Monthly Archives: February 2017

NICE focuses on improving treatment and diagnosis of liver disease

I have to thank the lovely Prim for forwarding this link to me about NICE and new draft guidance on treatment and diagnosis of liver disease (cue obligatory pictures of liver disease!)

Here’s the NICE report:

People who drink too much should be sent for scans to detect early liver disease, says NICE

Almost 1.9 million harmful drinkers in England could be sent for scans for cirrhosis by their GPs to detect disease early so treatment and lifestyle changes are more effective.

A draft quality standard out for consultation advises GPs to send people for scans for cirrhosis if men are drinking more than 50 units per week or 22 pints and women are drinking more than 35 units per week or 3 ½ bottles of wine.

Access to the two recommended tests, transient elastography and acoustic radiation force impulse imaging is currently varied across England, whilst the first is available in at least 120 UK hospitals, the latter is a newer technology that is not as widespread.

Dr Andrew Fowell, consultant hepatologist at Portsmouth Hospitals NHS Trust and specialist committee member, said: “Identifying people who are at risk of liver disease and offering them non-invasive testing to diagnose cirrhosis is key to ensuring they are given the treatment and support they need early enough to prevent serious complications.”

“Ten years ago diagnosis of cirrhosis would often require a liver biopsy, but now with advances in non-invasive testing it is much easier for patients and health professionals to make a diagnosis.”

Draft guidance also calls for all those diagnosed with non-alcoholic fatty liver disease to be regularly tested for advanced liver fibrosis – so they can manage their condition and prevent it developing into cirrhosis.

Professor Gillian Leng, deputy chief executive of NICE, said: “Many people with liver disease do not show symptoms until it is too late.

“If it is tackled at an early stage, simple lifestyle changes or treatments can be enough for the liver to recover. Early diagnosis is vital, as is action to both prevent and halt the damage that drinking too much alcohol can do.

“This draft quality standard makes a number of important suggestions to improve care for those with liver disease from offering advice to less invasive testing.

NICE is calling for all adults and young people with cirrhosis to go for ultrasound scans every 6 months for hepatocellular carcinoma, in a bid to improve earlier diagnosis.

The draft quality standard also supports improvements in treatment to prevent vein bleeds in some adults and young people with cirrhosis. An estimated 2,687 people could be eligible for treatment each year.

Liver disease is the fifth largest cause of death in England and Wales. It is estimated over 4,000 people die from cirrhosis every year and 700 will need a transplant.

Consultation on the draft quality standard for liver disease is open until 2 February 2017.

I look forward to the new guidelines being published and if you are wanting to find out about liver scans prior to this please go to this blog post.

A retrospective on 2016 (Friday sober jukebox: some riot)

So as I have pared down my blog activity and news sources the one I repeatedly return to is Alcohol Policy UK.  They wrote an excellent retrospective piece about 2016 which you can read here:

 

Alcohol policy in 2016 & what’s in store for 2017?

But what really struck me about this blog were the images featured at the end entitled: Selected alcohol slides from the ‘most interesting things about drugs and alcohol in 2016’ from Andrew Brown:

The top image was the first which highlighted how over half (54%) of strong ciders sold in the off-trade in England and Wales in 2015 were sold at below 20p a unit  <pauses to let that sink in for a minute>  so for less than the cost of a pint of milk! 🙁

Below I share the other three because visual images can be so much more impactful than words.  They all tell a compelling story which as yet is not being addressed by our govt sufficiently to change the trajectory of the graphs.

Association between the experience of physical and sexual abuse in the lives of women and dependence to drugs and alcohol …..

 

 

The number of offences committed pre and post treatment for alcohol use disorders ……

 

 

 

Graphic confirmation that those with the most problems with alcohol are more likely to use the NHS …..

 

 

 

I’ll finish with a haunting performance from Elbow and the BBC Concert Orchestra of Guy Garvey’s ode to a friend lost to alcohol addiction  – some riot.

The impact of alcohol is all too plain to see and hear to those who have eyes and ears.  Shame our govt is looking the other way with its collective fingers in its ears (except perhaps Liam Byrne) …..

PS Yesterday was day 1250!

Risky Drinking

So this premiered on HBO in the US in December 2016.  Luckily for us the documentary Risky Drinking has now appeared on Youtube so we can watch it too 🙂

Here’s a synopsis/review from Esquire:

To qualify as a risky drinker, a woman has to drink more than three drinks in one day, or more than seven drinks in a week. A man must have more than four drinks in one day, or more than 14 in a week. The risk itself from breaching these limits isn’t simply defined; it ranges from increased risk of violence, accidents, and self-injury to increased risk of sexual assault. It means an increased risk that something will happen that will irreversibly change someone’s life.

