send a useful message,” he says. “For example, if you feel lazy it might be more pleasurable to stay at home, but if you go for a run, in the long-term your wellbeing will be better served.”

Dr Lomas says the same is true for more complex emotions. “Take guilt: it can be unwarranted, but it also tells us important information about ourselves, ways we have gone wrong in the past, and make us be better people in the future.” Accepting negative emotions can make you more appreciative of positive experiences.

And in that spirit only Nirvana fits 😉

 

Watch what they do, not what they say

minimum-unit-pricingSo only a week ago I was so happy to watch and celebrate the success of the Scottish courts regarding minimum unit pricing with the caveat that the date by which an appeal could be launched had not yet passed so that I was holding my breath.  I was hopeful yet cynical that this was a success that would be honoured and hold – but no.  Today I read with dismay that sure enough the Scottish Whisky Association will be appealing the decision AGAIN 🙁

Over to Alcohol Policy UK’s coverage:

Further minimum pricing delay as SWA appeal again

The Scotch Whisky Association (SWA) have confirmed they will appeal the recent decision by the Scottish Courts that minimum unit pricing (MUP) was legal and proportionate. The appeal was announced on the final day of the deadline, ignoring calls from health groups and the Scottish Government for the industry to accept the decision.

The latest announcement brings renewed uncertainty over when MUP will be implemented, but arguably less so as to whether it eventually will be. A common interpretation amongst MUP supporters is all the opposing arguments have been addressed and as such the further appeal simply amounts to ‘delaying tactics’. The Scottish Government first passed legislation to implement MUP in 2012 but have been forced through various legal hurdles primarily as a result of opposition claims that it contravened EU law. However the European Court of Justice (ECJ) ruled it was for the Scottish Inner House of the Court of Session to decide on MUP who decided it was proportionate and justifiable on health grounds.

The decision on the grant of permission to appeal will be judged by the Inner House of the Court of Session who will decide if they are satisfied that the appeal ‘raises an arguable point of law of general public importance’. If they consider it does, the appeal will go to the UK Supreme Court for consideration. Perhaps more likely, the Inner House may deny permission and the SWA can then apply for permission directly to the Supreme Court who will also consider if the appeal stated raises an issue of ‘general public importance’. If they decide not, the case will be concluded and Scotland will have no legal bar to implementation.

Julie Hesketh-Laird, Scotch Whisky Association acting chief executive, said the decision came “after wide consultation with our member companies” but were appealing given their “strong view that minimum pricing is incompatible with EU law and likely to be ineffective”.

Alison Douglas of Alcohol Focus Scotland said the SWA was “ignoring both the will of the Scottish Parliament and the court’s decision”. She also said “SWA members like Diageo and Pernod Ricard continue to put their shareholders’ profits above the public interest” and were “borrowing from the tactics of the tobacco companies in delaying this live-saving measure”.

Eric Carlin, Director of Scottish Health Action on Alcohol Problems (SHAAP) said the SWA’s decision “beggars belief” adding:

“They know that they will not win this case in London. Everyone knows that. Meanwhile 22 people die every week. One can only assume that their accountants have calculated that delaying the implementation of MUP will prolong, albeit for a short period, their profit-making from cheap booze, which damages the poor most of all.”

The Daily Record also strongly criticised the decision, stating the SWA ‘are the puppets of the powerful international drinks industry and their concerns about the health of the country are unconvincing’ and that MUP ‘would not affect the image of the prestigious malt brands that the SWA purport to defend. But it would hit sales of the low-cost white spirits that the same companies produce and which fuel the chaotically bad health outcomes for Scotland.’

See also:

  • Scotch whisky body accused of arrogance over minimum pricing – The Guardian
  • SWA poised for one last round in MUP legal battle – Scottish Licensed Trade News
  • Whisky group takes fight over minimum alcohol pricing to Supreme Court – The Telegraph
  • Bid to appeal against minimum alcohol pricing to Supreme Court – The BBC
  • Scottish whisky industry to appeal minimum alcohol pricing in UK Supreme Court – Drink Business Review

Beggars belief indeed but sadly actions speak louder than words and yes the drinks industry shareholder profits appear to be more important than the health of the Scottish public …….

Edited to add: (source)

At least half of the alcohol sold in Scotland is below the sought 50 pence MUP, a survey suggests. More than two-thirds (69%) of the spirits currently sold fall below the 50p per unit threshold, according to analysts Nielsen – BBC news

The case for minimum alcohol pricing in Wales was published in a Wales Online essay by Professor Jonathan Shepherd. It claims a 50p per unit minimum price would save nearly £900m over 20 years by cutting crime and illness, with 50 fewer deaths a year. It highlights a three litre bottle of white cider, about same amount of alcohol as 22 shots  of vodka, are available in supermarkets for just £3.49.

 

Making a difference to the child of an alcoholic

nacoa-webWhile the battle about Minimum Unit Pricing rages on this for me is the most important progress being made.  As Liam Byrne promised the Government now wants to “put every child of an alcoholic drinker in contact with help that would make a difference.”

