Category Archives: Alcohol research findings and media coverage

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 …..

Alcohol misuse most often treated in middle age

This report featured in the Institute of Alcohol Studies report in November 2016.  This report struck me because I stopped drinking just before my 45th birthday.

Average age of alcohol only clients seeking treatment is 45 years (04 November)

Drinkers in their forties make up the most number of alcohol only treatment users for substance misuse in England, according to new figures published by Public Health England (PHE).

The National Drug Treatment Monitoring System (NDTMS) report ‘Adult substance treatment activity in England 2015-16’ shows that in the 12 months to 31st March 2016, clients exhibiting problematic or dependent drinking represented a total of 144,908 individuals, the second largest group in treatment (see pie chart, illustrated right). Of these, 85,035 were treated for alcohol treatment only and 59,873 for alcohol problems alongside other substances.

The overall number of individuals in treatment for alcohol fell by 4% compared to 2014-15, with the numbers for alcohol only decreasing by 5% since then, to reach its lowest total since 2009-10 (illustrated below). However, this figure still represents more than double the annual number of alcohol only clients recorded since records began in 2005-06 (35,221 clients).

The report noted that those in treatment for alcohol only and opiates tend to be much older than individuals who have presented for problems with other substances. The median age of alcohol only clients was 45 years, with 68% aged 40 or over and 11% aged 60 years and over.

Roughly three-fifths of alcohol only clients were male (61%) although this was a lower proportion than those representing the entire treatment population in 2015-16 (70%). The report’s authors suggested that this finding is “likely (to) reflect the differences in the gender prevalence of problematic alcohol and drug use.” PHE will be releasing estimates of alcohol dependency late 2016.

Individuals starting treatment in 2015-16 were most likely to present with problematic alcohol use (62%, or 84,931 new clients) (illustrated, below). But alcohol only clients also had the highest rates of successful exits of all clients presenting for treatment, with just under two-thirds (62%) successfully completing treatment, up on 61% in the previous year.

However, there were also more deaths among those accessing treatment for alcohol only problems; there were 817 deaths in 2015-16, 3% more than the previous year.

The report also noted that since alcohol service providers started reporting to NDTMS in 2005-06, alcohol citations have remained relatively stable, although the gathering of information on alcohol treatment service providers since 2008-09 may have been one of the main drivers of an overall increase in clients seeking treatment for substance use in general over the last decade.

Responding to the latest figures, Rosanna O’Connor, Director, Alcohol, Drugs & Tobacco within the PHE Health and Wellbeing Directorate, said:

“It is clear from the data that there is an increasing need for services to meet the complex needs of older more vulnerable drug and alcohol users in treatment as well as finding ways of helping those accessing services for the first time to get the treatment they need and move on with their lives.

“Within the data there is much to be hopeful about… But we certainly can’t be complacent – PHE, national and local government and providers, all need to enhance our efforts to ensure that treatment is a safe platform from which to achieve recovery.”

Before you pick up a drink again maybe reflect on this data and if you are in this age range perhaps ask yourself the question whether you really want to go back to that cycle of drinking or whether a longer period of abstinence might be helpful to evaluate your relationship to drinking further?  Just a thought 🙂

Do I Drink Too Much?

So it’s the last day of January and to those of you taking part in Dry January congratulations if you made it this far.  Have you been reflecting on whether you drink too much as part of that month off?  Perhaps on your last night of sipping sparkling water you might want to watch this documentary which aired in December on BBC Wales.  Thanks to my friend Libby for bringing it to my attention!

Lib featured it as part of her News and Update round-up for December on Alcohol Policy UK and if you wish to read all of it you can find it here:

News & updates December 2016: middle-age health, drink-driving, the rise of alcohol-free & the return of benchgirl

Public Health England publish review of evidence on alcohol

Public Health EnglandThis summary report was published by Alcohol Research UK in December.  It looked at Public Health England’s new published review of evidence on alcohol.