Or, as the new documentary Risky Drinking from HBO and the National Institute of Alcohol Abuse and Alcoholism shows, risky drinking could have already changed someone’s life. Now, the risk is that their life will spiral completely out of control.

The documentary follows four individuals, each on the spectrum for at-risk drinking, and each on the verge of toppling further into their dependencies. Kenzie is a young professional who parties on weekends; most binge drinkers are in her age group, 18 to 34. She downs shots and dissolves into tears each night out. “We haven’t gotten raped or murdered yet,” says her friend. Then there’s Mike, who is on the verge of domestic violence with his wife, and Noel, whose dependency affects her two daughters. The last is Neal, a grandfather so dependent on alcohol that he thinks he’s going to die (and who violently shakes when off the drink).

Risky Drinking doesn’t finish their stories. All we know is that each tries to get help, whether from medication, support groups, or moderation management, which is a treatment plan that doesn’t require total abstinence. Whether they are successful—whether they can get out of range of “alcohol use disorder,” which makes up one third of the drinking spectrum—is left unanswered. It’s a frustratingly open ending. But then, frustration is what you feel as you watch Kenzie, Mike, Noel, and Neal drink themselves stupid.

As the documentary points out, 70 percent of Americans drink alcohol. It’s worth knowing the risks, even if most Americans aren’t at the disorder stage—at least not yet. Risky Drinking assumes you already know this. It’s just showing you what risky drinking itself looks like for real people, if you care to watch.

Here’s the trailer:

And if you want to watch the full documentary film go here:

http://www.hbo.com/documentaries/risky-drinking

Or here: https://youtu.be/4hKmYthx718

Interestingly in looking for the new link for you to watch I came across this panel interview with the experts featured and this is what they had to say:

“Alcohol is a bigger cost on society than all the rest of the drugs combined.” – George Koob, Ph.D.

“It’s the worst drug of all and it’s hidden in plain sight. – Stephen Ross, M.D.

“People don’t drink because they’re crazy; they drink because it works in some way.” – Carrie Wilkens, Ph.D.

“We do have a large epidemiological study in the field now that is looking at rates of fetal alcohol spectrum disorder and we’re hopeful, but the early evidence is concerning.” – Deidra Roach, M.D.

Here’s the panel discussion in full:

Improve services to address addiction related unemployment (this is not a love song)

So maybe not the sexiest post-Valentine subject matter but important none the less – and an excuse to feature a Banksy which is always a bonus! 😉  This was a report on service provision to address addiction related unemployment featured by Alcohol Policy UK in December.

Over to Alcohol Policy UK:

Dame Carol Black’s review into the effects on employment outcomes of drug or alcohol addiction and obesity has been released by the Department for Work and Pensions.

The review sets out a series of recommendations to improve options and support for those with drug and alcohol dependence, and does not endorse restricting benefits as was speculated in 2015.

Whilst the scope of the report covers also the role of obesity on employment outcomes, it states the issue is ‘different’ to substance addiction and ‘is treated seperately’. Specifically on alcohol, the report states:

‘Alcohol misuse may also be a cause or a consequence of unemployment. It is certainly a predictor both of unemployment and of future job loss, but evidence also suggests that increased alcohol consumption may follow job loss. Unlike dependence on heroin and crack cocaine, alcohol dependence is not strongly associated with lower socioeconomic status although the resultant health harms are. Nevertheless, the employment rate for those who develop problematic dependence is less than half that of the rest of the population’.

Overall the review describes the importance of employment in supporting addiction ‘recovery’, but neither drug and alcohol or job support services are sufficiently meeting the needs of service users. As such it recommends ‘practical interventions, including changes in services, practices, behaviour and attitudes.’

Three main areas where action is needed in relation to drugs, alcohol and employment are identified:

  • Addiction treatment does not, in itself, ensure employment, though it brings other social gains. Work has not hitherto been an integral part of treatment, and it needs to be if progress is to be made.
  • The benefits system, which has a central role in helping people enter or return to work, requires significant change. The system is hampered by a severe lack of information on health conditions, poor incentives for staff to tackle difficult or long-term cases, and a patchy offer of support for those who are reached.
  • Employers are the gatekeepers to employment and, without their co-operation employment for our cohorts is impossible. Employers are understandably reluctant to hire people with addiction and/or criminal records. They have told us that they need Government, quite simply, to de-risk these recruitment decisions for them.