As the Institute of Alcohol Studies reported in September: the National Association for Children Of Alcoholics (NACOA) held their first All-Party Parliamentary Group (APPG) for Children of Alcoholics.

Who are NACOA?

Nacoa (The National Association for Children of Alcoholics) is a charity founded in 1990 to address the needs of children growing up in families where one or both parents suffer from alcoholism or a similar addictive problem. We provide a a free and confidential telephone and email helpline that is open to people of all ages, from all walks of life, to offer support and advice to anybody affected. Professionals or concerned others can contact us for information, advice and support. Soon, we will also host an online message board service, where users may record their thoughts and share experiences online. Nacoa aims to promote research into the problems children of alcohol dependent parents face and the prevention of alcoholism developing in this vulnerable group. It is exciting therefore to be connected with the Institute of Alcohol Studies (IAS) as part of the government’s new All-Party Parliamentary Group (APPG) on Children of Alcoholics, which wants to put every child of an alcoholic drinker in contact with help that would make a difference.

The problem?

As the IAS report Alcohol’s harm to others shows, prevalence of alcohol harm on others in the UK is high, and younger people are more likely to report having experienced a number of harms than older age groups. Research suggests that approximately 1 in 5 children in the UK are living in a household where one or both parents drink hazardously (Manning et al., 2009). Nacoa’s survey of over 4,000 respondents also found that those identifying as children of alcoholics, when compared to a control group, were six times more likely to witness domestic violence, five times more likely to develop an eating problem, three times more likely to consider suicide, and four times more likely to become dependent on alcohol themselves.

How do we help?

Since 1990, staff and volunteers have seen profound changes to the way that children of parents with alcohol problems are discussed in the public domain. As well as providing a national service, Nacoa aims to break down social taboos and afford young people the agency to address their problems rather than hiding away. While alcohol problems are often associated with deprivation, Nacoa also hears from young people suffering in families who, to the outside world, seem functional and successful. These individuals can feel stranded between maintaining the family secret and seeking help for themselves. In these cases, more often than not, young people fall between services and feel totally isolated. Nacoa’s helpline offers the opportunity to discuss problems confidentially with trained helpline counsellors and make plans for a better future. Our nationwide service delivers help to those suffering in silence to all corners of the UK. Through our campaigns with prominent patrons – such as Calum Best, Elle Macpherson and Liam Byrne MP – we aim to share stories, break down stigma, and let people know they are not alone.

NACOA and the All-Party Parliamentary Group on Children of Alcoholics

From September 2016, Nacoa is hoping to use its breadth of experience to influence major policy change in the UK through the All-Party Parliamentary Group on Children of Alcoholics. Since the APPG’s inception, Nacoa has worked hard to encourage people in the public eye to take part as well as facilitating case studies for press and media to change how parental alcoholism is addressed at a national level.

The Group’s first meeting took place on the 15th September at the House of Commons, and the committee heard evidence from IAS, Nacoa patrons – Calum Best, Lauren Booth and Nacoa supporter Kim Woodburn – as well as other charities and research specialists. Nacoa’s Chief Executive and co-founder, Hilary Henriques MBE, presented to the committee and argued that government could and should do more to provide vital lifelines direct to children who may feel scared to speak out and compelled to ‘keep the family secret’. While locally provisioned adult treatment services and support are in need of reform and further assistance, services also need to be provided directly to young people in their own right. On the ITV Good Morning sofa, Liam Byrne said that he hopes this parliamentary attention ‘sends a message out to the 1 in 5 children who are children of alcoholics that says this is not your fault, you are not alone, and there is help available to you, like the brilliant Nacoa helpline.’

Call for evidence

To provide evidence to the APPG from your personal or professional experience, visit: liambyrne.co.uk/coa/. Together, we will be able to reach out to the 2.6 million children living in the UK with a parent who drinks too much and let them know that they are not alone and Nacoa is here to help. Our helpline number is 0800 358 3456 and email is helpline@nacoa.org.uk. You can find further information and research on our website nacoa.org.uk. For regular updates please follow @NacoaUK and like us on Facebook.

This was picked up by The Mirror newspaper:

The Mirror reported shock as 2.6m British children with alcoholic parents are left with ‘no hope and no help from authorities’, as MP Liam Byrne seeks to raise the profile of the harm to children from parental alcohol abuse | Alcohol Policy, UK

This truly swells my heart that the Govt is now seeking to make a difference for this silent and truly vulnerable group.  Now we need to extend that support to include offering restorative therapeutic relationships for these young people 😉

Edited to add: a new resource to add to my list is the blog coa is a thing and this is just one of their many brilliant blog posts:

7 myths about alcoholism, through a child of an alcoholic’s eyes. 

Shoot the Damn Dog

shoot-the-damn-dogBack in June I blogged about the sad death of Sally Brampton and at the time added her book to my reading wish list.  ‘Shoot the damn dog‘ finally arrived from the library and oh my goodness what a beautiful book.  It should be mandatory reading for each and every one of us depressed, drinker or otherwise.