Public Health England has published a review of international evidence on alcohol policy and harm reduction.  The new report, based on almost two years of research and analysis, addresses a number of key policy areas.

These include:

  • The price of alcohol and its effect on consumption
  • The impact of both the number of alcohol outlets in a given area, and the times at which they operate, on a range of potential harms
  • The effectiveness of existing controls on marketing, sponsorship and promotion
  • The role of ‘brief interventions’ in preventing harmful drinking
  • The effectiveness of schools-based education programmes
  • The evidence on alcohol treatment in tackling harmful and dependent drinking

We welcome this important contribution to the literature on alcohol harm prevention. It provides both a resource for identifying key evidence and an evaluation of the relative effectiveness of policy interventions based on an extensive process of reflection and review.

Today’s report also provides a new analysis of drinking trends and their economic effects. It confirms that average consumption has been falling in the UK for over ten years, especially among young people. However, it also shows that trends vary between social groups, reminding us that average consumption provides only a rough guide to where harms are concentrated, and that harms can rise even when overall consumption falls.

Importantly, the report confirms previous studies showing that around one third of all the alcohol consumed is drunk by the heaviest drinking 5% of the population.  This demonstrates not only how heavy drinking is concentrated, but the very high proportion of alcohol that is sold to people with serious drinking problems.

The report draws particular attention to the impact of alcohol on economic productivity: suggesting that drinking causes more years of life lost to the workforce than are caused by the top ten most common cancers combined. While the precise social costs of alcohol remain hard to quantify, this report shows clearly that heavy drinking creates an enormous burden for the wider economy.

The PHE report echoes previous evidence reviews in demonstrating that price is a key policy lever in shaping consumption. Its findings suggest that a combination of minimum pricing and more targeted taxation could reduce both harmful drinking and health inequalities (especially the so-called ‘alcohol harm paradox’). Clearly, this is a significant finding as the Scottish Government continues to deal with a prolonged legal challenge to MUP from the Scotch Whisky Association.

The report also argues that while evidence on factors such as outlet density is less compelling than is the case for price, nonetheless limiting hours of sales can reduce antisocial behaviour and drink-driving. While, in the UK, evidence on the relaxation of licensing hours since 2005 has not shown a clear effect in terms of crime, disorder or hospital admissions the authors point to international studies and reviews that show a stronger correlation.

The report also follows previous reviews in pointing to evidence that exposure to marketing can lead to earlier and higher levels of consumption among young people. It finds no robust evidence that existing marketing controls are effective in preventing youth exposure to marketing, and so will strengthen calls for a reassessment of the current regulatory framework.

It also finds no clear evidence that voluntary industry-led partnerships (including the recent ‘Responsibility Deal’) reduce alcohol harms. This is partly because there are insufficient independent and robust evaluations of such schemes to provide clear evidence of an effect, and also because it has been argued that many of the changes introduced under the Responsibility Deal would have happened anyway.

While the report confirms that, from a public health perspective, price, availability and marketing are key issues, it also addresses questions around treatment and interventions. This is especially important as the impact of austerity continues to be felt in widespread cuts to budgets for treatment services across the country.

The review finds considerable evidence that screening and brief interventions in primary care can help prevent harmful drinking. On a policy level, a key question now is how to support GPs in actually carrying out screening and delivering interventions effectively where there is a need. Currently, delivery of interventions in primary care remains low so work to better incentivise and train GPs is needed. The review, however, also notes that the evidence for the effectiveness of brief interventions in other settings (such as the workplace or local pharmacies) is much less robust..

In line with most previous reviews, the report finds that while education can play an important role in raising awareness and knowledge, the evidence for its effectiveness in changing behaviour is weak. This is not necessarily because schools-based prevention and education is wholly ineffective, but because its impact is inevitably limited (behaviours are driven by far more than simple knowledge of harms) and because the delivery of programmes is often highly inconsistent.

Finally, on drink-driving, the review finds strong evidence that reducing the blood alcohol limit is effective in reducing accidents. England and Wales currently have a BAC limit of 0.8 g/l – the highest in Europe, alongside Malta.