Specific challenges are also identified, including ‘fractured commissioning responsibilities and lines of accountability’ that undermine efforts to develop co-ordinated responses. Whilst recognising low waiting times for alcohol treatment, stakeholders reported that alcohol services were ‘still inadequate to meet need in a number of areas’. The Government’s 2010 Drug Strategy, which listed a series of recovery-focused aims, ‘has yet to be realised’, in part owing to the ‘failure of the benefits systems to identify addiction (and indeed other relevant health conditions)’.

A series of recommendations include ‘the introduction of an expanded recovery measure that includes work and meaningful activity (including volunteering)’ as part of the outcomes monitoring for drug and alcohol treatment. It also proposes to trial discussions with a healthcare professional for welfare claimants to discuss ‘the impact of their health condition on their ability to work’. Initiatives to support employers in actively recruiting those in recovery will need to ‘de-risk’ companies from doing so, as explored in an FT blog.

David Best, Professor of Criminology, commented:

“How to read policy reviews? It correctly identifies a gap in supporting the employment needs of alcohol and drug users in employment, and also identifies two key issues – DBS checks and the ‘benefit trap’. The Black Review correctly identifies gaps in provision and joined up working and makes some interesting suggestions around including employment and volunteering in outcome measurement; suggests the use of peer mentors; and has some interesting ideas about collocating workers. But it all feels a bit tame and safe. There is no real drivers for the inter-agency working and pathway modelling that would be required of each workforce and the idea of partnership seems optimistic. There is also little adequate differentiation of the needs of problem drinkers who will typically have a different work history from problem drug users. Individual examples of good practice and innovation are all very well but what is lacking in the review is suggested mechanisms for making these more than beacons of hope in the darkness. So the review is encouraging in as far as it goes… but that is not very far”

A Collective Voice post said the report was a ‘real opportunity for the alcohol and drug treatment sector which we must seize’. According to LocalGov, the Local Government Association (LGA) welcomed the report but warned it was not ‘radical’ enough. See also reports in the Telegraph and Guardian.

Earlier this year the BMA released an updated briefing for medical and other professionals on addressing alcohol and drug use in the workplace, including guidance on supporting or recruiting employees with histories of substance misuse.

Agree with all of the above and know that Focus12 is supportive of these recommendations both in theory and in practice – says she who was a volunteer for them to help my own recovery 🙂

It feels only right to follow this blog up with this sober jukebox tune 😉

Manifesto for Children of Alcoholics – Launched Today

Another email from Liam Byrne today launching the children of alcoholics – manifesto for change yesterday, so on Valentine’s Day no less ….

Dear Friend

Today the All-Party Group launches the first ever manifesto for children of alcoholics.

Thank you for all your help in putting this together!

The hard-hitting manifesto, published to coincide with International Children of Alcoholics Week, sets out a 10-point plan to help Britain’s 2.6 million innocent victims of drink – the children of hard-drinking parents.

It is co-written by children of alcoholics, policy makers and experts from charities, interest groups and medicine.

You can read it here:

Children of Alcoholics – A Manifesto for Change
 
I’ve also launched a petition calling on the Government to back the manifesto. Please consider adding your signature and sharing with your friends and family.

(Click on the image below to access the petition)

I welcome any feedback

Very best


Liam Byrne MP

I’ve signed the petition and hope you will too 🙂

Edited to add: picked up by The Guardian too!

MPs and peers launch manifesto in support of children of alcoholic parents

Group behind initiative reveal feelings of shame and fear of own childhoods and call on ministers to tackle UK’s ‘secret scandal’

A third Labour MP has spoken of the “secrecy, shame and fear” of living with an alcoholic parent, as she urged more government action to help the children of people with alcohol problems.

Byrne, whose late father, Dermot, had alcohol problem, said the issue was “the biggest, dirtiest secret in Britain”, adding: “The challenge for the children of alcoholics is they fall through the cracks.

“They are on the cusp of these three different systems. Their parents are covered by the adult social care system, they themselves are covered by the children’s social care system, then there is the public health system.”

The manifesto was produced by the all-party parliamentary group on children of alcoholics, supported by the archbishop of Canterbury. It found an absence of strategies to deal with the issue and a lack of funding in many areas.

It also issued 10 demands for government action, including better education for children and professionals, better support or families and action on availability and promotion of alcohol.