She was the most eloquent of writers and this book is poignant, honest, heartbreaking and brave.  She does for depression what we try to do out here about booze – tell our story in the hope that it helps someone else who recognises themselves in our words.  I saw myself in Sally’s experience and I could quote huge swathes of this book exclaiming ‘me too!’

I shall desist apart from to share brief excerpts as to why she wrote the book, her experience with booze and therapy.

So why am I writing this book?  I’m writing it because although I dislike the confessional, I was (and continue to be) so repulsed by the stigma around depression that I determined I must stand up and be counted, not hide away in shame. …… I wish I could say it was bravery that drove me to pin myself like a butterfly to the pages of a national newspaper, but it was actually anger.  I admit that my anger took me by surprise.  But then, so did depression.  I had never thought about its implications, or its consequences.  The more I inhabited it, the more I came to see the fear and shame surrounding it.  The more depressives I met, the more I came to understand  that we are not simply fighting an illness, but the attitudes that surround it.”  Replace the word depression with alcoholism and all of that could have been said by me, here.  I share her anger at how those of us who become alcohol dependent can at times feel stigmatised and ashamed.

I am drunk, I think, because I learned to use alcohol to try to crush my pain…… I learned that alcohol is the best anaesthetic in the world.  If I drank, I did not feel……. And I knew, in that part of my brain that was still robustly sane, that alcohol would not free me from the pain, except temporarily.  I knew that alcohol was a depressive, that I was taking an anti-depressive pill with one hand and a bottled depressive with the other.  And I also knew that I was trying to kill myself.  Alcoholism is a slow, ugly form of suicide.

As my shrink explained, ‘ You have to find your way into alcoholism which means drinking sufficient amounts to develop a dependency.  Why you do that is open to interpretation.  But once you have developed a dependency, you have an addiction not only to alcohol but also to a pattern of behaviour.  The only way out of addiction is to stop the substance abuse, and to learn new ways of behaviour.’  Shrinks call depressive drinking, ‘self-medication’.  I could stop for a day, a week or a month.  I could stop drinking for 3 months or even six.  Stopping is easy.  Staying stopped is overwhelmingly difficult if you are drinking to stop pain.”

Every addiction is a manifestation of emotional distress.  Nobody becomes an alcoholic or a binge eater because they love alcohol or food, they simply use excess alcohol or food to dull the pain that they are unable to express in words.  Most of this, of course, is unconscious.  If I am in emotional pain, my instinct is to take it away.  My way of doing that is to drink, as I have learned that it relieves (if only temporarily) my pain.  I have learned a disorderly habit of behaviour, that, once learned, is difficult to dismantle.  It is a condition, an emotional illness or a behavioural disorder.  It is, if you like, an inappropriate response to difficulty or pain.  It is the messenger, not the message.  Now that I am well again, perhaps I could drink again.  It is simply a risk that I am not prepared to take.

Yes to all of the above.

Looking at our own selves is horribly difficult to do, requiring a level of honesty and humility that can at times feel unbearable.  Few people are prepared to engage with it fully but without it, I truly believe that we cannot be happy…..  Therapy helped, but it is not magic.  It does not change our thoughts and behaviours.  It only teaches us what they might be.  It does not work unless we take from it what we have learned and put it into action.  So it is not, as so many people seem to think, a piece of indulgent navel gazing.  Nor is it about blaming the parents.  It is, I’d say, quite the opposite.  It is about understanding and accepting our parents.

There is a saying, ‘it’s never too late to have a happy childhood‘.  I’d rephrase that.  I’d say, it’s never too late to stop a difficult childhood from turning us into unhappy adults.  A difficult childhood may have set up a series of behaviours and responses that leads us to repeat those same patterns in our adult lives.  That does not mean that we have to continue those patterns.

I was given a birthday card with those exact words on during the first years of my recovery not just by one person but two – MrHOF and my sister.  The identical card by two different people, who are both very close to me and know me very well, on the same birthday!  It is on the wall above my desk …..

There is so much wisdom in this book I really do urge you to go read it in it’s entirety .

Sponsored blog post: Baclofen revisited

uk-rehabSo earlier this month I was approached by AddictionHelper (also known as UK Rehab as pictured to the left) about them providing some sponsored content and they suggested the subject of Baclofen.    I have written only one post about this medication that you can read here.  And then serendipitously someone in the UK who had recently used Baclofen successfully (and will be 1 year sober on 1st January 2017) left a comment on that  blog post and wanted to speak more about their experience.  So I put the two in touch and here is the result 🙂

Baclofen: A new remedy for alcoholism?

Baclofen is a medication used in the treatment of multiple sclerosis and spinal cord injuries. Over the last decade, however, it has been put to the test in different quarters as a treatment for alcoholism.

The increase in the frequency of baclofen usage can be attributed to the fact that it has shown a proclivity for reducing withdrawal symptoms in alcoholic individuals. Presently, baclofen is still used in the treatment of alcoholism in an “off-label” manner (use outside regulatory approved boundaries).  However, trials over the last decade, point to the possible removal of the “off-label” tag.