Overall, this report represents a key summary of the available evidence on alcohol. It confirms that there are policy levers available to Government that can have a measurable impact on alcohol harm reduction. Clearly, alcohol policy needs to balance a range of interests, but if the Government is serious about seeking to reduce the health impacts of alcohol then this evidence review is of critical importance.

The PHE report is based on a very wide-ranging analysis of available research and an extensive process of peer review. We hope that it forms a key element in the development of alcohol policies in future.

So 5% of the population equates to approximately 2.6 million people here in the UK …… (source).  And Alcohol Policy UK pose the prompted question which I’d like to know the answer to as well:

PHE evidence review 2016: will Government policy respond?

 

 

Alcohol-related cancers projected to rise – can mass media campaigns help?

cruk-university-of-sheffield-logoThis was published by Alcohol Policy UK in December regarding alcohol-related cancers.

Increasing recognition of the risks of alcohol-related cancer has been a priority for a number of health organisations, with recent research identifying limited levels of awareness and projected rises in incidences.

report released last month commissioned by Cancer Research UK (CRUK) attracted significant media coverage of its findings that alcohol-related cancers could cause around 135,000 deaths over the next 20 years in England. The modelling was carried out by Sheffield University and analysed figures under a number of consumption forecasts, and also provided updated estimates of the potential benefits of Minimum Unit Pricing (MUP). A 50 pence MUP could reduce all alcohol-attributable deaths by 7,200, including 670 cancer deaths over the next two decades, reducing alcohol-related healthcare costs by £1.3 billion.

The report follows findings released earlier in the year by CRUK stating the understanding of the link between alcohol consumption and cancer was “worryingly low”; only 13% identified cancers as a possible risk when asked to identify alcohol-related health conditions associated with drinking too much. Recognition improved when prompted with possible cancer types, but those such as breast cancer had far lower recognition than less prevalent alcohol-related cancers. See here for a CRUK alcohol and cancer page.

Data used from the report though has just been published in BMC Public Health journal revealing significantly higher awareness of the links in the North East region, where Balance North East has been conducting media campaigns including TV advertswww.reducemyrisk.tv and #7cancers Twitter activity.

Media campaigns: a question of behaviour change?

Health groups though tend not to want to see health campaigns in isolation owing to the limited impact on behaviour. Indeed similar debates have taken place with regard to the awareness of the revised drinking guidelines and the limitations of their impact on consumption.

Ealier this year Chief Medical Officer Dame Sally Davies attracted controversy for suggesting drinkers should think ‘Do I want the glass of wine or do I want to raise my own risk of breast cancer?’ each time they drink. Whether any significant number of people have taken on the CMO’s advice – or indeed deliberately rejected it – will remain unknown, but based on the evidence of the complexity of behaviour change it would seem unlikely.

As such health groups, including CRUK, not only wish to see media campaigns and improved information through mandatory labelling, but also action on price, availability and marketing. Such levers have considerably stronger evidence to support an impact on drinking behaviours, but are of course opposed by those who may support informed individual decision making but not the Government in influencing it via regulation.

As for the near future, momentum may continue with a general trend in increasing awareness of alcohol health harms. Whether this will be supported in England by legislation to ensure mandatory labelling on containers, or indeed change environmental influences, is uncertain. In the meantime, alcohol-related cancers are likely to rise before they fall, even should consumption fall further.

estimated-trends-in-annual-alcohol-attritubutable-cancer-deaths-following-reduction-in-consumptionA picture paints a thousand words ……

And edited to add this small celebratory footnote: Voted  Top 100 Addiction Blogs Winner from thousands of top Addiction blogs in Feedspot’s index using search and social metrics.  Ranked 53rd based on Google reputation and search ranking, influence and popularity on Facebook, Twitter and other social media sites, quality and consistency of posts and Feedspot’s editorial team and expert review 🙂