Edited to add: 5/5/17

Health Minister Nicola Blackwood has written to Duncan Selbie, chief executive of Public Health England, confirming that the children of alcoholics would become a key priority for the year 2017/2018, reported the Express. The Government’s “Best start in life” programme will “support the development of a strategy to address the needs of children living with alcohol dependent parents.”

Guest Post: How Self-Forgiveness Allows Me to Let Go of My Perfectionism

What better day is there to feature a guest blog post about perfectionism? 🙂

I wasn’t really aware of it but for most of my life I had this mentality that if I couldn’t do something perfectly I just wouldn’t do it all. This meant that sometimes I would perform to my optimal ability and the results would be great, but more often than not it meant that I just didn’t do whatever it was I was supposed to do, or planned to do. I would be afraid that I wasn’t going to be perfect and so rather then prove that this was true, I would just avoid trying new things and avoid possibly failing. I would never talk to another person the way that I talked to myself. The horrible things that I used to say to myself would have left most people in tears and broken.  One of the hardest things I have had to learn again was to myself in a different matter.  I have learned a lot about the power of positive self-talk and the role that plays in self-forgiveness.

It is strange because I have found that many addicts and alcoholics express this same issue and for a people who are known to consistently screw things up during their active addiction, having a perfectionist mindset almost sounds counterintuitive. It is one of those dichotomies of addiction that you have to experience to understand and for many alcoholics and addicts, myself include, the want for perfection actually causes them to stay sick for a long time.

I know that it did for me because I would always put so much pressure on myself to be perfect that I would enviably buckle under that pressure and grab for a bottle or a pill. I just couldn’t live up to my own expectations and because of this I often times failed at what I was doing before I even set out to try it. It really was a miserable way to live and I would try to justify why I didn’t do something or why I failed at something by saying, “If I had really tried it would have been different” or “I didn’t do this or that because I didn’t want to” but the reality is I was just scared to not be perfect because of what that meant to me.

Not being perfect was a big deal to me because I at some point in my life made the agreement with myself that all love was contingent on performance. This means that I believed that people would only love me if I was good enough or I performed well enough and that as soon as I fell below the threshold of perfectionism that I had set out to achieve they would abandon me. I couldn’t fathom that people loved me for who I was and this is because I hated myself and so therefore I assumed that everyone else did as well.

I believed that if I only achieved this or did this, then I would be good enough for myself and in turn be good enough for people to love. As you can probably already tell this sort of thinking didn’t really work out for me and while I would feel accomplished for fleeting periods of time, achieving “perfection” never really brought about the feelings that I wanted. I was always left feeling like I was lacking something and after the self-congratulation ended I was left with my underlying self-rejection and feelings of being unlovable.

When I got sober I had to face a lot of this. I had to face the fact that I was human and let me tell you that was probably the most difficult things for me to do. I had to come to terms with the fact that I wasn’t a superwoman and crazy as it sounds, I had to forgive myself for this. I actually had to forgive myself for not being perfect. Finally let myself off the hook, so that I could be comfortable in my own skin. Finally be comfortable with the fact that I, of myself, was enough and that love is not predicated on how well I performed that day.

The thing that really allowed this to happen was coming to understand that God loved me regardless of how I acted. That infinite power that loves me wasn’t sitting around somewhere with a book saying, “I’ll give Rose 30% love today because she’s only acted 30% good.” That’s insane and when I came to realize that God loved me no matter what and that God had forgiven me for all of my transgressions already, I began to see that I had to forgive myself as well.

This way of thinking completely changed my life and it opened the door for me to just relax and do the best that I could. I didn’t need to be perfect anymore. I could fail. I could try new things and I could admit that I didn’t know how to do something. Imagine that. Perfect me admitting that I didn’t have all of the answers. It was really very freeing and in doing so I actually found, paradoxically, that my performance got better. By not holding myself to an impossible standard I was able to do better at work. I was able to do better within my family. And I was able to do better as a friend because I wasn’t so rigid in my belief that everything had to be a particular way or it was a failure.

Don’t get me wrong, there are still sometimes today when I believe that I have to be perfect or everyone will leave me, and I’ll be a completely alone failure, but for the most part I have learned to love myself to the degree where I can see the fallacy in this thinking. I have more of a desire to be myself, with all of the failings and successes, then to be an automaton robot who goes around pretending to be perfect all of the time. It isn’t always easy to set aside my pre-programmed want for perfection, but with each passing day, I get better at it. I get more comfortable in my skin and I learn to forgive myself, and others, more and more.