Related studies on baclofen and alcohol relationship

Many baclofen related studies have been completed in the past. One of such studies shows that only high doses of baclofen can lead to the desired indifference towards alcohol.  Another study highlighted the relationship between the amount of alcohol consumed before treatment and the right dosage required by patients to achieve desired results.

Bacloville is one of the main studies that have been done on the drug. The study was conducted at the Paris Descartes University and led by Philippe Jaury.  During the study, high doses of baclofen (average of 160mg per day), was administered to 320 volunteers aged 18-65 over a twelve-month period. 56.8% of the subjects on baclofen decreased their consumption to normal levels or became abstinent at the end of the period.  36.5% of subjects who were given placebos posted similar results.

The latest study at the Paul Brousse hospital, led by Michel Reynaud featured 320 subjects who were already abstinent for 20 weeks. They were given baclofen at 153mg per day. The results were less than stellar. Only 11.9% of subjects taking Baclofen remained alcohol-free while 10.5% of those on placebo did (Note from Lou: daily recommended maximum dose of Baclofen is 100mg within the UK).

While the evidence exists about the efficacy of baclofen in the treatment of alcoholism, addiction experts believe that it may not be a definitive solution for a while yet. Although clinical trials have been positive, more data is required to come to a conclusive agreement. Many, however, agree that baclofen has a higher chance of ensuring positive results in individuals that are more severely dependent on alcohol.

Side effects of baclofen

A study revealed that 88% of patients reported at least one undesirable side-effect as a result of baclofen usage. In some cases, the severity of the side-effects led to the cessation of baclofen-based treatment.

Some of the common side effects of baclofen include memory loss weight loss or gain, dysphoria, bowel disorder, sensory alterations, fatigue, sleepiness, insomnia, dizziness, nausea, paraesthesia, decrease or increase of libido, different forms of pain among other symptoms. There have been some documented cases of seizures and breathing problems as a more serious side effect.

The result of the baclofen-induced chemical alterations in the brain can equally lead to reduced efficacy of other vital medications in use by an individual.  Contraindications include psychological conditions, epilepsy, ulcers and heart-related ailments.

The dosage is decreased strategically, to combat the adverse effects of baclofen, over a two-week period with the aid of a qualified medical personal.

The effects of baclofen on alcoholism may be inconclusive, but past results make it a worthy option for alcoholics seeking remedy from their condition. However, baclofen based treatments for alcohol must only be administered by qualified professionals to avoid debilitating side effects that could prove fatal.

Personal Experience of Baclofen C Allan

I read about Baclofen and Olivier Ameison on the web-forum mywayout,org, an American based site covering most areas of alcoholism and the various methods of over coming this disease – I am not a “meeting” type of guy and indeed the thought of a meeting worried me as it would “interfere with my “drinking schedule” as every meet would be a driver away

Following a TIA in March 2015 – My Neurologist informed me that I had to make a considerable change to my personal circumstances, in particular my diet and my alcohol intake needed to improve – The results of the TIA are not noticeable externally, however there are occasions when my motor skills are confused, for instance I have to think before I can react to left and right handed commands (it is a bit like being spoken to in a foreign language and having to translate it first) and I also tend to type a lot of my words with letters the wrong way around – For instance I just wrote tpye instead of type

Having read many clinical trials papers following up on Ameison’s personal findings and the titration schedule as drawn up by French Physicians I started my initial titration on 20th December 2015 – On the 2nd January I stopped drinking, full stop, this was surprisingly easy, bearing in mind I had over the past 3+ decades consumed the equivalent to 180 units a week as I learned to pass out from the 220-250 a week unit intake I consumed at my peak – I put this solely down to Baclofen as I had tried (oh so) many times with self control – My Baclofen dosage at this time was 60mg a day. This dose was not sufficient to prevent my cravings so I continued titrating until I reached 180mg a day when my cravings ceased – As had the anxiety that I thought was a usual thing that on reflection had been the catalyst to my epic drinking history – It is moot as to whether or not Baclofen has reduced my anxiety or if the lack of alcohol has effected this – I suspect a little of both although without Baclofen, I could not have stopped drinking – Chicken and egg scenario

Anyway, I titrated up as per the French Physicians Guide (Translated by my friend David Harris), although I was not drinking against my will, I noticed a distinct lack of anxiety – I suffered this compulsively, some of the anxieties I had are on reflection, quite laughable now – At the time I did not realise that this was not normal – I thought everyone fet this way – I use an analogy to describe the feeling

It is like having a car, over the years the suspension becomes soft and saggy – You only notice how bad it has become when you replace the suspension – Because of the gradual effect of the loss of performance – My anxiety mirrored this

I was luck to make some good friends, mainly in the US, one in particular, who is IMO, a leading knowledge in Baclofen for AUD having correlated vast amounts of information and trial data over the years – He himself is an alcoholic, in remission thanks to Baclofen

I approached my GP in the early part of my titration and explained to her what my plan was – I had in the past I had heard some bad stories about GP’s reaction to non prescription medication, indeed one girl from Kent had been told to “find another GP” – My GP was terrific, she asked me to send her some information and as she could clearly see at that stage (BP and weight down) she even intimated she may even prescribe “off label” – So I took her up on her offer and sent her basically everything I could find on Baclofen 