Guest Post: Finding the Link Between Substance Abuse and Schizophrenia

pt_figure_dopamine-pathways-in-schizophrenia_53127-pngI was contacted on email by Justin in November who said; “I am a recovering addict and content writer interested in providing a guest post article.  In my path to recovery I’ve taken to writing content about addiction, recovery and substance abuse through my treatment program.”  Here’s what he wrote about substance abuse and schizophrenia:

New studies have found a link between substance abuse and schizophrenia.  While the relationship between mental health and substance abuse is an incredibly complex one, a group of Denmark researchers have determined that abuse of virtually every type of drug can contribute to mental deterioration and eventual, schizophrenia.

A common misconception about schizophrenia is that those afflicted have split personality disorder or multiple personalities.  However, this has been determined false, as most people suffering from schizophrenia are non violent and lead fairly normal lives, posing no immediate threat to others. Per the National Institute of Mental Health:

“Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be very disabling.”

Rather than split personality disorder, which is a separate diagnosis, those suffering from early onset schizophrenia can experience a decrease in mental processing, rational thinking and general mental well being.  Furthermore, in can take years for schizophrenia to fully develop and during this time, can manifest itself as more common mental health disorders like depression and anxiety.

So what environmental and societal factors can worsen these symptoms into full blown schizophrenia?

The new Denmark study has determined that substance abuse can not only trigger schizophrenia in people genetically at risk, but also increase the chances of developing schizophrenia by up to six times.

While the direct cause and effect relationship between substance abuse and schizophrenia is tremendously complex, the study found the following increases in risk:

  • Cannabis: 5.2 times
  • Alcohol: 3.4 times
  • Hallucinogenic drugs: 1.9 times
  • Sedatives: 1.7 times
  • Amphetamines: 1.24 times
  • Other substances: 2.8 times.

The study notes, while the effects are not often immediately noticed, symptoms of schizophrenia as it relates to drug abuse, often surface later in life: sometimes ten to fifteen years after the substance abuse diagnosis.

Mental health and substance abuse treatment centers often offer dual diagnosis programs for this exact reason, noting that symptoms of schizophrenia can be coupled with drug use.

A particularly worrisome finding of the study is the risk found with two of the most prevalent substances, marijuana and alcohol.  While marijuana is federally illegal, it is used medicinally and recreationally in many stages, including California.  A large factor in the correlation found between cannabis and schizophrenia is due to the fact that people can be exposed to it second hand.  That is to say, unlike most other substances (not smoked), marijuana can be introduced to people’s systems indirectly, simply by being in close proximity of someone that is using the drug.

Alcohol on the other hand, tops the list, as it’s the most socially acceptable and easily obtainable substance given it’s legal place in American media and culture.

While the newly discovered findings presented by the Denmark study do not provide us with a black and white relationship between schizophrenia and substance abuse, the evidence is undeniable: The prolonged abuse of illicit drugs and alcohol increases the risk of developing schizophrenic tendencies and symptoms later in life.

Article courtesy of the team at Muse Treatment

Thank you Justin!

Back to life, back to reality … Women closing the drinking gap on men

women-closing-the-drinking-gap-on-menIt’s the end of the Christmas and New Year break and most of us head back to work or school, hence the Soul II Soul lyrics in the blog post title.  And part of that reality is that women are closing the drinking gap on men as reported by the Institute of Alcohol Studies in October 2016.  Over to their analysis:

Trend most evident among young adults, international analysis shows (25 October)

Women are catching up with men in terms of their alcohol consumption and its impact on their health, finds an analysis of the available international evidence, spanning over a century and published in the online journal BMJ Open.

This trend is most evident among young adults, the findings show. Historically, men have been far more likely than women to drink alcohol and to drink it in quantities that damage their health, with some figures suggesting up to a 12-fold difference between the sexes. But now evidence is beginning to emerge that suggests this gap is narrowing.