Rose Lockinger is a passionate member of the recovery community. A rebel who found her cause, she uses blogging and social media to raise the awareness about the disease of addiction. She has visited all over North and South America. Single mom to two beautiful children she has learned parenting is without a doubt the most rewarding job in the world. Currently the Outreach Director at Stodzy Internet Marketing.

You can find her on LinkedIn, Facebook, & Instagram

Friday Sober Jukebox: Right Here Right Now

So I’ve been reflecting a great deal in the last few weeks.  It’s been triggered by changes in events, seeing T2 Trainspotting and a trip to my old spiritual home Brighton.  I’ve been struggling to stay in the present – right here and now and so I’m getting it down on paper.  Just like Spud in T2 to me writing is a vital addiction recovery tool.

This image is of a friend of ours who is no longer with us.  We met Mark as I worked with his partner in medical sales and marketing while living in the city.  He was a great guy who was heavily involved in the music and art scene in Brighton and we last saw him at a 40th bday party for a mutual friend of ours back in 2007.  This graffiti art was sprayed in the North Laine to commemorate Mark who took his own life in 2013.  He had long struggled with depression and it finally won in March of that year – he had not long celebrated his 51st birthday.  This was the first time we’d been back and seen this fitting memorial and it really hit me hard.

What triggered the trip to Brighton was that our plan to emigrate to Australia hasn’t been going as well as we hoped.  Although I have a valued skill which has been welcomed my age is counting against me in the visa process and our family out there have had happy family news here and may be returning later this year.  If that happens our Australia plan may well be sadly no longer viable.  So we were thinking about where else we might like to live – and we’ve missed Brighton since we left and hence the visit.

This scene from T2 and what Renton said has really stayed with me, particularly his last words about getting away.

I interpreted that as him getting away from Edinburgh but actually I think he also may have meant getting away from himself.  And that has got me really thinking about whether, in AA wisdom, I am trying to do a ‘geographic’.

Let me explain.  Stopping drinking was hugely motivated by giving my kids a better childhood, and therefore future, than I had.  I assumed that this meant giving myself the headspace to make better decisions for them including about where we work and live.  But actually when I think about it really deeply where we are has nothing to do with that.

My childhood was less than ideal because I had a father whose primary concern was alcohol and a mother who was at best emotionally unavailable (because of her own self pre-occupation) and at worst emotionally hostile.  Having more emotionally stable, present and available parents would have ensured a better future for me rather than where we lived as children.

Drinking kept me in that same emotionally unavailable place.  Us not drinking has already improved my kids future in terms of how it compares to both my parents way of relating to me in my childhood.  Plus I recently realised that all the professional development I’ve been doing for the last 12 years wasn’t about career advancement but about re-parenting myself so that I could parent my children better.  Psychology degree, health visitor training, school nurse post, child and adolescent psychotherapeutic counselling training – notice a trend?  Maybe that valuable training, experience and getting sober is how I’ve already improved their future?

So does it matter whether we are in Australia or Brighton or where we are currently?  Wherever I go there I am.  So although Renton suggests he was trying to escape the geography of where he was – I think it was more than that and I wonder if that is true of me too?

Reading Pete Walker he says

No “positive” feeling can be induced to persist as a permanent experience, no matter what Rational-Emotive Therapy tells us. As disappointing as this may be, as much as we might like to deny it, as much of a cause of ongoing life frustration for each of us as it is, and as much as we were raised and continue to be reinforced for trying to control and pick our feelings, they are still by definition of the human condition, largely outside the province of our wills.  

I think I am guilty of that here too.  Whereas I am no longer ricocheting off of verges drunk I’ve been cognitively bouncing between the potential sober happy future of Australia and the memory of a happy and booze soaked past in Brighton – and yes memories came back of me taking a break from drinking even when we lived here (I remember achieving one stint of 18 days AF).  I’ve been chasing fantasy chocolate unicorns rather than living in the present – right here, right now.  The week-end in Brighton has allowed me to accept this – not in resignation or defeat but as a sign of growth.  And anyway who needs to live in Brighton when you can have your every fantasy chocolate creation now delivered wherever you live in the UK? 😉

And that segways nicely with this tune that spun round (and video shot as though I was running along the beach) that Sunday morning  as I was making this important realisation.

In memory of Mark – much loved and missed in the present.

Edited to add: Hot dang – Mark Manson wrote a post about a very similar thing on the very same day! https://markmanson.net/disease-of-more

 

Alcohol marketing rules failing to protect our youth

Too much news not enough blog posts!  I’m already writing posts for May so time to squeak in some extra one’s with important news stories.  Thank you marketing week for the image 😉

The top story from the Institute of Alcohol Studies for January was the headline grabbing blog post title that alcohol marketing rules are failing to to protect our youth.  To which I cynically want to respond: no shit sherlock!