I went back to see her four months later and she was pleased with what she saw (BP perfect and 5 stone shed) – She then prescribed me my maintenance dose of 150mg a day by prescription – It was not a financial issue, the prescription, it was the recognition by the medical profession that Baclofen has a place in alcoholism – The French, who do prescribe Baclofen for AUD are generally limited to 100mg a day with therapy – She was keen to prescribe Baclofen to her other patients – Currently I suggested this may not be a good idea for reasons I may elaborate on at another time when i have some more time

So today I am indifferent to alcohol, I can drink coffee while the others get drunk – I don’t currently need alcohol to make me someone different – 150mg a day, with a NHS prescription and the support of my GP – Cannot get much better than that.

Thank you to Mark from AddictionHelper (and Chris Allan) for this content.  I can’t advise on the use of Baclofen or the best rehabilitation for you, if that is what you need, so please do contact UK rehab who will be able to help.

 

Research highlights issue of alcohol in the criminal justice system

alcohol and criminal justice systemThis image comes from this report published in December 2013 which is not the focus of this blog post but certainly compliments it!  This post is about alcohol and the criminal justice system as detailed in a new research study from Teeside University.

Three quarters of people in the criminal justice system in the UK have a problem with alcohol, new research at Teesside University has found.

The study also found that those in the criminal justice system are almost 10 times more likely to be dependent on alcohol compared with the general population.

The research was led by Professor Newbury-Birch, Professor of Alcohol and Public Health Research in Teesside University’s Health and Social Care Institute.

Professor Newbury-Birch and her team carried out a systematic review of the literature to determine prevalence levels of alcohol in the various stages of the criminal justice system in the UK.

Figures showed that around three quarters of people in contact with the criminal justice system in the UK have a problem with alcohol – compared to around a quarter in the general population. This applies to those who have been arrested in police custody, those in the probation setting and those in the prison system.

And, over a third of people in the criminal justice system are dependent on alcohol compared to around 4% in the general population.

Those classified as having a problem with alcohol are people whose pattern of drinking increases the risk of either physical or psychological problems.

Dependency implies the person has a cluster of physiological, behavioural and cognitive patterns which conform to the ‘alcohol dependence syndrome’.

Professor Newbury-Birch, who has recently been nominated for the renowned Stockholm Criminology Prize for her work around alcohol, public health and knowledge exchange in the criminal justice system, said: ‘This study was the first of its kind to synthesise what we know about risky drinking in the criminal justice system in the UK. It shows that alcohol dependency and risky drinking are prevalent throughout all stages of the criminal justice system.’

The research found that up to 88% of adults in the police custody setting, 69% in the probation setting and 86% in the prison system are risky drinkers. Furthermore, using adults risky drinking limits, 64% of young people aged between 11 and 17 in the criminal justice system were risky drinkers. The study also found that up to 38% of people in the police custody setting, 33% in the probation setting and 43% in the prison system scored positive for dependency.

Professor Newbury-Birch added: ‘This work is so important to the field, it gives us the information we need to develop appropriate interventions in the criminal justice setting for those with alcohol problems.’

Professor Newbury-Birch and her team of researchers are also involved in a collaborative research project with Dr Aisha Holloway from the University of Edinburgh, examining a new approach to help male remand prisoners tackle drinking problems.

They will conduct in-depth interviews and surveys with male remand prisoners in a Scottish and English Prison to create an intervention to help reduce alcohol related crime.

Professor Newbury-Birch said: ‘In order to get appropriate interventions in place around alcohol we need to be working with practitioners and individuals involved in the criminal justice system – I am lucky to be involved with a group of dedicated researchers, practitioners and policy makers to take this work forward.’

Someone then asked these question of our politicians:

Alcoholic Drinks: Misuse

To ask the Secretary of State for Health, what recent assessment he has made of the level of alcohol dependency in the criminal justice system | They work for you, UK

Alcoholic Drinks: Misuse

To ask the Secretary of State for Health, what steps his Department is taking to develop (a) interventions for people with alcohol problems before they commit criminal offences and (b) support for people with alcohol problems within the criminal justice system; and if he will make an assessment of the implications for his policies of the findings of research by Professor Newbury-Birch of Teesside University, published in June 2016, on alcohol and the criminal justice system | They work for you, UK

MrHOF is a teacher in a prison and can personally attest regarding the lengths that his client group will go to create and distill illegal hooch – collecting up apple cores and other discarded fruit from bins to ferment a vile and dangerous brew.

Edited to add: And this arrived in my inbox today too!

Alcohol Concern call for attention on alcohol and youth offending

 

Student debt worries causing depression and alcohol dependency

common-peopleAs alcohol awareness week continues the focus here turns to what appears to be an increasingly common experience for students.   As the cost of higher education continues to rise increasing student debt load new research has found this is causing increasing levels of anxiety and depression which is being self-medicated with alcohol leading to further spiraling problems.