In a bid to quantify this trend over time, a research team pooled the data from 68 relevant international studies published between 1980 and 2014. The studies calculated male-to-female ratios for 3 broad categories of alcohol use and harms (any alcohol use, problematic alcohol use and alcohol-related harms) stratified by 5-year birth cohorts ranging from 1891 to 2001, generating 1,568 sex ratios (see above data table).

Sixteen of the studies spanned 20 or more years; five spanned 30 or more. All the studies included explicit regional or national comparisons of men’s and women’s drinking patterns across at least two time periods.

Results:

The pooled data showed that the gap between the sexes consistently narrowed across all three categories of any use, problematic use, and associated harms over time.

Men born between 1891 and 1910 were twice (2.2) as likely as their female peers to drink alcohol; but this had almost reached parity among those born between 1991 and 2000 (1.1, illustrated). The same patterns were evident for problematic use, where the gender gap fell from 3 to 1.2, and for associated harms, where the gender gap fell from 3.6 to 1.3.

After taking account of potential mathematical bias in the calculations, the gender gap fell by 3.2% with each successive five-year period of births, but was steepest among those born from 1966 onwards.

Associated health harms fall disproportionately on female drinkers

The calculation used was not designed to address whether alcohol use is falling among men or rising among women, the researchers caution.

But among the 42 studies that reported some evidence for a convergence of drinking levels between the sexes, most (n = 31) indicated that this was driven by greater use of alcohol among women, and 5% of the sex ratios were under 1, suggesting that women born after 1981 may actually be drinking more than their male peers, the researchers claimed.

Conclusions

The researchers wrote: “Findings confirm the closing male–female gap in indicators of alcohol use and related harms. The closing male–female gap is most evident among young adults, highlighting the importance of prospectively tracking young male and female cohorts as they age into their 30s, 40s and beyond.”

While they did not set out to explain the reasons behind their observed findings, they emphasised that their results “have implications for the framing and targeting of alcohol use prevention and intervention programmes.”

They concluded: “Alcohol use and alcohol use disorders have historically been viewed as a male phenomenon. The present study calls this assumption into question and suggests that young women in particular should be the target of concerted efforts to reduce the impact of substance use and related harms.

“These findings (also) highlight the importance of further tracking young male and female cohorts as they age into their 30s, 40s and beyond”, they added.

Institute of Alcohol Studies director Katherine Brown said: “The findings from this study illustrate a trend that has been in the making for decades. Women are increasingly subjected to heavily targeted marketing practices by alcohol companies enticing them to drink more. This is a global phenomenon, with drinks manufacturers producing sweet, often pink, fizzy alcoholic beverages that appeal to young women, with glamorous advertising campaigns.

“Another major driver of alcohol consumption is price, with very cheap products commonly on sale for as little as 16 pence per unit in shops and supermarkets. We are no longer a nation of pub goers, with two-thirds of all UK alcohol drunk at home. Pre-loading on cheap shop bought alcohol before a night out is common practice and police have reported strong links to crime, disorder and vulnerable behaviour in towns and city centres.

“Alcohol places a huge strain on our NHS and emergency services, with the total costs to society at £21 billion each year. We need to take this issue seriously and introduce evidence-based measures such as minimum unit pricing and marketing restrictions in order to protect out future generations and improve the health and wellbeing of our most vulnerable communities.”

Coverage from Alcohol Policy UK:

‘Women have caught up with men’ in alcohol consumption levels, headlines reported across the media. According to international research the gap between men and women is closing rapidly when it comes to use and alcohol-related harms, though in the UK men still drink more. See NHS behind the headlines analysis or BBC, The Sun and Guardian reports.

To act as a counter-balance to this view here is a recent article from the Guardian citing another BMJ study:

Female binge drinkers unfairly stigmatised by media, says study

It’s worth a read and has an interesting conclusion that begs the question: who is funding this research?

Further evidential data:

(taken from HSE 2015)

Health Survey for England 2015: latest consumption figures

Eight in 10 middle-aged Britons ‘are overweight or exercise too little’ (oh and drink too much!)