Greater exposure raises likelihood of earlier and heavier drinking (10 January)

Young people across the world are over-exposed to extensive alcohol marketing practices, claim leading public health experts, who want governments to renew their efforts to address the problem by strengthening the rules governing alcohol marketing with more effective independent statutory regulations.

Their call coincides with the publication of a series of reports in a special edition of the scientific journal Addiction that presents the latest evidence on alcohol marketing and its impact on children. Key findings from the collection of peer-reviewed manuscripts include:

  • Exposure to alcohol marketing is associated with youth alcohol consumption
  • Analysis of alcohol promotion during the 2014 FIFA World Cup indicates alcohol marketing practices frequently appeared to breach industry voluntary codes of practice’
  • Alcohol industry self-regulatory codes do not sufficiently protect children and adolescents from exposure to alcohol promotions, especially through social media.

The Addiction supplement comprises 14 papers, with research presented from around the world.

Alcohol is the leading cause of death and disability for young males aged 15–24 in nearly every region of the world, and young females of the same age in the wealthy countries and the Americas.

The new systematic review – which identified 12 additional studies – found an association between level of marketing exposure and youth drinking behaviour, and found that exposure to ads was even more strongly associated with progression to binge drinking than with initiation of alcohol use.

“This latest review of the scientific literature adds stronger evidence to the claim that exposure to alcohol marketing among youth is linked to more underage youth drinking and, in particular, binge drinking,” said study leader David Jernigan, PhD, the director of CAMY and an associate professor in the Department of Health, Behavior and Society at the Bloomberg School.

The supplement’s lead editor, Professor Thomas Babor of the University of Connecticut said: “Governments are responsible for the health of their citizens. No other legal product with such potential for harm is as widely promoted and advertised in the world as alcohol. These papers provide a wealth of information to support governments in their efforts to protect children and other vulnerable populations from exposure to alcohol marketing.”

Methods

The researchers relied upon four different medical and scientific databases to identify articles for possible inclusion in the review. Studies were included in the final review if they met a number of criteria, including whether they used original data and included measures of marketing exposure and alcohol consumption for at least 500 underage youth. Studies were included only if they used self-reported and observed actual alcohol use such as binge drinking, as opposed to just measures of intentions to consume alcohol in the future. The studies were conducted in seven countries and involved more than 35,000 participants.

Several of the included studies found that levels of marketing exposure appear to be as high or nearly as high among younger adolescents as they are among older adolescents and young adults, suggesting that current voluntary alcohol industry marketing codes are not protecting kids as young as 10 years old.

Reaction

Alcohol NGOs and health experts welcomed the findings as further evidence of self-regulation’s failure to curb alcohol marketing to young people. Chris Brookes of the UK Health Forum noted that: “Governments have previously approved self-regulatory measures on alcohol advertising; however, we can no longer say that they might work to protect our young people – they don’t. In a literature review of more than 100 studies, none was identified that supported the effectiveness of industry self-regulation programmes.”

However, the advertising industry regulator has criticised the research, claiming that the UK’s regulatory framework has had a positive impact on recent official figures showing under-age drinking at a record low and a decline in binge drinking.

“Alcohol policy is clearly on the right track and alcohol advertising – which protects children and respects adults – is an important part of that,” says Ian Barber, the AA’s director of communications.

In the UK, advertising for alcoholic drinks follows a code enforced by the Advertising Standards Authority, while the packaging and branding of the products is subject to self-regulation. And according to the Guardian, AB Inbev and Diageo, two of the world’s biggest alcoholic drinks makers, have reported ploughing as much of 15% of their annual global sales back into marketing, amounting to £5.75bn and £1.6bn respectively.

Ian Hamilton, lecturer in the Department of Health Sciences at the University of York, whose interests include substance use addiction, told the newspaper the AA’s claim that the UK’s alcohol advertising rules are among the strictest in the world, major operators had nevertheless found ways to evade marketing legislation the UK.

“Some of the messages are quite subtle, but they are persistent,” he said. “So this idea that alcohol is necessary for social success, or is both a stimulant as well as a sedative, that it removes sexual inhibition, that it improves – bizarrely – your sporting and mental abilities.

“Of course, the way they do it is they don’t say go and buy Carlsberg, but they’ll do endorsed interviews with celebrities or they’ll offer free music downloads or notices of events, so they do it in quite subtle and clever ways.”