Over to the August coverage in The Independent:

Students who experience financial difficulties and worry about debt have a higher chance of suffering from depression and alcohol dependency, new research has found.

Conducted by the University of Southampton and Solent NHS Trust, the study showed symptoms of anxiety and alcoholism worsened over time for those who struggled to pay the bills, while those who were more stressed about graduate debt had higher levels of stress and depression. 

The study asked more than 400 undergraduate freshers from across the UK to assess a range of financial factors, including family affluence, recent financial difficulties, and attitudes towards their finances at four time points across their first year, allowing researchers to examine which came first: financial difficulties or poor mental health.

The study also found students who had considered not going to university or had considered abandoning their studies for financial reasons had a greater deterioration in mental health over time.

Leader of the study and visiting academic at Southampton University, Dr Thomas Richardson, described how the findings suggest “a vicious cycle” whereby anxiety and problem drinking “exacerbate financial difficulties,” which then go on to increase anxiety and alcohol intake. He said: “Interventions which tackle both difficulties at the same time are therefore most likely to be effective.”

One occupational therapy student told researchers how he had been forced to quit university because of depression and not being able to support himself financially. He said: “When I was not very well, I was not able to work part-time, so was unable to supplement my income during university. Having financial difficulties increased my day-to-day stress levels and something usually had to give – it was usually my academic studies. It was a vicious cycle.”

Students and the wider higher education community have already been speaking out and campaigning against the rising cost of university as tuition fees rise, maintenance grants are axed, and the Tories make a retrospective hike in student loan repayments.

According to the Sutton Trust, English graduates are leaving university with substantially higher levels of debt than those from any other English-speaking nation. 

Dr Richardson, who has been conducting staff training at English universities on debt and mental health, acknowledged how starting university can be “a stressful and daunting time” for young people where finances can cause worry. He said: “We might not be able to change how much debt students are in, but we can work with them to help them  manage their finances and worries about money in order to mitigate the impact of these worries on mental health.”

Elaine Hindal, chief executive of Drinkaware, the alcohol education charity, acknowledged how alcohol can have a temporary, positive impact on mood, but warned: “Regular, excessive drinking can have long-term implications for students’ mental health.”

She continued: “Alcohol is a depressant and can disrupt the delicate balance of chemicals that affect mood. This can lead to increased anxiety and stress, and even depression.”

The rise in mental health issues among students is a growing problem in the UK and has been widely-reported in recent months. According to a report put together for the vice-chancellor of York University in May, comparing 2014 to 2015, 80 per cent of UK universities highlighted a noticeable increase in complex mental health crises among their student population.

According to ambulance call-out figures – from 1 January to 8 February 2016 alone – from the 24 emergency call-outs the university received, half were for self-harm or suicide attempts. Last year, 43 out of 134 emergency call-outs were for self-harm or suicide attempts.

A staggering 63 per cent of students also told specialist student loan lender, Future Finance, they are worrying about their finances all the time or very often, something which is set to increase with the rise of tuition fees.

Shortly after this survey, figures from the ONS revealed the number of student suicides across England and Wales to have soared to their highest level since 2007; there were 130 suicides among both nations’ full-time students aged 18 and over in 2014, with the number considerably higher among men (97). In In 2007, there were 75 suicides.

Ulster University’s Professor Siobhan O’Neill described to a wellbeing conference in June that student life today is “fraught with loneliness and anxiety,” as she addressed the issues of self-harm, alcohol, and suicide, presenting, for the first time, findings from a study of 355 suicides in young people aged under 25 years in Northern Ireland.

She told the conference young people who die by suicide are “somewhat different” from the older age groups, and explained: “Over half will have had a prior attempt; around 64 per cent of the males will have used alcohol at the time of death, and a third of females who die by suicide in this group are students.”

Student finance site Save the Student also recently revealed how students are being “short-changed” by the UK finance system as they scramble to find an extra £3,000 a year amid soaring living costs, something which is driving desperate students to gamble and sell used underwear and laughing gas in order to make ends meet.

If you’re a student and feel you need help or support while at university, contact your university’s student services or students’ union advice service. You can also find out more about mental health support at Student Minds and Drinkaware

 

Korsakoff’s syndrome treatment model (DDN feature)

korsakoff-syndromeToday I’m re-sharing from Alcohol Policy UK their feature post on Korsakoff syndrome (or Wernicke-Korsakoff syndrome).

This month’s Drink and Drugs News (DDN) includes a feature article exploring a new model helping Korsakoff’s syndrome sufferers back to community living. The article states:

Korsakoff’s syndrome belongs in a spectrum of disorders categorised as alcohol-related brain damage (ARBD). It is a severe memory disorder associated with excessive, long-term alcohol misuse, and results in the loss of specific brain functions due to the lack of vitamin B1 or thiamine. Post-mortem studies suggest that Korsakoff’s occurs in about 2 per cent of the population and 12.5 per cent of dependent drinkers.