Ladies it’s the beginning of January and it’s not too late to join us for Dry January.  You can start the clock today and not become part of these statistics of the future.

Shame Backdraft

OLYMPUS DIGITAL CAMERA

So once again I’m listening to a Ruth Buczynski seminar about shame featuring Peter Levine, Ron Siegel, Kelly McGonigal and Bill O’Hanlon where I learn something new that feels very familiar.  It’s called ‘backdraft’ and is about the backlash that can happen when someone is feeling ashamed and is met by compassion.  It reminds me of that moment when I am close to tears and someone moves into hug me to which I respond “please don’t”.  It is almost a warning that you are in danger of killing me with kindness.  Sound familiar?

Over to the experts:

Most clinicians have witnessed how difficult memories resurface when a client feels truly seen, heard, and loved in therapy. A metaphor for this process is “backdraft.” Backdraft occurs when a firefighter opens a door with a hot fire behind it. Oxygen rushes in, causing a burst of flame. Similarly, when the door of the heart is opened with compassion, intense pain can sometimes be released. Unconditional love reveals the conditions under which we were unloved in the past. Therefore, some clients, especially those with a history of childhood abuse or neglect, are fearful of compassion (Gilbert et al., 2011).

It is related to trauma and the belief held by the person that they are undeserving of kindness but in fact it is more than that.  They are perhaps so unused to compassion that they find the experience unsafe, threatening and dangerous.

Childhood trauma survivors may also equate self-compassion with self-pity or self-centeredness. They may have been told as children to “get over yourself” when they suffered and complained. It is important to understand that by entering into our emotional pain with kindness, we are less likely to wallow in self-pity. The reason is that self-compassion recognizes the shared nature of human suffering and avoids egocentrism. Sometimes only a few minutes is all that is needed to validate our pain and disentangle ourselves from it.

Self-compassion is often confused with narcissistic self-love, although research indicates that there is no link between narcissism and self-compassion (Neff, 2003; Neff & Vonk, 2009).  Victims of childhood trauma often do not have enough narcissism, feeling that meeting their own basic survival needs is a forbidden indulgence. Anxiety may arise from the looming possibility of breaking an invisible bond with a primary caregiver who thought the child should suffer for his or her misdeeds or bad nature. Self-deprivation becomes “safety behaviour” (Gilbert & Proctor, 2006). It is a necessary compromise made by an abused child in order to survive, so the client becomes frightened, viscerally and unconsciously, when he or she breaks the contract. For this reason, sincere efforts by therapists to help abused or neglected clients may be met with resistance. These clients first need to contact their emotional pain, see how it originated through no fault of their own (“you’re not to blame!”), and then gradually bring the same tenderness to themselves that they are likely to give to other, vulnerable beings.

Three symptom clusters commonly found in post traumatic stress disorder (PTSD) are (1) arousal, (2) avoidance, and (3) intrusions. Interestingly, these three categories closely correspond to the stress response (fight–flight–freeze) and to our reactions to internal stress (self-criticism, self-isolation, and self-absorption) mentioned earlier (see below).

PTSD symptom Stress Response Reactions to internal stress
Arousal Fight Self-criticism
Avoidance Flight Self-isolation
Intrusion Freeze Self-absorption

Together they point toward self-compassion as a healthy, alternative response to trauma. Self kindness can have a calming effect on autonomic hyperarousal, common humanity is an antidote to hiding in shame, and balanced, mindful awareness allows us to disentangle ourselves from intrusive memories and feelings. Research shows that people who lack self-compassion are likely to have critical mothers, to come from dysfunctional families, and to display insecure attachment patterns (Neff & McGeehee, 2010; Wei, Liao, Ku, & Shaffer, 2011). Childhood emotional abuse is associated with lower self compassion, and individuals with low self-compassion experience more emotional distress and are more likely to abuse alcohol or make a serious suicide attempt (Tanaka, Wekerle, Schmuck, Paglia-Boak, & the MAP Research Team, 2011; Vettese, Dyer, Li, & Wekerle, 2011).