Solutions

The papers offer guidelines to developing more effective alcohol marketing regulations:

  • The most effective response to alcohol marketing is likely to be a comprehensive ban on alcohol advertising, promotion and sponsorship, in accordance with each country’s constitution or constitutional principles
  • Regulations should be statutory, and enforced by an appropriate public health agency of the local or national government, not by the alcohol industry
  • Regulations should be independent of the alcohol industry, whose primary interest lies in growing its markets and maximising profits
  • A global agreement on the marketing of alcoholic beverages would support country efforts to move towards a comprehensive ban on alcohol advertising, promotion and sponsorship
  • Collaboration with other population-level efforts to restrict marketing of potentially harmful products, such as ultra-processed food, sugary beverages, tobacco, and breast-milk substitutes, should be encouraged and supported.

“It is clear that self-regulation is not working and we welcome calls for greater action from governments to protect children from exposure to alcohol marketing,” said Prof Sir Ian Gilmore, chair of the Alcohol Health Alliance (AHA), an umbrella group of more than 40 UK health NGOs, including the Academy of Medical Royal Colleges.

Hamilton also warned that a blanket ban on alcohol advertising could be seen as “taking a sledgehammer to crack a nut”, with the danger that such a policy could give drinking a kind of outlaw prestige that might increase its appeal to some. But he admitted that a similar policy on tobacco advertising had apparently proved successful in diminishing the appeal of smoking. “I think the state does have some kind of responsibility,” Hamilton said. “We can’t have do-it-yourself regulation by industry whose prime motive is to find the next generation of consumers.”

The Addiction supplement, ‘Alcohol marketing regulation: From research to public policy’, is freely accessible from the Wiley Online Library. You can also listen to David Jernigan talk about the supplement’s findings in greater depth in our Alcohol Alert podcast.

The latest Institute of Alcohol Studies (IAS) Alcohol Alert: January 2017 in its entirety is now available (here for PDF version).

Alcohol Policy UK picked up on the special issue of Addiction also which you can read here.

And Liam Byrne interviews Alaistair Campbell about this very thing!

PS New follower on Twitter:

Looking for volunteers for research studies in alcohol addiction, sobriety, weight loss and weight gain. QMUL Led by

If you’d like to volunteer tweet him 🙂

Six ways to crack wine o’clock and go semi-sober

sober-vs-intoxicated-brain-scansAlthough my way of being is sober I recognise that not everyone who arrives on this blog has stopped drinking and may be looking for help to go semi-sober – so to moderate or manage your drinking.  As February rolls round before those of you having done Dry January reward yourself with a drink maybe this article from The Telegraph, featured in October last year, will help you approach the rest of the year at an even more moderate pace 🙂

When I was growing up, there was no point at which my mum sighed “ah, wine o’ clock,” and uncorked a bottle. The idea of rewarding yourself after a day’s hard graft with a goldfish bowl of Pinot Grigio hadn’t yet occurred to women. 

It has now. Women are drinking more than ever before – and we’re not talking Hogarth-style Gin Lane reprobates, but middle-class mums, counting down the hours from the school run till six or exhausted office workers, marking the transition from work to play with what writer Kingsley Amis perfectly described as a “festive pop”. 

A study of four million adults, published yesterday, found that women are now drinking as much as, or even more than, men. 

I was an early adopter of wine o’ clock back in the 90s, when I had a demanding freelance career, and young children. At six-thirty, all I could think about was that first chilled glass of white. I say this with no shameful, misery-memoir ‘and that was how I became an alcoholic’ addendum, I was just immensely grateful that a substance existed which could wipe my brain of urgent work problems and allow me to burn 12 fish fingers without crying. 

I never felt I was a key player in a growing social problem – I just thought I was having a normal (slightly hectic) suburban life. And I’m pretty sure that 99 per cent of the other thirty and forty something women who stagger towards the bottle like the ancient mariner sighting land every night feel the same way. 

Sadly, though, daily drinking for decades means all the lovely Aldi £5.99 specials take a toll. Alcohol is a risk factor for various cancers, heart disease and high blood pressure; over 64 000 women attended hospital for drink-related issues in 2013/14.

We all know it’s doing us no good, and the popularity of ‘Dry January’ and this month’s ‘Go Sober For October’ suggests a growing desire to cut down on drinking – without going completely teetotal. 

Laura Willoughby is the founder of Club Soda, an online resource for people who want to cut down a little. 

“Most people are not dependent on alcohol but we do need skills to help us keep drinking under control,” she says, “from how to deal with mates in the pub to, knocking daily drinking at home on the head.”