However owing to limited resources and low level recognition of ARBDs, specialised service provision is particularly limited. The Arbennig Unit – part of Queen’s Court Residential Service in Conwy and run by care provider Potens – was set up in 2002 to support younger adults with alcohol-acquired brain injuries. The service aims to provide a people with Korsakoff’s opportunities for choice and independence, with the Arbennig clinical support model based on the idea that rehabilitation should aim towards a structured, alcohol-free life.

The feature says Korsakoff’s sufferers often have a chaotic lifestyle with little, if any, of the social support networks that many people take for granted. In response the Potens’ support model looks at involvement of key professionals, but does not underestimate the importance of family and friends. Korsakoff’s sufferers health has also often also been compromised by poor diet and underlying mental health issues can become more pronounced after a period of abstinence. 

However Glenn Barnett says Korsakoff patients are capable of new learning, particularly if they live in a calm and well structured environment and if new information is cued. Read the full article including case study here.

Specialised ARBD services: a rare find?

What with shrinking drug and alcohol treatment budgets, increased scope for specialist services is unlikely. Indeed a 2014 report by a collection of medical bodies called for clinical commissioning groups to support services that provide specialist care for patients with alcohol-related brain damage. It identified the scope for provision within four specialist contexts: alcohol treatment services, prisons, acute hospitals and pregnancy/fetal alcohol spectrum disorder (FASD).

In 2014 Alcohol Concern Wales also released a report warning ARBD is poorly understood by the public and many healthcare professionals, emphasising the need for early identification and treatment. Further training and clear care pathways for the diagnosis and treatment of ARBD were also recommended. However in the current context of growing populations and shrinking resources, specialist ARBD responses are likely to remain the exception rather than the rule.

I nursed many patients with this disease on the ward and even now in the community we are involved in the care of those with Korsakoff, known more colloquially as alcoholic dementia, where they sadly invariably end up on residential dementia units.

Judge rejects appeal against plans to introduce alcohol minimum unit pricing

one-thousandSo this post is a double celebration.  One major victory and one minor achievement 🙂  The major victory is by the Scottish law courts and their battle with the Scottish Whisky Association regarding the implementation of minimum unit pricing.  Those of you who have read this blog for a while will know that I have been banging the minimum unit pricing drum at every given opportunity and you can read all my posts here on the subject.  I am so pleased and proud of the Scottish for not giving up on this and putting the public health of their nation above the profits of the drinks industry which is as present in Scotland as anywhere else.  That said the industry have 28 days to appeal from the ruling on the 21st October which expires in two days time.  This may not be over just yet!

Over to the Scottish Herald who shared the good news:

Judges at Scotland’s highest civil court have rejected an appeal against plans to bring in minimum pricing for alcohol.

The Court of Session in Edinburgh refused the case, which had been brought by the Scotch Whisky Association (SWA) and others, saying that “the grounds submitted in the appeal were not well founded”.

They made their final ruling after considering whether the infringement of European trade laws that minimum pricing would bring are justified by the benefits to public health – and if this could be achieved by any other means.

MSPs passed legislation at Holyrood in 2012 to bring in minimum pricing, which would initially be set at 50p per unit.

But implementation of the policy stalled after the SWA and other European wine and spirits producers took legal action, arguing minimum pricing would breach European law.

The ruling has been welcomed by groups including Scottish Health Action on Alcohol Problems (SHAAP).

Dr Peter Rice, SHAAP Chair, said: “As the heaviest drinkers in Scotland have switched from drinking in pubs to drinking at home, and from whisky and beer to vodka and strong cider, doctors and health professionals have seen the impact on our patients.

“We are satisfied that the Scottish courts have concluded that MUP is legal, as we have argued for many years, and we now call for it to be implemented without delay.

“During the years when the SWA and its backers have prevented implementation, front line staff have seen hundreds of deaths and thousands of lives damaged. Much of this harm would have been avoided if MUP had been in place.

“We now call for the SWA to step aside and allow this life saving measure to go ahead.”

Alison Douglas Chief Executive of Alcohol Focus Scotland said: “This is a great day for Scotland’s health! Minimum pricing is widely supported by doctors, social workers, children’s charities and many more who want to get rid of the cheap vodkas and super-strength ciders that cause so much damage.

“Scotland has been waiting more than four years to implement this policy which will prevent thousands of hospital admissions and crimes, and save hundreds of lives. We hope that minimum pricing will now be put in place as quickly as possible so we can start seeing the benefits.”

The judges said the previous Court of Session ruling “correctly concluded that whatever arguments may be deployed against it, there was evidence which demonstrated that the alternative of increased tax, with or without a prohibition on below cost sales, would be less effective than minimum pricing”.

SWA chief executive David Frost said the organisation will now consult with its members before deciding on any further action, which could see the case taken to the UK Supreme Court.

Holyrood’s Public Health Minister Aileen Campbell hailed the “landmark” verdict from the Court of Session.

She said: “I am delighted that the highest court in Scotland has reinforced the initial judgment in our favour from 2013. This follows the opinion of the European Court of Justice, which ruled that it was for our domestic courts to make a final judgment on the scheme.

“The Scotch Whisky Association represents some of Scotland’s finest whisky brands, and while they were entitled to raise this action, they and the wider drinks industry must now respect the democratic will of the Scottish Parliament and the ruling of the Court of Session and enable this life-saving measure to be introduced.