These quotes are taken from a chapter of a book by Christopher Germer & Kristen Neff that you can read here:

germer-neff_-trauma

I found an excellent blog post about it here:

Mindful self-compassion and backdraft

So there you have the connection between shame and booze once again.  Low self compassion, higher emotional distress and greater levels of self-medication with alcohol.

If you are unsure of how self-compassionate you are you can score yourself here:

Test how self-compassionate you are

Unsurprisingly my score was low to middling but not as low as it used to be when I was drinking!  So how do we work on improving our low self-compassion?

The response is to teach ourselves how to take a self-compassion break

If you start to do this even if you are still drinking, the shift in self-perception may be enough to get you started on thinking about cutting down or stopping.  Give it a try – what have you got to lose? 🙂

 

 

 

 

Friday Sober Inspiration: Stop Abandoning Yourself

chris-carr-stop-abandoning-yourselfThis is another excerpt from Sally Brampton’s ‘shoot the damn dog’ because her words are too powerful not to share.  This passage is about self-abandonment where she has a discussion with her therapist who explains that she needs to stop abandoning herself.

“‘Stop abandoning yourself’ a therapist, Elizabeth, once said to me.  ‘What?’ I didn’t understand.  She explained it like this: 

  • Every time you feel sad and swallow down your tears, you abandon yourself.
  • If someone hurts you and you pretend that you are fine, you abandon yourself.
  • Every time you don’t eat, or fail to feed yourself, you abandon yourself.
  • If you are tired, but refuse to rest, you abandon yourself.
  • If you drink too much and poison yourself with alcohol,  you abandon yourself.
  • If you don’t ask for what you need from someone with whom you are intimate, you abandon yourself.
  • If you don’t ask for help when you need it, you abandon yourself.

‘You suffer’ Elizabeth said, ‘from a failure of care’.  From who? ‘From yourself’, she says. And before that, from your parents.  They are the ones who should have taught you how to take care of yourself.

An inability to take care of oneself or soothe oneself is a sign of immaturity.  It is a failure of understanding, or of teaching.  If you are not taught as a child how to take care of yourself, you do not know as an adult.  The pattern becomes ingrained.  You are now an adult inhabited by a child.  The child pleads, the adult overrules.  You deny yourself proper care.

And so, as I understand it, I adjusted to constant loss as well as the inability to articulate any distress on, as one therapist described it, an ‘adapted’ level.  The term, ‘adapted child’ was originally used by Eric Berne, the father of Transactional Analysis in the 1950’s.  Essentially it means the compliant, orderly side of us that hides anger, pleases others and generally acts the good boy or girl.  The more the behaviour is rewarded (and the more that any other behaviour is punished or, more usually, ignored) the more we adapt ourselves to keeping quiet and not making a fuss.  Put in another way, we adopt the position known in therapeutic terms as ‘abandonment or withdrawal’.

It is not, either, only the still, pale, silent child who has withdrawn.  Withdrawal takes place at a far deeper level and may be disguised by a bright, lively and social exterior – the sort of exterior that indicates compliance because compliance brings its own rewards.

A child who feels ignored or misunderstood turns that message against themselves.  It becomes, ‘I have no right to  feel the way that I do’.  And an analyst will, inevitably, take that to yet another level.  A child whose deeper feelings are constantly minimised, challenged or simply ignored, ends up believing, ‘I have no right to be the way that I am.  I reject myself’.”

We unconsciously reject ourselves so don’t even realise when we are then abandoning ourselves.  And booze is a really good salve for self-rejection.  No pain, no feeling right?  It also helps us play up to that bright, lively social exterior that hides our withdrawn inner self.  This could have been describing me.

Now you see why sober self-care is such a big deal out here in the recovery and sober blogging community.  Self care is the opposite of a failure of care.  Self-care is nurturing and restorative.  January is a good month to start non-alcohol focused self-care 🙂

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.