She says a month booze-free can be a good way to change ingrained habits – but if you simply want to start drinking less so your head isn’t full of wasps in the morning, here’s six suggestions. If you’re anything like me, after trying them all, you’ll reward yourself with a really good bottle of something. Nobody’s perfect.

Reset Your Brain

Therapist Marisa Peer says the key to cutting down lies in breaking alcohol’s ‘pleasure’ association.  “Your brain is quite simple in that it believes what you tell it. That’s when a change in habit becomes painless and permanent. Tell it that you enjoy not drinking, and you love the feeling of being alert in the morning.” When you have an alcohol free day, plan an activity you know you’ll enjoy for that day or the morning after, so your brain starts to associate not drinking with pleasure instead. 

Buy smaller glasses

Almost every stylish bar now serves wine in glasses the size of astronauts’ helmets. The trend has also crept into homeware – red wine glasses now come as a standard 250 ml, twice the recommended 1.5 unit size 125 ml – but simply buying smaller glasses can help you drink less. In a 2013 US study, when researchers asked people to pour out the same amount of wine but gave them different sized glasses, those using wider glasses poured out 11 per cent more. 

Try the HALT test 

“Alcohol can creep into your daily routine, much like ‘a coffee in the morning’ has become routine for many people,” says London based GP Dr Tatiana Lapa. She advises that women have at least three alcohol-free days in the week to avoid drinking becoming a routine. “And before you open a bottle, borrow a trick from AA and ask yourself, am I Hungry, Angry, Lonely or Tired? Once you’ve identified the trouble, you can address it directly, rather than attempting a general cure-all with wine. “Light a candle, watch a film or TV show, listen to music, or have a relaxing bath,” says Marisa Peer. “Stop telling yourself you need alcohol to relax or socialise – you don’t see children having a glass of wine before they play!”

Never have two bottles in the fridge

My worst hangovers have been entirely down to someone saying “shall we open another?” Making a conscious effort to buy only one bottle at a time – or none – can make you ration the wine. “Take it in turns with your partner to bring home a treat instead – some nice chocolate, or ingredients for a special dinner,” says a spokesperson for the charity Drinkaware. “It’s about breaking the routine.”

Have decent alternatives

Tap water won’t float anyone’s enjoyment boat,  so invest in some decent non-alcoholic alternatives, which have improved substantially in recent years, from alcohol free wines such as Eisberg – which has seen sales grow by 40 per cent this year – to Seedlip, billed as the world’s first distilled non-alcoholic spirit, made with botanicals such as lemon peel and cardamom, and tasty with tonic or as part of a mocktail. Switching to a 5.5 per cent wine, instead of the usual 12-14 per cent, can more than halve the number of units you drink in an evening. 

Start Later

Try not opening a bottle till you start cooking, or until the kids are in bed. Or you could agree to only drink with food, like our sensible continental friends. Drinking with food slows down the rate that alcohol is absorbs into the bloodstream, meaning you’ll end up drinking more slowly and so end up consuming less, advises Drinkaware.

Having detoxed after the Christmas excesses during January, go easy on the retox!

 

Breakthrough in campaign for children of alcoholics

An update from Liam Byrne following today’s House of Commons debate about alcohol harm and the need for a plan from Government to support Britain’s 2.5 million children of parents who drink too much.

Liam Byrne today welcomed a breakthrough in the campaign for Britain’s children of alcoholics after a new commitment was made by Government to sit down with campaigning MPs to develop the first ever national strategy for children of alcoholics.

The commitment came from the Public Health Minister in a Westminster Hall debate in the House of Commons on alcohol policy called by Liam Byrne, Fiona Bruce and Bill Esterson.

In a powerful and moving speech, Labour’s Shadow Health Secretary Jon Ashworth told his personal story as the child of an alcoholic and made a bold offer to work across political divides to develop a strategy to help Britain’s 2.5 million children of hard-drinking parents.

Responding, the Public Health Minister Nicola Blackwood was moved to tears as she urged MPs to carry on their work.

Liam Byrne MP, founder and chair of the All-Party Parliamentary Group on Children of Alcoholics, said:

“This is a breakthrough. For over a year we’ve tried to make sure that the voices of children of alcoholics are heard in Parliament. Now the Government has listened. The Government has agreed to sit down and hammer out a plan. Crucially, Ministers have agreed with our number one goal: no child of an alcoholic should ever feel alone”.

The response of the Public Health Minister reduced me to tears …..