“This policy was passed by the Scottish Parliament unopposed more than four years ago.

“In that time, the democratic will of our national Parliament has been thwarted by this ongoing legal challenge, while many people in Scotland have continued to die from the effects of alcohol misuse.

“Today’s ruling is a landmark one, and should mark the end of the legal process, allowing this important policy to finally be brought forward.”

The Scottish Government has consistently argued minimum pricing is the “most effective mechanism” for tackling alcohol misuse and reducing the harm it can cause.

But the SWA claimed it would be ineffective in its aims, penalise responsible drinkers and was beyond the powers of Holyrood.

Judge Lord Doherty initially rejected the challenge at the Court of Session in 2013 but it was referred to the European Court of Justice (ECJ) in Luxembourg the following year.

Last December, an ECJ ruling said the plan would breach European Union law if alternative tax measures could be introduced.

The court concluded a tax rise on alcoholic drinks ”is liable to be less restrictive of trade” than minimum pricing.

The ECJ said it would be for the Court of Session to make a final decision after determining whether any alternative measure could equal the stated public health benefit while being less restrictive of trade.

Mr Frost said: “We regret the Court of Session’s ruling in favour of the Scottish Government on minimum unit pricing (MUP).

“We continue to believe that MUP is a restriction on trade and that there are more effective ways of tackling alcohol misuse.

“However, we of course remain committed to working with all partners to address this problem so that the long-term trend of declining alcohol-related harm in Scotland continues.

“We will study the details of the judgement and consult our members before deciding on next steps, including any possible appeal to the UK Supreme Court.”

The opinion, delivered by Lord President Lord Carloway, said the “targeted objective” of the MUP policy is “the consumption of cheap alcohol by those whose health is most likely to be adversely affected by it”.

It said: “In practical terms, the measure achieves the targeted objective by setting a floor price below which alcohol cannot be sold. Alcohol will not be sold for less than 50p per unit. Those who currently consume cheap alcohol at a harmful and hazardous level will not be able to switch to another product to maintain their consumption levels.

“The true area for debate is whether modification of taxation, within the permissible bounds of EU law, can achieve similar results in targeting cheap alcohol as is undoubtedly achievable with minimum pricing.

“Here, of course, the elephant in the room is the fact that the Scottish Government has no power to raise taxation on alcohol. That is a matter reserved to the United Kingdom Government.

“Conversely, the UK Government has little responsibility for the health of the inhabitants of Scotland; that being a devolved matter.”

It also said a “fundamental problem with an increase in tax is simply that it does not produce a minimum price”, adding that supermarkets have in the past “absorbed any tax increases by off-setting them against the price of other products unrelated to alcohol”.

Increasing tax could also have “a disproportionate, undesirable and unnecessary effect on moderate drinkers, who do not generally represent a significant problem in societal terms”, according to the ruling.

It added: “It is reasonable to conclude that alternative measures, including increases in taxation, are not capable of protecting life and health as effectively as minimum pricing, while being less restrictive of trade.”

First Minister Nicola Sturgeon, who took minimum pricing legislation through Holyrood when she served as health secretary, said she is “delighted” the policy has been upheld by the Court of Session.

She tweeted: “Minimum pricing is a vital public health measure with strong support from those who work in frontline of alcohol misuse. It will save lives.”

The ruling was also welcomed by academics at Sheffield University who carried out research for the Scottish Government on the likely impact of minimum pricing.

Professor Petra Meier, director of the Sheffield Alcohol Research Group, said: “Our analyses of minimum unit pricing have consistently shown that the policy is an effective and well-targeted approach to reducing the harm caused by alcohol.

“Increasing alcohol taxation is also an effective approach but large tax increases would be required to achieve the same effects as a 50p minimum unit price. This is because minimum unit pricing targets the high-strength and low-cost alcohol which is disproportionately purchased by heavier drinkers.”

Scottish Conservative health spokesman Donald Cameron said Tories had backed the policy “on the condition it would be legally sound and could be dropped if found not to be working”.

He added: “It’s taken the SNP a considerable length of time to get to this stage. But now it’s happened, we need to monitor the results closely to see what impact it has on Scotland’s damaging and complex relationship with alcohol.”

Scottish Green Party health spokeswoman Alison Johnstone said: “The big drinks firms stalling this sensible piece of public health legislation are copying the historic behaviour of the tobacco industry.

“Let’s hope the Scotch Whisky Association gets the message and allows the Scottish Government to get on and implement this urgent public health priority.”

Hear hear!!

Research conducted by experts from the Sheffield Alcohol Research Group (SARG)1 at the University of Sheffield have been influential in providing evidence to inform policy which now paves the way for the Scottish government to implement the new plan, passed by MSPs in 2012 (source)

And further coverage from Alcohol Policy UK:

Scottish Courts approve minimum pricing – but further delay still possible

The second more minor achievement is that yesterday was my 1000th blog post.  I would not still be here without you so I now owe you 1001th thanks! 😉